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OBJECTIVE: To analyze HIV Post-Exposure Prophylaxis (PEP) prescription and return for follow-up appointments. METHODS: This was a descriptive cross-sectional study using data on people who sought PEP in emergency care units (UPAs) and specialized medical services in Salvador, BA, Brazil, between January-December/2018. RESULTS: Of the 1,525 people who sought PEP at UPAs, 1,273 (83.5%) met PEP eligibility criteria, while 252 (16.5%) did not; of the eligible group, 1,166 (91.6%) had antiretrovirals prescribed, while 107 (8.4%) eligible people did not; of the total number of people with PEP prescriptions, only 226 (19.4%) returned for the first follow-up appointment, 115 (9.9%) for the second, and 33 (2.8%) for the third in order to complete the protocol. CONCLUSION: We found a significant proportion of eligible users who did not have PEP prescribed at UPAs and a significant loss of return for specialized service follow-up appointments.
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Fármacos Anti-VIH , Infecciones por VIH , Profilaxis Posexposición , Humanos , Estudios Transversales , Brasil , Infecciones por VIH/prevención & control , Masculino , Femenino , Profilaxis Posexposición/estadística & datos numéricos , Profilaxis Posexposición/métodos , Adulto , Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/uso terapéutico , Persona de Mediana Edad , Adulto Joven , Servicio de Urgencia en Hospital/estadística & datos numéricos , Adolescente , Estudios de Seguimiento , Citas y HorariosRESUMEN
Abstract Objective: To analyze HIV Post-Exposure Prophylaxis (PEP) prescription and return for follow-up appointments. Methods: This was a descriptive cross-sectional study using data on people who sought PEP in emergency care units (UPAs) and specialized medical services in Salvador, BA, Brazil, between January-December/2018. Results: Of the 1,525 people who sought PEP at UPAs, 1,273 (83.5%) met PEP eligibility criteria, while 252 (16.5%) did not; of the eligible group, 1,166 (91.6%) had antiretrovirals prescribed, while 107 (8.4%) eligible people did not; of the total number of people with PEP prescriptions, only 226 (19.4%) returned for the first follow-up appointment, 115 (9.9%) for the second, and 33 (2.8%) for the third in order to complete the protocol. Conclusion: We found a significant proportion of eligible users who did not have PEP prescribed at UPAs and a significant loss of return for specialized service follow-up appointments.
Resumen Objetivo: Analizar la prescripción de Profilaxis Post Exposición (PPE) al Virus de la Inmunodeficiencia Humana (VIH) y la concurrencia a las consultas de control y seguimiento. Método: Estudio de datos descriptivo transversal de personas que solicitaron la PPE en Unidades de Atención de Emergencia (UPA) y servicios médicos especializados en Salvador, BA, Brasil, durante los meses de enero a diciembre de 2018. Resultados: De las 1.525 personas que consultaron por PEP en las unidades hospitalarias de emergencia, 1.273 (83,5%) cumplieron criterios de elegibilidad para profilaxis y 252 (16,5%) no los cumplieron; entre los elegibles, a 1.166 (91,6%) personas se les recetaron antirretrovirales (ARVs), pero 107 (8,4%) no los recibieron. Del total de personas que recibieron prescripción de PPE, solamente 226 (19,4%) regresaron a la primera consulta; 115 (9,9%) a la segunda consulta y 33 (2,8%) a la tercera consulta para completar el protocolo. Conclusión: Hubo una proporción significativa de usuarios elegibles que no recibieron prescripción de PEP en las Unidades de Atención de Emergencia y una pérdida significativa en las consultas de control al servicio especializado.
Resumo Objetivo: Analisar a prescrição da profilaxia pós-exposição (PEP) ao vírus da imunodeficiência humana (HIV) e o retorno às consultas de acompanhamento. Métodos: Estudo transversal descritivo, sobre dados de pessoas que buscaram a PEP em unidades de pronto atendimento (UPAs) e serviço médico de atenção especializada em Salvador, BA, Brasil, entre janeiro e dezembro/2018. Resultados: Das 1.525 pessoas que buscaram a PEP nas UPAs, 1.273 (83,5%) apresentaram critérios de elegibilidade à profilaxia e 252 (16,5%) não os apresentaram; entre os elegíveis, 1.166 (91,6%) pessoas tiveram prescrição dos antirretrovirais (ARVs), mas 107 (8,4%) não os receberam; do total de pessoas com prescrição de PEP, apenas 226 (19,4%) retornaram à primeira consulta, 115 (9,9%) à segunda consulta e 33 (2,8%) à terceira consulta para conclusão do protocolo. Conclusão: Observou-se proporção importante de usuários elegíveis que não receberam prescrição de PEP nas UPAs e perda significativa nas consultas de retorno ao serviço especializado.
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This study aimed to identify sociodemographic and academic factors associated with unhealthy lifestyles among Brazilian undergraduate nursing students. A cross-sectional study was completed by 286 nursing students in Brazil. Multinomial logistic regression was conducted to examine the association between sociodemographic and academic variables with the latent lifestyle indicator. The model fit's validity was assessed using Akaike information coefficient estimation, Hosmer-Lemeshow test, and the ROC curve. A high health risk lifestyle was 2.7 times more likely among students aged 18-24 years than students aged 25 years or older (OR = 2.7, 95% CI = [1.18, 6.54] p = 0.02); 2.3 times more likely among students with ≥400 h of semester time (OR = 2.3, 95% CI = [0.93, 5.90], p = 0.07); and 3.8 times more likely among female students (OR = 3.8, 95% CI = [0.82, 8.12], p = 0.09). A moderate health risk lifestyle was 1.8 times more likely among students from the 6th to 10th semesters (OR = 1.8, 95% CI = [-0.95, 3.75], p = 0.07). Sociodemographic and academic factors were associated with unhealthy lifestyles. Health promotion efforts are necessary to improve nursing students' health behaviors.
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Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Femenino , Brasil , Estudios Transversales , Factores Socioeconómicos , Estilo de Vida , Encuestas y CuestionariosRESUMEN
BACKGROUND: This study aimed to verify the association between Sedentary Behavior (SB) and performance on cognitive function tests in middle-aged and elderly adults. METHODS: This cross-sectional study included 6505 participants (55.2% women) of ELSA-Brasil, with a median age of 61 years. The different types of SB considered were sitting time and screen time. The scores obtained in the memory, language, and executive function tests were used to assess cognitive performance (CP). The association between SB and CP was assessed using linear regression. RESULTS: For men, sitting time was associated with better performance in memory, language, and executive function tests. Screen time on the weekend, showed a favorable association with performance in the executive function test. Occupational screen time on weekdays was positively associated with language test performance. For women, sitting time and occupational screen time were positively associated with performance on memory tests. SB was favorably associated with performance in language tests and executive function tests. CONCLUSIONS: SB seems to favor CP in this population without evident dementia and with a high level of education. The type of SB (mentally active or passive) and the schooling seem to be of particular interest for cognitive performance.
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Cognición , Conducta Sedentaria , Persona de Mediana Edad , Adulto , Anciano , Masculino , Humanos , Femenino , Estudios Transversales , Factores de Riesgo , Función EjecutivaRESUMEN
Resumo Esta investigação teve como objetivo caracterizar as mulheres que realizaram o pré-natal no Brasil segundo raça/cor e variáveis sociodemográficas e verificar associação entre os indicadores de processo do cuidado no pré-natal e a raça/cor das mulheres. Estudo transversal de base populacional empreendido com dados da Pesquisa Nacional de Saúde de 2013. Realizou-se análise bivariada mediante modelo de regressão logística multinível, estimando-se as odds ratio para medir a associação entre os indicadores de processo do cuidado pré-natal adequado e raça/cor das mulheres e verificando os respectivos intervalos de confiança de 95%. Os achados evidenciaram que mulheres negras possuem menor chance de iniciar o pré-natal antes das 12 semanas de gestação, ter seis ou mais consultas, realizar teste de HIV, exame VDRL e receber orientações referentes aos cuidados na gestação e parto. Identificamos desigualdades na atenção à saúde das mulheres brasileiras atendidas no pré-natal relacionadas à raça/cor e a outras características sociodemográficas. Conclui-se que ser negra e ocupar lugares sociais desfavoráveis acarretam desvantagens para as mulheres quanto ao acesso a um pré-natal considerado adequado segundo os critérios estabelecidos pelo Ministério da Saúde do Brasil.
Abstract The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women's ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women's ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.
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The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women's ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women's ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.
Esta investigação teve como objetivo caracterizar as mulheres que realizaram o pré-natal no Brasil segundo raça/cor e variáveis sociodemográficas e verificar associação entre os indicadores de processo do cuidado no pré-natal e a raça/cor das mulheres. Estudo transversal de base populacional empreendido com dados da Pesquisa Nacional de Saúde de 2013. Realizou-se análise bivariada mediante modelo de regressão logística multinível, estimando-se as odds ratio para medir a associação entre os indicadores de processo do cuidado pré-natal adequado e raça/cor das mulheres e verificando os respectivos intervalos de confiança de 95%. Os achados evidenciaram que mulheres negras possuem menor chance de iniciar o pré-natal antes das 12 semanas de gestação, ter seis ou mais consultas, realizar teste de HIV, exame VDRL e receber orientações referentes aos cuidados na gestação e parto. Identificamos desigualdades na atenção à saúde das mulheres brasileiras atendidas no pré-natal relacionadas à raça/cor e a outras características sociodemográficas. Conclui-se que ser negra e ocupar lugares sociais desfavoráveis acarretam desvantagens para as mulheres quanto ao acesso a um pré-natal considerado adequado segundo os critérios estabelecidos pelo Ministério da Saúde do Brasil.
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Atención Prenatal , Grupos Raciales , Brasil , Estudios Transversales , Femenino , Humanos , Parto , Embarazo , Factores SocioeconómicosRESUMEN
Chagas disease (CD) is among the top 10 causes of inability to blood donation. Blood donation centers screen for anti-Trypanosoma cruzi antibodies using highly sensitive immunoenzymatic (ELISA) or chemiluminescent methods, which can lead to false positive results. Since positive samples cannot be used, to avoid the loss of valuable blood donations, it is necessary to improve specificity without reducing the sensitivity of the tests used for blood screening. For this purpose, our group has developed four chimeric proteins (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) that have been evaluated in phase I and II studies with high performance and low cross-reactivity rates. The study included a panel of 5,014 serum samples collected from volunteer blood donors at the Hematology and Hemotherapy Foundation of the State of Bahia (Brazil). They were subjected to the detection of anti-T. cruzi antibodies, using all four IBMP antigens individually and latent class analysis (LCA) as a reference test, since there is no gold standard test for this purpose. Considering the sample size analyzed, LCA classified 4,993 (99.6%) samples as T. cruzi-negative and 21 (0.42%) as T. cruzi-positive. Sensitivity values ranged from 85.71% for IBMP-8.1 and 90.48% for IBMP-8.2-95.24% for IBMP-8.3 and 100% for IBMP-8.4, while specificity ranged from 99.98% for IBMP-8.3 and IBMP-8.4-100% for IBMP-8.1 and IBMP-8.2. Accuracy values ranged from 99.4 to 99.98%. The pretest probability for the molecules was 0.42, whereas the positive posttest probability ranged from 95.24 to 99.95% and the negative posttest probability ranged from 0.00001 to 0.0006% for all antigens. The higher odds ratio diagnosis was found for IBMP-8.4, which has been shown to be a safe single antigen for serological screening of CD in blood samples. The use of chimeric IBMP antigens is an alternative to reduce the number of bags discarded due to false-positive results. These molecules have high diagnostic performance and were shown to be suitable for use in screening CD in blood banks, isolated (IBMP-8.4) or in combination; and their use in blood banks could significantly reduce unnecessary disposal of blood bags or the risk of T. cruzi transmission.
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ABSTRACT Objectives: to describe clinical characteristics and mortality of people with ischemic cerebrovascular accidents (strokes); to compare disability before the event and 90 days after. Methods: longitudinal study with 308 people hospitalized in Salvador-BA. Data collection took place from 03/2019 to 01/2020. Descriptive and inferential statistics were used. Results: mean age was 64.8 years, and National Institute of Health Stroke Scale score was 10.7. The median length of stay in the hospital was 11 days. Afro-descendants predominated (84%), elementary educational level (68.4%), income up to three minimum wages (89.1%), arrival within 4.5 hours of symptoms (57.9%) and admission to a specialized unit (71.8%). Prevalence of thrombolysis: 26%. The asymptomatic before the event category predominated (85.3%) as did the moderate/severe disability (41.5%) after 90 days. 19.7% of the sample evolved to death. Conclusions: the high mortality and disability generated by the event have implications for health management and care.
RESUMEN Objetivos: describir características clínicas y la mortalidad de personas con accidente cerebrovascular isquémico; comparar la discapacidad antes del evento y 90 días después. Métodos: estudio longitudinal, con 308 personas hospitalizadas en Salvador-BA. Recolecta de datos ocurrió de 03/2019 a 01/2020. Empleado estadística descriptiva e inferencial. Resultados: la mediana de edad fue de 64,8 años, y la puntuación de la National Institute of Health Stroke Scale fue 10,7. La mediana del tiempo de internación fue de 11 días. Predominaron negros (84%), hasta la educación primaria (68,4%), renta hasta tres salarios mínimos (89,1%), llegada hasta 4,5 horas del inicio de los síntomas (57,9%) e internación en unidad especializada (71,8%). Realizaron trombolisis: 26%. Predominó la categoría asintomática (85,3%) antes del evento y discapacidad moderada/severa (41,5%) tras 90 días. Óbito alcanzó 19,7% de la muestra. Conclusiones: la alta mortalidad y discapacidad generadas por el evento hay implicaciones a la gestión y cuidado en salud.
RESUMO Objetivos: descrever características clínicas e a mortalidade de pessoas com acidente vascular cerebral isquêmico; comparar a incapacidade antes do evento e 90 dias depois. Métodos: estudolongitudinal, com 308 pessoas hospitalizadas em Salvador-BA. A coleta de dados ocorreu de 03/2019 a 01/2020. Empregou-se estatística descritiva e inferencial. Resultados: a média de idade foi de 64,8 anos ( dp=14,1) e a pontuação da National Institute of Health Stroke Scale foi 10,7 (dp=7,2). Amediana do tempo de internação foi de 11 dias. Predominaram negros (84,0%), escolaridade até o fundamental (68,4%), renda até três salários mínimos (89,1%), chegada até 4,5 horas do início dos sintomas (57,9%) e internação em unidade especializada (71,8%). Realizaram trombólise: 26,0%. Predominou a categoria assintomática (85,3%) antes do evento e incapacidade moderada/severa (41,5%) após 90 dias (p= 0.117). Óbito atingiu 19,7% da amostra. Conclusões: a alta mortalidade e incapacidade geradas pelo evento têm implicações para a gestão e cuidado em saúde.
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OBJECTIVES: to describe clinical characteristics and mortality of people with ischemic cerebrovascular accidents (strokes); to compare disability before the event and 90 days after. METHODS: longitudinal study with 308 people hospitalized in Salvador-BA. Data collection took place from 03/2019 to 01/2020. Descriptive and inferential statistics were used. RESULTS: mean age was 64.8 years, and National Institute of Health Stroke Scale score was 10.7. The median length of stay in the hospital was 11 days. Afro-descendants predominated (84%), elementary educational level (68.4%), income up to three minimum wages (89.1%), arrival within 4.5 hours of symptoms (57.9%) and admission to a specialized unit (71.8%). Prevalence of thrombolysis: 26%. The asymptomatic before the event category predominated (85.3%) as did the moderate/severe disability (41.5%) after 90 days. 19.7% of the sample evolved to death. Conclusions: the high mortality and disability generated by the event have implications for health management and care.
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Personas con Discapacidad , Accidente Cerebrovascular , Hospitalización , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Accidente Cerebrovascular/complicaciones , Resultado del TratamientoRESUMEN
OBJECTIVES: To investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. DESIGN: Cross-sectional study based on registry data from Brazil's influenza surveillance system. SETTING: Public and private hospitals across Brazil. PARTICIPANTS: Eligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020. MAIN OUTCOME MEASURES: Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. RESULTS: A sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33). CONCLUSIONS: The combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults.
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COVID-19 , Enfermedades Cardiovasculares , Adulto , Anciano , Brasil/epidemiología , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Humanos , Pacientes Internos , Obesidad/complicaciones , Obesidad/epidemiología , SARS-CoV-2RESUMEN
BACKGROUND: Chikungunya is an arbovirus, transmitted by Aedes mosquitoes, which emerged in the Americas in 2013 and spread rapidly to almost every country on this continent. In Brazil, where the first cases were detected in 2014, it currently has reached all regions of this country and more than 900,000 cases were reported. The clinical spectrum of chikungunya ranges from an acute self-limiting form to disabling chronic forms. The purpose of this study was to estimate the seroprevalence of chikungunya infection in a large Brazilian city and investigate the association between viral circulation and living condition. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a population-based ecological study in selected Sentinel Areas (SA) through household interviews and a serologic survey in 2016/2017. The sample was of 1,981 individuals randomly selected. The CHIKV seroprevalence was 22.1% (17.1 IgG, 2.3 IgM, and 1.4 IgG and IgM) and varied between SA from 2.0% to 70.5%. The seroprevalence was significantly lower in SA with high living conditions compared to SA with low living condition. There was a positive association between CHIKV seroprevalence and population density (r = 0.2389; p = 0.02033). CONCLUSIONS/SIGNIFICANCE: The seroprevalence in this city was 2.6 times lower than the 57% observed in a study conducted in the epicentre of the CHIKV epidemic of this same urban centre. So, the herd immunity in this general population, after four years of circulation of this agent is relatively low. It indicates that CHIKV transmission may persist in that city, either in endemic form or in the form of a new epidemic, because the vector infestation is persistent. Besides, the significantly lower seroprevalences in SA of higher Living Condition suggest that beyond the surveillance of the disease, vector control and specific actions of basic sanitation, the reduction of the incidence of this infection also depends on the improvement of the general living conditions of the population.
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Anticuerpos Antivirales/sangre , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/virología , Virus Chikungunya/inmunología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Fiebre Chikungunya/inmunología , Fiebre Chikungunya/transmisión , Niño , Preescolar , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/inmunología , Enfermedades Transmisibles Emergentes/transmisión , Enfermedades Transmisibles Emergentes/virología , Brotes de Enfermedades , Femenino , Humanos , Inmunidad Colectiva , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Lactante , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Estudios Seroepidemiológicos , Adulto JovenRESUMEN
Objetivo investigar as variáveis que interferem na inatividade física total em mulheres com excesso de peso. Métodos pesquisa transversal que realizou levantamento de dados sociodemográficos, autopercepção de saúde, autoeficácia para atividade física, peso e altura em 142 mulheres. O International Physical Activity Questionnaire foi utilizado para avaliar a atividade física. Empregou-se estatística descritiva e inferencial. Adotou-se significância estatística de 5%. Resultados a prevalência de inatividade física total foi 34,5%. Constatou-se associação significante entre inatividade física total e idade na análise bivariada. Na análise multivariada apenas mulheres com autopercepção de saúde regular e ruim apresentaram aumento de 124 e 150%, respectivamente, da inatividade física total. Conclusão a inatividade física associou-se à autopercepção de saúde regular e ruim, sendo um parâmetro de saúde para a elaboração de políticas e ações de promoção à saúde.
ABSTRACT Objective to investigate the variables that interfere with total physical inactivity in overweight women. Methods cross-sectional research that collected sociodemographic data, self-perceived health, self-efficacy for physical activity, weight, and height in 142 women. The International Physical Activity Questionnaire was used to evaluate physical activity. Descriptive and inferential statistics were used. A 5% statistical significance level was adopted. Results the prevalence of total physical inactivity was 34.5%. A significant association between total physical inactivity and age was found in the bivariate analysis. In the multivariate analysis, only women with regular and poor self-perceived health showed an increase of 124% and 150%, respectively, of total physical inactivity. Conclusion physical inactivity was associated with regular and poor self-perception of health, being a health parameter for the development of health promotion policies and actions.
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Mujeres , Factores Epidemiológicos , Conducta Sedentaria , Actividad Motora , ObesidadRESUMEN
OBJECTIVE: This study investigated whether the presence of care workers who completed a specialization course on family health was associated with improved care and maternal and child health indicators in municipalities in the state of Mato Grosso do Sul, Brazil. METHODS: Negative binomial regression models with fixed effects were used for the 79 municipalities in the state of Mato Grosso do Sul, with repeated observations for the period 2009-2015. For our reference, the parameter "number of professionals who completed the course" calculated the proportion of professionals who completed the course, and was divided by the total number of primary health care professionals in the municipality to create a ratio. The cutoff points used represented tertile distribution: T3: high (0.35-1.00), T2: intermediate (0.02-0.33) and T1: low (0.00-0.01); to avoid biased results, the analysis was also performed for the years prior to the beginning of the course in question (2009 and 2010). RESULTS: During the study period, enrollment of pregnant women, exclusive breastfeeding for children under 4 months, and up-to-date vaccinations in children younger than 1 year to 23 months increased (high to intermediate categories) in municipalities where professionals who completed the specialization course worked. Growth in the intermediate ratio was also observed in indicators related to cervical cancer screening and new diagnoses of congenital syphilis in infants under one year of age. CONCLUSIONS: The presence of care workers who completed a specialization course on family health was seen to be associated with improved care and indicators for maternal and child health in municipalities in the state of Mato Grosso do Sul, Brazil. These findings reaffirm the importance and effectiveness of policies on training and continuing education for the Brazilian Unified Health System.
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Salud Infantil/estadística & datos numéricos , Educación Continua , Personal de Salud/educación , Salud Materna/estadística & datos numéricos , Adulto , Femenino , Humanos , Lactante , Masculino , Embarazo , Sistema de RegistrosRESUMEN
OBJECTIVE: identify the stress level among nursing undergraduates and the associated sociodemographic and academic factors; to compare stress level among college students according to the training phase in the course. METHOD: cross-sectional study with 286 university students. The instrument of sociodemographic and academic characterization and the stress scale were applied. The overall stress level was assessed by standardized score. In the bivariate analysis, Pearson's chi-square or Fisher's exact test was used, and multiple logistic regression analysis was performed using the Poisson model. Statistical significance of 5% was adopted. RESULTS: higher proportion of college students presented medium/high level of global stress. Students from 6th to 10th semesters presented higher levels of stress compared to those from 1st to 5th, in the Realization of practical activities, Professional Communication (p = 0.014), Environment (p = 0.053) and Vocational Training (p = 0.000) domains). In the multivariate analysis, they contributed to the highest level of stress the variables attending the 6th to 10th semesters, female gender, monthly income ≤ one minimum wage and income considered insufficient. CONCLUSION: women in a more advanced stage of education and with low economic condition present a higher level of stress in their academic education.
Asunto(s)
Estrés Psicológico/psicología , Estudiantes de Enfermería/psicología , Adolescente , Brasil , Estudios Transversales , Educación en Enfermería/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos , Adulto JovenRESUMEN
Resumo Objetivo Verificar a associação entre tabagismo, estresse, variáveis sociodemográficas e acadêmicas e a qualidade do sono de universitários de enfermagem. Métodos Estudo transversal, com 286 universitários de uma instituição pública de ensino superior, em Salvador/BA. Aplicou-se a Escala de Qualidade do Sono de Pittsburgh, a Escala de Estresse Percebido e instrumentos sobre tabagismo, variáveis sociodemográficas e acadêmicas. Na análise bivariada utilizou-se o teste Qui-quadrado de Pearson ou Exato de Fisher e as variáveis com valor de p ≤ 0,20 entraram na análise multivariada utilizando-se o Modelo de Regressão de Poisson Robusto. Adotou-se significância estatística de 5%. A modelagem foi realizada com o procedimento backward e para escolha do modelo utilizou-se o critério de informação de Akaike. Resultados Na análise múltipla, universitários com renda familiar mensal inferior a quatro salários mínimos tiveram aumento de 20% na qualidade de sono ruim quando comparados aqueles com renda maior a sete salários (RP: 1,20; IC 95% 1,01;1,43). Aqueles com alto nível de estresse percebido tiveram aumento de 11% na qualidade do sono ruim em comparação com aqueles com baixo nível (RP: 1,11; IC 95% 1,02;1,20). Fumantes/ex-fumantes também tiveram aumento de 11% na qualidade de sono ruim quando comparados aos não fumantes (RP:1,11; IC 95% 1,04;1,18). O modelo foi ajustado por carga horária no curso e idade. Conclusão A baixa renda, o nível alto de estresse e o tabagismo foram associados a qualidade do sono ruim. Os resultados desafiam a proposição de intervenções capazes de minimizar a qualidade do sono ruim em universitários de enfermagem.
Resumen Objetivo Verificar la relación entre tabaquismo, estrés y variables sociodemográficas y académicas y la calidad del sueño en estudiantes universitarios de Enfermería. Métodos Estudio transversal, con 286 estudiantes universitarios de una institución pública de educación superior en Salvador, estado de Bahia. Se aplicó el Índice de Calidad del Sueño de Pittsburgh, la Escala de Estrés Percibido e instrumentos sobre tabaquismo y variables sociodemográficas y académicas. En el análisis bivariado se utilizó la prueba χ2 de Pearson o la prueba exacta de Fisher. Las variables con valor de p ≤ 0,20 se incluyeron en el análisis multivariado, en el que se utilizó el Modelo de Regresión de Poisson Robusto. Se adoptó significación estadística de 5%. El modelo se realizó con el procedimiento backward y para elegir el modelo se utilizó el criterio de información de Akaike. Resultados En el análisis múltiple, estudiantes universitarios con ingresos familiares inferiores a cuatro salarios mínimos tuvieron un aumento del 20% en el sueño de mala calidad en comparación con aquellos con ingresos mayores a siete salarios (RP: 1,20; IC 95% 1,01;1,43). Aquellos con un alto nivel de estrés percibido tuvieron un aumento del 11% en el sueño de mala calidad en comparación con los de bajo nivel (RP: 1,11; IC 95% 1,02;1,20). Fumadores/exfumadores también tuvieron un aumento del 11% en el sueño de mala calidad en comparación con los no fumadores (RP:1,11; IC 95% 1,04;1,18). El modelo se ajustó por carga horaria de la carrera y edad. Conclusión Los ingresos bajos, el alto nivel de estrés y el tabaquismo se relacionaron con el sueño de mala calidad. Los resultados muestran un desafío para proponer intervenciones capaces de minimizar el sueño de mala calidad en estudiantes universitarios de Enfermería.
Abstract Objective To verify the association between smoking, stress, sociodemographic and academic variables and sleep quality of nursing undergraduates. Methods Cross-sectional study with 286 undergraduates from a public higher education institution in the city of Salvador, state of Bahia. The Pittsburgh Sleep Quality Scale, the Perceived Stress Scale and tools on smoking, sociodemographic and academic variables were applied. Bivariate analysis was performed using Pearson's chi-square test or Fisher's exact test, and variables with p values <0.20 entered the multivariate analysis using the Poisson Robust Regression Model. Statistical significance of 5% was adopted. The modeling was performed with the backward procedure and the model was chosen using the Akaike information criterion. Results In the multiple analysis, undergraduates with a monthly family income of less than four minimum wages had a 20% increase in poor sleep quality when compared to those with a higher income than seven minimum wages (PR: 1.20; 95% CI 1.01; 1.43). Those with high level of perceived stress had an 11% increase in poor sleep quality compared with those with low level (PR: 1.11; 95% CI 1.02; 1.20). Smokers/former smokers also had an 11% increase in poor sleep quality compared to non-smokers (PR: 1.11; 95% CI 1.04; 1.18). The model was adjusted by course load and age. Conclusion Low income, high stress level and smoking were associated with poor sleep quality. The results challenge the proposition of interventions that can minimize the quality of bad sleep in nursing undergraduates.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Sueño , Trastornos del Sueño-Vigilia , Estrés Psicológico , Estudiantes de Enfermería , Factores de Riesgo , Estudios TransversalesRESUMEN
OBJECTIVE: To assess the effectiveness of remote monitoring in the knowledge of overweight women. METHOD: Randomized clinical trial with 101 women, randomly assigned to the control group (CG=50) and to the intervention group (IG=51). The IG received educational intervention over the telephone, during three months and routine follow-up in the service, while the CG only received conventional follow-up. The knowledge was assessed by a specific questionnaire. Data were analyzed by the Robust Linear Regression Model, adopting a statistical significance of 5%. RESULTS: In the intragroup assessment, an increase in the correct answers with a statistically significant difference was observed only for the IG in the domains: "Concept and causes of overweight," "Complications of overweight" and "Eating habits." In the intergroup comparison, an increase in the average knowledge was verified in the same domains for the IG (p≤0.005). CONCLUSION: nursing telemonitoring contributed positively to the improvement of women's knowledge.
Asunto(s)
Conocimiento , Obesidad/terapia , Telemedicina/normas , Adulto , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/psicología , Encuestas y Cuestionarios , Telemedicina/métodos , Telemedicina/tendenciasRESUMEN
This study evaluated the work capacity of motorcycle taxi drivers and its association with sociodemographic and work and quality of life factors. This is a cross-sectional study realized with 392 motorcycle taxi drivers that used a form containing demographic and labor data, Work Capacity Index, the WHOQOL-bref. We employed a descriptive and inferential analysis. The moderate/good prevalence work capacity was 51%. Motorcycle taxi drivers aged 40 years and over recorded a 31% increase in low work capacity (PR: 1.31; 95% CI: 1.07; 1.61) compared to younger workers. Motorcycle taxi drivers aged 21-29 and 30-39 years evidenced a higher median for absenteeism (p = 0.023) and self-prognosis regarding future work capacity (p < 0.001). A greater proportion of diseases diagnosed among those with five or more years of service (p = 0.003) and of self-prognosis in those with five years or less of service (p < 0.001) was observed. Motorcycle taxi drivers with moderate/good capacity showed better perception of quality of life in the physical realm (p < 0.001). Work capacity of motorcycle taxi drivers was associated with higher exposure to noxious factors that affect their quality of life and work force. Priority public policies and educational actions are required to minimize this exposure.
Objetivou-se avaliar a capacidade para o trabalho de mototaxistas e sua associação com fatores sociodemográficos, laborais e qualidade de vida. Estudo transversal, realizado com 392 mototaxistas, utilizando-se formulário com dados sociodemográficos, laborais, Índice de Capacidade de Trabalho e o WHOQOL-bref. Empregou-se análise descritiva e inferencial. A prevalência de capacidade para o trabalho moderada/boa foi de 51%. Mototaxistas com 40 ou mais anos tiveram aumento de 31% na capacidade baixa para o trabalho (RP: 1,31; IC 95%: 1,07; 1,61) comparados aos mais jovens. Mototaxistas de 21 a 29 e de 30 a 39 anos apresentaram maiores medianas para absenteísmo (p = 0,023) e prognóstico próprio sobre a capacidade de trabalho no futuro (p < 0,001). Houve maior proporção para doenças diagnosticadas entre aqueles com cinco anos ou mais na profissão (p = 0,003) e para prognóstico próprio naqueles com cinco anos ou menos (p < 0,001). Mototaxistas com capacidade moderada/boa apresentaram melhor percepção de qualidade de vida no domínio físico (p < 0,001). A capacidade baixa para o trabalho de mototaxistas foi associada à maior exposição aos fatores nocivos que afetam sua qualidade de vida e força de trabalho. É necessário priorizar políticas públicas e ações educativas para minimizar essa exposição.
Asunto(s)
Absentismo , Motocicletas/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Evaluación de Capacidad de Trabajo , Adulto , Factores de Edad , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Política Pública , Calidad de Vida , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Resumo Objetivou-se avaliar a capacidade para o trabalho de mototaxistas e sua associação com fatores sociodemográficos, laborais e qualidade de vida. Estudo transversal, realizado com 392 mototaxistas, utilizando-se formulário com dados sociodemográficos, laborais, Índice de Capacidade de Trabalho e o WHOQOL-bref. Empregou-se análise descritiva e inferencial. A prevalência de capacidade para o trabalho moderada/boa foi de 51%. Mototaxistas com 40 ou mais anos tiveram aumento de 31% na capacidade baixa para o trabalho (RP: 1,31; IC 95%: 1,07; 1,61) comparados aos mais jovens. Mototaxistas de 21 a 29 e de 30 a 39 anos apresentaram maiores medianas para absenteísmo (p = 0,023) e prognóstico próprio sobre a capacidade de trabalho no futuro (p < 0,001). Houve maior proporção para doenças diagnosticadas entre aqueles com cinco anos ou mais na profissão (p = 0,003) e para prognóstico próprio naqueles com cinco anos ou menos (p < 0,001). Mototaxistas com capacidade moderada/boa apresentaram melhor percepção de qualidade de vida no domínio físico (p < 0,001). A capacidade baixa para o trabalho de mototaxistas foi associada à maior exposição aos fatores nocivos que afetam sua qualidade de vida e força de trabalho. É necessário priorizar políticas públicas e ações educativas para minimizar essa exposição.
Abstract This study evaluated the work capacity of motorcycle taxi drivers and its association with sociodemographic and work and quality of life factors. This is a cross-sectional study realized with 392 motorcycle taxi drivers that used a form containing demographic and labor data, Work Capacity Index, the WHOQOL-bref. We employed a descriptive and inferential analysis. The moderate/good prevalence work capacity was 51%. Motorcycle taxi drivers aged 40 years and over recorded a 31% increase in low work capacity (PR: 1.31; 95% CI: 1.07; 1.61) compared to younger workers. Motorcycle taxi drivers aged 21-29 and 30-39 years evidenced a higher median for absenteeism (p = 0.023) and self-prognosis regarding future work capacity (p < 0.001). A greater proportion of diseases diagnosed among those with five or more years of service (p = 0.003) and of self-prognosis in those with five years or less of service (p < 0.001) was observed. Motorcycle taxi drivers with moderate/good capacity showed better perception of quality of life in the physical realm (p < 0.001). Work capacity of motorcycle taxi drivers was associated with higher exposure to noxious factors that affect their quality of life and work force. Priority public policies and educational actions are required to minimize this exposure.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Adulto Joven , Evaluación de Capacidad de Trabajo , Motocicletas/estadística & datos numéricos , Absentismo , Enfermedades Profesionales/epidemiología , Pronóstico , Política Pública , Calidad de Vida , Prevalencia , Estudios Transversales , Encuestas y Cuestionarios , Factores de Edad , Persona de Mediana EdadRESUMEN
Objetivo: analisar a utilização de medicamentos prescritos no setor de terapia semi-intensiva da oncopediatria em um hospital filantrópico, tendo em vista o desenvolvimento da farmacovigilância na prática farmacêutica. Métodos: foi realizada avaliação das prescrições médicas e pesquisa bibliográfica nas bases de dados sobre medicamentos no período de junho de 2015 a junho de 2016. As variáveis adotadas foram relacionadas às características sociodemográficas, clínicas, e os medicamentos prescritos foram classificados de acordo com a Anatomical Therapeutic Chemical Classification (ATC). Foram incluídas todas as prescrições oncológicas da unidade de terapia semi-intensiva, considerando a faixa etária de 0-18 anos, estratificada em 0-11 anos, 12-14 anos e 15-18 anos, no período de junho de 2015 a junho de 2016, excluindo aquelas que não atendiam aos requisitos. Os dados foram compilados no programa Statistical Package for the Social Sciences (SPSS), versão 22.0. Resultados: a maioria dos pacientes pertencia ao sexo masculino com prevalência na faixa etária entre 00-11 anos. A leucemia linfoide aguda foi o diagnóstico mais observado, e o desfecho de alta melhorada representou mais da metade da amostra. As classes terapêuticas mais prescritas corresponderam aos antineoplásicos, anti-infecciosos e aos que atuam no Sistema Nervoso Central (SNC). Conclusões: os resultados sugerem que o tratamento farmacológico, em unidade de terapia intensiva, envolve um grupo extenso de medicamentos, com predomínio de antineoplásicos, antibióticos e fármacos que atuam no SNC. É necessária atenção especial para a conduta terapêutica no atendimento à população pediátrica, visando minimizar, sobretudo, os eventos adversos inerentes ao tratamento oncológico.
Objective: ito analyze the use of drugs as prescribed in the semi-intensive therapy sector of oncopediatrics in a philanthropic hospital, in view of the development of pharmacovigilance in pharmaceutical practice. Methods: the evaluation of medical prescriptions and bibliographic research was carried out in the databases on drugs from June 2015 to June 2016. The variables adopted were related to sociodemographic, clinical characteristics and the prescribed drugs were classified according to the Anatomical Therapeutic Chemical Classification (ATC). All the oncological prescriptions of the semi-intensive therapy unit were included, considering the age range 0-18 years, stratified in 0-11 years, 12-14 years and 15-18 years, in the period from June 2015 to June of 2016, excluding those that did not meet the requirements. The data were compiled in the Statistical Package for the Social Sciences (SPSS), version 22.0. Results: most of the patients belonged to males with a prevalence in the age range between 00-11 years old. Acute lymphoblastic leukemia was the most observed diagnosis and the improved high endpoint accounted for more than half of the sample. The most prescribed therapeutic classes corresponded to: antineoplastic, anti-infectious and those acting on the Central Nervous System (CNS). Conclusions: the results suggest that pharmacological treatment in an intensive care unit involves an extensive group of drugs, with a predominance of antineoplastics, antibiotics and drugs acting in the CNS. Special attention is required for therapeutic management in the pediatric population, in order to minimize the adverse events inherent to cancer treatment.
Asunto(s)
Pediatría , Oncología Médica , Preparaciones Farmacéuticas , AntineoplásicosRESUMEN
Influenza vaccine is recommended for all health workers, but vaccination coverage remains unsatisfactory. A cross-sectional study that aimed to identify factors associated with influenza vaccination was carried out with health workers from a large Hospital Complex in Salvador, Bahia. A self-administered questionnaire was used based on the models "Knowledge, Attitudes and Practices" and "Health Belief Model". The dependent variable was the vaccination status against influenza in 2014, and the independent variables were sociodemographic factors, vaccine history, knowledge and attitudes about influenza/influenza vaccine. Logistic regression was used, odds ratio was calculated with 95% confidence intervals, adjusting for sex, age and occupation. The best multivariate model was chosen through backwards elimination and the Akaike Information Criterion. 755 workers participated. Influenza vaccine coverage was 61.5%, being higher among nurses (69.0%) and lower among physicians (49.1%). The factors associated with being vaccinated against influenza were: knowing that even when healthy, one must vaccinate against influenza (OR = 3.15; 95%CI:1.74-5.71); knowing that the vaccine does not protect for many years (OR = 2.08; 95%CI:1.30-3.33); and not to be afraid of post-vaccine adverse effects (OR = 1.93; 95%CI: 1.26-2.95).
A vacina influenza é recomendada para todos trabalhadores de saúde, mas sua cobertura permanece insatisfatória. Estudo transversal que objetivou identificar fatores associados à vacinação contra influenza, realizado com trabalhadores de saúde de um grande Complexo Hospitalar de Salvador, Bahia. Utilizou-se questionário autoaplicável baseado nos modelos "Conhecimento, Atitudes e Práticas" e "Health Belief Model". A variável dependente foi a vacinação contra influenza em 2014, e as independentes representaram fatores sociodemográficos, histórico vacinal, conhecimentos e atitudes sobre influenza/vacina influenza. Usou-se regressão logística, calculou-se odds ratio a intervalos de confiança de 95%, ajustando para sexo, idade e profissão. Elegeu-se o melhor modelo multivariado através de eliminação retrógada e do Critério de Informação de Akaike. Participaram 755 trabalhadores. A cobertura da vacina influenza foi de 61,5%, sendo maior entre enfermeiros (69,0%) e menor entre médicos (49,1%). Os fatores associados a vacinar-se contra influenza foram: conhecer que mesmo estando saudável deve-se vacinar (OR = 3,15; IC95%:1,74-5,71); saber que a vacina não protege por muitos anos (OR = 2,08; IC95%:1,30-3,33); e não temer efeitos adversos pós-vacinais (OR = 1,93; IC95%:1,26-2,95).