CD4+ T Lymphocytes Subsets in Early Life: Does Exclusive Breastfeeding Promote Allergy?

Breastfeeding provides ideal nutrition and passive immunization for growing infants, protecting them from potentially fatal infectious diseases. Exclusive breastfeeding is recommended for at least six months and should be continued complementarity for another year. One of the justifications for this recommended practice is the prevention of allergic diseases, which has been controversial for many years. Here we reviewed data regarding breastfeeding practices and hypothesized that exclusive breastfeeding for long periods may affect the availability of helper T lymphocyte 1-polarizing antigens in babies. This fact could favor helper T lymphocyte 2 (TH2) phenotype development and consequently increase the incidences of allergies, although we have found no consistent evidence in the literature supporting or denying that breastfeeding plays a role in allergic diseases. The literature mostly presents inconsistencies and/or methodological issues precluding a final answer to this issue. The development of the adaptive immune system depends on exposure to antigens that elicit the production of specific cytokines and activates T lymphocyte populations. It is believed that a promotion of the TH2 phenotype to the detriment of another lymphocyte subset takes place, although the exact knowledge about when this process begins is still under investigation. Therefore, the recent increase in allergy incidence might be partly explained by breastfeeding practices in the world and by the hypothesis presented here, affecting the baby's immune system development through selective antigen availability.

[The importance of waste from healthcare services for teachers, students and graduates of the healthcare sector]. / A importância dos resíduos de serviços de saúde para docentes, discentes e egressos da área da saúde.

This study aimed to explore the perception healthcare sector teachers, students and graduates from two institutions of higher learning in Rio Grande do Sul, on the generation of waste from healthcare services. It used a qualitative research approach, performed with 13 teachers, 18 students and 12 healthcare professionals, who were collected through a focus group. The main results showed there is a perception toward the importance of proper segregation and disposal of Healthcare Service Waste, also there is a lack of concern for the reduction of these wastes. Therefore, the issue requires a broader understanding of the environment, with a view of planetary sustainability, exposing needs to provide the healthcare professionals with knowledge and awareness of the importance of handling these types of waste.

Emergency department use and Artificial Intelligence in Pelotas: design and baseline results.

OBJETIVO: To describe the initial baseline results of a population-based study, as well as a protocol in order to evaluate the performance of different machine learning algorithms with the objective of predicting the demand for urgent and emergency services in a representative sample of adults from the urban area of Pelotas, Southern Brazil. METHODS: The study is entitled "Emergency department use and Artificial Intelligence in PELOTAS (RS) (EAI PELOTAS)" (https://wp.ufpel.edu.br/eaipelotas/). Between September and December 2021, a baseline was carried out with participants. A follow-up was planned to be conducted after 12 months in order to assess the use of urgent and emergency services in the last year. Afterwards, machine learning algorithms will be tested to predict the use of urgent and emergency services over one year. RESULTS: In total, 5,722 participants answered the survey, mostly females (66.8%), with an average age of 50.3 years. The mean number of household people was 2.6. Most of the sample has white skin color and incomplete elementary school or less. Around 30% of the sample has obesity, 14% diabetes, and 39% hypertension. CONCLUSION: The present paper presented a protocol describing the steps that were and will be taken to produce a model capable of predicting the demand for urgent and emergency services in one year among residents of Pelotas, in Rio Grande do Sul state.

Views of primary healthcare physicians on occupational health.

Introduction: The incorporation of occupational health action in healthcare units is a major public health challenge. Objectives: This study aims to the perceptions of primary health care (PHC) physicians about occupational health. Methods: This is a qualitative exploratory-descriptive study was conducted in a municipality located in the central region of the state of Rio Grande do Sul, Brazil. Data were collected through individual interviews using a semi-structured questionnaire, whose first part focused on participants' sociodemographic profile and to professional training, and the second one was specific about the researched theme. Research participants were physicians working in PHC. Professionals with an experience of less than 6 months and those absent during the data collection period due to vacation or sickness were excluded. Results: Ten physicians met inclusion and were therefore interviewed. The main results indicated that the interviewed participants agree that work is an important health condition. They also reported difficulties in taking measures to prevent and promote occupational health and lack of training on the theme. Conclusions: In general, physicians' perception about the theme is based on the implementation of measures mostly targeted at treating users' symptoms, rarely addressing aspects related to prevention or rehabilitation in daily practices. Training about occupational health is insufficient.

Nutritional status and dietary intake of pregnant women.

OBJECTIVE: To evaluate weight gain during pregnancy according to the pregestational state in women who underwent prenatal care in Primary Health Care. METHODS: A cross-sectional study with the participation of 255 pregnant women. Socioeconomic and demographic variables were collected using a structured questionnaire. Women were evaluated for nutritional status and dietary intake. Data related to the age of the pregnant woman, gestational week, current weight, pregestational weight, and height were obtained from the prenatal follow-up form. The Statistical Package for the Social Sciences (SPSS) was used for statistical analysis. RESULTS: Pregestational nutritional status assessment showed that 43.2% (n=110) of the women started gestation with overweight and 4.3% (n=11) started with low weight. 51% percent (n=130) gained gestational weight above the recommended level. The mean age of women with pregestational BMI ≥ 25 kg/m2 was significantly higher than that of those with BMI <25 kg/rrP (p<0.001). Total energy (p=0.037) and calcium (p=0.004) intake were higher in women with weight gain above the recommended. DISCUSSION: The results presented highlight the importance of strategies in public health to avoid excess weight gain during pregnancy. CONCLUSION: Pregnant women presented a gestational weight gain above the recommended maximum value according to pregestational BMI, which may contribute to adverse maternal and infant outcomes.

Coronavirus disease 2019 population-based prevalence, risk factors, hospitalization, and fatality rates in southern Brazil.

OBJECTIVES: To assess population-based prevalence, risk factors, hospitalization, and infection fatality rates (IFR) associated with COVID-19. METHODS: We conducted two household surveys among the non-institutionalized adult population from May 30 to June 17, 2020, in Lajeado, an 84,000-inhabitant industrial city in southern Brazil. Primary outcome was prevalence of SARS-CoV-2 infection. Secondary outcomes were COVID-19-related hospitalizations and deaths occurring up to June 20, 2020. We summarized prevalence rates across surveys with meta-analysis. We assessed age-range IFR and hospitalization rate and regressed these rates over age strata using nonlinear (exponential) coefficients of determination (R2). RESULTS: Summarized overall prevalence was 3.40% (95% CI, 2.74-4.18), 34% lower in older adults ≥60 years. Prevalence was 14.3 and 5.4 times higher among household contacts and meat-precessing plant (MPP) workers, respectively. IFR ranged from 0.08% (0.06-0.11) to 4.63% (2.93-7.84) in individuals 20-39 years and ≥60 years, respectively. R2 for hospitalization rate and IFR over age were 0.98 and 0.93 (both p-values <0.0001), respectively. CONCLUSIONS: This is the first population-based study in Brazil to estimate COVID-19 prevalence, hospitalization, and fatality rates per age stratum. Rates were largely age-dependent. Household contacts and MPP workers are at higher risk of infection. Our findings are valuable for health-policy making and resource allocation to mitigate the pandemic.

Emergency department use and Artificial Intelligence in Pelotas: design and baseline results / Uso serviços de serviços de urgência e emergência e Inteligência Artificial em Pelotas: protocolo e resultados iniciais

RESUMO Objetivo: To describe the initial baseline results of a population-based study, as well as a protocol in order to evaluate the performance of different machine learning algorithms with the objective of predicting the demand for urgent and emergency services in a representative sample of adults from the urban area of Pelotas, Southern Brazil. Methods: The study is entitled "Emergency department use and Artificial Intelligence in PELOTAS (RS) (EAI PELOTAS)" (https://wp.ufpel.edu.br/eaipelotas/). Between September and December 2021, a baseline was carried out with participants. A follow-up was planned to be conducted after 12 months in order to assess the use of urgent and emergency services in the last year. Afterwards, machine learning algorithms will be tested to predict the use of urgent and emergency services over one year. Results: In total, 5,722 participants answered the survey, mostly females (66.8%), with an average age of 50.3 years. The mean number of household people was 2.6. Most of the sample has white skin color and incomplete elementary school or less. Around 30% of the sample has obesity, 14% diabetes, and 39% hypertension. Conclusion: The present paper presented a protocol describing the steps that were and will be taken to produce a model capable of predicting the demand for urgent and emergency services in one year among residents of Pelotas, in Rio Grande do Sul state.

RESUMO Objetivo: Descrever os resultados iniciais da linha de base de um estudo de base populacional, bem como um protocolo para avaliar o desempenho de diferentes algoritmos de aprendizado de máquina, com o objetivo de predizer a demanda de serviços de urgência e emergência em uma amostra representativa de adultos da zona urbana de Pelotas, no Sul do Brasil. Métodos: O estudo intitula-se "Emergency department use and Artificial Intelligence in PELOTAS (RS) (EAI PELOTAS)" (https://wp.ufpel.edu.br/eaipelotas/). Entre setembro e dezembro de 2021, foi realizada uma linha de base com os participantes. Está previsto um acompanhamento após 12 meses para avaliar a utilização de serviços de urgência e emergência no último ano. Em seguida, serão testados algoritmos de machine learning para predizer a utilização de serviços de urgência e emergência no período de um ano. Resultados: No total, 5.722 participantes responderam à pesquisa, a maioria do sexo feminino (66,8%), com idade média de 50,3 anos. O número médio de pessoas no domicílio foi de 2,6. A maioria da amostra tem cor da pele branca e ensino fundamental incompleto ou menos. Cerca de 30% da amostra estava com obesidade, 14% com diabetes e 39% eram hipertensos. Conclusão: O presente trabalho apresentou um protocolo descrevendo as etapas que foram e serão tomadas para a produção de um modelo capaz de prever a demanda por serviços de urgência e emergência em um ano entre moradores de Pelotas, no estado do Rio Grande do Sul.

[Use of contraceptive methods by sexually active women in São Leopoldo, Rio Grande do Sul, Brazil]. / Uso de métodos contraceptivos entre mulheres com vida sexual ativa em São Leopoldo, Rio Grande do Sul, Brasil.

In 2003, a population-based cross-sectional study was conducted in the urban area of São Leopoldo, Rio Grande do Sul, Brazil. The sample included 867 sexually active women from 20 to 60 years of age. The objective was to describe the use of contraceptive methods. Data were collected using a standardized questionnaire. The study analyzed the prevalence of contraceptive use and socioeconomic variables in women reporting an active sex life (84.5%), stratified by age groups. Some 627 (61.1%) women reported use of contraceptive methods. In the 20-49-year old group, 48.8% reported using oral contraceptives, 18.7% tubal ligation, 17.3% condoms, and 7.3% IUDs. In the 50-60-year old group, the most widely used method was tubal ligation (79.6%). Regarding tubal ligation, the schooling variable showed a linear trend, that is, women with less schooling showed a higher prevalence. Prevalence of oral contraception was higher in low-income women.

[Use of condoms during sexual intercourse: a population-based study]. / Uso de preservativos nas relações sexuais: estudo de base populacional.

OBJECTIVE: To describe characteristics associated with failure to use condoms during sexual intercourse by women. METHODS: We conducted a cross-sectional population-based study including 1,026 women aged 20-60 years living in the urban area of a city in Southern Brazil, in 2003. Cluster sampling was carried out by randomly selecting 40 of the city's 270 census sectors. We performed logistic regression analysis of failure to use condoms in relation to socioeconomic, demographic, obstetric, and health care usage variables. RESULTS: Among studied women, 867 (84.5%) reported being sexually active; of these, 252 (29.1%) wore condoms during sexual intercourse. Logistic regression showed that the most vulnerable groups were women who were married or in stable partnerships, and women aged more than 40 years. We found no associations with the other variables explored. CONCLUSIONS: Prevalence of condom use was low; we were able to identify a group of women that needs to be targeted by health policies and services in order to improve perception of the risk of acquiring sexually transmitted diseases.

[Midwives and care in childbirth]. / As parteiras e o cuidado com o nascimento.

This study aimed at knowing the care in childbirths conducted by midwives by the middle of 20th century It is a study of qualitative approach using as reference the Content Analysis. Four midwives were interviewed. Five categories emerged: Motivation to be a midwife; learning to be a midwife; positioning the midwife's work; developing care; work compensation. Midwives sought this occupation for institutional and job need. They learned the work in courses and practice. At home, conditions were poor, and in hospitals, they conducted the majority of the childbirth. They took the necessary care for mother and child. They have reported to be patient so that mothers could have normal childbirth. They conducted with selflessness because social recognition was their compensation.

Nutritional status and dietary intake of pregnant women / Estado nutricional e ingesta dietaria de mujeres embarazadas

ABSTRACT Objective To evaluate weight gain during pregnancy according to the pregestational state in women who underwent prenatal care in Primary Health Care. Methods A cross-sectional study with the participation of 255 pregnant women. Socioeconomic and demographic variables were collected using a structured questionnaire. Women were evaluated for nutritional status and dietary intake. Data related to the age of the pregnant woman, gestational week, current weight, pregestational weight, and height were obtained from the prenatal follow-up form. The Statistical Package for the Social Sciences (SPSS) was used for statistical analysis. Results Pregestational nutritional status assessment showed that 43.2% (n=110) of the women started gestation with overweight and 4.3% (n=11) started with low weight. 51% percent (n=130) gained gestational weight above the recommended level. The mean age of women with pregestational BMI ≥ 25 kg/m2 was significantly higher than that of those with BMI <25 kg/rrP (p<0.001). Total energy (p=0.037) and calcium (p=0.004) intake were higher in women with weight gain above the recommended. Discussion The results presented highlight the importance of strategies in public health to avoid excess weight gain during pregnancy. Conclusion Pregnant women presented a gestational weight gain above the recommended maximum value according to pregestational BMI, which may contribute to adverse maternal and infant outcomes.(AU)

RESUMEN Objetivo Evaluar la ganancia de peso durante el embarazo según el estado pregestacional en mujeres que se sometieron a atención prenatal en Atención Primaria de Salud. Métodos Se hizo un estudio transversal con la participación de las mujeres embarazadas. Las variables socioeconómicas y las variables demográficas se utilizaron a un cuestionario cuestionable. Las mujeres fueron evaluadas para el estado nutricional y la dieta. La relación con la edad de la mujer embarazada, la semana de gestación, obesidad, peso actual, peso previo a la gestación se obtuvieron de la forma prenatal. El Statistical Package para las Ciencias Sociales (SPSS) fue utilizado para el análisis estadístico. Resultados La evaluación del estado nutricional previo a la gestación reveló que el 43,2% (n=110) de las mujeres comenzaron su gestación con sobrepeso y el 4,3%, con un peso muy bajo. El 51% (n=130) obtuvo un peso gestacional por encima del recomendado. La edad media de las mujeres con un IMC previo a la gestación mayor o igual a 25 kg/m2 fue significativamente más alto que la de las mujeres con un BMI inferior a 25 km/ m2. La ingesta de energía total (p=0,037) y el calcio (p=0,004) fue mayor en las mujeres que subieron peso por encima del recomendado. Discusión Los resultados obtenidos resaltan la importancia de las estrategias de salud pública para evitar la ganancia de peso durante el embarazo. Conclusión Las mujeres embarazadas aumentan de peso por encima del valor máximo recomendados, acorde con el IMC previo a la gestación. Este hecho provoca consecuencias negativas en materia de maternidad e infancia.(AU)

[Analysis of the use of data from the Primary Health Care Information System (SIAB): an integrative review of the literature]. / Análise da utilização das informações do Sistema de Informação de Atenção Básica (SIAB): uma revisão integrativa.

This paper aimed to identify instances of the use of data from the Primary Health Care Information System in the existing scientific literature. This study is an Integrative Literature Review and the search for articles was performed in May, 2013 in the Virtual Healthcare Library (MedLine, Lilacs and SciELO), considering publications from 2008 to 2012. The search for articles initially located 164 texts, though after applying the inclusion and exclusion criteria, this review concentrated on 12 articles. The main results showed that there are fragilities like the use of the form just for the record and the insufficient training of the teams. However, the positive aspect is that the Primary Health Care Information System is the leading source of health information and statistics, and that its information can and must be used for health planning activities. Thus, it is an information system that assists municipal management and the actions in health of its teams, alerting the community to the need for care of individual health.

Temporal evolution and spatial distribution of maternal death.

OBJECTIVE: To analyze the temporal evolution of maternal mortality and its spatial distribution. METHODS: Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008. RESULTS: There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding. CONCLUSIONS: The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women's reproductive and maternal health. It is needed to qualify the attention to women's health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.

Relationship between pregestational nutritional status and type of processing of foods consumed by high-risk pregnant women / Relação entre o estado nutricional pré-gestacional e o tipo de processamento de alimentos consumidos por gestantes de alto risco

Abstract Objectives: to relate pregestational nutritional status, maternal age and number of pregnancies to the distribution of macronutrients and micronutrients according to the type of processing offoods consumed by high-risk pregnant women. Methods: a retrospective cross-sectional study was carried out with data from medical records of 200 pregnant women served by a public outpatient clinic in Rio Grande do Sul from 2014 to 2016. Results: the mean percentages of lipids, monounsaturated fatty acids, polyunsaturated fatty acids and sodium intake were higher among ultra-processed foods. There was a significant inverse correlation between maternal age and total calorie intake (p=0.003) and percentage of carbohydrates (p=0.005) and proteins (p=0.037) from ultra-processed foods. There was also a significant association between pregestational nutritional status and total calorie intake (p=0.018) and percentage of carbohydrates (p=0.048) from ultra-processed foods. Conclusions: the mean percentages of lipids, monounsaturated fatty acids, polyunsaturated fatty acids and sodium intake were higher among ultra-processed foods. It was observed that the older the maternal age of high-risk pregnant women, the lower the intake of total calories and percentages of carbohydrates and proteins from ultra-processed foods. It was also observed that pregestational nutritional status was significantly associated with the intake of total calories and percentage of carbohydrates from ultra-processed foods.

Resumo Objetivos: relacionar o estado nutricional pré-gestacional, a idade materna e o número de gestações com a distribuição de macronutrientes e micronutrientes conforme o tipo de processamento dos alimentos consumidos por gestantes de alto risco. Métodos: estudo retrospectivo transversal, realizado a partir de dados de prontuários de 200 gestantes atendidas em um ambulatório público do Rio Grande do Sul, no período de 2014 a 2016. Resultados: a média de consumo em percentuais de lipídios, ácidos graxos monoinsaturados, poli-insaturados e sódio foi maior entre os alimentos ultraprocessados. Observou-se correlação significativamente inversa entre a idade materna e o consumo de calorias totais (p=0,003), percentuais de carboidratos (p=0,005) e proteínas (p=0,037) provenientes de alimentos ultraprocessados. Verificou-se também associação significativa entre o estado nutricional pré-gestacional e o consumo de calorias totais (p=0,018) e percentual de carboidrato (p=0,048) provenientes de alimentos ultraprocessados. Conclusões: a média de consumo em percentuais de lipídios, ácidos graxos monoinsaturados, poli-insaturados e sódio foi maior entre os alimentos ultraprocessados, verificou-se que quanto maior a idade materna da gestante de alto risco, menor é o consumo de calorias totais, percentuais de carboidratos e proteínas, oriundos dos alimentos ultraprocessados e identificou-se também que o estado nutricional pré-gestacional possui associação significativa com o consumo de calorias totais e percentual de carboidrato provenientes de alimentos ultraprocessados.

Perfil Sociodemográfico e Consumo Alimentar de Gestantes Hipertensas / Perfil Sociodemográfico y Consumo Alimentario de Gestantes con Hipertensión Arterial / Socio-Demographic Profile and Food Consumption of Hypertensive Pregnant Women

Introdução: A hipertensão na gestação é considerada um problema de saúde pública e diversos fatores estão envolvidos na sua ocorrência, como os relacionados às condições sociodemográficas, dietéticos e o estado nutricional. Objetivo: Determinar e relacionar o perfil sociodemográfico, clínico e o estado nutricional de gestantes hipertensas com a ingestão dietética. Métodos: Trata-se de uma pesquisa transversal e quantitativa com dados coletados a partir de 96 prontuários de gestantes hipertensas atendidas em um Ambulatório de Gestação de Alto Risco do interior do Rio Grande do Sul, durante o período 2014 a 2016. Foram coletados dados sociodemográfico, clínicos, estado nutricional e consumo dietético, o qual foi avaliado a partir do recordatório alimentar de 24 horas de um dia. A análise estatística dos dados ocorreu através do software Statistical Package for the Social Scienses (SPSS), versão 22.0, considerando nível de significância máximo de 5% (p≤0,05). Resultados: A maioria das gestantes atendidas apresentaram-se com idade entre 30 a 39 anos (47,4%), brancas (86%), ensino médio completo (52,6%), casadas (89,5%), exercendo atividade profissional remunerada (36,9%), iniciou o acompanhamento no segundo trimestre de gestação (56,3%) e com obesidade (87,5%). O carboidrato e o sódio tiveram um consumo significativamente superior e o cálcio e potássio, significativamente inferior ao recomendado, enquanto que proteína e lipídio atenderam à recomendação. Discussão: A faixa etária das gestantes e o consumo de sódio acima do recomendado podem ter contribuído para o diagnóstico de hipertensão gestacional. Enquanto o estado nutricional pré-gestacional de obesidade, que também configura fator de risco gestacional, parece ser resultado do consumo de carboidratos acima do recomendado. Não houve relação entre os valores pressóricos e o consumo de sódio, possivelmente pelo fato de as pacientes já estarem medicadas para tal. Conclusão: A maioria das gestantes apresentavam-se na faixa etária de risco, eram da raça branca, com ensino médio completo, casada ou em união estável, iniciou o acompanhamento nutricional no segundo trimestre de gestação e encontrava-se com diagnóstico de estado nutricional pré-gestacional de obesidade. Não observou-se associação significativa entre a faixa de idade, etnia, estado civil, escolaridade e atividade laboral com o estado nutricional. O consumo de carboidrato e sódio foi significativamente superior, e o de cálcio e potássio significativamente inferior ao recomendado

Introducción: La hipertensión en la gestación es un problema de salud pública y existen diversos factores que están relacionados con su incidencia, tales como factores sociodemográficos, dietéticos y el estado nutricional. Objetivo: Determinar y relacionar el perfil sociodemográfico, clínico y el estado nutricional de un grupo de gestantes hipertensas con la ingesta dietética. Métodos: Se trata de una investigación transversal y cuantitativa con datos recogidos a partir de 96 historias clínicas de gestantes con hipertensión arterial atendidas en un centro de salud de atención a las Gestantes de Alto Riesgo del interior de Rio Grande del Sur, durante el periodo de 2014 a 2016. Fueron recogidos datos sociodemográficos, clínicos, del estado nutricional y de consumo dietético, lo que fue evaluado a partir de un Cuestionario de Recuerdo de Consumo de Alimentos de 24 horas. El análisis estadístico de los datos recogidos se desarrolló a través del programa Statistical Package for the Social Scienses (SPSS), versión 22.0, considerando un nivel de significación máximo de 5% (p≤0,05). Resultados: La mayoría de las gestantes atendidas presentaban una edad comprendida entre los 30 y 39 años (47,4%), eran blancas (86%), con educación secundaria completa (52,6%), casadas (89,5%), con actividad laboral remunerada (36,9%), iniciaron el seguimiento de la gestación en el segundo trimestre (56,3%) y padecían obesidad pregestacional (87,5%). Los carbohidratos y el sodio presentaron un consumo significativamente superior y el calcio y el potasio significativamente inferior al recomendado, las proteínas y los lípidos tuvieron ingestas adecuadas a las recomendaciones. Discusión: el rango de edad de las gestantes y el consumo de sodio por encima del recomendado pueden estar relacionados con el diagnóstico de hipertensión arterial. La prevalencia de obesidad pregestacional, además de ser un factor de riesgo para la hipertensión está relacionado también con una alta ingesta de carbohidratos. No hubo relación entre las cifras de tensión arterial y el consumo de sodio, posiblemente por el hecho de que las pacientes ya estaban medicadas para ello. Conclusiones: La mayoría de las gestantes se encontraban en el rango de edad de riesgo, eran de color blanco, con educación secundaria completa, casadas, con seguimiento desde el segundo trimestre de gestación y con obesidad pregestacional. No se observó una asociación significativa entre el rango de edad, etnia, estado civil, escolaridad y actividad laboral con el estado nutricional. El consumo de carbohidratos y sodio fue significativamente superior, mientras que el de calcio y potasio significativamente inferior al recomendado

Introduction: Hypertension in pregnancy is considered a public health problem and several factors are involved in its occurrence, such as those related to sociodemographic, dietary conditions and nutritional status.Objective: To determine and relate the sociodemographic, clinical profile and nutritional status of hypertensive pregnant women with dietary intake. Methods: This is a cross-sectional and quantitative survey with data collected from 96 charts of hypertensive pregnant women attended at a High Risk Pregnancy Clinic in the interior of Rio Grande do Sul, during the period 2014 to 2016. Sociodemographic data, clinical status, nutritional status, and dietary intake, which were evaluated from the 24-hour food recall. Statistical analysis of the data was performed using the Statistical Package for the Social Sciences (SPSS), version 22.0, considering a maximum significance level of 5% (p≤0.05). Results: Most of the pregnant women attended were aged between 30 and 39 years (47.4%), white (86%), with high school (52.6%), married (89.5%) and paid work activity (36.9%), followed up in the second trimester of gestation (56.3%) and with obesity (87.5%). Carbohydrate and sodium had a significantly higher intake and calcium and potassium, significantly lower than recommended, while protein and lipid met the recommendation. Discussion: The age range of pregnant women and sodium intake above the recommended level may have contributed to the diagnosis of gestational hypertension. While the pre-gestational nutritional status of obesity, which also configures gestational risk factor, appears to be a result of carbohydrate consumption above the recommended level. There was no relationship between blood pressure values and sodium consumption, possibly because the patients were already medicated for this purpose. Conclusion: Most of the pregnant women were in the age range risk, were of the white ethnicity, with full secondary education, married or in a stable union, started the nutritional monitoring in the second trimester of gestation and was diagnosed with pre-nutritional status of obesity. There was no significant association between age, ethnicity, marital status, schooling and work activity with nutritional status. The consumption of carbohydrate and sodium was significantly higher, and calcium and potassium significantly lower than that recommended

Factors associated to maternal and child's health in Rio Grande do Sul, Brazil / Fatores associados à saúde materno-infantil no Rio Grande do Sul, Brasil

Abstract Objectives: to analyze the factors associated to maternal and child's health from the Live Births Information System (Sinasc) in Rio Grande do Sul, 2012. Methods: a cross-sectional ecological study with analysis on Sinasc variables from 19 Regional Health Coordinations in Rio Grande do Sul. The variables occurrence frequencies were calculated and analyzed by Spearman correlation. Results: we observed that a higher maternal level of education, the presence of a partner and the adequate number of prenatal consultations reduced the frequency of vaginal delivery, as for the proportion of cesarean section, it was 62%. The frequency of low schooling was associated to prematurity (rho = 0.521, p=0.022) and low birth weight (rho = 0.542, p=0.016). The low prenatal coverage correlated positively with the Apgar score ≤ 7 in the 5th minute (rho = 0.467; p=0.044) and negatively with adequate birth weight (rho = -0.500; p=0.029). Conclusions: this study allows to identify factors associated to maternal and child's health contributing information to the development of actions that qualifies pregnant women's healthcare.

Resumo Objetivos: analisar os fatores associados à saúde materno-infantil a partir do Sistema de Informações sobre Nascidos Vivos (Sinasc), no Rio Grande do Sul, 2012. Métodos: estudo ecológico transversal com análise das variáveis do Sinasc das 19 Coordenadorias Regionais de Saúde, do Rio Grande do Sul. Foram calculadas as frequências de ocorrência das variáveis e analisadas por correlação de Spearman. Resultados: observou-se que a maior escolaridade materna, a presença de companheiro e o número adequado de consultas no pré-natal reduzem a frequência de parto vaginal, sendo a proporção de cesarianas de 62%. A frequência de baixa escolaridade se mostrou associada à prematuridade (rho= 0,521; p=0,022) e ao baixo peso ao nascer (rho = 0,542; p=0,016). A baixa cobertura de pré-natal correlacionou-se positivamente com o Apgar ≤ 7 no 5º minuto (rho = 0,467; p=0,044) e negativamente com o peso adequado ao nascer (rho = -0,500; p=0,029). Conclusões: o estudo permite a identificação dos fatores associados à saúde materno-infantil contribuindo com informações para o desenvolvimento de ações que qualifiquem a atenção à saúde das gestantes.

[Epidemiological profile of maternal deaths in Rio Grande do Sul, Brazil: 2004-2007]. / Perfil epidemiológico das mortes maternas ocorridas no Rio Grande do Sul, Brasil: 2004-2007.

This study analyzed the epidemiological profile of maternal deaths that occurred from 2004 to 2007 in Rio Grande do Sul, by means of Maternal Mortality Rates and Specific Maternal Mortality Ratio. Data was obtained from the Health Information System database and 323 maternal deaths were identified. In order to analyze indicators, Poisson regression and statistical tests were carried out. A decrease in maternal mortality rates (0.98) was identified, although there was no difference in estimate measures (CI95% 0.87-1.10). Maternal deaths were more frequent in women who were over 40 years old, had low schooling, black skin and no partners. The period of highest risk of maternal death was during pregnancy and birth, and the main direct causes were arterial hypertension and bleeding. Maternal mortality is an important issue to be confronted and reduced, given most maternal deaths could have been avoided.

Discutir saúde e imigração no contexto atual de intensa mobilidade humana / Debating health and migrations in a context of intense human mobility / Discutir sobre salud e inmigración en el contexto actual de intensa movilidad humana

Este artigo aborda as relações entre imigração e saúde no Brasil, partindo de uma abordagem histórica que busca contextualizar o debate no país desde o século XIX até os dias atuais. A problematização dessas relações destaca os desafios das políticas sociais de acolhimento e integração dos imigrantes no mundo globalizado. Por meio da revisão bibliográfica sobre imigração e saúde no contexto brasileiro e internacional, buscamos prioridades que se impõem à saúde coletiva em face da intensa mobilidade humana atual. As desigualdades socioeconômicas marcam a experiência de parte dos imigrantes, expondo estas populações a uma maior vulnerabilidade, adoecimento e menor qualidade de vida. Apontamos a necessária promoção da equidade de acesso à saúde, prevenção contra a discriminação, ampliação das políticas públicas, formação dos profissionais e oferta de serviços adaptados, abordando a temática das migrações como determinante social de saúde.(AU)

This paper discusses the relationship between immigration and health in Brazil, from a historical approach seeking to put in context this debate from the nineteenth century to the present day. These relationships highlight the challenges of social policies of reception and integration of immigrants in a globalized world. Through literature review on immigration and health both in the Brazilian and the international context, we seek to reveal essential priorities to public health emerging from the present intense human mobility. Socioeconomic inequalities are the hallmark of the immigrants' experience, exposing these populations to greater vulnerability, illness and a reducing their quality of life. We conclude on the much needed promotion of equitable access to health, discrimination prevention, expansion of public policies, adequate training of professionals and offering services that are fitted to migrants, from the point of view of migration as a social determinant of health.(AU)

Este artículo aborda las relaciones entre inmigración y salud en Brasil, partiendo de un abordaje histórico que busca la contextualización del debate en el país desde el siglo XIX hasta los días actuales. La problematización de esas relaciones subraya los desafíos de las políticas sociales de acogida e integración de los inmigrantes en el mundo globalizado. Por medio de la revisión bibliográfica sobre inmigración y salud en el contexto brasileño e internacional, buscamos prioridades que se imponen a la salud colectiva frente a la intensa movilidad humana actual. Las desigualdades socio-económicas marcan la experiencia por parte de los inmigrantes, exponiendo a esas poblaciones a una mayor vulnerabilidad, enfermedad y menor calidad de vida. Señalamos la necesaria promoción de la equidad de acceso a la salud, prevención contra la discriminación, ampliación de las políticas públicas, formación de los profesionales y oferta de servicios adaptados, abordando la temática de las migraciones como factor determinante social de salud.(AU)

Avaliação da Atenção Primária à Saúde utilizando o Instrumento PCATool-Brasil / Evaluation of Primary Health Care using the PCATool-Brazil Instrument / Evaluación de Atención Primaria de Salud utilizando el Instrumento PCATool-Brasil

Introdução: A avaliação dos serviços é relevante, uma vez que permite o planejamento das ações em saúde. Objetivo: O presente estudo tem como objetivo avaliar a Atenção Primária à Saúde com o uso do instrumento PCATool-Brasil (versão profissionais da saúde), aplicado às equipes de atenção básica do município de Lajeado, sede da 16ª Coordenadoria Regional da Saúde do Rio Grande do Sul. Métodos: Realizou-se um estudo transversal com 54 profissionais lotados nas unidades básicas de saúde, que responderam ao instrumento PCATool-Brasil. Resultados: O Escore Geral, mensurado pela média do Escore Essencial e do Escore Derivado, superou o ponte de corte de 6,6. A média do Escore Essencial foi de 6,66, enquanto a média do Escore Derivado foi de 7,60. Conclusão: As equipes possuem, de maneira geral, alto grau de orientação à Atenção Primária à Saúde, embora dois atributos essenciais possuam indicadores que necessitam ser melhorados.

Introduction: The evaluation of services is relevant, since it allows the planning of health care actions. Objective: This study aims to evaluate Primary Attention to Health Care through the PCATool - Brazil (professional health version) instrument, applied to primary health care teams of the municipality of Lajeado, headquarters of the 16th Regional Health Coordination of Rio Grande do Sul. Methods: A cross-sectional study was carried out with 54 professionals in the basic health care units, who answered the PCATool instrument - Brazil. Results: The General Score, measured through the average of the Essential Score and the Derived Score, exceeded the cut-off point of 6.6. The average score for the Essential Score was 6.66, while the average for the Derived Score was 7.60. Conclusion: In general, the teams have a high degree of orientation towards Primary Attention to Health Care, although two essential attributes have indicators that need to be improved.

Introducción: La evaluación de los servicios es relevante, ya que permite la planificación de acciones de salud. Objetivo: Este estudio tiene como objetivo evaluar la Atención Primaria de Salud a través del instrumento PCATool-Brasil (versión profesional de la salud) aplicada a los equipos de cuidados primarios de Lajeado, sede de la 16ª Coordinación Regional de Salud de Rio Grande do Sul. Métodos: Se realizó un estudio transversal con 54 profesionales que trabajan en unidades básicas de salud, que respondieron al instrumento PCATool-Brasil. Resultados: La puntuación global excedió el punto de corte de 6,6. La puntuación de los atributos esencial fue de 6,66, mientras que la puntuación promedio de los atributos derivados fue de 7,60. Conclusión: En general, los equipos tienen un alto grado de orientación a la atención primaria de salud, aunque dos atributos esenciales tienen indicadores que deben ser mejorados.

Características da equipe de atendimento pré-hospitalar no interior do Rio Grande do Sul / Characteristics of a pre-hospital care team in the state of Rio Grande do Sul / Características del personal de atención pre-hospitalia en el interior del estado de Rio Grande do Sul

O objetivo foi caracterizar a equipe de atendimento pré-hospitalar no interior do Rio Grande do Sul. O estudo foi exploratório-descritivo,quantitativo, do qual participaram 44 profissionais de saúde que atuam em serviço pré-hospitalar. Foi utilizado instrumento estruturado quedeu origem ao banco de dados em planilha Excel e análises estatísticas no software SPSS. Evidenciou-se que a maioria são homens, acima de 36anos e técnicos em enfermagem, seguido de médicos e enfermeiros. A maioria dos entrevistados (43,2%) sente-se motivada pela área de atuação,40,9% pela questão salarial e 86,4% estão satisfeitos. A maior parte dos entrevistados conhece o protocolo utilizado na empresa e reconhece ascomplicações de um cuidado mal-assistido, na dúvida (97,7%) questiona o colega, pois reconhece as complicações éticas. O atendimento deprofissionais capacitados e integrados resultará na qualidade do atendimento pré-hospitalar, influenciando positivamente na diminuição decomplicações de um cuidado primário mal-assistido.

The study objective was to characterize a pre-hospital care team in the state of Rio Grande do Sul. It is an exploratory descriptive quantitativeresearch. Forty-four health professionals working in pre-hospital care participated in the study. A data basis originated from a structured tool;the statistical analysis used SPSS software. The majority of the study subjects were male nursing technicians, doctors and nurses over 36 years ofage. Most respondents (43.2%) felt motivated by their respective specialty; 40.9% were interested in the salary; 86.4% were satisfied. The majorityof respondents knew the company’s protocol and were aware of the ethical complications of a poor service; when in doubt 97.7% asked forcolleagues’ help. Health care provided by qualified professionals contributes to the quality of pre-hospital care, influencing positively the reductionof complications of inadequate primary care.

El objetivo del presente trabajo fue caracterizar el personal de atención pre-hospitalaria del interior del Estado de Rio Grande do Sul. Se tratade un estudio exploratorio, descriptivo, cuantitativo en el cual participaron 44 profesionales de la salud del servicio pre-hospitalario. A travésde un instrumento estructurado fue elaborado un banco de datos en planilla Excel y análisis estadísticas en el software SPSS. Se observó que lamayoría del personal eran varones mayores de 36 años técnicos de enfermería, después de médicos y enfermeros. La mayoría de los encuestados,el 43,2% se sentía motivado por el área de práctica, el 40,9% por el tema salarial y el 86,4% se decían satisfechos. Casi todos conocían el protocolode la empresa, y estaban al tanto de las complicaciones de la atención deficiente; ante la duda el 97,7% recurría a un colega, ya que conocía lascomplicaciones éticas. Con la atención de profesionales capacitados e integrados se podrá lograr mejorar la calidad de la atención pre-hospitalariay que disminuyan las complicaciones provocadas por una atención primaria poco eficiente.