Brazilian immigrant fathers' perspectives on child's eating and feeding practices: a qualitative study conducted in the United States.

OBJECTIVES: Brazilians comprise a rapidly growing immigrant Latino group in the USA, yet little research has focused on health issues affecting Brazilian children in immigrant families. As increasing evidence is documenting fathers' influential role in their children's eating behaviours and ultimately weight status, the current study sought to explore the Brazilian immigrant fathers' perspectives and practices related to child's feeding practices and their preschool-aged children's eating. DESIGN: Qualitative study using in-depth, semi-structured interviews. Interviews were conducted in Portuguese by native Brazilian research staff using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed thematically using a hybrid approach that incorporated deductive and inductive analytical approaches. SETTING: Massachusetts. PARTICIPANTS: Twenty-one Brazilian immigrant fathers who had at least one child aged 2-5 years. RESULTS: Results revealed fathers' awareness of the importance of healthy eating for their children, their influence as role models and their involvement in feeding routines of their preschool-aged children. Moreover, fathers were receptive to participating in family interventions to promote their children's healthy eating. Nearly all fathers reported wanting to learn more and to do 'what's right' for their children. CONCLUSIONS: The current study provides new information about Brazilian immigrant fathers' views about factors influencing their children's healthy eating behaviours and paternal feeding practices. Future research should quantify fathers' feeding styles and practices and solicit fathers' input in the design of culturally appropriate family interventions targeting the home environment of preschool-aged children of Brazilian immigrant families.

Alcohol consumption is associated with DXA measurement of adiposity: the Pró-Saúde Study, Brazil.

PURPOSE: Evaluate the association between alcohol consumption and body adiposity. METHODS: We analyzed cross-sectional data from a longitudinal investigation (Pró-Saúde Study), comprising a sample of 514 civil servants of both sexes (35-64 years). Daily alcohol consumption (wine, beer, and other alcoholic drinks) over the previous 6 months was assessed via food frequency questionnaire and categorized as no doses, up to 1 dose, and ≥1 dose. The total body mass, total fat mass (TFM), android fat mass (AFM), and gynoid fat mass (GFM) were measured via dual-energy X-ray absorptiometry. AFM (AFM%) and GFM (GFM%) were expressed as percentages relative to TFM. The ratio of AFM% and GFM% was calculated. Multiple linear regression analyses were performed after adjusting for age, calories not originating from alcohol, leisure-time physical activity and education. RESULTS: Among nondrinkers, 59 % were women, and the age range between 45 and 54 years was predominant (44.3 %); 63.7 % of the nondrinkers were overweight/obese. Among drinkers of 1 dose or more/day, 67 % were males aged between 45 and 54 years (43.7 %); 69.1 % were overweight/obese. Among men, the daily consumption of ≥1 alcohol dose (13 g) was associated with an approximately 2 % (ß = 2.2, IC = 0.077; 4.303) adjusted for age, calories not originated from alcohol, leisure-time physical activity and education, increase in TFM, compared to those who reported no alcohol consumption during the previous 6 months. This association was not observed among women. In both sexes, no associations were observed between alcohol consumption and the other evaluated parameters of adiposity. CONCLUSION: Among men only, daily consumption of ≥1 alcohol dose was associated with increased adiposity, despite the relatively low average alcohol consumption in this study population.

Characterization and completeness of notification sheet of violence against the older adults in Niterói-RJ, 2011-2020.

OBJECTIVE: to analyze the profile of violence against the elderly and the degree of completeness of event notification forms in Niterói, Rio de Janeiro, Brazil. METHODS: this was a descriptive study having as its data source violence notification forms held on the Notifiable Health Conditions Information System for the period 2011-2020; analysis of form completeness was performed according to criteria proposed by the Ministry of Health. RESULTS: of the 486 registered cases, physical violence was the most reported type of violence (48.1%), followed by psychological violence (22.2%) and self-harm (21.4%); the fields with the highest degree of incompleteness were victim's level of schooling (32.8%) and repeat violence (41.5%). CONCLUSION: despite the increase in notifications in the period, predominantly of physical violence, completeness of some of the form fields continues to be poor, which reinforces the importance of training professionals to improve the reporting process and data quality.

Association Between Interpersonal Violence With Inadequate Nutritional Status Among Brazilian Adolescents.

Research focusing on the relationship between interpersonal violence and nutritional status in adolescence is scarce and has distinct results. The objective of this study is to investigate the association of family physical and sexual violence with inadequate nutritional status in Brazilian adolescents. We used data from the 2015 Brazilian National Survey of School Health. This study includes 11.850 students, older than 13 years, attending from sixth to ninth grade of elementary school and from the 1st to the 3rd year of high school. The exposures were family physical violence and rape. The outcome was nutritional status, assessed through body mass index. The association between exposures and outcome were investigated using a multinomial logistic regression model. These analyses were adjusted for demographic, socioeconomic, and family variables. The prevalence of family physical violence victimization was approximately 14% among adolescents for both sexes. The prevalence of rape was 4.6% and 5.7% among male and female adolescents, respectively. Family physical violence was not associated with being underweight, overweight, or obese, in either crude or adjusted models for both sexes. Sexual violence was inversely associated with being underweight only for male adolescents (OR: 0.21, CI 95%: 0.06-0.75). In female adolescents, sexual violence was associated with overweight/obesity (OR: 1.64, CI 95%:1.15-2.33). In this study, rape, but not family physical violence victimization, was associated with nutritional status in adolescents of both sexes. Nonetheless, this association was different between boys and girls. Rape was inversely associated with being underweight in male adolescents, whereas, in female adolescents, it was associated with excess body weight.

Physical intimate partner violence and dietary patterns in pregnancy: a Brazilian cohort.

Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns ("Healthy", "Common-Brazilian", and "Processed") were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with "Healthy" and "Common-Brazilian" dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.

Maternal common mental disorders and malnutrition in children: a case-control study.

BACKGROUND: Despite improvements in the nutritional status of Brazilian children, child malnutrition remains a public health issue. The objective of the present study was to analyse the effect of maternal common mental disorders (MCMD) on child malnutrition in a large Brazilian urban centre with low rates of child malnutrition. Furthermore, we explored the hypothesis that a reduction in the quality of maternal caregiving mediates the relationship between maternal mental health problems and child nutrition. METHODS: A case-control study including 294 children aged between 0 and 5 years, with 147 cases and 147 age- and sex-matched controls, was conducted in the city of Salvador, northeastern Brazil. Mothers completed the Self-Report Questionnaire (SRQ-20), the family's socio-economic status was evaluated and the Home Observation for Measurement of the Environment (HOME) Inventory was applied. Children were diagnosed as moderately or severely malnourished when the weight-for-height z-score was below -2 SD. Conditional logistic regression was used in the analysis, and the final model was created using the backward technique. RESULTS: MCMD doubled the risk of moderate or severe malnutrition in children (OR = 2.04; 95% CI: 1.10-3.78). Maternal caregiving can be an important factor mediating the relationship between maternal mental health and child malnutrition. CONCLUSION: MCMD must be taken into account in programmes for the treatment and prevention of malnutrition, especially in areas of low malnutrition prevalence.

Intimate partner violence, breastfeeding, breastmilk substitutes and baby bottle use in the first year of life. / Violência entre parceiros íntimos, oferta de leite materno, substitutos e uso de mamadeiras no primeiro ano de vida.

This article aims to investigate the relationship between intimate partner physical violence (IPPV) and breastfeeding (BF), use of breastmilk substitutes (BMS) and bottle-feeding among children aged 12 to 15 months. This is a cross-sectional study with mothers in primary care facilities of the city of Rio de Janeiro. IPPV was identified by the Brazilian version of the Conflict Tactics Scales 1-Form R and feeding practices were identified by a 24-hour Dietary Recall. Associations were verified by logistic regression with odds ratio (OR) estimates and 95% confidence intervals. BF was offered to 58.5% of the children and BMS to 88.5%. Also, 70.5% of the children used a baby bottle. Physical violence was observed in 26.7% of couples. Households where couples physically abuse each other are more likely to not breastfeed (OR=2.14, p-value=0.030), to use breastmilk substitutes (OR=5.15, p-value=0.03) and bottle-feed (OR=2.71; p-value=0.01), when compared to households without physical violence. The results highlight the need to investigate intrafamily relationships in cases where inadequate breastfeeding practices are identified, and to enable health professionals to support families in conflict situations.

O objetivo deste artigo é investigar a relação da violência física entre parceiros íntimos (VFPI) e a oferta de leite materno (LM), os substitutos do leite materno (SLM) e o uso de mamadeiras entre crianças entre 12 e 15 meses. Estudo transversal com mães em unidades de saúde do município do Rio de Janeiro, realizado entre junho de 2005 e dezembro de 2009. A VFPI foi identificada pela versão brasileira da Conflict Tactics Scales 1- Form R e as práticas de alimentação foram identificadas por recordatório de 24 horas. As associações foram verificadas por regressão logística mediante estimativas de razão de chances (RC) e intervalos de confiança de 95%. O leite materno foi ofertado a 58,5% das crianças e os substitutos do leite materno a 88,5%, e 70,5% das crianças usavam mamadeira. A violência física foi observada em 26,7% dos casais. Em lares onde os casais se agridem fisicamente há uma maior chance de não ofertar leite materno, maior chance de ofertar substitutos do leite materno e de usar mamadeira comparado aos lares onde não existe violência física. Os resultados chamam atenção para a necessidade de se investigar as relações intrafamiliares em casos que são identificadas práticas inadequadas de aleitamento, e de capacitar os profissionais de saúde para apoiar as famílias em situações de conflito.

Faith, Family, and Social Networks: Effective Strategies for Recruiting Brazilian Immigrants in Maternal and Child Health Research.

Participation of racial/ethnic minority and immigrant populations in research studies is essential to understand and address health disparities. Nonetheless, these populations are often underrepresented in research because of limited participation that may be due to barriers to participation such as fear and mistrust of research, lack of or limited access to healthcare and social services, time and employment constraints, participation-associated costs (e.g., travel costs), language barriers, undocumented status, and cultural differences. Brazilians comprise a rapidly growing immigrant population group in the United States (US), and there is a need to identify and understand factors affecting the health status of Brazilian immigrants that are amenable to intervention. Therefore, this paper presents effective strategies and lessons learned from outreach and recruiting Brazilian immigrants living in the US to enroll in maternal and child health research studies. Using a data recruitment log, we collected quantitative and qualitative data on recruitment strategies that were employed to recruit pregnant women and parents into six health research studies. Direct recruitment strategies included personal contacts of research staff and recruiting partners, and on-site, in-person outreach and recruitment at faith- and community-based events (e.g., meeting participants after church services, at faith-based community events), and private and social events (e.g., household parties) conducted by bilingual, bicultural research assistants who were members of the priority population. We also used snowball sampling as a recruitment strategy by asking enrolled participants to share information about our studies and encourage their family and friends to participate. Indirect recruitment methods included posting flyers at local businesses, social service agencies, faith-based and healthcare organizations, and posting announcements on social media (Facebook). Direct recruitment methods in combination with snowball sampling were the most successful strategies for recruiting Brazilian immigrant parents, while social media was an effective indirect method for recruiting first-time pregnant women. In addition, analyses of qualitative data found that research staff's understanding of the sociocultural context of the target population combined with the use of linguistically and culturally sensitive recruitment strategies tailored to meet the needs of Brazilian immigrants was important for overcoming barriers to participation and facilitating successful recruitment and enrollment of participants. Study findings provide information on a suite of effective strategies and lessons learned for reaching, recruiting, and enrolling Brazilian immigrants in maternal and child health research. Future studies should continue to purposefully collect information on recruitment strategies and disseminate the findings, which will be instrumental in researchers' efforts to increase participation of ethnic minority and immigrant populations such as Brazilians in health research.

Cross-Cultural Adaptation of the Brazilian Portuguese Version of the Caregiver's Feeding Styles Questionnaire.

The present study describes the cross-cultural adaptation of the Brazilian version (Rio de Janeiro) of the Caregiver's Feeding Styles Questionnaire (CFSQ) among caregivers of children aged 3 to 6 years enrolled in a family health service in Rio de Janeiro, Brazil. The cross-cultural adaptation process included the following phases: (1) literature review; (2) translation and back-translation of the instrument; (3) assessment of semantic equivalence through cognitive interviews with caregivers; (4) discussion with experts; (5) pretesting of the revised version; and (6) assessment of psychometric characteristics, including reliability and validity of the scale. Results showed the appropriateness of the caregiver's feeding styles concept within the Brazilian culture and that the instrument was understandable to caregivers enrolled in a family health service. The CFSQ measurements showed perfect intra-observer reliability for "demandingness" and almost perfect for "responsiveness". Inter-observer reliability was almost perfect for both dimensions, "demandingness" and "responsiveness". Factor analysis of the Brazilian CFSQ version proposed an instrument with one dimension and 13 items. The satisfactory results of the cross-cultural adaptation of the CFSQ suggest its applicability in the population of interest with the possible reduction of some scale items.

[Profile of hospital admissions due to acute poisoning among children under 6 years of age in the metropolitan region of Rio de Janeiro, Brazil]. / Intoxicações exógenas em crianças menores de seis anos atendidas em hospitais da região metropolitana do Rio de Janeiro.

OBJECTIVE: To describe the profile of poisoning cases among children attended during three years at emergency hospitals in the metropolitan area of Rio de Janeiro, Brazil. METHODS: All confirmed or suspected poisoning cases, due to drugs and biological substances; organic solvents and hydrocarbons; chemical products; carbon monoxide and other gases; and pesticides, were collected. RESULTS: 1,574 cases of poisoning in children up to 5 years of age were detected. Around 40% of the cases involved chemical products of domestic use, 35% were caused by drugs, and 15% by pesticides. More than half of pesticide poisonings involved the 'chumbinho', an illegal product sold as a rodenticide, and usually including in its formulation a carbamate. Distribution of agents varied significantly by gender, the relative frequency of poisonings due to drugs and 'chumbinho' being higher among females than males. Participation of chemical products of domestic use decreased with age, but the role of drugs increased as agents of poisoning. During the observation period there was no significant reduction in the total number of annual cases. CONCLUSION: Supporting the expansion of the network of Poison Control Centers, developing intervention for the production of safer packaging devices for drugs chemical products, suppressing the illegal commerce of 'chumbinho', and fostering health education activities might contribute to modify this situation.

[Association between abdominal circumference and hypertension among women: the Pró-Saúde Study]. / Associação entre circunferência abdominal e hipertensão arterial em mulheres: Estudo Pró-Saúde.

This study aimed to estimate the prevalence of hypertension according to levels of abdominal circumference (AC) and body mass index (BMI, expressed as kg/m(2)) among public employees at a university in Rio de Janeiro, Brazil. Cross-sectional data were obtained for 1,743 non-pregnant women aged 24-69 years participating in the Pró-Saúde Study. Underweight women and those with BMI > 35 kg/m(2) were excluded. Hypertension was defined as systolic blood pressure >140 mmHg or diastolic > 90 mmHg or the use of anti-hypertensive drugs. Age-adjusted prevalence rates for hypertension were calculated considering two strata of AC (normal: < 88 cm; high: > 88 cm) and three levels of BMI (normal: 18.5-24.9 kg/m(2); overweight: 25.0-29.9 kg/m(2); and obesity I: 30.0-34.9 kg/m(2)). Among normal-weight women, participants with high AC showed a two-fold higher prevalence of hypertension as compared to those with AC < 88 cm (18% vs. 8%, p < 0.05). Routine measurement of AC, in addition to BMI, could contribute to early identification of hypertension in women.

[Association between domestic maltreatment and excess weight and fat among students of the city/state of Rio de Janeiro, Brazil]. / Associação entre maus-tratos familiares e excesso de peso e de gordura em escolares do município do Rio de Janeiro/RJ, Brasil.

This study sought to investigate the relationship between domestic maltreatment and excess weight, body fat and abdominal fat among adolescents from the public schools in the city of Rio de Janeiro - Brazil. It involved a cross-sectional study using data from the Risk Factor Surveillance System and Protection of Health of Adolescents, held in 2007 by the municipality of Rio de Janeiro. The sample consisted of 1628 students aged 13 to 19 years, of both sexes, in the 9th year of school. Excess weight, body fat and abdominal fat (outcome variables) and domestic maltreatment (physical and verbal aggression) were evaluated. The association between domestic maltreatment and outcome variables was conducted via logistic regression models. Domestic maltreatment showed an inverse relationship to excess weight and fat for girls, but only physical aggression was significantly associated with excess weight (OR = 0.499, CI = 0.212 to 0.951). As for the boys, the results pointed to excess weight and fat but without statistical significance. Health policies must consider the differences between the genders in coping with experiences of violence that may influence the health and well-being of adolescents.

O objetivo deste estudo foi investigar a relação entre maus-tratos na família e excesso de peso, de gordura corporal e de gordura abdominal dos adolescentes da rede pública de ensino de município do Rio de Janeiro ­ Brasil. Trata-se de um estudo transversal que utiliza dados do Sistema de Vigilância de Fatores de Risco e Proteção à Saúde de Adolescentes, realizado em 2007, pelo município do Rio de Janeiro. A amostra foi composta por 1.628 escolares de 13 a 19 anos, de ambos os sexos, cursando o 9˚ ano do ensino fundamental. O excesso de peso, de gordura corporal e de gordura abdominal (desfechos) e os maus-tratos familiares (a agressão física e verbal) foram avaliados. A associação entre os maus-tratos e os desfechos foi realizada via modelos de regressão logística. Os maus-tratos apresentaram uma relação inversa com o excesso de peso e o de gordura para as meninas, mas somente a agressão física se associou significativamente com o excesso de peso (RC = 0,499; IC = 0,212-0,951). Já para os meninos, os resultados apontaram para o excesso de peso e de gordura mas sem significância estatística. Políticas de saúde devem considerar as diferenças existentes entre os gêneros no enfrentamento às experiências de violência que possam influenciar a saúde e o bem-estar do adolescente.

Intimate partner violence and breastfeeding practices: a systematic review of observational studies.

OBJECTIVE: To review the association between intimate partner violence and breastfeeding practices in the literature. DATA SOURCES: The search was carried out in five databases, including MEDLINE, LILACS, SCOPUS, PsycoINFO, and Science Direct. The search strategy was carried out in February 2017. The authors included original studies with observational design, which investigated forms of intimate partner violence (including emotional, physical, and/or sexual) and breastfeeding practices. The quality of the studies was assessed based on the bias susceptibility through criteria specifically developed for this review. SUMMARY OF DATA: The study included 12 original articles (10 cross-sectional, one case-control, and one cohort study) carried out in different countries. The forms of intimate partner violence observed were emotional, physical, and/or sexual. Breastfeeding was investigated by different tools and only assessed children between 2 days and 6 months of life. Of the 12 studies included in this review, eight found a lower breastfeeding intention, breastfeeding initiation, and exclusive breastfeeding during the first six months of the child's life, and a higher likelihood of early termination of exclusive breastfeeding among women living at home where violence was present. The quality varied between the studies and six were classified as having low bias susceptibility based on the assessed items. CONCLUSIONS: Intimate partner violence is associated with inadequate breastfeeding practices of children aged 2 days to 6 months of life.

Intimate partner physical violence and inadequate weight gain in pregnancy / Violência física entre parceiros íntimos e ganho de peso inadequado durante a gestação

Abstract Objectives: to evaluate the association between intimate partner physical violence (IPPV) and inadequate gestational weight gain (GWG). Methods: cross-sectional study composed of 554 women who attended four Basic Health Units in the city of Rio de Janeiro between 2005 and 2009. The GWG was calculated through the difference between the final weight of pregnancy and pre-gestational weight. For the measurement of IPPV, the Portuguese version of the Conflict Tactics Scales (CTS-1) was used. Data analysis was based on multinomial logistic regression models, estimating odds ratios and respective 95% confidence intervals for associations between the variables of interest. Results: the prevalence of minor and severe IPPV was 31.6% and 16.3%, respectively. Almost two-thirds of the women had insufficient or excessive GWG. After adjusting the model, it was observed that the presence of IPPV increased by 1.66 (CI95%=1.05-2.64) times the chances of insufficient GWG, compared to couples who did not experience this type of violence. Concerning the excessive GWG, the associations with IPPV were not statistically significant. Conclusion: women who experience IPPV in their relationships are more likely to have insufficient GWG during pregnancy. From this perspective, prenatal care becomes an essential service for screening domestic violence and its possible repercussions.

Resumo Objetivos: avaliar a associação entre violência física entre parceiros íntimos (VFPI) e o ganho de peso gestacional (GPG) inadequado. Métodos: estudo seccional composto por 554 mulheres que compareceram a quatro Unidades Básicas de Saúde do município do Rio de Janeiro, entre 2005 e 2009. O GPG foi calculado através da diferença entre o peso final da gestação e o peso pré-gestacional. Para a mensuração da VFPI foi utilizada a versão em português da Conflict Tactics Scales (CTS-1). A análise dos dados se baseou em modelos de regressão logística multinomial, estimando-se razões de chance e respectivos intervalos de 95% de confiança para as associações entre as variáveis de interesse. Resultados: a prevalência de VFPI menor e grave foi 31,6% e 16,3%, respectivamente. Quase dois terços das mulheres apresentaram GPG insuficiente ou excessivo. Após o ajuste do modelo, observou-se que a presença de VFPI aumentou em 1,66 (IC95%=1,05-2,64) vezes as chances de GPG insuficiente, em comparação aos casais que não vivenciaram este tipo de violência. Em relação ao GPG excessivo as associações com VFPI não foram estatisticamente significantes. Conclusões: mulheres que vivenciam a VFPI têm maiores chances de apresentarem GPG insuficiente. Nessa perspectiva, o pré-natal passa a ser um serviço fundamental para o rastreamento de violência doméstica e suas possíveis repercussões.

Caracterização e completitude das fichas de notificação de violência contra a pessoa idosa em Niterói-RJ, 2011-2020 / Caracterización y completitud de las fichas de notificación de violencia contra las personas mayores en Niterói-RJ, 2011-2020 / Characterization and completeness of notification sheet of violence against the older adults in Niterói-RJ, 2011-2020

Objetivo: analisar o perfil da violência contra a pessoa idosa e o grau de completitude das fichas de notificação do evento em Niterói, Rio de Janeiro, Brasil. Métodos: estudo descritivo, utilizando como fonte de dados as fichas de notificação de violência obtidas do Sistema de Informação de Agravos de Notificação, 2011-2020; a análise da completitude realizou-se segundo critérios propostos pelo Ministério da Saúde. Resultados: dos 486 casos registrados, o tipo de violência mais notificada foi a violência física (48,1%), seguida das violências psicológica (22,2%) e autoprovocada (21,4%); os campos com maior grau de incompletitude corresponderam à escolaridade da vítima (32,8%) e à violência de repetição (41,5%). Conclusão: apesar do aumento das notificações no período, predominantemente de violência física, alguns campos importantes das fichas persistem com baixa completitude, o que reforça a importância do treinamento dos profissionais visando melhorar o processo de notificação e a qualidade dos dados.

Objetivo: Analizar el perfil de la violencia contra los ancianos y el grado de integridad de los formularios de notificación de eventos en Niterói, Rio de Janeiro, Brasil. Métodos: estudio descriptivo con fuente de datos las fichas de notificación de violencia obtenidas en Sistema de Información de Agravios de Notificación, 2011-2020; análisis de la exhaustividad se realizó según criterios propuestos por el Ministerio de Sanidad. Resultados: De 486 casos registrados, el tipo de violencia más notificado fue física (48,1%), seguida psicológica (22,2%) y autolesión (21,4%); campos con mayor grado de incompletitud fueron: educación de la víctima (32,8%) y reincidencia en la violencia (41,5%). Conclusiones: A pesar del aumento de notificaciones en el periodo, predominantemente violencia física, persisten algunos campos importantes con baja completitud, lo que refuerza la importancia de la capacitación de los profesionales para mejorar el proceso de notificación y la calidad de los datos.

Objective: to analyze the profile of violence against the elderly and the degree of completeness of event notification forms in Niterói, Rio de Janeiro, Brazil. Methods: this was a descriptive study having as its data source violence notification forms held on the Notifiable Health Conditions Information System for the period 2011-2020; analysis of form completeness was performed according to criteria proposed by the Ministry of Health. Results: of the 486 registered cases, physical violence was the most reported type of violence (48.1%), followed by psychological violence (22.2%) and self-harm (21.4%); the fields with the highest degree of incompleteness were victim's level of schooling (32.8%) and repeat violence (41.5%). Conclusion: despite the increase in notifications in the period, predominantly of physical violence, completeness of some of the form fields continues to be poor, which reinforces the importance of training professionals to improve the reporting process and data quality.

Physical intimate partner violence and dietary patterns in pregnancy: a Brazilian cohort / Violência física por parceiro íntimo e padrão de alimentação na gestação: uma coorte brasileira

Abstract Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns ("Healthy", "Common-Brazilian", and "Processed") were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with "Healthy" and "Common-Brazilian" dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.

Resumo Pouco se sabe sobre as repercussões da violência por parceiro íntimo (VPI) nos desfechos nutricionais da gravidez, principalmente no que diz respeito à dieta. O objetivo foi investigar se a ocorrência de VPI física na gestação está associada aos padrões alimentares gestacionais. 161 gestantes adultas participaram de um estudo prospectivo no Rio de Janeiro, Brasil. A VPI física geral e grave foi medida para avaliar a VPI a qualquer momento durante a gravidez. Três padrões alimentares gestacionais ("Saudável", "Brasileiro Comum" e "Processado") foram estabelecidos pela análise de componentes principais. O efeito da VPI física foi testado em relação ao escore de adesão a cada um dos padrões alimentares. A ocorrência de VPI física geral e grave em qualquer momento da gestação foi de 20,4% e 6,8%, respectivamente. Mulheres que viviam em relacionamentos íntimos em que ocorreu VPI física geral e grave tiveram um aumento médio de 0,604 unidades (IC95% 0,149-1,058) e 1,347 unidades (IC95% 0,670-2,024), respectivamente, no escore de adesão ao padrão alimentar processado. Não foi observada associação com os padrões alimentares "Saudável" e "Brasileiro Comum". A VPI física foi associada à maior adesão a um padrão alimentar de menor qualidade nutricional na gestação.

[Suicide attempts recorded at a general hospital in Rio de Janeiro, Brazil]. / Tentativas de suicídio em um hospital geral no Rio de Janeiro, Brasil.

Previous suicide attempts are an important predictor of both repeated attempts and suicide. This paper presents the profile of patients who had attempted suicide and were admitted to a general hospital in Rio de Janeiro, Brazil. From April 2001 to March 2002, 160 suicide attempts were recorded (68% women; 26% adolescents). Ingestion of pesticides and prescription drugs were the two most common methods used. The two methods had been used by similar numbers of women, while two-thirds of men had used pesticides. As for prevalence of factors associated with attempted suicide, 21% of patients had been in contact with health services within 30 days prior to the event, 28% mentioned previous suicide attempts, and 23% reported other cases of suicide or attempts in the family. Despite the limited data in Brazil, suicide attempts appear to be an important health problem, particularly among youth. Surveillance systems for suicide attempts could help expand knowledge on this problem.

The magnitude of intimate partner violence in Brazil: portraits from 15 capital cities and the Federal District.

This paper concerns the prevalence of intimate partner violence in 15 State capital cities and the Federal District of Brazil. A population-based multi-stage survey in 2002/2003 involved 6,760 15-69-year-old women (respondents). Using the Conflict Tactics Scales--Form R, the overall prevalence of psychological aggression and "minor" and severe physical abuse within couples was 78.3%, 21.5%, and 12.9%, respectively. Prevalence rates varied distinctively between cities. For instance, total physical abuse ranged from 13.2% to 34.8%. On the whole, prevalence was higher in the North and Northeast cities than in the Southeast, South, and Central West. Also, all types of intimate partner violence were more frequent in couples including women who were younger (< 25 years) and had less schooling (< 8 years). After stratifying by gender, although women tended to perpetrate at least one act of physical abuse more often, scores were consistently higher among male partners who were perpetrators. The results are compared to international findings. Regional, demographic, and gender differentials are discussed in light of the growing role of the Brazilian health sector in relation to intimate partner violence.

Maternal mental health and nutritional status of six-month-old infants.

OBJECTIVE: To analyze if maternal mental health is associated with infant nutritional status at six month of age. METHODS: A cross-sectional study with 228 six-month-old infants who used primary health care units of the city of Rio de Janeiro, Southeastern Brazil. Mean weight-for-length and mean weight-for-age were expressed in z-scores considering the 2006 World Health Organization reference curves. Maternal mental health was measured by the 12-item General Health Questionnaire. The following cutoff points were used: ≥ 3 for common mental disorders, ≥ 5 for more severe mental disorders, and ≥ 9 for depression. The statistical analysis employed adjusted linear regression models. RESULTS: The prevalence of common mental disorders, more severe mental disorders and depression was 39.9%, 23.7%, and 8.3%, respectively. Children of women with more severe mental disorders had, on average, a weight-for-length 0.37 z-scores lower than children of women without this health harm (p = 0.026). We also observed that the weight-for-length indicator of children of depressed mothers was, on average, 0.67 z-scores lower than that of children of nondepressed women (p = 0.010). Maternal depression was associated with lower mean values of weight-for-age z-scores (p = 0.041). CONCLUSIONS: Maternal mental health is positively related to the inadequacy of the nutritional status of infants at six months.

Intimate partner violence and early interruption of exclusive breastfeeding in the first three months of life.

The aim of this study was to investigate the role of intimate partner violence in the early interruption of exclusive breastfeeding in the first three months of life. We used data from a prospective cohort of 564 children attending four primary health clinics in Rio de Janeiro, Brazil. Interruption of exclusive breastfeeding was defined as a child receiving any kind of liquid or solid, regardless of breast milk intake, measured by a 24 hour recall. The Portuguese version of the Conflict Tactics Scales (CTS-1) was used to assess intimate partner violence. Associations were expressed as prevalence ratios and relative risks and their respective 95% confidence intervals. Children of mothers who experienced severe violence had 30% greater likelihood of early interruption of exclusive breastfeeding in the second month of life as compared to those who did not experience this type of violence. Strategies in health services for promoting exclusive breastfeeding should consider identifying and addressing family violence.