Maternal and neonatal factors related to prematurity.

OBJECTIVE: To identify maternal and neonatal factors associated with prematurity in the municipality of Porto Alegre. METHOD: This was a population-based case-control study. The cases were newborns under 37 weeks of gestation and the controls were newborns over 37 weeks. The data came from the records of 19,457 births in the city of Porto Alegre in the year 2012 from the Information System on Live Births of the Municipal Health Department. The analysis was carried outand adjusted by a Logistic Regression according to a hierarchical model. The variables studied were allocated into three hierarchy levels: sociodemographic variables; reproductive history; and gestational and birth factors. RESULTS: There were 767 cases allocated and 1,534 controls in a design of a case for two controls (1:2) by simple randomization. In the final model, a statistically significant association was found for prematurity for the following variables: mother's age under 19 years old (OR=1.32; CI 95%: 1.02-1.71) or over 34 years old (OR=1.39; CI 95%: 1.12-1.72); inadequate maternal schooling for age (OR=2.11; CI 95%: 1.22-3.65); multiple pregnancies (OR=1.14; CI 95%: 1.01-1.29); C-section (OR=1.15; CI 95%: 1.03-1.29); birth weights under 2,500g (OR=4.04; CI 95%: 3.64-4.49); Apgar score at five minutes between zero and three (OR=1.47; CI 95%: 1.12-1.91); and inadequate prenatal care (OR=1.18; CI 95%: 1.02-1.36). CONCLUSION: The present study showed the most immediate consequence of prematurity for newborns by evidencing its association with worse Apgar scores and low birth weight. The following factors were also shown as possible more distal determinants of prematurity: mother's age; inadequate maternal education; multiple gestation; inadequate prenatal care; and C-section. OBJETIVO: Identificar fatores maternos e neonatais associados à prematuridade no município de Porto Alegre. MÉTODO: Estudo do tipo caso-controle de base populacional. Os casos foram recém-nascidos com menos de 37 semanas de gestação, e os controles foram os recém-nascidos com 37 semanas ou mais. Os dados provieram dos registros de 19.457 nascimentos do município de Porto Alegre, no ano de 2012, no Sistema de Informações sobre Nascidos Vivos da Secretaria Municipal da Saúde. Foi realizada análise ajustada mediante Regressão Logística segundo modelo hierárquico. As variáveis estudadas foram alocadas em três níveis de hierarquia: variáveis sociodemográficas; história reprodutiva; fatores gestacionais e de nascimento. RESULTADOS: Foram alocados 767 casos e 1.534 controles, em um desenho de um caso para dois controles (1:2), mediante randomização simples. No modelo final, foi encontrada associação estatisticamente significante para prematuridade para as seguintes variáveis: idade materna menor que 19 anos (OR=1,32; IC 95%: 1,02 - 1,71) e maior que 34 anos (OR=1,39; IC 95%: 1,12 - 1,72); escolaridade materna inadequada para a idade (OR=2,11; IC 95%: 1,22 - 3,65); gravidez múltipla (OR=1,14; IC 95%: 1,01 - 1,29); cesariana (OR=1,15; IC 95%: 1,03 - 1,29); peso ao nascer menor a 2.500g (OR=4,04; IC 95%: 3,64 - 4,49); Índice de Apgar no 5° minuto de zero a três (OR=1,47; IC 95%: 1,12 - 1,91) e pré-natal inadequado (OR=1,18; IC 95%: 1,02 - 1,36). CONCLUSÃO: O presente estudo evidenciou as consequências mais imediatas da prematuridade para os recém-nascidos ao revelar sua associação com piores escores de Apgar e baixo peso ao nascimento. Mostrou como possíveis determinantes mais distais de prematuridade: idade materna, educação materna inadequada, gestação múltipla, pré-natal inadequado e realização de cesariana.

Trends in hospital admissions and mortality from diabetes mellitus in Rio Grande do Sul: historical series 2000-2020.

OBJECTIVE: To analyze the trends of hospital admissions and deaths from diabetes mellitus in the 18 host municipalities of the 19 regional health coordination offices and in Rio Grande do Sul, 2000-2020. METHOD: Ecological study with secondary data collected in the Hospital Information System, the Mortality Information System, and the Brazilian Institute of Geography and Statistics, from 2000-2020. Coefficients were standardized using the direct method and Prais-Winsten regression analysis. RESULTS: A downward trend wasfound in the coefficients of hospitalizations for diabetes mellitus in most cities and states. In 2020, for both areas, hospitalizations for diabetes mellitus were below the average of the period. The mortality trend remained stationary in almost all municipalities and in the state. CONCLUSION: There was evidence of a decrease in hospitalizations and stationary mortality by DM in most municipalities analyzed, possibly due to the policies and actions implemented in the period, despite the aging of the population.

Association between social capital and food patterns in women from Southern Brazil. / Associação entre capital social e padrões alimentares em mulheres do Sul do Brasil.

The present study aimed to verify the association between psychosocial aspects (social capital) and food patterns in adult women. A cross-sectional, population-based study was conducted with a representative sample of 1,128 women, aged 20 to 69 years, living in the urban area of the municipality of São Leopoldo, Rio Grande do Sul, Brazil, in 2015. The food patterns were identified based on the frequency of food intake and classified as: healthy (fruits, vegetables, and whole foods), at-risk (ultraprocessed foods), and Brazilian (rice and beans), while social capital was evaluated using a collective efficacy scale. It was observed that 18.9% of the sample was classified with high collective efficacy. After adjusting for potential confounding factors, a 44% higher probability was observed for adherence to the healthy pattern (PR [prevalence ratio] = 1.44; 95%CI [95% confidence interval]: 1.01-2.03; p = 0.040) and 71% higher for the Brazilian pattern (PR = 1.71; 95%CI: 1.18-2.47; p= 0.004) among women with a higher level of collective efficacy, when compared to those with a low level of collective efficacy. Thus, this study verified a significant relationship between psychosocial aspects and food intake in women.

O presente estudo objetivou verificar a associação entre aspectos psicossociais (capital social) e padrões alimentares em mulheres adultas. Realizou-se um estudo transversal, de base populacional, com uma amostra representativa de 1.128 mulheres, de 20 a 69 anos de idade, residentes na área urbana do município de São Leopoldo, Rio Grande do Sul, em 2015. Os padrões alimentares foram identificados com base na frequência de consumo alimentar e classificados em: saudável (frutas, vegetais e alimentos integrais), de risco (alimentos ultraprocessados) e brasileiro (arroz e feijão), enquanto o capital social foi avaliado por meio de uma escala de eficácia coletiva. Observou-se que 18,9% da amostra foi classificada com alta eficácia coletiva. Após ajuste para potenciais fatores de confusão, observou-se uma probabilidade 44% maior para adesão ao padrão saudável (RP [razão de prevalência] = 1,44; IC95% [intervalo de confiança de 95%]: 1,01-2,03; p = 0,040) e 71% maior para o padrão brasileiro (RP = 1,71; IC95%: 1,18-2,47; p = 0,004) entre as mulheres com um maior nível de eficácia coletiva, quando comparadas às com baixo nível de eficácia coletiva. Assim, este estudo verificou uma relação significativa entre aspectos psicossociais e consumo alimentar em mulheres.

Vaccination coverage against human papillomavirus (HPV) and associated factors in female academics from a university in southwestern Goiás, Brazil.

OBJECTIVE: To check the coverage of the HPV vaccine in women enrolled in health courses at a university in southwest Goiás, Brazil, and the factors associated with vaccination. METHODS: This is a cross-sectional study, including female university students of health courses, aged 18 years or more. A standardized and self-applying questionnaire was used. Participants who received two or more doses of the vaccine were considered immunized. Multiple analysis was performed using multinomial logistic regression. RESULT: We observed that, of the 1510 participants, 473 (31.3%) had two or more doses of HPV vaccine, 167 (11.0%) one dose and 870 (57.6%) were unvaccinated. Participants under 21 years of age and in socioeconomic stratum A were 2 times more likely to have received two or more doses of the vaccine (Prevalence Ratio = 1.95; 95%CI 1.40-2.70 and Prevalence Ratio = 2.09; 95%CI 1.39-3.13, respectively). CONCLUSIONS: The research revealed extensive possibility for interventions with the aim of achieving greater vaccination coverage among female university students. Even women with more knowledge and high economic stratum showed low vaccination coverage, suggesting that results of higher vaccine coverage can be obtained with vaccination carried out in a school environment.

[Food environment in São Leopoldo, Rio Grande do Sul, Brazil: the association with neighborhood sociodemographic variables]. / Ambiente alimentar em São Leopoldo, Rio Grande do Sul, Brasil: associação com variáveis sociodemográficas da vizinhança.

The scope of this study is to describe the food environment of a medium-sized municipality in southern Brazil and compare the availability of different types of food outlets in neighborhood socioeconomic and demographic environments. An ecological study was carried out in 45 buffers of 400m in São Leopoldo county, RS. The buffer was calculated from the center point of the residences of women participating in a larger research project. All streets were surveyed to identify food stores and record their geographical coordinates, as well as apply the NEMS questionnaire on the availability, price and quality of 108 items. The commercial outlets were classified as supermarkets, grocery stores, fruit stores and convenience stores. Supermarkets and grocery stores were present in higher quantity in lower income buffers and grocery stores were more prevalent in those with higher population tertiles. Another result was a direct relationship between NEMS and tertile income scores for supermarkets, grocery stores and fruit stores, and an indirect relationship for the same stores and population tertile. The availability of healthy food was higher in areas with higher income and lower numbers of inhabitants, indicating the need for better distribution of food stores and availability of varieties of food in the municipality.

O objetivo deste estudo é descrever o ambiente alimentar de um município de médio porte do Sul do Brasil e relacionar a disponibilidade de diferentes tipos de comércios de alimentos com características socioeconômicas e demográficas do entorno. Trata-se de estudo ecológico em 45 buffers, de 400m, em São Leopoldo, Rio Grande do Sul. O buffer foi calculado a partir do centróide das residências das mulheres participantes de um projeto de pesquisa maior. Todas as ruas foram percorridas para a identificação dos estabelecimentos de alimentos, que tiveram suas coordenadas geográficas registradas, bem como foram avaliados, através do questionário NEMS (Nutrition Environment Measures Survey in Stores), sobre disponibilidade, preço e qualidade de 108 itens. Os comércios foram classificados em supermercados, mercearias, fruteiras e lojas de conveniência. Os supermercados e as mercearias estavam em maior número nos buffers de menor renda e mercearias mais presentes naqueles de maior tercil populacional. Observa-se relação direta entre escores do NEMS e tercil de renda para supermercados, mercearias e fruteiras e indireta para os mesmos comércios e tercil populacional. A disponibilidade de alimentos saudáveis se mostrou mais elevada em áreas de maior renda e menor número de habitantes, o que sinaliza a necessidade de melhor distribuição dos comércios e variedades de alimentos.

Factors associated with common mental disorders: a study based on clusters of women.

OBJECTIVE: to identify factors associated with common mental disorders (CMD) in a sample of adult women in Southern Brazil. METHODS: This population-based study, composed of 1,128 women, investigated socioeconomic, behavioral and health/disease explanatory demographic variables. Five response groups were explored: one group with common mental disorders - cut-off point 6/7 in the Self-Reporting Questionnaire 20 (SRQ-20) - and four others corresponding to the different clusters found using the latent class clustering technique, also from the SRQ-20. These four clusters (low, medium-depressive, medium-digestive and high) were named (denominated) based on the mean scores in the SRQ-20 in each group and on the response patterns of the variables and factorial characteristics. The "low" cluster comprised women with lower SRQ-20 scores and, therefore less likely to present CMD. The "high" cluster, with high mean values in the SRQ-20, was related to higher psychiatric morbidity. We used the Poisson regression technique to compare the findings of the different groups. RESULTS: We identified ten variables as factors associated with CMD. Age, education, smoking, physical activity, perception of health and number of medical appointments were the common variables for the cut-off point and cluster-based analyses. Heavy alcohol use was associated only when the sample was evaluated as a cut-off point. Social class, work situation and existence of chronic diseases were associated only when the sample was analyzed by clusters. There was a significant association in the "high" cluster with lower classes (D or E), smoking, physical inactivity, existence of chronic diseases and negative perception of health. CONCLUSION: We identified different associated factors according to the response groups considered. New approaches allowing identification of subgroups of individuals with specific characteristics and associated factors may contribute for a more accurate understanding of CMD and provide the basis for health interventions.

Sedentary behavior across different domains among adult women in the south of Brazil: a population based study. / Comportamento sedentário em diferentes domínios de mulheres adultas do sul do Brasil: um estudo de base populacional.

The aim of this study was to describe sedentary behavior (SB) across leisure, occupation, and transport domains and determine factors associated with excessive sedentary behavior (ESB). Cross-sectional survey with a representative sample of 1,126 women aged 20-69 years living in São Leopoldo/RS. SB, demographic, socioeconomic, behavioral and health factors data were collected using a questionnaire administered by interviewers. The cut-off point for ESB was defined as the median. Associations were tested using Poisson regression with robust error variance. The medians and interquartile intervals (min/day) for leisure, occupation, and transport SB were 163.9(86.6-2710.5), 51.4(0-257.1), and 17.1(5.7-37.3), respectively. The likelihood of leisure SB increased with education level, was higher among women who were not employed, lived in household without children, and smokers. In other domains, there was an inverse association between age, being white, economic class, education level, and income and ESB. Direct association between living in a household with a car and excessive transport SB and women who were not employed were 30% less likely to engage in ESB in this domain. The predominant domain in Total SB was leisure. Associations differed across domains, indicating that domain-specific interventions should be implemented in addressing excessive SB.

O objetivo deste estudo foi descrever o comportamento sedentário (CS) nos domínios lazer, ocupação e deslocamento e verificar fatores associados ao excesso deste comportamento (ECS). Estudo transversal, com amostra representativa de 1.126 mulheres, 20-69 anos, de São Leopoldo/RS. CS, variáveis demográficas, socioeconômicas, comportamentais e relacionada à saúde foram avaliados através de questionário, aplicado em forma de entrevista. Considerou-se ECS valores acima da mediana. Utilizou-se regressão de Poisson com variância robusta. As medianas e intervalos interquartílicos (min/dia), para o CS no lazer, ocupação e deslocamento foram, respectivamente, 163,9 (86,6-2710,5), 51,4 (0-257,1) e 17,1 (5,7-37,3). A probabilidade do ECS no lazer aumentou com a escolaridade, foi maior entre as mulheres que não trabalhavam, sem crianças em casa e fumantes. Nos demais domínios, a probabilidade aumentou inversamente com a idade, foi maior entre mulheres brancas e aumentou com a classe econômica, escolaridade e renda. A probabilidade de ECS no deslocamento também aumentou com o número de carros no domicílio e foi 30% menor entre mulheres que não trabalhavam. O maior tempo de CS observado foi no domínio do lazer. As associações diferiram segundo o domínio, indicando distintas intervenções.

Tendência de internações por condições sensíveis à atenção primária em Pelotas, Brasil, de 2000 a 2021 / Tendencias en hospitalizaciones por afecciones sensibles a la atención primaria en Pelotas, Brasil, de 2000 a 2021 / Trend in hospitalizations for conditions sensitive to primary care in Pelotas, Brazil, from 2000 to 2021

Resumo O objetivo do artigo é descrever as características das internações por condições sensíveis à atenção primária (ICSAP) no município de Pelotas quanto à ocorrência por sexo, faixa etária e por principais causas no período de 2000 a 2021. Adicionalmente, foi realizada a análise de tendência das ICSAP do município comparando-a com a do restante do Rio Grande do Sul, sua associação com o gasto público per capita em saúde e com a cobertura populacional de ESF. Estudo ecológico utilizando a Lista de CSAP do Ministério da Saúde disponível no Sistema de Informações Hospitalares do Sistema Único de Saúde. As informações sobre o gasto em saúde foram obtidas no Sistema de Informações sobre Orçamento Público em Saúde. A cobertura de ESF estava disponível no Departamento de Atenção Básica. Encontrou-se diminuição das ICSAP em Pelotas e no restante do Estado. As ICSAP foram mais frequentes nas pessoas de 60 anos ou mais. A principal causa de internação foi insuficiência cardíaca. Em Pelotas a cobertura de ESF e o gasto em saúde apresentaram associação com as ICSAP. Apesar das medidas aplicadas a partir de 2017, políticas implantadas anteriormente, o aumento do gasto em saúde e a ampliação da cobertura podem ter influenciado a diminuição das ICSAP.

Abstract This article aims to describe the characteristics of hospitalizations for ambulatory care sensitive conditions (HACSC) in the municipality of Pelotas regarding occurrence by sex, age group and main causes in the period from 2000 to 2021. Additionally, a trend analysis of the HACSC in the municipality was carried out, comparing it with the rest of Rio Grande do Sul, its association with public expenditure per capita on health and with the population coverage of FHS. Ecological study using the ambulatory care sensitive conditions list from the Ministry of Health available in the Hospital Information System of the Unified Health System. Information on health expenditure was obtained from the Public Health Budget Information System. FHS coverage was available at the Primary Care Department. A decrease in HACSC was found in Pelotas and in the rest of the state. HACSC were more frequent in people aged 60 years or older. The main cause of hospitalization was heart failure. In Pelotas, FHS coverage and health expenditure were associated with HACSC. Despite the measures applied from 2017, policies implemented previously, the increase in health spending and the expansion of coverage may have influenced the decrease in HACSC.

Resumen Este artículo tiene como objetivo describir las características de las hospitalizaciones por condiciones sensibles de atención primaria (HCSAP) en la ciudad de Pelotas, Brasil, en términos de ocurrencia por sexo, grupo etario y causas principales, de 2000 a 2021. Adicionalmente, se realizó un análisis de tendencias de las HCSAP en el municipio comparándolas con el del resto de Rio Grande do Sul, su asociación con el gasto público per cápita en salud y con la cobertura poblacional de ESF. Este estudio ecológico ha utilizado el Listado CSAP del Ministerio de Salud disponible en el Sistema de Información Hospitalaria del Sistema Único de Salud brasileño. La información sobre el gasto en salud se obtuvo del Sistema de Información del Presupuesto de Salud Pública. La cobertura de ESF estaba disponible en el Departamento de Atención Básica. Se constató una disminución de las HCSAP en Pelotas y el resto del Estado. Las HCSAP han sido más comunes en personas de 60 años o más y la principal causa de hospitalización fue la insuficiencia cardíaca. En Pelotas, la cobertura de ESF y el gasto en salud se asociaron con las HCSAP. A pesar de las medidas aplicadas desde 2017, las políticas implementadas anteriormente, el aumento del gasto en salud y la ampliación de la cobertura pueden haber influido en la disminución de las HCSAP.

Prevalência de depressão entre estudantes de Medicina em universidade de Goiás / Prevalence of depression among medicine Medicine students at a university in Goiás

RESUMO Introdução: Depressão é uma designação sindrômica que pode compreender um amplo espectro de quadros clínicos, mas que tem despertado interesse acadêmico tanto por sua prevalência quanto pelo investimento em dispositivos terapêuticos. O Brasil lidera, na América Latina, o ranking de pessoas com depressão em termos absolutos e relativos, e, no mundo, está entre as nações com a maior prevalência de condições clínicas designadas como depressão (5,9% do total ou cerca de 11,5 milhões de pessoas). Objetivo: Este estudo teve como objetivo determinar a prevalência de depressão e condições associadas entre estudantes dos cursos de Medicina da Universidade de Rio Verde, no estado de Goiás. Métodos: Trata-se de um Estudo transversal realizado na Universidade de Rio Verde com estudantes de Medicina. Realizou a coleta de dados mediante instrumento autoaplicável, cujo desfecho foi o diagnóstico médico referido de depressão. Realizaram-se análises bruta e ajustada por meio da regressão de Poisson. Resultado: Dos 1.609 participantes do estudo, 334 (20,8%; IC95% 18,8; 22,7) apresentaram depressão. Na análise ajustada, permaneceram associados sexo feminino, idades acima de 20 anos, baixo apoio social, fumantes e autopercepção de saúde classificada como razoável e ruim. Conclusão: A prevalência de depressão foi elevada, apontando para o sofrimento mental entre estudantes dos cursos de Medicina, sendo importante que as escolas conheçam essa realidade. A variável associada ao desfecho passível de modificação foi apoio social, indicando a importância da implantação de estratégias que minimizem o problema e a elaboração de políticas com aconselhamento educacional e apoio psicológico para os alunos.

ABSTRACT Introduction: Depression is a syndromic term that can encompass a broad spectrum of clinical conditions, but which has aroused academic interest as a result of both its prevalence and the investment in therapeutic devices. Brazil leads Latin America in the ranking of people with depression in absolute and relative terms, and globally has one of the highest rates of prevalence of clinical conditions designated as depression (5.9% of the total population or around 11.5 million people). Objective: To determine the prevalence of depression and associated conditions among medical students at the University of Rio Verde in the state of Goiás. Methods: This was a cross-sectional study carried out at the University of Rio Verde/GO with medical students. Data collection was through a self-administered instrument, the outcome of which was the referred medical diagnosis of depression. Raw and adjusted data analyses were performed using Poisson regression. Results: Among the 1609 study participants, 334 (20.8%; CI 95% 18.8; 22.7) had depression. In the adjusted analysis, the remaining associated factors were: female gender, age over 20 years with low social support, smokers and self-perceived health classed as fair and poor. Conclusion: The prevalence of depression was high, pointing to mental suffering among medical students, and it is important for schools to be aware of this reality. The variable associated with the outcome that could be modified was social support, indicating the importance of implementing strategies that minimize the problem and the development of policies with educational counseling and psychological support for students.

Social inequalities in the use of contraceptives in adult women from Southern Brazil.

OBJECTIVE: To describe the contraceptive methods used by adult women and the associated socioeconomic and demographic factors. METHODS: Population-based cross-sectional study with 20 to 49-year-old women from São Leopoldo, state of Rio Grande do Sul, in 2015. Three outcomes were considered to analyze the association with demographic and socioeconomic characteristics: use of oral contraceptive pills, tubal ligation and male condom. The crude prevalence ratios, stratified by age, and 95% confidence intervals (95%CI) were obtained using Poisson regression, taking the experimental error into account. RESULTS: A total of 736 women, aged from 20 to 49 years old, were evaluated. The prevalence of the use of oral contraceptive pills, tubal ligation and male condom were respectively 31.8% (95%CI 28.4-35.3), 11.1% (95%CI 9.0-13.6) and 10.9% (95%CI 8.7-13.3). In addition, 10.5% (n = 77) of the women reported making combined use of oral contraceptive pills and condom. In the stratified analysis, younger women with lower education level and from lower social classes reported less use of oral contraceptive pills. Tubal ligation was more prevalent among the lower social classes, but only in the age group from 30 to 39 years old. No differences were found in relation to male condom. CONCLUSIONS: The results indicated that differences persist in relation to contraception, which can be associated with both the difficulties of access to these inputs and the frailty of actions in reproductive health to achieve the needs and preferences of women who are more socially vulnerable.

[Performance of lipid profile request between public and private sectors]. / Desempenho da solicitação do perfil lipídico entre os setores público e privado.

OBJECTIVE: To evaluate the performance of lipid profile screening according to the mode of financing of medical appointments - public or private. METHODS: A population-based cross-sectional study was carried out with a multi-stage sampling strategy. The study included 3,136 adults (>or=20 years old) from the city of Pelotas, Southern Brazil, in 2006. The following indicators were calculated: coverage (proportion of screened individuals among those meeting screening criteria), focus (proportion of individuals meeting screening criteria among those who were tested), screening errors (tests in individuals not meeting screening criteria - overscreening - and no screening of individuals meeting the screening criteria - underscreening), and screening ratio (ratio between number of individuals who met screening criteria and the number who failed to meet screening criteria among all individuals tested). Bivariate analyses were performed using Chi-squared tests. 95% confidence intervals (95% CI) were calculated for all parameters assessed. RESULTS: General coverage was 73.0% (95%CI: 70.8;75.2), and focus was 67.2% (95% CI: 64.7;69.3). In the public sector, compared to the private/health plan sector, coverage was lower (65.2% vs. 82.2%; p<0.001), focus was higher (74.7% vs. 62.3%; p<0.001), overscreening was lower (33.1% vs. 56.4%; p<0.0001), and underscreening was higher (34.8% vs. 17.8%; p<0.0001). Screening ratio was higher in the public (1.97) than in the private sector (1.46). CONCLUSIONS: The evaluation of adequacy of lipid profile requests among the population can provide important information regarding the following of protocols for screening and following-up dyslipidemias in different healthcare systems and, within a same system, between different modes of financing. Evaluations of this type provide an opportunity to diagnose inequalities and plan efforts to ensure greater equity of care.

Associação entre capital social e padrões alimentares em mulheres do Sul do Brasil / Association between social capital and food patterns in women from Southern Brazil

Resumo O presente estudo objetivou verificar a associação entre aspectos psicossociais (capital social) e padrões alimentares em mulheres adultas. Realizou-se um estudo transversal, de base populacional, com uma amostra representativa de 1.128 mulheres, de 20 a 69 anos de idade, residentes na área urbana do município de São Leopoldo, Rio Grande do Sul, em 2015. Os padrões alimentares foram identificados com base na frequência de consumo alimentar e classificados em: saudável (frutas, vegetais e alimentos integrais), de risco (alimentos ultraprocessados) e brasileiro (arroz e feijão), enquanto o capital social foi avaliado por meio de uma escala de eficácia coletiva. Observou-se que 18,9% da amostra foi classificada com alta eficácia coletiva. Após ajuste para potenciais fatores de confusão, observou-se uma probabilidade 44% maior para adesão ao padrão saudável (RP [razão de prevalência] = 1,44; IC95% [intervalo de confiança de 95%]: 1,01-2,03; p = 0,040) e 71% maior para o padrão brasileiro (RP = 1,71; IC95%: 1,18-2,47; p = 0,004) entre as mulheres com um maior nível de eficácia coletiva, quando comparadas às com baixo nível de eficácia coletiva. Assim, este estudo verificou uma relação significativa entre aspectos psicossociais e consumo alimentar em mulheres.

Abstract The present study aimed to verify the association between psychosocial aspects (social capital) and food patterns in adult women. A cross-sectional, population-based study was conducted with a representative sample of 1,128 women, aged 20 to 69 years, living in the urban area of the municipality of São Leopoldo, Rio Grande do Sul, Brazil, in 2015. The food patterns were identified based on the frequency of food intake and classified as: healthy (fruits, vegetables, and whole foods), at-risk (ultraprocessed foods), and Brazilian (rice and beans), while social capital was evaluated using a collective efficacy scale. It was observed that 18.9% of the sample was classified with high collective efficacy. After adjusting for potential confounding factors, a 44% higher probability was observed for adherence to the healthy pattern (PR [prevalence ratio] = 1.44; 95%CI [95% confidence interval]: 1.01-2.03; p = 0.040) and 71% higher for the Brazilian pattern (PR = 1.71; 95%CI: 1.18-2.47; p= 0.004) among women with a higher level of collective efficacy, when compared to those with a low level of collective efficacy. Thus, this study verified a significant relationship between psychosocial aspects and food intake in women.

Trends in hospital admissions and mortality from diabetes mellitus in Rio Grande do Sul: historical series 2000-2020 / Tendencias de la hospitalización y la mortalidad por diabetes mellitus en Rio Grande do Sul: série histórica 2000-2020 / Tendência das hospitalizações e mortalidade por diabetes mellitus no Rio Grande do Sul: série histórica 2000-2020

ABSTRACT Objective: To analyze the trends of hospital admissions and deaths from diabetes mellitus in the 18 host municipalities of the 19 regional health coordination offices and in Rio Grande do Sul, 2000-2020. Method: Ecological study with secondary data collected in the Hospital Information System, the Mortality Information System, and the Brazilian Institute of Geography and Statistics, from 2000-2020. Coefficients were standardized using the direct method and Prais-Winsten regression analysis. Results: A downward trend wasfound in the coefficients of hospitalizations for diabetes mellitus in most cities and states. In 2020, for both areas, hospitalizations for diabetes mellitus were below the average of the period. The mortality trend remained stationary in almost all municipalities and in the state. Conclusion: There was evidence of a decrease in hospitalizations and stationary mortality by DM in most municipalities analyzed, possibly due to the policies and actions implemented in the period, despite the aging of the population.

RESUMEN Objetivo: Analizar la tendencia de hospitalizaciones y muertes por diabetes mellitus en las 18 ciudades sede de las 19 coordinaciones regionales de salud y en Rio Grande do Sul, 2000-2020. Método: Estudio ecológico con datos secundarios recolectados en el Sistema de Información Hospitalaria, el Sistema de Información de Mortalidad y el Instituto Brasileño de Geografía y Estadística, de 2000 a 2020. Los coeficientes se estandarizaron mediante el método directo y el análisis de regresión de Prais-Winsten. Resultados: Se encontró una tendencia a la baja en los coeficientes de hospitalizaciones por diabetes mellitus en la mayoría de las ciudades y estados. En 2020, en ambas las áreas, las internaciones por diabetes mellitus estuvieron inferiores al promedio obtenido en el período. La tendencia de mortalidad se mantuvo estacionaria en casi todos los municipios y en el estado. Conclusión: Se evidenció una disminución de las internaciones y de la mortalidad estacionaria por DM en la mayoría de los municipios analizados, posiblemente en función de las políticas y acciones implementadas en el período, a pesar del envejecimiento de la población.

RESUMO Objetivo: Analisar a tendência das internações hospitalares e dos óbitos por diabetes mellitusnos 18 municípios-sede das 19 coordenadorias regionais de saúde e no Rio Grande do Sul, 2000-2020. Método: Estudo ecológico com dados secundários coletados no Sistema de Informações Hospitalares, Sistema de Informação sobre Mortalidade e Instituto Brasileiro de Geografia e Estatística, de 2000-2020. Foi realizada padronização dos coeficientes pelo método direto e análise por regressão de Prais-Winsten. Resultados: Encontrou-se tendência de diminuição dos coeficientes de internações por diabetes mellitus na maioria dos municípios e Estado. Em 2020, foram observadas hospitalizações por diabetes mellitus abaixo da média obtida no período, para ambos. A tendência de mortalidade permaneceu estacionária em quase todos os municípios e no Estado. Conclusão: Foi evidenciada diminuição das internações e mortalidade estacionária por DM na maioria dos municípios analisados, possivelmente em virtude das políticas e ações implementadas no período, apesar do envelhecimento da população.

[Abdominal obesity epidemiology amongst adult women resident in Southern Brazil]. / Epidemiologia da obesidade abdominal em mulheres adultas residentes no sul do Brasil.

The objective of this study was to investigate the risk factors associated with abdominal obesity in women. A cross-sectional population based study was carried out on 981 women aged 20 to 60 years living in Southern Brazil. Abdominal adiposity was assessed by waist circumference (WC) = 88 cm. Poisson regression models were used to obtain prevalence ratios (PR) and their confidence intervals. The abdominal obesity prevalence was 23.3% (IC95%: 20.7-26.0). The main factors associated with the outcome were: having low education level, being unemployed, being more than 40 years old, having family obesity history, and being married. Adjusted analyses showed increased obesity prevalence in hypertensive women (Prevalence Ratio--PR = 2.06; CI95%: 1.58-2.69) and those having higher number of children (PR = 1.17; CI95% 1.00-1.37). Later menarche, at 12-13 years and at 14 years of age, protected against obesity comparing to women with earlier menarche at 8-11 years, respectively, 31% and 46% of protection. The understanding of how the abdominal obesity is distributed among the population allows effective planning and action implementation towards the reduction rates of this nutritional and public health problem.

Hospitalization for primary care susceptible conditions, health spending and Family Health Strategy: an analysis of trends. / Internações por condições sensíveis à atenção primária, gastos com saúde e Estratégia Saúde da Família: uma análise de tendência.

The goal of this study was to analyze the trend over time of hospitalizations due to conditions susceptible to primary healthcare (HCSPC), and how it relates to healthcare spending and Family Health Strategy (FHS) coverage in the city of São Leopoldo, Rio Grande do Sul State, Brazil, between 2003 and 2012. This is an ecological, time-trend study. We used secondary data available in the Unified Healthcare System Hospital Data System, the Primary Care Department and Public Health Budget Data System. The analysis compared HCSPC using three-year moving averages and Poisson regressions or negative binomials. We found no statistical significance in decreasing HCSPC indicators and primary care spending in the period analyzed. Healthcare spending, per-capita spending and FHS coverage increased significantly, but we found no correlation with HCSPC. The results show that, despite increases in the funds invested and population covered by FHS, they are still insufficient to deliver the level of care the population requires.

Clinical and Epidemiological Profile after Covid-19 Hospitalization in São Leopoldo, RS / Perfil Clínico e Epidemiológico Após Hospitalização por Covid-19 em São Leopoldo, RS

The disease associated with SARS-CoV-2 is called coronavirus disease 2019 (COVID-19) and has a wide clinical spectrum, ranging from asymptomatic infections to severe conditions. In this scenario, the objective of this study was to describe the clinical and epidemiological profile of the population infected with SARS-CoV-2 that required hospitalization in 2020 in São Leopoldo, RS, and to associate the different variables studied with the death outcome. This is a retrospective cohort study, with descriptive and associative analysis of the population of all adult individuals hospitalized for SARS-CoV-2 infection in 2020 in São Leopoldo. Clinical and epidemiological data were collected from the patients, and the following variables were investigated in the medical records: age, sex, race, marital status, length of stay, use of invasive or non-invasive ventilatory support, smoking history, previous comorbidities and symptoms, and outcome hospital discharge or death. The study included 481 patients consecutively, with a higher prevalence of age in the age group from 60 to 69 years (24.3%). 54.9% were male (n=264), and 84.8% (n=340) were white. There were 175 deaths (36.4%), with CI 95% 32.1-40.7. The variables age (80 years or older, 53.4%, p<0.001), length of stay (8 days or more, 47.1%, p<0.001) and need for invasive mechanical ventilation (95.1%, p<0.001) were associated with death. By sharing information with transparency and data quality about the panorama of the first year of the pandemic in the city, this study provides elucidating data, such as the characteristics of hospitalized patients and risk factors for complications related to COVID-19. (AU)

A doença associada ao SARS-CoV-2 é denominada doença do coronavírus 2019 (COVID-19), e possui amplo espectro clínico, variando de infecções assintomáticas a quadro graves. Neste cenário, o objetivo deste estudo foi descrever o perfil clínico e epidemiológico da população infectada por SARS-CoV-2 que necessitou internação em 2020 em São Leopoldo, RS, e associar as diferentes variáveis estudadas com o desfecho morte. Trata-se de um estudo de coorte retrospectivo, com análises descritivas e associativas da população de todos os indivíduos adultos internados por SARS-CoV-2 em 2020 em São Leopoldo. Foram coletados dados clínicos e epidemiológicos dos pacientes, e investigadas nos prontuários as seguintes variáveis: idade, sexo, raça, estado civil, tempo de internação, uso de suporte ventilatório invasivo ou não invasivo, história de tabagismo, comorbidades e sintomas prévios, e desfecho de alta hospitalar ou óbito. O estudo incluiu 481 pacientes de forma consecutiva, com maior prevalência de idade na faixa etária de 60 a 69 anos (24,3%). 54,9% eram do sexo masculino (n=264), e 84,8% (n=340) eram brancos. Ocorreram 175 óbitos (36,4%), com IC 95% 32,1-40,7. As variáveis idade (80 anos ou mais, 53,4%, p<0,001), tempo de internação (8 dias ou mais, 47,1%, p<0,001) e necessidade de ventilação mecânica invasive (95,1%, p<0,001) estiveram associadas ao óbito. Ao compartilhar informações com transparência e qualidade de dados sobre o panorama do primeiro ano da pandemia na cidade, este estudo fornece dados elucidativos, como as características dos pacientes internados e fatores de risco para complicações relacionadas à COVID-19. (AU)

Hospitalizations for primary care-sensitive conditions in Pelotas, Brazil: 1998 to 2012. / Hospitalizações por condições sensíveis à atenção primária em Pelotas: 1998 a 2012.

OBJECTIVE:: To verify the hospitalization trend for primary care sensitive-conditions in Pelotas, Rio Grande do Sul, Brazil from 1998 to 2012. METHODS:: An ecological study compared hospitalizations rates of the city of Pelotas with the rest of state of Rio Grande do Sul. Analysis was conducted using direct standardization of rates, coefficients were stratified by sex and the Poisson regression was used. RESULTS:: Hospitalizations for sensitive conditions decreased in Pelotas and Rio Grande do Sul. In Pelotas, a 63.8% decrease was detected in the period observed, and there was a 43.1% decrease in the state of Rio Grande do Sul. Poisson regression coefficients showed a decrease of 7% in Pelotas and of 4% in the rest of Rio Grande do Sul each year. CONCLUSION:: During the study period, several changes were introduced in the Brazilian Unified Health System ("Sistema Único de Saúde") that may have influenced the results, including changes in administration, health funding, and a complete reworking of primary care through the creation of the Family Health Strategy program ("Estratégia Saúde da Família").

Tempo utilizando computador como discriminador de obesidade, sedentarismo e fatores de risco cardiovascular em universitários / Time using a computer as a discriminator of obesity, sedentarism and cardiovascular risk factors in university students

Resumo: Introdução: Os universitários apresentam maior risco de adotar o comportamento sedentário em virtude da própria rotina, a qual requer muito tempo dedicado às aulas e a utilização frequente do computador para os estudos. Essa situação tem se tornado preocupante porque o comportamento sedentário tem sido associado a desfechos adversos em saúde, como mortalidade e doenças crônicas não transmissíveis. Objetivo: Este estudo teve como objetivo analisar o tempo despendido com o uso do computador como discriminador da obesidade, do sedentarismo e de fatores de risco cardiovascular em universitários. Método: Trata-se de estudo transversal realizado com 2.275 acadêmicos de cursos da área da saúde de uma fundação pública do estado de Goiás. Os dados foram obtidos por meio da aplicação de um questionário composto por variáveis sociodemográficas, relativas ao curso e a aspectos comportamentais e de saúde. A variável de desfecho foi o tempo utilizando o computador (TC). Identificaram-se o poder discriminatório e os pontos de corte do TC para os desfechos de interesse por meio das curvas Receiver Operating Characteristic (ROC) com IC95%. Resultado: O tempo médio usando o computador para estudos, trabalho ou lazer foi de 3,90 horas/dia para mulheres e 3,82 horas/dia para homens. A área sob a curva ROC entre o TC e o sedentarismo foi de 0,54 (IC95% 0,51-0,58) para mulheres e 0,56 (IC95% 0,50-0,63) para homens. Já para a hipertensão arterial sistêmica (HAS), foi de 0,57 (IC95% 0,50-0,64) para mulheres. Os melhores pontos de corte relacionados a essas condições foram 3,5 e 4,5 horas, respectivamente. Conclusão: O TC apresentou boa capacidade preditiva para discriminar o sedentarismo e a HAS entre universitários. Sugere-se que a diminuição do TC e sua substituição por atividades ativas possam contribuir para a melhoria do perfil de saúde e a qualidade de vida dos acadêmicos.

Abstract: Introduction: University students are at greater risk of adopting a sedentary behavior due to their routine, with a large amount of time being dedicated to classes and studying in front of a computer. This situation has become a matter of concern, because sedentary behavior has been associated with adverse health outcomes such as mortality and chronic non-communicable diseases. Objective: To analyze the time spent using the computer as a discriminator of obesity, sedentary lifestyle and cardiovascular risk factors in University students. Method: This was a cross-sectional study with 2,275 students from courses in the health area of a public institution in Goiás. Data were obtained by applying a questionnaire consisting of sociodemographic, course-related, behavioral and health variables. The outcome variable was time using the computer (TC). The discriminatory power and the cutoff points of time using the computer for the outcomes of interest were identified using the Receiver Operating Characteristic (ROC) curves with 95%CI. Result: The mean time spent using the computer for studying, working, or leisure was 3.90 hours/day for women and 3.82 hours/day for men. The area under the ROC curve between TC and sedentary lifestyle was 0.54 (95%CI 0.51-0.58) for women and 0.56 (95%CI 0.50 - 0.63) for men. As for systemic arterial hypertension (SAH) it was 0.57 (95%CI 0.50 - 0.64) for women. The best cutoff points related to these conditions were 3.5 and 4.5 hours, respectively. Conclusion: The TC showed good predictive capacity to discriminate a sedentary lifestyle and SAH among University students. It is suggested that the reduction of TC and its replacement by active activities can contribute to improving the health profile and quality of life of students.

[Dietary patterns of adult women living in an urban area of Southern Brazil]. / Padrões alimentares de mulheres adultas residentes em área urbana no sul do Brasil.

OBJECTIVE: To explore the dietary patterns of adult women and to provide information for validating the instrument used. METHODS: A population-based cross-sectional study was carried out in a representative sampling of 1,026 women aged 20 to 60 years living in Southeastern Brazil, in 2003. A 70-item food frequency questionnaire was used to measure food intake. Dietary patterns were identified using principal component analysis. RESULTS: The reliability of factor analysis was assessed through the Kaiser-Meyer-Olkin statistic, that was equal to 0.823, the Bartlett test of sphericity, which reached statistical significance (chi-square (1225)=7406.39; p<0.001), and the determinant of the correlation matrix (6,28-4). Five dietary patterns were identified, each one consisting of 10 items (foods), which were grouped as healthy food pattern cost 1, healthy food pattern cost 2, healthy food pattern cost 3, risk food pattern cost 1 and risk food pattern cost 3. CONCLUSIONS: There were identified five dietary patterns among adult women. There was a clear difference in terms of the cost of these patterns. These findings suggest that cost may be one of the determinants of food choice and food intake in this population.

Hospitalizations owing to ambulatory care sensitive conditions in Florianopolis, Santa Catarina - an ecological study, 2001-2011. / Hospitalizações por condições sensíveis à atenção primária em Florianópolis, Santa Catarina - estudo ecológico de 2001 a 2011.

OBJECTIVE: to evaluate trends in rates of hospitalizations owing to ambulatory care sensitive conditions in the municipality of Florianópolis, Santa Catarina, Brazil, from 2001 to 2011, and to assess correlation with the public health expendutures Family Health Strategy (FHS) population coverage. METHODS: this was an ecological study using Ministry of Health secondary data; data were analyzed using Poisson Regression. RESULTS: the regression coefficient was 0.97, showing a decrease of 3% per year in hospitalizations owing to ambulatory care sensitive conditions, a three-fold increase in FHS coverage and seven times more financial investment per capita in health services, from R$67.65 in 2001 to R$471.03 in 2011; FHS investments per capita in health and population coverage were negatively correlated to the rate of hospitalizations owing to ambulatory care sensitive conditions. CONCLUSION: financial investment and FHS expansion had led to major reductions in the rate of hospitalizations owing to ambulatory care sensitive conditions.