Older adults' dependence in activities of daily living: Implications for oral health.

OBJECTIVE: To assess the relationship between ADL and oral health status in older adults. DESIGN AND SAMPLE: Quantitative, analytical, cross-sectional research with 280 people aged ≥60 in public primary health care centers in the city of Fortaleza, Northeastern Brazil. MEASURES: Collection of sociodemographic data, oral discomfort data, and general health data and application of the Community Oral Health Indicator-COHI and the activities of daily living scale. RESULTS: Significant differences in functional dependence were found between age groups (p < .001), incomes (p = .034), and levels of education (p = .003). Tooth loss (OR = 2.13; p = 0.025), having no teeth (OR = 2.97), difficulties in chewing and swallowing food (OR = 2.56; p = 0.003), problems with taste of food (OR = 2.06; p = .044), poor self-rated general health (OR = 3.7; p = .001), hearing problems (OR = 2.23; p = .009) and speech problems (OR = 3.15; p = .002) increased chances for functional dependence. Dependent individuals were less likely to use toothpaste, thereby increasing the potential for caries (p = .013). Age 80 or older (p < .001), ages 70-79 (p < .001), three or more visible dental cavities (p = .030) and difficulty chewing and swallowing food (p = .027) remained associated with dependence in ADL in the logistic regression model. CONCLUSION: Functional dependence in activities of daily living has implications for the oral health status of older people.

Spectra of mothers of premature children about the educative circle of culture.

We sought to know the spectra of mothers of premature children regarding their experience with circle of culture of educational character and identifying the learning provided by the circle of culture about newborn care after hospital discharge. A descriptive study was performed in a hospital located in Fortaleza, Brazil. Three meetings of a circle of culture with 17 mothers of premature newborns were performed. The interpretation of the corpus was performed using thematic analysis. Emerged from the categories: Maternal experience in a circle of culture; Promoted social support among mothers through the circle of culture; and Learning provided by the circle of culture. It was concluded that teaching parents during the hospitalization of the child should be held in a way to involve parents in the care of the newborn, provide moments of health education, opportunities for support and dialogue between professionals and family.

Nursing students' personality (Temperament and Character), burnout symptoms, and health and well-being.

Background: About 9 million nurses will be needed by 2030. To face these unprecedented times, governments/institutions focus on educating as many nursing students as possible. This strategy is clouded by burnout and lack of both health and well-being among students and by the fact that personality is one of the major determinants of these health outcomes. Nevertheless, recent findings show that personality is a complex adaptive system (i,e., nonlinear) and that combinations of people's temperament and character traits (i.e., joint personality networks) might provide further information to understand its development, academic burnout, and lack of health and well-being. Aims: Our aims were to investigate the linear relationship between nursing students' personality, burnout, health, and well-being; investigate the linear mediational effects of personality and burnout on health and well-being; and investigate differences in these health outcomes between/within students with distinct joint personality networks (i.e., nonlinear relationships). Method: Swedish nursing students (189 women, 29 men) responded to the Temperament and Character Inventory, The Maslach Burnout Inventory-General Survey for Students, and the Public Health Surveillance Well-Being Scale. We conducted correlation analyses and Structural Equation Modeling and, for the nonlinear relationships, Latent Profile Analysis and Latent Class Analysis for clustering and then Analyses of Variance for differences in health outcomes between/within students with distinct personality networks. This study was not pre-registered. Results: High levels of health and well-being and low burnout symptoms (low Emotional Exhaustion, low Cynicism, and high Academic Efficacy) were associated with low Harm Avoidance and high Self-Directedness. Some personality traits were associated with specific health outcomes (e.g., high Self-Transcendence-high Emotional Exhaustion and high Persistence-high Academic Efficacy) and their effects on health and well-being were mediated by specific burnout symptoms. Cynicism and Emotional Exhaustion predicted low levels of health and well-being, Academic Efficacy predicted high levels, and Cynicism lead both directly and indirectly to low levels of health and well-being through Emotional Exhaustion. We found two joint personality networks: students with an Organized/Reliable combination who reported being less emotionally exhausted by their studies, less cynical towards education, higher self-efficacy regarding their academic work/skills, and better health and well-being compared to nursing students with an Emotional/Unreliable combination. Conclusions: The coherence of temperament-character, rather than single traits, seems to determine students' health outcomes. Thus, nursing education might need to focus on helping students to develop professional skills and health-related abilities (e.g., self-acceptance and spiritual-acceptance), by supporting self-awareness.

School-Based meditation in adolescents: an integrative literature review.

OBJECTIVES: Utility of cognitive-behavioral practice interventions in school settings have been discussed by the scientific community regarding their possibility of insertion in the educational field. In this way, this review article analyzes the scientific production on the practice of meditation offered at school in adolescents, since the appropriation of studies that point to reflections and perspectives of meditative practice can favor the development of new pedagogical trajectories in the school environment. CONTENT: The electronic databases VHL, PubMed, and CAPES were consulted, using the combination of the terms related to meditation, adolescents, and school. This analysis resulted in eight articles, including field research and reviews, published between 2010 and 2021. SUMMARY: The articles showed improvement in emotional coping skills, social relationships, self-regulation, control of mood levels, stress, depression, and anger, and significant gains in self-reflection and academic attention. They pointed out that elementary and high school students present more significant responses, and these factors, such as duration, frequency, and systematization of the session, can interfere with these responses. OUTLOOK: These results indicate that meditation practice in adolescents can be a valuable strategy for health promotion and educational training in the school environment.

Smartphone addiction and postural alterations in the cervical region in adolescents.

OBJECTIVE: To evaluate smartphone addiction and postural alterations in the cervical region in adolescents. METHODS: A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis. RESULTS: Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05). CONCLUSIONS: The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.

Factors related to smartphone addiction in adolescents from a region in Northeastern Brazil. / Fatores relacionados à dependência do smartphone em adolescentes de uma região do Nordeste brasileiro.

Adverse effects on the physical and mental health of adolescents associated with excessive smartphone use have been reported. This paper aims to assess adolescent smartphone addiction and related factors in a region in Northeastern Brazil. This cross-sectional study was carried out in six State-run Professional Education Schools in Fortaleza, Ceará, Brazil, from September to October 2019 with 286 adolescents aged 15-19 years who completed five data collection instruments. Bivariate and multivariate analyses were performed to assess factors related to the outcome using SPSS version 23.0. Smartphone addiction prevalence rate was 70,3% and was associated with being underage (OR=0,583; p=0,001), fewer sleep hours (OR=0,715; p=0,020), longer use on weekends (OR=1,115; p=0,015), cervical pain (OR=2,206; p=0,020), and suspected common mental disorder (OR=1,272; p=0,000). A high smartphone addiction level was observed among adolescents in the sample and was related to multiple factors. Attention should be drawn to the importance of educational campaigns to guide adolescents, parents, educators, and health professionals about the risks of excessive smartphone use to the health of adolescents.

Há relatos de efeitos adversos na saúde física e mental dos adolescentes associados ao uso excessivo do smartphone. O objetivo deste artigo é avaliar a dependência do smartphone e os fatores relacionados em adolescentes de uma região do Nordeste brasileiro. Trata-se de estudo transversal realizado em seis Escolas Estaduais de Educação Profissional (EEEPs), na cidade de Fortaleza, Ceará, Brasil, desenvolvido entre setembro e outubro de 2019. Participaram 286 adolescentes, entre 15 e 19 anos, que responderam cinco instrumentos de coleta. Análises bivariada e multivariada foram utilizadas para avaliar os fatores relacionados ao desfecho, pelo SPSS versão 23.0. A dependência do smartphone apresentou prevalência de 70,3%, e mostrava associação com menor idade (OR=0,583; p=0,001), menos horas de sono (OR=0,715; p=0,020), mais tempo de uso no final de semana (OR=1,115; p=0,015), queixa de dor cervical (OR=2,206; p=0,020) e suspeita de transtorno mental comum (OR=1,272; p=0,000). Evidenciou-se elevada dependência do smartphone nos adolescentes da amostra, relacionada a múltiplos fatores. Alerta-se para a importância de campanhas educativas que orientem os adolescentes, pais, educadores e profissionais de saúde para os riscos do uso excessivo de smartphones à saúde dos adolescentes.

Health and nursing system in France. / Système de santé et de soins infirmiers en France.

This paper concerns the French Health Care System that revolutionized the rationale of the existing social protection. It emphasizes that, in this country, it is essential to train professionals integrated into a "know-how", and also prepared for the current and future changes in the nursing profession. A literature review was carried out based on the classification and analysis of the texts and documents researched, and we tried to understand the French Health and Nursing System. This allowed the construction of two thematic categories. The first one is the "Health Service" that addresses health training courses for prevention, while the second one deals with Nursing Education, which is a competency-based framework. The demography of nurses in France is also discussed, which highlights the increased number of nurses from 2010 to 2018.

Cet article concerne le Système de Santé en France. Il souligne que dans ce pays il est essentiel de former des professionnels insérés dans un «savoir-faire¼, et également préparés aux mutations actuelles et à venir de la profession infirmière. Ainsi, une revue de la littérature a été réalisée à partir de la classification et de l'analyse des textes et des documents recherchés, nous avons essayé de comprendre le Système de Santé Français et de soins infirmiers. Cela a permis la construction de deux catégories thématiques. La première est le Service Sanitaire réalisé par les étudiants des formations en santé qui traduit la volonté du Gouvernement de placer la prévention au cœur de son action. Et la deuxième aborde la Formation des infirmiers qui est un référentiel basé sur la compétence. La démographie des infirmières en France est également abordée, ce qui met en évidence l'augmentation du nombre d'infirmières de 2010 à 2018.

Mapping nursing training in Brazil: challenges for actions in complex and globalized scenarios. / Mapeando a formação do enfermeiro no Brasil: desafios para atuação em cenários complexos e globalizados.

The article discusses the professional formation of nurses, implications of the increase in the number of Higher Education Institutions and their distribution in Brazil. It considers the results of the Nursing Profile Survey in Brazil, carried out with 35,916 nursing professionals, in 2013. The analysis that characterizes the trajectory of undergraduate nursing in this article is structured in three dimensions: the increase in the number of undergraduate and postgraduate nursing education institutions; the boom in nursing schools and the public vs. private relationship; and the territorial distribution of the registered nurse in Brazil. The increase in the number of Nursing Education Institutions implies an exponential formation, with a predominance of private schools in undergraduate and postgraduate courses. The courses seek to align themselves with changes in health and society, but it is crucial to equalize the territorial asymmetries between the undergraduate and graduate training institutions, the overconcentration and care gaps resulting from the insufficiency of nurses per inhabitant, as well as to qualify the nurses for the exercise of their professional activities in the face of global changes.

O artigo discorre sobre a formação profissional do enfermeiro, implicações da expansão das Instituições de Ensino Superior e a distribuição dessas no Brasil. Considera os resultados da Pesquisa Perfil da Enfermagem no Brasil, realizada com 35.916 profissionais de Enfermagem, em 2013. A análise que caracteriza a trajetória da graduação em enfermagem neste artigo, estrutura-se em três dimensões: a expansão da formação do enfermeiro na graduação e pós-graduação; o boom de escolas de enfermagem e a relação público x privado; e, a distribuição territorial do profissional enfermeiro no Brasil. O crescimento de Instituições de Ensino em Enfermagem implica em uma formação exponencial, com predomínio de escolas privadas na graduação e na pós-graduação; os cursos buscam alinhar-se às mudanças na saúde e sociedade, mas urge equalizar as assimetrias territoriais entre as instituições formadoras na graduação e pós-graduação, a superconcentração e vazios assistenciais decorrentes da insuficiência de enfermeiros por habitantes, bem como qualificar o enfermeiro para o exercício profissional ante as transformações globais.

Health Systems and Nursing Skills in Portugal. / Sistemas de Saúde e Competências do Enfermeiro em Portugal.

The paper discusses the Portuguese Health System that has adopted the Beveridge model, which is based on the financing of health services by taxpayers' income, based on a public system, where the right to health is independent of work and employment. Nursing education is structured in Pre-Graduate Education - Degree; Master and Doctorate in Nursing Sciences and Nursing. The competency of the generalist nurses refers to the professional performance showing the effective application of knowledge and skills, which allows them to make a clinical judgment and decide. The exercise of competencies is based on the interpersonal relationship between the nurse and the individual client or group; decision-making based on scientific evidence, clinical judgment based on the needs of individual or group care, prescribed nursing interventions considering the safety of care and the client, early detection of the real or diagnostic potentials seeking resolution or minimization of consequences, by the values of the patients, as well as respect and professional regulation that establish good practice.

O artigo discorre sobre o Sistema de Saúde em Portugal que possui o modelo de Beverigde, baseado no financiamento dos serviços de saúde pelas receitas, obtidas por impostos sobre o rendimento dos contribuintes, alicerçado num sistema público, em que o direito à saúde é independente do trabalho e do emprego. O ensino de Enfermagem está estruturado em: Formação Pré-Graduada ­ Licenciatura; Mestrado e Doutorado em Ciências de Enfermagem e Enfermagem. A competência do enfermeiro de cuidados gerais refere-se ao desempenho profissional demonstrador da aplicação efetiva do conhecimento e das capacidades, que lhe permitem o juízo clínico e a tomada de decisão. O exercício das competências baseia-se na relação interpessoal entre o enfermeiro e o cliente individual e/ou grupo; tomada de decisão baseada em evidência científica, juízo clínico fundamentado nas necessidades de cuidados individuais ou do grupo, intervenções de Enfermagem prescritas considerando a segurança dos cuidados e do cliente, detecção precoce dos reais ou potenciais diagnósticos buscando resolução ou minimização das consequências, pelos valores dos clientes, além do respeito e regulamentação profissional que estabelecem a boa prática.

Happiness as a strength in the promotion of adolescent and adult young health.

OBJECTIVES: to assess the relation between sociodemographic characteristics of young people associated with the subjectivity of being happy; to evaluate the relationship between the subjectivity of being happy and the perception of health status; to evaluate the relationship between the subjectivity of being happy and the school and family environments and peer groups at school. METHODS: this is an observational study, with an intentional sample of 1,069 young Portuguese people, with ages varying from 14 to 24, most of them women, attending secondary education. The self-filling questionnaire was used. RESULTS: there are statistically significant associations between the subjectivity of being happy and schooling, perception of health status, family APGAR, school and family involvement, absence of problems or teasing by peers at school. CONCLUSIONS: a positive and holistic care coupled with the potential of obtaining and consolidating healthy lifestyles for young people will enable health professionals to perceive them as agents of individual and social change.

[Cultural practices about breastfeeding among families enrolled in a family health program]. / Práticas culturais sobre aleitamento materno entre famílias cadastradas em um Programa de Saúde da Família.

The objective of this study was to identify the cultural practices about breastfeeding among families enrolled in a Family Health Program (FHP). This exploratory study was performed in the city of Pentecoste (Ceará, Brazil), with 15 mothers who showed some restrictive factor for breastfeeding. Data collection was through direct observation and semi-structured interviews. The analysis revealed empirical categories of pleasure in breastfeeding and the prevention of diseases; influence from family/community; and the difficulty to sustain breastfeeding. The mothers reported difficulties related to the practice of breastfeeding, a lack of adequate health service support involving not only biological but also social and cultural factors. There is a disconnection between the scientific discourse and families' everyday cultural practices.

Smartphone addiction and postural alterations in the cervical region in adolescents / Dependência do smartphone e alteração postural da região cervical de adolescentes

ABSTRACT Objective: To evaluate smartphone addiction and postural alterations in the cervical region in adolescents. Methods: A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis. Results: Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05). Conclusions: The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.

RESUMO Objetivo: Avaliar a dependência do smartphone e a alteração postural da região cervical em adolescentes. Métodos: Estudo transversal, com 281 adolescentes (15 a 19 anos), que frequentavam da 1ᵃ à 3ᵃ série do ensino médio, realizado entre setembro e outubro de 2019 na cidade de Fortaleza, Ceará, Brasil. A coleta dos dados ocorreu em duas etapas. Na primeira, eles responderam a quatro questionários autoaplicáveis: questionário sociodemográfico, condições de saúde e uso do smartphon e, Questionário Nórdico de Sintomas Musculoesqueléticos (NMQ), Self-Report Questi onnaire (SRQ-20) e o Smartphone A ddiction Inventory (SPAI-BR). Na segunda etapa, foram submetidos a fotogrametria pelo Software de Avaliação Postural (SAPO) e avaliação antropométrica (peso e altura). Para a análise dos dados, foi utilizado o SPSS Statistics versão 23.0. Resultados: Do total, 63,3% (n=178) dos adolescentes apresentaram dependência do smartphone, com o uso de 5,8 horas (±3,5) durante a semana e 8,7 (±4,0) no fim de semana. Ao analisar o alinhamento postural na visão anterior, observou-se redução significativa da inclinação lateral de cabeça ao digitar no smartphon e (p=0,002) comparado à posição anatômica (baseline). Na visão lateral foi constatado aumento da anteriorização de cabeça durante o uso do smartphon e (p<0,05). Houve associação da dependência do smartphone com a anteriorização de cabeça (p<0,05). Conclusões: O uso do smartphone na posição de digitação causa alteração postural na região cervical, destacadamente naqueles que apresentam dependência do dispositivo. Dessa forma, são necessárias medidas de promoção de saúde que alertem os adolescentes sobre os efeitos adversos causados pelo uso prolongado do smartphone.

[Cultural meanings of infantile asthma]. / Significados culturais da asma infantil.

OBJECTIVE: To analyze the cultural meanings of infantile asthma from the perspective of the mother/carer of the child. METHODOLOGICAL PROCEDURES: Qualitative research conducted in 2004, in the city of Fortaleza (Northeastern Brazil). An ethnographic approach was utilized, consisting of participant observation and interviews with seven mothers, accompanying their children in a hospital emergency ward. Thematic analysis was the technique employed when identifying the meanings of mothers' discourse. ANALYSIS OF RESULTS: Two discussion categories were identified: "disinformation on illness" in which it was possible to perceive that the mothers were not informed with respect to their children's illness; and "cultural care" in which they relate information on caretaking and they use resources of popular knowledge to prevent their children's asthma, such as environmental care and the use of popular remedies, based on medicinal plants. CONCLUSIONS: The disinformation and lack of maternal knowledge on infantile asthma among the mothers indicate the need for an intense educational program, problematizing in nature and based on dialogue, conducted in close collaboration with the treatment aimed at improving the prognosis of the disease.

[International research in nursing: thematic and methodological tendencies]. / Pesquisa internacional em enfermagem: tendências temáticas e metodológicas.

It was aimed to analyze the research tendency developed by nursing in international scope. Obtained data of two nursing journals were analyzed from the total of 104 articles, being 58 of the Nursing and Health Sciences and 48 of the Journal of Research in Nursing published in the period of 2005 the 2006. The most investigated thematic areas are: professional formation (19.2%), adult health (11%), collective health (11%) and Care and Autonomy (9.6%). A major tendency of data collection carried outin hospital area (42.3%), teaching (34.7%), and public health (23%). We consider that the articles under analysis reveal tendency for qualitative approach, however, the study reveals the need to expand some areas such as the management.

Factors associated with interpersonal violence among children from public schools in Fortaleza, Ceará, Brazil. / Fatores associados à violência interpessoal entre crianças de escolas públicas de Fortaleza, Ceará, Brasil.

The school has witnessed the growth of manifestations of interpersonal violence among children, and in this perspective, this paper examines the prevalence of interpersonal violence in the relationship between students and the associated factors. This is a cross-sectional study developed with 874 public school students aged 10 and 11 years conducted in 2013. A questionnaire implemented the collection of data that were submitted to bivariate analysis with statistical significance calculation between associations. The results show that the child-perpetrator (83.2%) is associated with the male gender (PR=1.08), as well as being beaten at home (PR=1.13) and having a family that encourages retaliation (PR=1.17). The child-victim (89.5%) is associated with the family that encourages retaliation (PR=1.05), participation in conflicts (93.6%) and age. The 10-year-old child is up to 3.0% more likely to participate in conflicts. The "family that encourages retaliation" is positively associated with the situations of assault, victim condition and participation in conflicts, which entails the reframing of these parental practices.

A escola presencia o crescimento das manifestações de violências interpessoais entre crianças e, nesta ótica, o artigo analisa a prevalência destas no relacionamento entre escolares e os seus fatores associados. Estudo transversal, com 874 alunos de escolas públicas municipais, de 10 e 11 anos idade, realizado no ano de 2013. Um questionário instrumentou a coleta de dados que foram submetidos à análise bivariada com cálculo de significância estatística entre as associações. Os resultados apontam que a criança agressora (83,2%) associa-se ao sexo masculino (RP = 1,08), bem como apanhar em casa (RP = 1,13) e ter uma família que incentiva o revide (RP = 1,17). A criança vítima (89,5%), a família que incentiva o revide (RP = 1,05) e, a participante de conflitos (93,6%), a família incentivar o revide (RP = 1,05) e a idade. A criança de 10 anos tem até 3,0% mais de chance de participar em situações de conflitos. A "família que incentiva o revide" associa-se as situações de agressão, de vítima e de participação em conflitos, o que enseja uma ressignificação dessas práticas familiares.

Analysis of cases of gestational and congenital syphilis between 2008 and 2010 in Fortaleza, State of Ceará, Brazil. / Análise dos casos de sífilis gestacional e congênita nos anos de 2008 a 2010 em Fortaleza, Ceará, Brasil.

This study analyzes the reported cases of syphilis in pregnant women and the possible outcomes for fetuses and the newborn in Fortaleza, Ceará. It is a cross-sectional study that analyzed 175 reported cases of syphilis in pregnant women matched with the corresponding reports of congenital syphilis during the years 2008-2010. Descriptive statistics with absolute and relative frequencies, central tendency and dispersion measures, and the Pearson's chi-square test were used to analyze the statistical significance using the p-value <0.05. Sociodemographic variables of pregnant/postpartum women, the assistance provided to newborns and the outcome of cases were analyzed. The results showed the occurrence of syphilis in young women with more than 85% of inappropriate treatment, 62.9% of untreated sexual partners or lack of statistics and high percentages of non-realization of the recommended tests for congenital syphilis investigation in children. Among the fetuses, five were stillborn, one miscarried and there were three neonatal deaths. The lack of adequate treatment of pregnant women may be associated with morbidity and mortality of fetuses, maintaining this infection as a burden on the list of public health problems.

O presente estudo analisa os casos notificados de sífilis em gestantes e os possíveis desfechos para o feto e o recém-nascido em Fortaleza, Ceará. Estudo transversal que analisou 175 casos notificados de sífilis em gestantes, pareados com as correspondentes notificações de sífilis congênita durante os anos de 2008 a 2010. Utilizou-se estatística descritiva com frequências absolutas e relativas, medidas de tendência central e dispersão e qui-quadrado de Pearson para analisar a significância estatística, utilizando o valor de p < 0,05. Foram analisadas variáveis sociodemográficas das gestantes/puérperas, da assistência prestada aos recém-nascidos e o desfecho dos casos. Os resultados mostraram a ocorrência da sífilis em mulheres jovens com mais de 85,0% de tratamentos inadequados, 62,9% dos parceiros sexuais não tratados ou com informação ignorada e percentuais elevados da não realização dos exames preconizados para a investigação de sífilis congênita nas crianças. Dentre os conceptos, cinco foram natimortos, um aborto e três óbitos neonatais. A falta de tratamento adequado dos casos de sífilis em gestantes pode estar associada à morbimortalidade dos conceptos, mantendo essa infecção como um fardo no rol dos problemas de saúde pública.

Um estudo da prevalência e da caracterização da mortalidade em crianças e adolescentes por leucemia no Nordeste do Brasil / A study of the prevalence and characterization of mortality in children and adolescents due to leukemia in Northeastern Brazil / Estudio de prevalencia y caracterización de la mortalidad por leucemia en niños y adolescentes del Nordeste Brasileño

Objetivo: Caracterizar a prevalência da mortalidade por leucemias em crianças e adolescentes no Nordeste Brasileiro e sua relação com determinantes sociais da saúde no período de 2008 a 2018. Método: A pesquisa foi um estudo epidemiológico, do tipo ecológico, cujas unidades de análisede área foram os 9 (nove) estados brasileiros da Região Nordeste. Os dados desse estudo foram do tipo secundário, obtidos através do Departamento de Informática do Sistema Único de Saúde (DATASUS), provenientes do Sistema de Informação sobre Mortalidade (SIM). Para esta investigação elegeu-se, crianças e adolescentes, com faixa etária entre 0 (zero) e 19 (dezenove) anos, com óbitos no período de 2008 a 2018, cujo, a leucemia foi a causa básica mencionada na Declaração de Óbito (DO) por meios de códigos conforme a 10o Classificação Internacional de Doenças (CID-10). Resultados: foram registrados 3.025 óbitos por leucemias durante o período analisado. O CID-91 foi o primeiro colocado em número de óbitos (54,9%), em segundo lugar, CID-92 apresentando 30% das notificações e em seguida CID-95 (14,6%), CID-93 (0,3%), CID-94 (0,2%) dos óbitos. Sendo que desses, 57,6% foram do sexo masculino e 42,4% do sexo feminino. A faixa etária mais prevalente foi de 15 a 19 anos de idade (26,1%). A cor parda foi a mais autodeclarada (58,0%). O estado da Bahia foi o mais acometido por óbitos durante o período. Conclusão: O CID-91 teve maior prevalência entre óbitos notificados, que os maiores números de óbitos foram no sexo masculino com faixa etária dos adolescentes entre 15 e 19 anos e de cor parda, e que a mortalidade por leucemia ainda é um sério problema de saúde pública que pode ser reparado com medidas de prevenção e de promoção em saúde.

Objective: to characterize the prevalence of mortality of leukemia in children and adolescents in Brazilian's Northeast and the relationship with social determinants of health in the period from 2008 to 2018. Methods: It is an ecological epidemiological study that analyzed 9 (nine) Brazilian states of the Northeast Region. Data were collected through the Department of Informatics of the Unified Health System (DATASUS), from the Mortality Information System (SIM). For this, children and adolescents, aged between 0 (zero) and 19 (nineteen) years old, with deaths in the period from 2008 to 2018, that leukemia was the cause mentioned in the Death Certificate (DO) according to the 10th International Classification of Diseases (ICD-10) were included. Results: 3,025 deaths from leukemia were recorded during the analyzed period. ICD-91 was ranked first in number of deaths (54.9%), secondly, ICD-92 with 30% of notifications and then ICD-95 (14.6%), ICD-93 (0. 3%), ICD-94 (0.2%) of deaths. Regarding this, 57.6% were male and 42.4% female. The most prevalent aged group was 15 to 19 years old (26.1%). The brown color was the most self-declared (58.0%). The state of Bahia was the most affected by deaths during this period. Conclusion: The ICD-91 had a higher prevalence among notified deaths, that the highest number of deaths were in males aged between 15 and 19 years and of brown skin color, and that mortality from leukemia is still a serious problem of public health that can be repaired with prevention and health promotion measures.

Objetivo: caracterizar la prevalencia de mortalidad por leucemia en niños y adolescentes del Nordeste brasileño y la relación con los determinantes sociales de la salud en el período de 2008 a 2018. Métodos: Se trata de un estudio epidemiológico ecológico que analizó 9 (nueve) estados brasileños de la Región Nordeste. Los datos fueron recolectados a través del Departamento de Informática del Sistema Único de Salud (DATASUS), a partir del Sistema de Información de Mortalidad (SIM). Para eso, fueron incluidos niños y adolescentes, con edad entre 0 (cero) y 19 (diecinueve) años, con muerte en el período de 2008 a 2018, que la leucemia fuese la causa mencionada en el Certificado de Defunción (DME) según la 10ª Clasificación Internacional de Enfermedades (CIE-10). Resultados: Se registraron 3.025 defunciones por leucemia durante el periodo analizado. La CIE-91 ocupó el primer lugar en número de defunciones (54,9%), en segundo lugar, la CIE-92 con un 30% de notificaciones y a continuación la CIE-95 (14,6%), CIE-93 (0. 3%), CIE-94 (0,2%) de defunciones. El 57,6% eran varones y el 42,4% mujeres. El grupo de edad más prevalente fue el de 15 a 19 años (26,1%). El color castaño fue el más autodeclarado (58,0%). El estado de Bahia fue el más afectado por muertes durante este período. Conclusiones: La CIE-91 tuvo una mayor prevalencia entre las muertes notificadas, que el mayor número de muertes se produjo en varones de 15 a 19 años y de color de piel morena, y que la mortalidad por leucemia sigue siendo un grave problema de salud pública que puede ser reparado con medidas de prevención y promoción de la salud.

Práticas de assistência ao parto e nascimento na perspetiva de gestantes com COVID-19 / Perspectives of pregnant women with COVID-19 on childbirth care practices / Prácticas de asistencia al parto y nacimiento desde la perspectiva de gestantes con COVID-19

Resumo Enquandramento: A pandemia de COVID-19 agravou as práticas de cuidar das mulheres no momento do parto. Objetivo: Compreender a perceção das grávidas com COVID-19 acerca da aplicabilidade das boas práticas de assistência ao parto e nascimento. Metodologia: Estudo exploratório e descritivo, com abordagem mista, realizado com 23 gestantes com COVID-19, num hospital público brasileiro. Resultados: O corpus geral consistia em 23 textos, com aproveitamento de 249 Segmentos de Texto (ST). O conteúdo analisado foi categorizado em cinco classes: COVID-19 no contexto da saúde do RN, com 56 STs (22,49%); Parto humanizado e COVID-19, com 51 STs (20,48%); A incerteza dos riscos maternos e fetais, com 39 STs (15,66%); Experiência do parto na pandemia por COVID-19, com 67 STs (26,91%); e Conhecimento sobre sintomas e prevenção contra a COVID-19, com 36 STs (14,46%). Conclusão: Foram encontradas gestantes com pouco conhecimento sobre a política e o seu direito à autonomia no trabalho de parto e pós-parto, evidenciando diversas práticas inadequadas durante a pandemia.

Abstract Background: The COVID-19 pandemic has aggravated childbirth care practices. Objective: To understand the perception of pregnant women with COVID-19 on the applicability of best childbirth care practices. Methodology: Exploratory and descriptive study, with a mixed methods approach, carried out with 23 pregnant women with COVID-19 in a Brazilian public hospital. Results: The general corpus comprised 23 texts with 249 Text Segments (TS). The analyzed content was categorized into five classes: COVID-19 in the context of NB health, with 56 TS (22.49%); Humanized childbirth and COVID-19, with 51 TS (20.48%); The uncertainty of maternal and fetal risks, with 39 TS (15.66%); Childbirth experience in the COVID-19 pandemic, with 67 TS (26.91%); and Knowledge about symptoms and prevention against COVID-19, with 36 TS (14.46%). Conclusion: Pregnant women have little knowledge about the policy and their right to autonomy in labor and postpartum, evidencing inadequate practices during the pandemic.

Resumen Marco contextual: La pandemia de COVID-19 ha empeorado las prácticas asistenciales de las mujeres en el momento del parto. Objetivo: Comprender la percepción de las mujeres embarazadas con COVID-19 sobre la aplicabilidad de las buenas prácticas en la atención al parto. Metodología: Estudio exploratorio y descriptivo, con enfoque mixto, realizado con 23 gestantes con COVID-19 en un hospital público brasileño. Resultados: El corpus general constó de 23 textos, y se utilizaron 249 segmentos de texto (ST). El contenido analizado se clasificó en cinco clases: COVID-19 en el contexto sanitario del RN, con 56 ST (22,49%); parto humanizado y COVID-19, con 51 ST (20,48%); la incertidumbre de los riesgos maternos y fetales, con 39 ST (15,66%); experiencia del parto en la pandemia por COVID-19, con 67 ST (26,91%), y conocimientos sobre los síntomas y la prevención de la COVID-19, con 36 ST (14,46%). Conclusión: Se observó que las gestantes tenían pocos conocimientos sobre la política y su derecho a la autonomía en el parto y el posparto, lo que puso de manifiesto varias prácticas inadecuadas durante la pandemia.

Perinatal outcomes of adolescent and adult mothers: a systematic review / Resultados perinatais de mães adolescentes e adultas: uma revisão sistemática / Resultados perinatales de madres adolescentes y adultas: una revisión sistemática

Objective: To identify and analyze studies published in the literature that researched adverse perinatal outcomes in live births to adolescent and adult mothers. Methods: The electronic databases PubMed and VHL (LILACS and MEDLINE) were consulted, using the MeSH descriptors with Boolean operators were used, which were grouped as follows: ("maternal age") AND ("risk factors") AND ("Pregnancy Complica- tions OR "Adverse Birth Outcomes" OR "Perinatal outcome"). This analysis resulted in eight articles published between 2018 and 2022. Results: Studies presented a strong as- sociation between young maternal age (<20 years) and unfavorable neonatal outcomes, such as low birth weight, premature delivery, need for oxygen therapy and admission to the Neonatal Intensive Care Unit. No significant data were found on adverse outcomes in pregnancies in the optimum age range (20>35 years). Conclusion: The analyzed studies point to a strong association between young maternal age and some clinical-obstetric complications.

Objetivo: Identificar e analisar estudos publicados na literatura que pesquisaram desfechos perinatais adversos em nascidos vivos de mães adolescentes e adultas. Métodos: Foram consultadas as bases de dados eletrônicas PubMed e BVS (LILACS e MEDLINE), utilizando-se os MeSH descritores com operadores booleanos, os quais foram agrupados da seguinte forma: ("maternal age") AND ("risk factors") AND ("Pregnancy Complications OU "Resultados adversos do parto" OU "Resultados perinatais"). Essa análise resultou em oito artigos publicados entre 2018 e 2022. Resultados: Os estudos apresentaram forte associação entre a idade materna jovem (<20 anos) e os desfechos neonatais desfavoráveis, como baixo peso ao nascer, parto prematuro, necessidade de oxigenoterapia e internação na UTI neonatal. Não foram encontrados dados significativos sobre resultados adversos em gestações na faixa etária ideal (20>35 anos). Conclusão: Os estudos analisados apontam para uma forte associação entre idade materna jovem e algumas complicações clínico-obstétricas.

Objetivo: Identificar y analizar estudios publicados en la literatura que investigaran resultados perinatales adversos en nacidos vivos de madres adolescentes y adultas. Métodos: Se realizaron búsquedas en las bases de datos electrónicas PubMed y BVS (LILACS y MEDLINE) utilizando los descriptores MeSH con operadores booleanos, que se agruparon de la siguiente manera: ("edad materna") AND ("factores de riesgo") AND ("complicaciones del embarazo OR "resultados adversos del parto" OR "resultados perinatales"). Este análisis dio como resultado ocho artículos publicados entre 2018 y 2022. Resultados: Los estudios mostraron una fuerte asociación entre la edad materna joven (<20 años) y los resultados neonatales desfavorables, como bajo peso al nacer, parto prematuro, necesidad de oxigenoterapia e ingreso en la UCI neonatal. No se encontraron datos significativos sobre resultados adversos en embarazos en el grupo de edad ideal (20>35 años). Conclusión: Los estudios analizados apuntan a una fuerte asociación entre la edad materna joven y algunas complicaciones clínico-obstétricas.

Intervenções não farmacológicas no controle da dor em recém-nascidos pré-termo: conhecimento da equipe de enfermagem / Non-pharmacological interventions in the control of pain in newborns pre-term: knowledge of nursing staff

Objetivo: Investigar o conhecimento da equipe de enfermagem sobre o manejo não farmacológico da dor e descrever os principais métodos não farmacológicos para o manejo da dor em recém-nascidos pré-termo sob cuidados intensivos. Método: Estudo exploratório-descritivo, com abordagem qualitativa, realizado em Unidade de Terapia Intensiva, de Fortaleza-CE, Brasil, cuja coleta de dados foi realizada de julho a agosto de 2018, por meio de entrevista e observação dos cuidados de enfermagem aos neonatos. Participaram duas enfermeiras e seis técnicas de enfermagem e observaram-se quatro recém-nascidos quanto às respostas fisiológicas e comportamentais aos procedimentos invasivos durante o tratamento intensivo. Resultados: Os métodos mais utilizados pela equipe de enfermagem na Unidade pesquisada foram: soro glicosado a 25%, sucção não nutritiva, contenção facilitada, leite materno e Método Canguru. Conclusão: Algumas participantes demonstraram não conhecer os métodos para manejo não farmacológico da dor em recém-nascidos pré-termo, constatando-se necessidade de mais pesquisas relacionadas à temática investigada.(AU)

Objective: To investigate the knowledge of the nursing staff on non-pharmacological pain management and describe the main non-pharmacological methods for pain management in preterm newborns under intensive care. Method: Exploratory-descriptive study, with a qualitative approach, carried out in an Intensive Care Unit, in Fortaleza-CE, Brazil, whose data collection was carried out from July to August 2018, through interviews and observation of nursing care to neonates. Two nurses and six nursing technicians participated and four newborns were observed for physiological and behavioral responses to invasive procedures during intensive care. Results: The methods most used by the nursing team in the researched unit were: 25% glucose serum, non-nutritive suction, facilitated containment, breast milk and Kangaroo Method. Conclusion: Some participants demonstrated that they do not know the methods for non-pharmacological management of pain in preterm newborns, confirming the need for more research related to the theme investigated. (AU)

Objetivo: Investigar los conocimientos del equipo de enfermería sobre manejo no farmacológico del dolor y describir los principales métodos no farmacológicos para manejo del dolor en recién nacidos prematuros en cuidados intensivos. Método: Estudio exploratorio descriptivo, cualitativo, realizado en Unidad de Cuidados Intensivos, en Fortaleza-CE, Brasil, cuya recolección de datos se realizó de julio a agosto de 2018, a través de entrevistas y observación de cuidados de enfermería a neonatos. Participaron dos enfermeras y seis técnicos de enfermería y se observaron a cuatro recién nacidos para determinar las respuestas fisiológicas y conductuales a los procedimientos invasivos durante los cuidados intensivos. Resultados: Los métodos más utilizados por el equipo de enfermería en la unidad investigada fueron: suero de glucosa al 25%, succión no nutritiva, contención facilitada, leche materna y método canguro. Conclusión: Algunos participantes señalaron no conocen los métodos para manejo no farmacológico del dolor en recién nacidos prematuros, por lo que se necesitan más investigaciones relacionadas al tema investigado.(AU)