Prevalence of sexual abuse and its association with health-risk behaviors among Brazilian adolescents: A populational study.

BACKGROUND: Analysis of sexual abuse has usually been neglected in research at developing countries despite its everlasting consequences. This study examined the prevalence of sexual abuse among Brazilian adolescents according to data from the National School Health Survey (PeNSE) and analyzed it based on Brazilian regions, sociodemographic aspects, health information, and health-risk behaviors among Brazilian adolescents who reported having experienced sexual abuse previously. PARTICIPANTS AND SETTING: The PeNSE data were utilized, and the sample included 102,072 students from all over Brazil, aged between 11 and 19 years. METHODS: Data were collected by questionnaires and were analyzed by multivariate analysis using the Poisson regression model. RESULTS: The results denoted a relation between sexual abuse, social determinants of health variables (i.e., black, indigenous, and mixed skin color/ethnicity; Brazilian region public school, age between 15 and 18 years, and low education level of the mother), and health-risk behaviors (i.e., early sexual intercourse, having multiple sexual partners, unprotected sexual intercourse, use of tobacco, alcohol, and illicit drugs). CONCLUSION: Therefore, reports of sexual abuse are associated with risky behaviors. Given these findings, targeted interventions on sexual abuse are essential for the health of adolescents and the prevention of risky behaviors, and can also facilitate programs to prevent sexual abuse.

Associação entre autoavaliação de saúde e tipos de atividades de vida diária em idosos / Association between health self-assessment and types of activities of daily living in older adults

Resumo Introdução Apesar das evidências de associação entre incapacidade funcional e autoavaliação de saúde ruim, ainda existe uma lacuna na literatura acerca da influência do tipo de atividade de vida diária na saúde dos idosos. Objetivo Identificar a prevalência de autoavaliação de saúde ruim de idosos e sua associação com a dependência para cada tipo de atividade da vida diária. Método Estudo transversal de base populacional, com amostra probabilística de 890 idosos residentes em Goiânia. Avaliaram-se variáveis demográficas, internações, número de morbidades, atividades básicas e instrumentais da vida diária. Realizou-se uma análise múltipla hierarquizada, considerando como medida de efeito a razão de prevalência. Resultados A prevalência de autoavaliação de saúde ruim foi de 11,5%. Os fatores associados foram: ter três ou mais doenças (RP: 4,26; 95% IC: 1,89-9,62), internação no último ano (PR: 1,59; 95% IC: 1,10-2,28), e incapacidades para: Transferir-se (RP: 2,60; 95% IC: 1,30-8,45), fazer compras (RP: 1,98; 95% IC: 1,16-3,39), usar transporte (RP: 3,86; 95% IC: 1,41-10,5), e usar telefone (RP: 1,60; 95% IC: 1,00-2,63). Conclusão A relação entre incapacidade e percepção negativa de saúde sinaliza a importância de incluí-las na avaliação de idosos em diferentes contextos da atenção à saúde, uma vez que a dependência pode refletir em alterações nas condições reais de saúde e qualidade de vida dos idosos.

Abstract Background Despite the evidence on the association between functional disability and poor self-rated health, there is still a gap on the influence of the type of activity of daily living (ADL) on the health of the elderly population. Objective To identify the negative self-assessment of health by older adults and its association with dependence on each type of ADL. Method A cross-sectional, population-based study with probabilistic data conducted with 890 elderly residents in Goiânia, state of Goiás, Brazil. The following variables were assessed: sample demography, hospitalization, number of morbidities, and basic and instrumental ADLs. A hierarchical multiple analysis was performed considering prevalence ratio (PR) as measure of effect. Results The prevalence of poor self-rated health was 11.5%. Associated factors were as follows: multimorbidity (PR: 4.26; 95% CI 1.89-9.62), hospitalization in the past year (PR: 1.59; 95% CI 1.10-2.28), and disability for transferring (PR: 2.60; 95% CI 1.30-8.45), shopping (PR: 1.98; 95% CI 1.16-3.39), use of transportation (PR: 3.86; 95% CI 1.41-10.5) and use of the telephone (PR: 1.60; 95% CI 1.00-2.63). Conclusion The association between functional disability and negative self-rated health indicate the importance of including them in the evaluation of different health care modalities, since dependence may reflect changes in the actual health conditions and quality of life of older adults.

Cuidados com o uso de insulinas disponibilizadas pelo sus: subsídios para o controle em diabetes mellitusManagement of insulin available by sus: support to control diabetes mellitus / Management of insulin available by sus: support to control diabetes mellitus / Cuidado en el uso de insulinas proporcionado porsus: subvenciones para el cuidado de diabetes mellitus

RESUMO Objetivo: Descrever os cuidados com o uso de insulinas disponibilizadas pelo SUS e analisar os fatores associados aos cuidados inadequados. Método: Estudo transversal com 113 pessoas com Diabetes Mellitus de um ambulatório de Goiânia-GO. Foram coletados dados em prontuários sobre conservação, preparo e administração de insulina que foram classificados em adequados e inadequados. Resultados: Do total de participantes,58,4% eram mulheres e a média de idade foi 48 anos. Hipertensão arterial foi relatada por 70,8% e 89,0% apresentaram hemoglobina glicada ≥7%. A totalidade dos usuários de insulina realizavam pelo menos um tipo de cuidado inadequado e 62,8% realizavam quatro ou mais. Os mais frequentes foram:conservarem locais não recomendados (46,7%), não aplicar insulina 30 minutos antes da refeição (87,5%), não avaliar presença de grumos no frasco de insulina NPH (71,9%) e não retirar a insulina da geladeira entre 15 e 30 minutos antes da aplicação (88,7%). Não houve diferença estatisticamente significante com as variáveis de exposição analisadas, porém a maior proporção de quatro ou mais cuidados inadequados ocorreu nas mulheres, nos jovens, naqueles com 11 ou mais anos de estudo, tempo de doença superior a 10 anos e, entre os que aplicam insulina uma ou duas vezes ao dia. Conclusão: Houve alta prevalência de cuidados inadequados e grande variabilidade de práticas, reforçando a importância da implementação da linha de cuidados em Diabetes Mellitus em todos os níveis de atenção à saúde.

RESUMEN Objetivo: describirlos cuidados con el uso de insulinas proporcionados por el Sistema Único de Salud (SUS) y analizar los factores asociados a los cuidados inadecuados. Método: estudio transversal con 113 personas con Diabetes Mellitus de un ambulatorio de Goiânia-GO-Brasil. Fueron recolectados datos en registros médicos sobre conservación, preparación y administración de insulina que fueron clasificados en adecuados e inadecuados. Resultados: del total de participantes, 58,4% era mujeres y el promedio de edad fue 48 años. La hipertensión arterial fue relatada por 70,8%;y 89,0% presentaron hemoglobina glicada ≥7%. La totalidad de los usuarios de insulina realizaban por lo menos un tipo de cuidado inadecuado y 62,8% realizaban cuatro o más. Los más frecuentes fueron: conservar en locales no recomendables (46,7%), no aplicar insulina 30 minutos antes de la comida (87,5%), no evaluar presencia de grumos en el envase de insulina NPH (71,9%) y no sacar la insulina de la heladera entre 15 y 30 minutos antes de la aplicación (88,7%). No hubo diferencia estadísticamente significante con las variables de exposición analizadas, perola mayor proporción de cuatro o más cuidados inadecuados ocurrió entre las mujeres, en los jóvenes, en aquellos con 11 o más años de estudio, tiempo de enfermedad superior a 10 años y, entre los que aplican insulina una o dos veces al día. Conclusión: hubo alta prevalencia de cuidados inadecuados y gran variabilidad de prácticas, reforzando la importancia de la implementación de la línea de cuidados en Diabetes Mellitus en todos los niveles de atención a la salud.

ABSTRACT Objective: To describe management practices of insulin provided by the SUS and analyze the factors associated with insulin management mistakes. Method: Cross-sectional study addressing 113 individuals with Diabetes Mellitus from an outpatient clinic in Goiânia, GO, Brazil. Data concerning insulin storage, preparation, and administration were collected from the patients' medical records and classified as appropriate or inappropriate. Results: 58.4% of participants were women aged 48 years old on average. Hypertension was reported by 70.8%, and glycated hemoglobin was ≥7% in 89.0%. All the patients made at least one insulin management mistake, and 62.8% made four or more mistakes. The most frequent mistakes were: storing insulin in non-recommended places (46.7%), not injecting insulin 30 minutes before meals (87.5%), not checking for the presence of lumps in the NPH insulin vial (71.9%), and not removing the insulin from the refrigerator between 15 and 30 minutes before injection (88.7%). No significant statistical differences were found among the exposure variables, though women, young individuals, those with 11 or more years of schooling, having the disease for more than ten years, and injecting insulin once or twice a day, more frequently made four or more management mistakes. Conclusion: A high prevalence of insulin management mistakes and considerable variability of practices were identified, reinforcing the importance of implementing a DM line of care at all healthcare system levels.

Body fat percentage assessment by skinfold equation, bioimpedance and densitometry in older adults.

BACKGROUND: Body fat estimation allows measuring changes over time attributed to interventions and treatments in different settings such as hospitals, clinical practice, nursing homes and research. However, only few studies have compared different body fat estimation methods in older adults with inconsistent results. We estimated body fat percentage (%BF) and the level of agreement among dual energy X-ray absorptiometry (DXA), bioelectrical impedance (BIA) and Durnin & Womersley's skinfold eq. (SF) in older Brazilian adults aged 60 years and older from the Elderly Project Goiânia, Brazil. METHODS: The analytical sample comprised of 132 participants who had DXA data. The level of agreement for the %BF estimated by BIA, SF and DXA i.e. reference method, was examined using Bland and Altman's and Lin's plot. RESULTS: Overall, women had higher body mass index and %BF values measured by all three methods used. BIA and SF equation showed strong concordance to estimate body fat percentage in all participants (CCC = 0.857 and 0.861, respectively) and among women (CCC = 0.788 and 0.726, respectively) when compared to DXA. However, both methods underestimated body fat percentage in women and men with high body fat percentage. A strong level of agreement was observed between DXA and the anthropometric equation developed by Durnin & Womersley in men (CCC = 0.846), while BIA had a moderate concordance (CCC = 0.505) in this group. CONCLUSION: The examined methods indicated different body fat estimates. However, the best agreement was observed between DXA and the anthropometric SF equation for men. Future research in older adults should develop new SF equations considering different ethnic groups.

Cardiovascular risk assessment: a comparison of the Framingham, PROCAM, and DAD equations in HIV-infected persons.

This study aims to estimate the risk of cardiovascular disease (CVD) and to assess the agreement between the Framingham, Framingham with aggravating factors, PROCAM, and DAD equations in HIV-infected patients. A cross-sectional study was conducted in an outpatient centre in Brazil. 294 patients older than 19 years were enrolled. Estimates of 10-year cardiovascular risk were calculated. The agreement between the CVD risk equations was assessed using Cohen's kappa coefficient. The participants' mean age was 36.8 years (SD = 10.3), 76.9% were men, and 66.3% were on antiretroviral therapy. 47.8% of the participants had abdominal obesity, 23.1% were current smokers, 20.0% had hypertension, and 2.0% had diabetes. At least one lipid abnormality was detected in 72.8%, and a low HDL-C level was the most common. The majority were classified as having low risk for CV events. The percentage of patients at high risk ranged from 0.4 to 5.7. The PROCAM score placed the lowest proportion of the patients into a high-risk group, and the Framingham equation with aggravating factors placed the highest proportion of patients into the high-risk group. Data concerning the comparability of different tools are informative for estimating the risk of CVD, but accuracy of the outcome predictions should also be considered.

Perfil das hospitalizações e fatores associados em idosos usuários do SUS / The profile of hospitalizations and associated factors among elderly users of the Brazilian Unified Health System (SUS)

Caracterizar as hospitalizações de idosos quanto aos grupos de causas, identificar a prevalência e os fatores associados. Estudo transversal com 418 idosos usuários do SUS selecionados por amostragem em múltiplos estágios proporcional aos nove Distritos Sanitários de Goiânia. A hospitalização foi definida a partir da resposta positiva à pergunta: "O (a) Sr. (a) esteve internado (a) no último ano?" As variáveis de exposição foram coletadas em questionário padronizado. As associações foram exploradas através da Razão de Prevalência e respectivos IC 95%. Empregou-se análise múltipla por meio da Regressão de Poisson hierarquizada. A prevalência de hospitalizações foi 24,4%, sendo as principais causas: doenças do aparelho circulatório (28,4%), respiratório (9,8%), e as infecciosas e parasitárias (9,8%). Na análise múltipla permaneceram associadas às hospitalizações as seguintes variáveis: classe econômica A/B, relato de 5 ou mais morbidades e perda de peso. Os achados deste estudo mostraram alta prevalência de hospitalizações e que os fatores associados estão principalmente relacionados a questões socioeconômicas e de condições de saúde, o que demonstra a necessidade de um acompanhamento destes casos na atenção primária a fim de prevenir hospitalizações desnecessárias.

This article seeks to establish the causes of hospitalizations among the elderly and identify the prevalence and associated factors. It is a cross-sectional study with 418 elderly users of SUS selected by multistage proportional sampling in the nine Sanitary Districts of Goiânia. Hospitalization was defined as a positive response to the question: "Were you hospitalized in the past year?" The independent variables were collected on a standardized questionnaire. Associations were explored through the prevalence ratio and the respective 95% CI. Multivariate analysis was conducted using hierarchical Poisson regression. The prevalence of hospitalizations was 24.4% and the major causes were circulatory (28.4%), respiratory (9.8%) and infectious and parasitic diseases (9.8%). In multivariate analysis, the following variables continued to be associated with hospitalizations: A/B economic class, reports of five or more diseases and weight loss. The results revealed a high prevalence of hospitalizations and that factors involved are mainly related to socioeconomic issues and health status, which demonstrates that it is necessary to monitor these cases in primary health care to prevent unnecessary hospitalization.

[The profile of hospitalizations and associated factors among elderly users of the Brazilian Unified Health System (SUS)]. / Perfil das hospitalizações e fatores associados em idosos usuários do SUS.

This article seeks to establish the causes of hospitalizations among the elderly and identify the prevalence and associated factors. It is a cross-sectional study with 418 elderly users of SUS selected by multistage proportional sampling in the nine Sanitary Districts of Goiânia. Hospitalization was defined as a positive response to the question: "Were you hospitalized in the past year?" The independent variables were collected on a standardized questionnaire. Associations were explored through the prevalence ratio and the respective 95% CI. Multivariate analysis was conducted using hierarchical Poisson regression. The prevalence of hospitalizations was 24.4% and the major causes were circulatory (28.4%), respiratory (9.8%) and infectious and parasitic diseases (9.8%). In multivariate analysis, the following variables continued to be associated with hospitalizations: A/B economic class, reports of five or more diseases and weight loss. The results revealed a high prevalence of hospitalizations and that factors involved are mainly related to socioeconomic issues and health status, which demonstrates that it is necessary to monitor these cases in primary health care to prevent unnecessary hospitalization.

[Self-assessment of health by older Brazilians: systematic review of the literature]. / Autoavaliação da saúde por idosos brasileiros: revisão sistemática da literatura.

OBJECTIVE: To conduct a systematic review of the literature on self-assessment of health status in the elderly population. METHODS: Medline and LILACS were searched following the Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Original articles on self-assessment of health status conducted with older Brazilians were selected. The following were examined: general characteristics of the studies, the prevalence of negative self-assessment of health, the factors associated with this negative self-assessment, the question used to inquire about health status and response categories. RESULTS: Of 97 studies identified, 11 met the inclusion criteria. Variations between the studies regarding the formulation of the question and answer choices were identified. The prevalence of negative health self-assessment ranged from 12.6 to 51.9% between studies. The most usual dependent variables associated with negative self-assessment of health were the presence of disease, number of medications, monthly family/household income, hospitalizations, medical office visits, difficulty/inability to perform activities of daily living, presence of depressive and anxiety symptoms, and complaints of insomnia. CONCLUSIONS: The heterogeneity of factors associated with a negative self-evaluation indicates that the health of older individuals is defined by determinants that fall within a broad view of health. The standardization of questions and answers for research on self-assessment of health in older people is recommended, since this information will produce knowledge and allow monitoring and comparison of results, and will therefore be useful in guiding decision-making regarding the formulation of health policies for Brazil and Latin America.

Autoavaliação da saúde por idosos brasileiros: revisão sistemática da literatura / Self-assessment of health by older Brazilians: systematic review of the literature

OBJETIVO: Realizar uma revisão sistemática da literatura sobre autoavaliação do estado de saúde na população idosa brasileira. MÉTODOS: Foram pesquisadas as bases de dados Medline e LILACS, conforme a metodologia PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Foram incluídos artigos originais sobre a autoavaliação do estado de saúde realizados com idosos brasileiros. Foram consideradas as características gerais dos estudos, a prevalência de autoavaliação negativa da saúde, os fatores associados a essa autoavaliação negativa, a pergunta utilizada para a consulta e as categorias de resposta. RESULTADOS: Dos 97 estudos encontrados, 11 atenderam os critérios de inclusão. Foram identificadas variações entre os estudos quanto à formulação da pergunta e às opções de resposta. A prevalência de autoavaliação negativa de saúde variou de 12,6 a 51,9% entre os estudos. As variáveis dependentes predominantemente associadas a autoavaliação negativa de saúde foram: presença de doenças, número de medicamentos em uso, renda familiar/domiciliar mensal, internações, consultas médicas, dificuldade/incapacidade para atividades de vida diária, presença de sintomas depressivos e ansiosos e queixa de insônia. CONCLUSÕES: A heterogeneidade de fatores associados à autoavaliação negativa indica que a saúde dos idosos é definida por determinantes que se aproximam do conceito ampliado de saúde. É recomendável a padronização das perguntas e respostas de pesquisa sobre autoavaliação de saúde em idosos, já que essas informações possibilitarão conhecer, acompanhar e comparar resultados para orientar a tomada de decisão no tocante à formulação de políticas de saúde para a Brasil e a América Latina.

OBJECTIVE: To conduct a systematic review of the literature on self-assessment of health status in the elderly population. METHODS: Medline and LILACS were searched following the Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Original articles on self-assessment of health status conducted with older Brazilians were selected. The following were examined: general characteristics of the studies, the prevalence of negative self-assessment of health, the factors associated with this negative self-assessment, the question used to inquire about health status and response categories. RESULTS: Of 97 studies identified, 11 met the inclusion criteria. Variations between the studies regarding the formulation of the question and answer choices were identified. The prevalence of negative health self-assessment ranged from 12.6 to 51.9% between studies. The most usual dependent variables associated with negative self-assessment of health were the presence of disease, number of medications, monthly family/household income, hospitalizations, medical office visits, difficulty/inability to perform activities of daily living, presence of depressive and anxiety symptoms, and complaints of insomnia. CONCLUSIONS: The heterogeneity of factors associated with a negative self-evaluation indicates that the health of older individuals is defined by determinants that fall within a broad view of health. The standardization of questions and answers for research on self-assessment of health in older people is recommended, since this information will produce knowledge and allow monitoring and comparison of results, and will therefore be useful in guiding decision-making regarding the formulation of health policies for Brazil and Latin America.

[Estimated mammogram coverage in Goiás State, Brazil]. / Estimativas da cobertura mamográfica no Estado de Goiás, Brasil.

This cross-sectional study aimed to estimate mammogram coverage in the State of Goiás, Brazil, describing the supply, demand, and variations in different age groups, evaluating 98 mammography services as observational units. We estimated the mammogram rates by age group and type of health service, as well as the number of tests required to cover 70% and 100% of the target population. We assessed the association between mammograms, geographical distribution of mammography machines, type of service, and age group. Full coverage estimates, considering 100% of women in the 40-69 and 50-69-year age brackets, were 61% and 66%, of which the Brazilian Unified National Health System provided 13% and 14%, respectively. To achieve 70% coverage, 43,424 additional mammograms would be needed. All the associations showed statistically significant differences (p < 0.001). We conclude that mammogram coverage is unevenly distributed in the State of Goiás and that fewer tests are performed than required.

Estimativas da cobertura mamográfica no Estado de Goiás, Brasil / Estimated mammogram coverage in Goiás State, Brazil

Este estudo transversal objetivou estimar a cobertura da mamografia no Estado de Goiás, Brasil, descrevendo sua oferta, demanda e variações para as diversas faixas etárias, tendo como unidades de observação 98 serviços de mamografia. Foram estimados as frequências de realização da mamografia por faixa etária e tipo de sistema de saúde, bem como o número de exames necessários para a cobertura de 70 por cento e 100 por cento da população-alvo. Foi avaliada a associação entre a realização da mamografia, a distribuição geográfica dos mamógrafos, o tipo de atendimento e a faixa etária. As estimativas de cobertura total para 100 por cento das mulheres nas faixas etárias de 40-69 anos e de 50-69 anos foram de 61 por cento e 66 por cento, tendo o Sistema Único de Saúde contribuído com 13 por cento e 14 por cento, respectivamente. Para atingir 70 por cento de cobertura, seria necessário realizar 43.424 mamografias adicionais. Todas as associações apresentaram diferença estatística significativa (p < 0,001). Conclui-se que a cobertura da mamografia está distribuída de maneira desigual no Estado de Goiás e o número de exames realizados é inferior ao necessário.

This cross-sectional study aimed to estimate mammogram coverage in the State of Goiás, Brazil, describing the supply, demand, and variations in different age groups, evaluating 98 mammography services as observational units. We estimated the mammogram rates by age group and type of health service, as well as the number of tests required to cover 70 percent and 100 percent of the target population. We assessed the association between mammograms, geographical distribution of mammography machines, type of service, and age group. Full coverage estimates, considering 100 percent of women in the 40-69 and 50-69-year age brackets, were 61 percent and 66 percent, of which the Brazilian Unified National Health System provided 13 percent and 14 percent, respectively. To achieve 70 percent coverage, 43,424 additional mammograms would be needed. All the associations showed statistically significant differences (p < 0.001). We conclude that mammogram coverage is unevenly distributed in the State of Goiás and that fewer tests are performed than required.

[Factors associated with poor self-rated health in elderly users of the Brazilian Unified National Health System]. / Fatores associados à autoavaliação de saúde ruim em idosos usuários do Sistema Único de Saúde.

This article reports on prevalence of poor self-rated health and associated factors among elderly users of the Brazilian Unified National Health System (SUS) in Goiânia, Goiás State, Brazil. The article is based on a cross-sectional study with a proportional sample of elderly in the nine health districts of Goiânia. Data were collected after a pilot study and training of field staff. The measure of association was the prevalence ratio (PR) and respective confidence interval (95%CI). Multivariate analysis was performed using hierarchical Poisson regression. In 403 elderly, prevalence of poor self-rated health was 27.5% (95%CI: 23.2-32.2). The rate was 29.7% in women and 29.1% among seniors aged 60-64 years. Variables associated with poor self-rated health according to multivariate analysis were: less than one year of schooling, lack of physical exercise, use of five or more medications, and recent weight loss. The results showed high prevalence of poor self-rated health and associated factors, including both adverse social conditions and individual health and lifestyle factors.

Fatores associados à autoavaliação de saúde ruim em idosos usuários do Sistema Único de Saúde / Factors associated with poor self-rated health in elderly users of the Brazilian Unified National Health System

This article reports on prevalence of poor self-rated health and associated factors among elderly users of the Brazilian Unified National Health System (SUS) in Goiânia, Goiás State, Brazil. The article is based on a cross-sectional study with a proportional sample of elderly in the nine health districts of Goiânia. Data were collected after a pilot study and training of field staff. The measure of association was the prevalence ratio (PR) and respective confidence interval (95 percentCI). Multivariate analysis was performed using hierarchical Poisson regression. In 403 elderly, prevalence of poor self-rated health was 27.5 percent (95 percentCI: 23.2-32.2). The rate was 29.7 percent in women and 29.1 percent among seniors aged 60-64 years. Variables associated with poor self-rated health according to multivariate analysis were: less than one year of schooling, lack of physical exercise, use of five or more medications, and recent weight loss. The results showed high prevalence of poor self-rated health and associated factors, including both adverse social conditions and individual health and lifestyle factors.

Foram investigados a prevalência e os fatores associados à autoavaliação do estado de saúde ruim em idosos usuários do SUS, em Goiânia, Goiás, Brasil. Estudo transversal, com amostra de idosos proporcional aos nove Distritos Sanitários de Goiânia. Os dados foram coletados após estudo piloto e treinamento da equipe de campo. A medida de associação foi a razão de prevalência (RP) e respectivos intervalos de 95 por cento de confiança (IC95 por cento). Realizou-se análise multivariada por regressão de Poisson hierarquizada. Em 403 idosos, a prevalência de autoavaliação do estado de saúde ruim foi de 27,5 por cento (IC95 por cento: 23,2-32,2), sendo 29,7 por cento nas mulheres e 29,1 por cento entre idosos com 60-64 anos de idade. As variáveis associadas após análise multivariada foram: ter menos de 1 ano de estudo, não praticar atividade física, uso de 5 ou mais medicamentos e perda de peso recente. Os resultados demonstraram elevada prevalência de autoavaliação de saúde ruim, e os fatores associados compreendem desde as condições sociais do idoso até as suas condições de saúde e estilo de vida.

[Functional capacity, socioeconomic conditions and of health of elderly assisted by Family Health teams in Goiania (GO, Brazil)]. / Capacidade funcional, condições socioeconômicas e de saúde de idosos atendidos por equipes de Saúde da Família de Goiânia (GO, Brasil).

The population ageing is a challenge for health professionals. This study seek to evaluate the functional capacity and to identify the factors associated to the dependence for the activities of daily life (ADL) and activities instrumental of daily life (AIDL), and also to describe the socioeconomic, demographic and health profile of the elderly. A transverse study was carried out with seniors assisted by Family Health teams of the District East Sanitary of Goiania (GO). A questionnaire was applied to obtain socioeconomic and demographic date, factors related to the health and scales of the functional evaluation. For analyses it was used Square-Qui Test considering the level of significance of 5%. The sample was composed by 388 elderly, 57.5% with age varying from 60 to 69 years, 58.5% female, 39.7% illiterate, 77.3% with income ≤ 2 minimum wages and 70.9% bearers of chronic diseases. It was verified that 34.8% needed help in one or more ADL and 60.6% in AIDL. The factors more frequently associated at dependence in both activities were: balance and mobility debilitated, depression, cognitive deficit and age ≥ 80 years. These results denote that the elderly are living aging characterized by comorbidities and dependence to accomplish daily activities.

Capacidade funcional, condições socioeconômicas e de saúde de idosos atendidos por equipes de Saúde da Família de Goiânia (GO, Brasil) / Functional capacity, socioeconomic conditions and of health of elderly assisted by Family Health teams in Goiania (GO, Brazil)

O envelhecimento populacional é um desafio para os profissionais de saúde. Este estudo objetivou avaliar a capacidade funcional e identificar os fatores associados à dependência para as atividades de vida diária (AVD) e instrumentais de vida diária (AIVD) e descrever o perfil socioeconômico, demográfico e de saúde de idosos. Trata-se de pesquisa transversal realizada com idosos atendidos pelas equipes de Saúde da Família do Distrito Sanitário Leste de Goiânia (GO). Aplicou-se questionário para obtenção de dados socioeconômicos e demográficos, fatores relacionados à saúde e escalas de avaliação funcional. Para análise, utilizou-se o teste Qui-Quadrado, considerando o nível de significância de 5 por cento. A amostra foi composta por 388 idosos, sendo 57,5 por cento entre 60 e 69 anos, 58,5 por cento do sexo feminino, 39,7 por cento analfabetos, 77,3 por cento com renda < 2 salários mínimos; 70,9 por cento referiram doenças crônicas. Verificou-se que 34,8 por cento necessitavam de ajuda em uma ou mais AVD e 60,6 por cento nas AIVD. Os fatores mais frequentemente associados a essa dependência em ambas as atividades foram: equilíbrio e mobilidade prejudicados, depressão, déficit cognitivo e idade > 80 anos. Esses resultados denotam que os idosos estão vivenciando envelhecimento caracterizado por comorbidades e dependência para realizar as atividades diárias.

The population ageing is a challenge for health professionals. This study seek to evaluate the functional capacity and to identify the factors associated to the dependence for the activities of daily life (ADL) and activities instrumental of daily life (AIDL), and also to describe the socioeconomic, demographic and health profile of the elderly. A transverse study was carried out with seniors assisted by Family Health teams of the District East Sanitary of Goiania (GO). A questionnaire was applied to obtain socioeconomic and demographic date, factors related to the health and scales of the functional evaluation. For analyses it was used Square-Qui Test considering the level of significance of 5 percent. The sample was composed by 388 elderly, 57,5 percent with age varying from 60 to 69 years, 58,5 percent female, 39,7 percent illiterate, 77,3 percent with income < 2 minimum wages and 70,9 percent bearers of chronic diseases. It was verified that 34,8 percent needed help in one or more ADL and 60,6 percent in AIDL. The factors more frequently associated at dependence in both activities were: balance and mobility debilitated, depression, cognitive deficit and age > 80 years. These results denote that the elderly are living aging characterized by comorbidities and dependence to accomplish daily activities.

Indicadores de Saúde Infantil em Goiânia, Goiás, no período de 2000 a 2004, segundo dados do Sistema de Informação da Atenção Básica ? SIAB / Child health indicators in Goiânia, Goiás, in the period of 2000 - 2004 according to data of the System of Information of Basic Attention ? SIAB / Indicadores de la salud de niño de Goiânia, Goiás, en el período de 2000 - 2004 según los datos del sistema de la información de la atención básica - SIAB

Buscou-se analisar indicadores de saúde infantil das famílias atendidas pelo Programa Saúde da Família de Goiânia no período de 2000 a 2004, com base nos dados do Sistema de Informação da Atenção Básica (SIAB). Estudo descritivo com análise de variáveis de seis Distritos Sanitários (DS). Realizou-se teste do qui-quadrado considerando o nível de significância valor-p < 0,05. No período entre 2000 e 2004 observou-se aumento da TMI (73,8%), no baixo peso ao nascer (5,6%), do aleitamento materno exclusivo (7,3%) e do acompanhamento de pré-natal iniciado no primeiro trimestre (13,7%). Observou-se redução na freqüência de crianças desnutridas menor de 1 ano (5,0%) e redução das hospitalizações em crianças menores de 5 anos por pneumonia (47,9 %) e desidratação (14,5%). A cobertura de vacinação foi superior a 90% nos seis DS estudados. Com a análise destes dados mais que um panorama da evolução da saúde infantil o que fica claro é a baixa confiabilidade do próprio SIAB. É necessário repensar a qualidade dos dados, bem como a regularidade com que o sistema é alimentado para no futuro utilizar estas informações de forma a realmente traçar um panorama da saúde e auxiliar no processo decisório de gestão do SUS.

Searched to analyze pointers of infant health of the families taken care of for the Program Health of the Family of Goiânia in the period of 2000 the 2004, on the basis of the data of the System of Information of the Basic Attention (SIAB). Descriptive study with analysis of variable of six Sanitary Districts (SD). Test of the qui-square was was done considering the level of significance value-p < 0,05. In the period between 2000 and 2004 there were observed increase of the infant mortality rate (73.8%), in the low birth weight (5.6%), of the exclusive breastfeeding (7.3%) and of the following prenatal initiated in the first trimester (13.7%). Reduction in the frequency of malnourished within the one-year-old group (5.0%) and reduction of hospitalizations within the five-year-old children for pneumonia was observed (47.9%) and dehydration (14.5%). The vaccination covering was superior 90% in the six studied SD. It became clear the evolution of the infant health is low trustness of the proper SIAB. It is necessary to rethink the quality of the data, as well as the regularity with that the system is fed and in the future using these information to trace a panorama of the health and assistant in the process of management of the SUS.

Buscaron para analizar indicadores de la salud infantil de las familias tomadas cuidado para de la salud del programa de la familia de Goiânia a el ciclo de 2000 el 2004, en base de los datos del Sistema de la Información de Atención Básica (SIAB). Estudio descriptivo con análisis de variables de seis Districtos Sanitarios (DS). La prueba del qui-cuadrado fue hecho considerando el nivel de la significación del valor-p < 0.05. En el período entre 2000 y 2004 fue observado el aumento del TMI (73.8%), en el peso bajo al nacimiento (5.6%), del aleitamento maternal exclusivo (7.3%) y del acompañamiento del prenatal iniciado en el primer trimestre (13.7%). Fue observada la reducción en la frecuencia de desnutridas minor de 1 año (5.0%) y fue observada la reducción de hospitalizaciones del hospitalización em niños minors de 5 años por pulmonía (47.9%) y la deshidratación (14.5%). La cubierta de la vacunación era el 90% superior en los seis DS estudiados. Con el análisis de estos datos más que un panorama de la evolución de la salud infantil cuál es claramente él es confiabilidade del SIAB. Es necesario repensar la calidad de los datos, así como la regularidad con eso el sistema se alimenta a usar en el futuro este la información para trazar un panorama de la salud y de la ayudante en la decidir al proceso de la gerencia del SUS.

Fatores associados à ocorrência de cesárea e aborto em mulheres selecionadas em um centro de saúde no município do Rio de Janeiro, Brasil / Factors associated to cesarean sections and abortions in women selected from a health clinic in the city of Rio de Janeiro, Brazil

OBJETIVOS: investigar fatores potencialmente associados à ocorrência de cesárea e aborto. MÉTODOS: foram analisados dados de uma coorte no pós-parto com 352 mulheres entre 15-45 anos. Os seguintes desfechos foram estudados: ocorrência de cesárea no último parto e ocorrência de aborto anterior à última gravidez. A análise estatística foi feita por meio de modelos de regressão logística multivariados e hierarquizados. RESULTADOS: as prevalências de cesárea e aborto foram de 36,3 por cento e 34,0 por cento, respectivamente. O modelo final revelou que as seguintes variáveis permaneceram estatisticamente associadas à ocorrência de cesárea: nível 1: cor de pele branca (OR=2,02; IC95 por cento: 1,29-3,16); nível 2: ligadura (OR=19,68; IC95 por cento: 5,77-67,15). As seguintes variáveis permane-ceram associadas à ocorrência de aborto: nível 1: idade >29 anos (OR=6,11; IC95 por cento: 2,94-12,72), estado marital: vive em união (OR=4,22; IC95 por cento: 2,03-8,78); solteira: (OR=3,70; IC95 por cento: 1,59-8,61). CONCLUSÕES: a cor de pele branca e a prática de ligadura foram co-variáveis potencialmente associadas à ocorrência de cesárea, enquanto o estado marital em união ou solteira e a idade materna estiveram associadas à ocorrência de aborto, sendo maior a probabilidade para mulheres acima de 29 anos.

OBJECTIVES: to investigate factors potentially associated to cesarean sections and abortions. METHODS: data from a cohort study during postpartum were analyzed for 352 women aged 15-45 years old. The following outcomes were studied: cesarean sections and abortions prior to current pregnancy. Statistical analysis included multivariate logistic regression models with hierarchical approach. RESULTS: c-sections and abortions prevalence were 36.3 percent and 34.0 percent, respectively. The final model indicated that the following variables remained associated to cesarean sections: level 1: Caucasian white (OR=2.02; 95 percentCI: 1.29-3.16); level 2: tubal ligation (OR=19.68; 95 percentCI: 5.77-67.15). The following variables remained associated to abortion occurrence: level 1: age >29 years (OR=6.11; 95 percentCI: 2.94-12.72); marital status: married (OR=4.22; 95 percentCI: 2.03-8.78), single (OR=3.70; 95 percentCI: 1.59-8.61). CONCLUSIONS: white Caucasian women and tubal ligation were potentially associated co-variables for cesarean sections performance while marital status and maternal age were associated to abortions, prevalent in women over 29 years old.