Prepartum, childbirth, and immediate puerperium: Nursing diagnoses of mothers of extremely preterm infants.

BACKGROUND: Maternal mortality remains high, despite all the advances and efforts that have occurred in recent years and is directly related to the quality of care provided during pregnancy, childbirth, and in the puerperium. PURPOSE: Identify the possible nursing diagnoses of mothers of newborns admitted to neonatal intensive care in the prepartum period, childbirth, and the puerperium. METHODS: Observational, cross-sectional study carried out by analyzing the medical records of mothers of newborns who required hospitalization in neonatal intensive care and determining the diagnoses through a process of diagnostic inference, based on NANDA-I Taxonomy, during the period from 2007 to 2016. FINDINGS: After reviewing the medical records of 272 mothers, a total of 3,843 observations were identified, distributed in 42 diagnoses, with Excessive fluid volume presenting the greatest predictive power over the outcome variable. The second group of more predictive variables comprised the Risk of vascular trauma, Risk of infection, Impaired parenthood, and Risk of body temperature imbalance. The third group, in turn, consisted of the following diagnoses: Insomnia, Pain during labor, Risk of impaired bonding, Acute pain, and Ineffective Breastfeeding. CONCLUSIONS: The present study enabled the identification of the most frequent NANDA-I nursing diagnoses occurring during the prepartum period, childbirth, and the immediate puerperium of mothers of newborns admitted to neonatal intensive care, as well as those of greatest importance. Based on the encountered diagnoses, it can be concluded that future studies should be carried out in order for validation. IMPLICATIONS: The knowledge of these diagnoses can contribute to the instrumentalization of nursing professionals, with consequent improvements in the nursing process and the provided assistance, aiming to assist in the reduction of maternal morbidity and mortality.

Suicide mortality among youth in southern Brazil: a spatiotemporal evaluation of socioeconomic vulnerability.

OBJECTIVE: To conduct a geospatial analysis of suicide deaths among young people in the state of Paraná, southern Brazil, and evaluate their association with socioeconomic and spatial determinants. METHODS: Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics. Data on suicide mortality rates (SMR) were extracted for three age groups (15-19, 20-24, and 25-29 years) from two 5-year periods (1998-2002 and 2008-2012). Geospatial data were analyzed through exploratory spatial data analysis. We applied Bayesian networks algorithms to explore the network structure of the socioeconomic predictors of SMR. RESULTS: We observed spatial dependency in SMR in both periods, revealing geospatial clusters of high SMR. Our results show that socioeconomic deprivation at the municipality level was an important determinant of suicide in the youth population in Paraná, and significantly influenced the formation of high-risk SMR clusters. CONCLUSION: While youth suicide is multifactorial, there are predictable geospatial and sociodemographic factors associated with high SMR among municipalities in Paraná. Suicide among youth aged 15-29 occurs in geographic clusters which are associated with socioeconomic deprivation. Rural settings with poor infrastructure and development also correlate with increased SMR clusters.

Suicide mortality among youth in southern Brazil: a spatiotemporal evaluation of socioeconomic vulnerability

Objective: To conduct a geospatial analysis of suicide deaths among young people in the state of Paraná, southern Brazil, and evaluate their association with socioeconomic and spatial determinants. Methods: Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics. Data on suicide mortality rates (SMR) were extracted for three age groups (15-19, 20-24, and 25-29 years) from two 5-year periods (1998-2002 and 2008-2012). Geospatial data were analyzed through exploratory spatial data analysis. We applied Bayesian networks algorithms to explore the network structure of the socioeconomic predictors of SMR. Results: We observed spatial dependency in SMR in both periods, revealing geospatial clusters of high SMR. Our results show that socioeconomic deprivation at the municipality level was an important determinant of suicide in the youth population in Paraná, and significantly influenced the formation of high-risk SMR clusters. Conclusion: While youth suicide is multifactorial, there are predictable geospatial and sociodemographic factors associated with high SMR among municipalities in Paraná. Suicide among youth aged 15-29 occurs in geographic clusters which are associated with socioeconomic deprivation. Rural settings with poor infrastructure and development also correlate with increased SMR clusters.

[The factors associated with physical inactivity in a city in southern Brazil]. / Fatores associados à inatividade física no lazer em município do Sul do Brasil.

OBJECTIVE: This study was aimed at determining the prevalence of and factors associated with gender-related physical inactivity in an urban area of a city in southern Brazil. METHODS: Data was obtained from a survey monitoring risk factors regarding chronic non-communicable diseases (NCD) in adults living in Maringá, Paraná, and the random sampling of 453 people living in the chosen urban area. RESULTS: The sample involved 351 women and 102 men; women's physical inactivity rate was 87.5 % and 86.3 % for men. Multivariate regression stated that women aged 50 to 59 years of age were physically active (p=0.01) and those having received 0-8 years of education had become inactive during their leisure time (p=0.02). Compared to males, women who reported being ex-smokers were classified as being active (p=0.03) and those who recognized their state of health as fair were classified as having become inactive during their spare time (p=0.04). CONCLUSION: Inactivity was thus observed amongst both males and females in the target population, even though risk varied and there were distinct protection levels; this would therefore soon become a modifiable risk factor. NCD prevention and control measures must thus be taken through surveillance strategies and monitoring the population's health status.

Fatores associados à inatividade física no lazer em município do Sul do Brasil / The factors associated with physical inactivity in a city in southern Brazil / Factores asociados con la inactividad física en una ciudad en el Sur de Brasil

Objetivo O objetivo deste estudo foi verificar a prevalência e fatores associados à inatividade física no lazer, segundo sexo, em residentes da área urbana de um município do Sul do Brasil. Métodos Os dados foram obtidos da pesquisa de monitoramento de fatores de risco para doenças crônicas não transmissíveis em adultos da cidade de Maringá, Paraná, através de inquérito populacional e amostra de 453 indivíduos. Resultados Foram avaliados 351 mulheres e 102 homens. A taxa de inatividade física no lazer foi de 87,5 % e 86,3 % para as mulheres e homens, respectivamente. Após regressão multivariada, notou-se que as mulheres com idade entre 50 e 59 anos estão fisicamente ativas (p=0,01), e aquelas com 0 a 8 anos de estudo, apresentaram-se inativas no lazer (p=0,02). E relação aos homens, os que declararam ser ex-fumantes, classificaram-se como ativos (p=0,03) e os que reconheceram o estado de saúde como regular, apresentaram-se inativos no lazer (p=0,04). Conclusão Foi possível perceber que embora com variáveis de risco e proteção distintas, a inatividade na população adulta encontra-se presente em ambos os sexos, e logo, por ser um fator de risco modificável, deve integrar-se no rol das medidas de prevenção e controle de doenças, através de estratégias de vigilância e monitoramento do estado de saúde da população.

Objective This study was aimed at determining the prevalence of and factors associated with gender-related physical inactivity in an urban area of a city in southern Brazil. Methods Data was obtained from a survey monitoring risk factors regarding chronic non-communicable diseases (NCD) in adults living in Maringá, Paraná, and the random sampling of 453 people living in the chosen urban area. Results The sample involved 351 women and 102 men; women's physical inactivity rate was 87.5 % and 86.3 % for men. Multivariate regression stated that women aged 50 to 59 years of age were physically active (p=0.01) and those having received 0-8 years of education had become inactive during their leisure time (p=0.02). Compared to males, women who reported being ex-smokers were classified as being active (p=0.03) and those who recognized their state of health as fair were classified as having become inactive during their spare time (p=0.04). Conclusion Inactivity was thus observed amongst both males and females in the target population, even though risk varied and there were distinct protection levels; this would therefore soon become a modifiable risk factor. NCD prevention and control measures must thus be taken through surveillance strategies and monitoring the population's health status.

Objetivo El objetivo de este estudio fue determinar la prevalencia y los factores asociados con inactividad física, por sexo, en los residentes de un área urbana en una ciudad del sur de Brasil. Métodos Los datos se obtuvieron de una encuesta de seguimiento de los factores de riesgo de enfermedades crónicas entre los adultos de la ciudad de Maringá, Paraná, de la cual se tomó una muestra de 453 personas. Resultados Se estudiaron 351 mujeres y 102 hombres. La tasa de inactividad física fue del 87,5 % y del 86,3 % para las mujeres y los hombres, respectivamente. Después de un análisis de regresión multivariada, se observó que las mujeres de edades comprendidas entre 50 y 59 años son físicamente activas (p=0,01), y las que tienen 0-8 años de estudio se han convertido en inactivas durante el tiempo libre (p=0,02). En comparación, los hombres que reportaron ser ex fumadores fueron clasificados como activos (p=0,03) y los que reconocen el estado de salud como regular, se habían convertido en inactivos durante el tiempo libre (p=0,04). Conclusión Se pudo observar que, si bien con diferentes riesgos y distinta protección, la inactividad en adultos está presente en ambos sexos, y que se convierte en un factor de riesgo modificable. Las medidas de prevención y de control de las enfermedades se deben integrar a través de estrategias de vigilancia y seguimiento del estado de salud de la población.