Women Abused: Analysis of Assistance Provided by Urgency Mobile Service.

Considering that reports of violence against women must come after a victim seeks help, the subject matter transcends health-related issues. In Brazil, mobile urgency services (SAMU/SIATE) frequently provide first aid to these women and, to the best of our knowledge, no other research has specifically examined the first reaction given to these women. The present study aimed to analyze SAMU/SIATE assistance to abused women in a cross-sectional study of the assistance to assaulted women provided by SIATE and SAMU Maringá/Norte Novo between 2011 and 2020. Women between 20 and 39 years old, non-pregnant, were the main victims, and 19.52% of them have used drugs of some kind. The (ex) partner figured as the perpetrator in 17.35%, but there was no information about this variable in 73.75% of the records. The Chi-square test shows a mortality rate superior to 70% among the severely traumatized victims. This is the first research work to examine the kind of care that SAMU/SIATE offers, and it identifies several weaknesses in its "modus operandi" that may prevent the results from being applied to larger contexts. In addition, further studies on mobile urgent care services in other provinces are required in order to suggest ways to lessen this epidemic.

Exploring regional disparities in lung cancer mortality in a Brazilian state: A cross-sectional ecological study.

BACKGROUND: Lung cancer (LC) is one of the main causes of mortality in Brazil; geographic, cultural, socioeconomic and health access factors can affect the development of the disease. We explored the geospatial distribution of LC mortality, and associated factors, between 2015 and 2019, in Parana state, Brazil. METHODS AND FINDINGS: We obtained mortality (from the Brazilian Health Informatics Department) and population rates (from the Brazilian Institute of Geography and Statistics [IBGE]) in people over 40 years old, accessibility of oncology centers by municipality, disease diagnosis rate (from Brazilian Ministry of Health), the tobacco production rate (IBGE) and Parana Municipal Performance Index (IPDM) (from Parana Institute for Economic and Social Development). Global Moran's Index and Local Indicators of Spatial Association were performed to evaluate the spatial distribution of LC mortality in Parana state. Ordinary Least Squares Regression and Geographically Weighted Regression were used to verify spatial association between LC mortality and socioeconomic indicators and health service coverage. A strong spatial autocorrelation of LC mortality was observed, with the detection of a large cluster of high LC mortality in the South of Parana state. Spatial regression analysis showed that all independent variables analyzed were directly related to LC mortality by municipality in Paraná. CONCLUSIONS: There is a disparity in the LC mortality in Parana state, and inequality of socioeconomic and accessibility to health care services could be associated with it. Our findings may help health managers to intensify actions in regions with vulnerability in the detection and treatment of LC.

Comparative Analysis of Mortality due to Breast Cancer and Mammography Uptake in the Federative Units of Brazil-2015 to 2021.

Objective: Compare the breast cancer mortality rate and the rate of mammograms with socioeconomic factors, in Brazilian´s Federative Units, during the period of 2015 to 2021. Methods: This is an ecological study, of a descriptive nature, which covers the 27 Brazilian federative units, using secondary data extracted from the DATASUS System. The information analyzed was mammography data, breast cancer mortality, demographic and economic data of the resident population and women over 20 years of age. Results: There is a direct relationship between mortality rate and mammograms rates in the Federative Units. The data obtained for Brazil presents a total of 133,048 deaths from breast cancer and 17,324,526 mammography exams in the period from 2015 to 2021. In other words, Brazil presents a standardized mortality rate value, 19.25 deaths per 100,000 women. Regarding the mammography rate, the value of the exam-specific mammography rate was 2,506.55 per 100,000 women. In relation to socioeconomic data by mortality rate group, higher mortality rates from breast cancer present higher rates in the variables: income rate by State (2,594.86), people with income (63.5), average percentage of women with more over 50 years old (29.5%), women with average years of education (6.64), white population (55.1%) and mammography exam rate (2873.20). When analysing the highest rates of mammography exam rates, higher rates are observed income rate by State (2,161.47), people with income (62.5%), average percentage of women over 50 years old (28.6%), women with an average number of years of education (5.8). Conclusion: Brazil has a high mortality rate due to breast cancer, when compared to other countries. The reasons are diverse, such as the modern, industrialized and populous lifestyle. The Federative Units with the highest mortality rate also have high rates of mammograms, that is, in the Federative Units with "better" sociodemographic conditions, the South and Southeast.

Uso da medicina popular na prevenção da Covid-19 / Use of folk medicine in the prevention of Covid-19 / Uso de la medicina popular en la prevención del Covid-19

A procura pela medicina popular tem sido recorrente, em que plantas medicinais são consumidas como agentes terapêuticos na prevenção de diversos sintomas e doenças. O objetivo deste estudo foi analisar a utilização de produtos naturais da medicina popular durante a pandemia, na prevenção da infecção e dos sintomas da COVID-19. Foi feito um estudo observacional transversal descritivo. Utilizou-se como processo de amostragem o método de recrutamento consecutivo de participantes (Snowball), por meio de um questionário distribuído nacionalmente pelas mídias sociais para a população acima de 18 anos de idade, no período de setembro de 2021 a março de 2022. Para as análises estatísticas foi utilizado o teste Qui-quadrado de Pearson e/ou o exato de Fisher, considerando intervalos de confiança de 95% e nível de significância de 5% (p < 0,05). Participaram do estudo 1022 pessoas. Variáveis como sexo, escolaridade, idade, área de residência e região geográfica influenciaram significativamente a busca e o consumo de produtos a base de plantas medicinais. A maioria da população utilizou produtos naturais a base de plantas medicinas no período, sentiu melhora da saúde ao consumi-los e indica o uso para a prevenção da COVID-19 e de sintomas associados. No entanto, merece atenção o risco de toxicidade proveniente do uso incorreto e de interações medicamentosas, sendo necessários mais estudos.

The demand for popular medicine has been recurrent, in which medicinal plants are consumed as therapeutic agents in the prevention of various symptoms and diseases. The objective of this study was to analyze the use of natural products from popular medicine during the pandemic, in the prevention of infection and symptoms of COVID-19. A descriptive cross-sectional observational study was carried out. The method of consecutive recruitment of participants (Snowball) was used as a sampling process, through a questionnaire distributed nationally on social media for the population over 18 years of age, from September 2021 to March 2022. Pearson's chi-square test and/or Fisher's exact test were used for statistical analysis, considering 95% confidence intervals and a significance level of 5% (p < 0.05). A total of 1022 people participated in this study. Variables such as gender, education, age, area of residence and geographic region significantly influenced the search for and consumption of products based on medicinal plants. The majority of the population used natural products based on medicinal plants in the period, felt an improvement in health when consuming them and indicated their use for the prevention of COVID-19 and associated symptoms. However, the risk of toxicity from incorrect use and drug interactions deserves attention, requiring further studies.

Ha sido recurrente la demanda de la medicina popular, en la que se consumen plantas medicinales como agentes terapéuticos en la prevención de diversos síntomas y enfermedades. El objetivo de este estudio fue analizar el uso de productos naturales de la medicina popular durante la pandemia, en la prevención de la infección y síntomas del COVID-19. Se realizó un estudio observacional descriptivo transversal. Se utilizó como proceso de muestreo el método de reclutamiento consecutivo de participantes (Bola de Nieve), a través de un cuestionario distribuido a nivel nacional en medios sociales para la población mayor de 18 años, de septiembre de 2021 a marzo de 2022. Para el análisis estadístico se utilizó la prueba de chi cuadrado de Pearson y/o la prueba exacta de Fisher, considerando intervalos de confianza del 95% y un nivel de significancia del 5% (p < 0,05). Un total de 1022 personas participaron en este estudio. Variables como el sexo, la educación, la edad, la zona de residencia y la región geográfica influyeron significativamente en la búsqueda y el consumo de productos a base de plantas medicinales. La mayoría de la población utilizó productos naturales basados en plantas medicinales en el periodo, sintió una mejora de la salud al consumirlos e indicó su uso para la prevención de la COVID-19 y los síntomas asociados. Sin embargo, el riesgo de toxicidad por el uso incorrecto y las interacciones farmacológicas merecen atención, requiriendo estudios adicionales.

Violence against health personnel before and during the COVID-19 pandemic.

OBJECTIVE: Violence in the workplace has been an alarming phenomenon around the world. The aim of this study was to analyze the frequency of violence against health personnel in urgent and emergency departments, before and during the COVID-19 pandemic. METHODS: This is an exploratory cross-sectional study including a structured online survey with the approval of the Research Ethics Committee. The sample was composed of health personnel over 18 years old who work in urgent and emergency departments. The survey was structured with sections: sociodemographic data, detailing of occupational data, and a survey of physical, verbal, sexual, and racial violence. Descriptive statistics included absolute frequencies and percentages for categorical variables and means with standard deviation for continuous variables. RESULTS: A total of 114 participants, aged between 20 and 60 years, answered the questionnaire; 68.4% of them were women. Most of them were white (71.9%), married or living with a partner (70.2%), residing in the south or southeast regions (85.1%) of Brazil, 56.1% doctors, 11.4% nurses, and 12.3% nursing technicians. The incidence of violence before the COVID-19 pandemic was 60%. During the pandemic, the incidence suffered low variation, being 57.9%. Only 37.7% said that their workplace offers some procedure/routine to report acts of violence suffered at work. Verbal violence was the most reported among the participants. Anxiety, tiredness, fear, low self-esteem, loss of concentration, and stress are the most frequent consequences of aggression. CONCLUSION: Our results suggest that the COVID-19 pandemic did not potentiate the episodes of violence; however, episodes of violence continue to occur, and so management and prevention measures must be implemented.

Violence against health personnel before and during the COVID-19 pandemic

SUMMARY OBJECTIVE: Violence in the workplace has been an alarming phenomenon around the world. The aim of this study was to analyze the frequency of violence against health personnel in urgent and emergency departments, before and during the COVID-19 pandemic. METHODS: This is an exploratory cross-sectional study including a structured online survey with the approval of the Research Ethics Committee. The sample was composed of health personnel over 18 years old who work in urgent and emergency departments. The survey was structured with sections: sociodemographic data, detailing of occupational data, and a survey of physical, verbal, sexual, and racial violence. Descriptive statistics included absolute frequencies and percentages for categorical variables and means with standard deviation for continuous variables. RESULTS: A total of 114 participants, aged between 20 and 60 years, answered the questionnaire; 68.4% of them were women. Most of them were white (71.9%), married or living with a partner (70.2%), residing in the south or southeast regions (85.1%) of Brazil, 56.1% doctors, 11.4% nurses, and 12.3% nursing technicians. The incidence of violence before the COVID-19 pandemic was 60%. During the pandemic, the incidence suffered low variation, being 57.9%. Only 37.7% said that their workplace offers some procedure/routine to report acts of violence suffered at work. Verbal violence was the most reported among the participants. Anxiety, tiredness, fear, low self-esteem, loss of concentration, and stress are the most frequent consequences of aggression. CONCLUSION: Our results suggest that the COVID-19 pandemic did not potentiate the episodes of violence; however, episodes of violence continue to occur, and so management and prevention measures must be implemented.

Prevalence and Impact of Academic Violence in Medical Education.

Situations of mistreatment in the academic environment are prevalent worldwide, but research in this area is scarce in middle-low-income countries. This study aimed to estimate the prevalence of mistreatment inflicted against Brazilian medical students. In addition, characterize these situations and analyze their consequences. Cross-sectional study conducted with 831 medical students from public and private institutions. Absolute and relative frequencies of the analyzed variables and possible associations were determined through univariate and multivariate logistic regression. Chi-square test of association with second-order Rao-Scott adjustment was also used. The response rate was 56%. Public institution pointed to a higher prevalence of mistreatment when compared to private (59% versus 43%). Female students were the most affected. Verbal and psychological aggression was more prevalent. The aggressor usually was a faculty member. Mistreatment incidence increased over the years of training, with higher rates in the internship. About 94% of the students felt affected in anyway, with 77% feeling diminished and depressed. More than 50% reported impaired academic performance. Almost 30% sought help from experts. The reporting rate was extremely low. Adequate identification of the situations by the victims, safe reporting mechanisms and, an educational system capable of maintaining an appropriate learning environment are essential to break this destructive cycle.

Colorectal cancer mortality in women: trend analysis in Brazil and its regions and states.

OBJECTIVES: to analyze colorectal cancer mortality trends in women in Brazil and its regions and states. METHODS: ecological, time-series study with trend analysis of deaths caused by colorectal cancer in women in Brazil and its regions and states between 2008 and 2019. Polynomial regression was used to treat the data. RESULTS: 48,225 deaths of women caused by colorectal cancer were examined. There was an increasing mortality trend in Brazilian women, with regional differences that resulted from socioeconomic, political, and cultural inequalities. The South Region stood out with the highest rate (7.32) in 2008, which increased to 8.65 in 2019, followed by the Southeast Region, whose rates were 6.72 and 9.05 in 2008 and 2019, respectively. CONCLUSIONS: colorectal cancer mortality increased, which indicates the need to expand public policies oriented toward screening and early diagnosis of colorectal cancer in women.

Factors associated with vaccination against Covid-19 in pregnant and hospitalized postpartum women: A retrospective cohort study.

OBJECTIVE: To analyze the characteristics associated with vaccination against Covid-19 in pregnant and postpartum women with Severe Acute Respiratory Syndrome in Brazil and to investigate a possible association between vaccination and the clinical course and outcome of the disease. METHODS: Retrospective cohort study of hospitalized pregnant and postpartum women diagnosed with Severe Acute Respiratory Syndrome (SARS) by SARS-CoV-2, presenting onset of signs and symptoms between May and October 2021. Secondary data were used, available in the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe). Data were analyzed using the SPSS statistical program, medians were applied to present continuous variables and frequencies, and proportions were calculated for categorical variables, using logistic and multivariate regression analysis. RESULTS: The final study population included 3,585 pregnant and postpartum women, of whom 596 (16.6) were vaccinated: 443 (74.3%) received one dose and 153 (25.7%) received two doses. They were factors associated with non-vaccination against Covid-19 age ≤ 19 anos (OR: 2.57; IC95% 1.40;4.71), non-white women (OR: 1.34; IC95% 1.07;1.67) and those who required ventilatory support (OR: 1.51; IC95% 1.19;1.90) and invasive ventilation (OR: 2.05; IC95% 1.37;3.08). On the other hand, vaccination was associated with advanced maternal age (OR: 0.60; IC95% 0.48;0.76), presence of comorbidities (OR: 0.57; IC95% 0.45;0.72) and loss of taste (OR: 0.63; IC95% 0.48;0.82). CONCLUSIONS: Demographic, ethnic-racial and clinical characteristics were associated with the vaccination status of pregnant and postpartum women with SARS by SARS-CoV-2 in Brazil. Vaccination against Covid-19 in the obstetric population has already shown positive results in the evolution of severe cases, which reiterates its importance. It is essential that health services advance vaccination against Covid-19 in the obstetric population, especially adolescentes and non-white women.

Use and Applicability of the Gail Model to Calculate Breast Cancer Risk: A Scoping Review.

OBJECTIVE: To perform a scoping review of the applicability of the Gail model in different countries for different ethnicities. METHODS: The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and search strategies based on the PICOS approach. The reviewed articles were included if they were published between 2013 and 2018 in English, Portuguese, or Spanish; were original articles available in full online; and described the use of the Gail model. The PubMed, Embase, and Web of Science data bases were searched. RESULTS: A total of 38 articles eligible for analysis were identified, of which 16 used the Gail model to assess breast cancer risk in women, eight analyzed the applicability of this tool in their population, seven compared the tool and/or modified it according to the specific risk factors of their population, and seven cited the model in determining eligibility for chemoprevention. CONCLUSION: The Gail model has different applicabilities Greater effectiveness and breast cancer risk are found in developed countries.

Violência mental: ansiedade e depressão durante a pandemia de COVID-19 no Brasil / Mental violence: anxiety and depression during COVID-19 pandemic in Brazil

Buscou-se avaliar a frequência de ansiedade e depressão e seus fatores associados ao longo da pandemia de COVID-19. Estudo transversal exploratório envolvendo 1.057 participantes, sendo aplicados os questionários GAD-7 e PHQ-9, através de Plataforma Google Forms, com amostragem bola de neve. A média de idade foi de 38 ± 14 anos, sendo 78% mulheres, provindos de 21 Estados brasileiros. Quarenta e dois por cento dos participantes tiveram escore GAD-7 ≥ 10, cerca de 53% teve escore PHQ-9 ≥ 10. Principais fatores de risco incluíram: gênero feminino, ser jovem, casado ou com companheiro, consumir bebidas alcoólicas, problemas psiquiátricos prévios, utilizar medicação para dormir, dormir menos de 8 horas, percepção negativa sobre COVID-19, estar em isolamento social, pesadelos frequentes e ideação suicida. O Brasil mantém-se com altos níveis de ansiedade e depressão durante a pandemia em associação com ideação suicida.

Anxiety and depression disorders are associated with professional and academic impairment and reduced life quality. Frequency of symptoms of anxiety and depression, and their association with health risk behaviors during the COVID-19 pandemic are evaluated. Cross-sectional study comprised 1,057 participants, 78% females, mean age 38±14 years, from 21 different Brazilian states. GAD-7 and PHQ-9 inventories were applied by Google Forms, with snowball sampling. Forty-two percent of the participants had a GAD-7 score ≥ 10, while 53% had a PHQ-9 score ≥ 10. Main risk factors comprised: being female, young, married or with partner, consuming alcoholic beverages, having previous psychiatric problems, taking sleeping pills, sleeping less than 8 hours, having a negative perception about COVID-19, staying isolated, having frequent nightmares and suicide thoughts. Brazil is a country featuring high levels of symptoms of anxiety and depression, significantly associated with suicide thoughts.

Gastroschisis annual incidence, mortality, and trends in extreme Southern Brazil

Abstract Objective: To analyze gastroschisis annual incidence, mortality rates, and trends in the Brazilian state of Rio Grande do Sul from the year 2000 to the year 2017. Method: Population-based study with the analysis of the temporal trend of gastroschisis annual incidence and mortality rates. Data were obtained from the Live Birth Information System and the Mortality Information System, with the analysis performed by polynomial regression modeling. Results: There were 2,612,532 live births, 705 hospitalizations, and 233 deaths due to gastroschisis. The annual incidence of gastroschisis was 2.69 per 10,000 live births. The annual incidence rate increased by 85% in the total period (p = 0.003), and mortality was 33% in the 2000-2017 period. Maternal age < 25 years was a risk factor for gastroschisis (p < 0.001). Children were more likely to be born weighing < 2,500 g (p < 0.001) and with a gestational age < 37 weeks (p < 0.001). The annual incidence trend was to increase, and the mortality trend was to decrease. Conclusion: Similar to what has been described in several regions/countries, there was a trend showing an 85% increase in the annual incidence of gastroschisis (p = 0.003) and the mortality was 33% with a trend of decreasing (p = 0.002).

Gastroschisis annual incidence, mortality, and trends in extreme Southern Brazil.

OBJECTIVE: To analyze gastroschisis annual incidence, mortality rates, and trends in the Brazilian state of Rio Grande do Sul from the year 2000 to the year 2017. METHOD: Population-based study with the analysis of the temporal trend of gastroschisis annual incidence and mortality rates. Data were obtained from the Live Birth Information System and the Mortality Information System, with the analysis performed by polynomial regression modeling. RESULTS: There were 2,612,532 live births, 705 hospitalizations, and 233 deaths due to gastroschisis. The annual incidence of gastroschisis was 2.69 per 10,000 live births. The annual incidence rate increased by 85% in the total period (p = 0.003), and mortality was 33% in the 2000-2017 period. Maternal age < 25 years was a risk factor for gastroschisis (p < 0.001). Children were more likely to be born weighing < 2,500 g (p < 0.001) and with a gestational age < 37 weeks (p < 0.001). The annual incidence trend was to increase, and the mortality trend was to decrease. CONCLUSION: Similar to what has been described in several regions/countries, there was a trend showing an 85% increase in the annual incidence of gastroschisis (p = 0.003) and the mortality was 33% with a trend of decreasing (p = 0.002).

Tendência de atendimentos por causas externas no Serviço de Atendimento Móvel de Urgência / Tendencia de los auxilios por causas externas en el Servicio de Atención Móvil de Urgencia / Trend of care for external causes in the Mobile Emergency Care Service

Resumo Objetivo Analisar tendência e os impactos causados pela regionalização nos atendimentos de emergência por causas externas efetuados pelo Serviço de Atendimento Móvel de Urgência (SAMU), antes, durante e depois do processo de regionalização. Métodos Estudo ecológico de tendência dos atendimentos do SAMU. Os períodos foram separados em 2010 a 2012 (pré-regionalização), 2013 a 2015 (transição) e 2016 a 2018 (consolidação). Foram coletadas as variáveis causas do atendimento, dia da semana, horário, local da ocorrência, recurso encaminhado e caracterização da vítima (sexo, idade, uso de álcool e desfecho do atendimento) totalizando 17.533 ocorrências. Foram excluídos os atendimentos que não se classificaram como causas externas. Foram realizadas estatística descritiva, tendência e teste de associação do qui-quadrado. Adotou-se nível de significância de 5% (p-valor ≤0,001). Resultados A maioria das vítimas era do sexo masculino, com maior prevalência na faixa etária de 30 a 59 anos. Houve diminuição do óbito no local de 41,7% após a regionalização. Observou-se aumento de atendimento de causas externas nas ambulâncias de Suporte Básico de Vida no ano de 2015 em relação a 2010 (47%), além de diminuição de aproximadamente 50% do número de atendimentos do Suporte Avançado de Vida. O número de atendimento conjunto das duas ambulâncias aumentou aproximadamente 390%. Conclusão A regionalização apresentou impacto importante na qualidade dos atendimentos prestados à população, resultando na diminuição da mortalidade no local da ocorrência.

Resumen Objetivo Analizar la tendencia y los impactos causados por la regionalización de los auxilios de emergencia por causas externas efectuados por el Servicio de Atención Móvil de Urgencia (SAMU) antes, durante y después del proceso de regionalización. Métodos Estudio ecológico de tendencia de los auxilios del SAMU. Los períodos fueron separados de la siguiente forma: 2010 a 2012 (preregionalización), 2013 a 2015 (transición) y 2016 a 2018 (consolidación). Fueron recopiladas las variables: causas del auxilio, día de la semana, horario, lugar del incidente, recurso enviado y caracterización de la víctima (sexo, edad, uso de alcohol y desenlace del auxilio), con un total de 17.533 incidentes. Se excluyeron los auxilios que no se clasificaron como causas externas. Se realizó estadística descriptiva, tendencia y prueba de asociación de ji cuadrado. Fue adoptado un nivel de significación de 5 % (p-valor ≤0,001). Resultados La mayoría de las víctimas era de sexo masculino, con mayor prevalencia del grupo de edad de 30 a 59 años. Hubo una reducción de fallecimiento en el lugar del 41,7 % después de la regionalización. Se observó un aumento de auxilios de causas externas en las ambulancias de Soporte Vital Básico en el año 2015 con relación a 2010 (47 %), además de una reducción aproximada del 50 % del número de auxilios de Soporte Vital Avanzado. El número de asistencia conjunta de las dos ambulancias aumentó un 390 % aproximadamente. Conclusión La regionalización presentó un impacto importante en la calidad de la atención brindada a la población, lo que redujo la mortalidad en el lugar del incidente.

Abstract Objective To analyze the trend and impacts caused by regionalization in emergency care for external causes performed by the Mobile Emergency Care Service (SAMU), before, during and after the regionalization process. Method This is an ecological study of SAMU care trend. The periods were separated in 2010 to 2012 (pre-regionalization), 2013 to 2015 (transition) and 2016 to 2018 (consolidation). The variables cause of care, day of the week, time, occurrence site, resource forwarded and victim characterization (gender, age, alcohol use and outcome of care) were collected, totaling 17,533 occurrences. Care that did not qualify as external causes was excluded. Descriptive statistics, trends and chi-square association test were performed. A significance level of 5% (p-value≤0.001) was adopted. Results Most victims were male, with a higher prevalence in the age group of 30 to 59 years. There was a decrease in death at the site of 41.7% after regionalization. There was an increase in care of external causes in Basic Life Support ambulances in 2015 compared to 2010 (47%), in addition to a decrease of approximately 50% in the number of Advanced Life Support services. The number of joint care of the two ambulances increased approximately 390%. Conclusion Regionalization had an important impact on the quality of care provided to the population, resulting in a decrease in mortality at the occurrence site.

Ergonomics of anatomical bra models for breastfeeding: a contribution of nursing / Ergonomía de modelos anatómicos de sostén para lactancia materna: una contribución de la enfermería / Ergonomia de modelos anatômicos de sutiã para amamentação: uma contribuição da enfermagem

ABSTRACT Objectives: to analyze the ergonomics of two models of breastfeeding bras. Methods: descriptive study carried out with 152 infants in a Brazilian university hospital. The prototypes were separated into two groups (A and B). To compare the two bra models, the Odds Ratio (OR) was used as a measure of the strength of the association. In subjective perceptions, the Modified Borg Scale, and the chi-square test of independence (χ2) were used. To compare the two prototypes, the Z test and logistic regression analysis were performed. A significance level of 5% was considered. Results: the bra in group B was more suitable for ergonomics of physical and psycho-aesthetic comfort than the bra in group A (p < 0.0001), according to the logistic regression tests. Conclusions: modeling B was ergonomically adequate, with usability and evaluation criteria centered on breastfeeding women.

RESUMEN Objetivos: analizar la ergonomía de dos modelados de sostén para lactancia materna. Métodos: estudio descriptivo realizado con 152 lactantes en un hospital universitario brasileño. Los prototipos fueron separados en dos grupos (A y B). Para comparar los dos modelados de sostén, fue utilizado la Odds Ratio (OR) como una medida de intensidad de la asociación. En las percepciones subjetivas, se utilizaron la Escala de Borg Modificada y el test chi-cuadrado de independencia (χ2). Para comparar los dos prototipos, se realizó el test Z y análisis de regresión logística. Se consideró un nivel de significación de 5%. Resultados: el sostén del grupo B fue el más adecuado para ergonomía de conforto físico y psicoestético del que el del grupo A (p < 0,0001), segundo los testes de regresión logística. Conclusiones: el modelado B fue ergonómicamente adecuado, con criterios de usabilidad y evaluación centrada en las lactantes.

RESUMO Objetivos: analisar a ergonomia de duas modelagens de sutiãs para amamentação. Métodos: estudo descritivo realizado com 152 lactantes em um hospital universitário brasileiro. Os protótipos foram separados em dois grupos (A e B). Para comparar as duas modelagens de sutiãs, foi utilizado a Odds Ratio (OR) como uma medida de intensidade da associação. Nas percepções subjetivas, utilizaramse a Escala de Borg Modificada e o teste qui-quadrado de independência (χ2). Para comparar os dois protótipos, realizou-se o teste Z e análise de regressão logística. Considerou-se um nível de significância de 5%. Resultados: o sutiã do grupo B foi o mais adequado para ergonomia de conforto físico e psicoestético do que o do grupo A (p < 0,0001), segundo os testes de regressão logística. Conclusões: a modelagem B foi ergonomicamente adequada, com critérios de usabilidade e avaliação centrada nas lactantes.

Colorectal cancer mortality in women: trend analysis in Brazil and its regions and states / Mortalidad por cáncer colorrectal en mujeres: análisis de tendencia en Brasil, Estados y Regiones / Mortalidade por câncer colorretal em mulheres: análise de tendência no Brasil, Estados e Regiões

ABSTRACT Objectives: to analyze colorectal cancer mortality trends in women in Brazil and its regions and states. Methods: ecological, time-series study with trend analysis of deaths caused by colorectal cancer in women in Brazil and its regions and states between 2008 and 2019. Polynomial regression was used to treat the data. Results: 48,225 deaths of women caused by colorectal cancer were examined. There was an increasing mortality trend in Brazilian women, with regional differences that resulted from socioeconomic, political, and cultural inequalities. The South Region stood out with the highest rate (7.32) in 2008, which increased to 8.65 in 2019, followed by the Southeast Region, whose rates were 6.72 and 9.05 in 2008 and 2019, respectively. Conclusions: colorectal cancer mortality increased, which indicates the need to expand public policies oriented toward screening and early diagnosis of colorectal cancer in women.

RESUMEN Objetivos: analizar las tendencias de mortalidad por cáncer colorrectal de mujeres en Brasil, Estados y Regiones. Métodos: estudio ecológico, de series temporales, con análisis de tendencia de decesos por cáncer colorrectal en mujeres, entre 2008 y 2019. Para análisis de tendencia se utilizó el modelo de regresión polinomial. Resultados: se analizaron 48.225 decesos de mujeres por cáncer colorrectal. Se observó tendencia creciente de mortalidad en las mujeres brasileñas, con diferencias regionales debidas a desigualdades de estándares socioeconómicos, políticos y culturales. Se manifiesta un aumento en la Región Sur, con tasa de 7,32 en 2008 incrementando a 8,65 en 2019, siguiéndole la Región Sudeste, con tasas de mortalidad de cáncer colorrectal de 6,72 y 9,05 en 2008 y 2019. Conclusiones: se observa aumento de tasas de mortalidad por cáncer colorrectal, demostrándose necesidad de incrementar las políticas públicas orientadas a estrategias de rastreo y diagnóstico precoz del cáncer colorrectal en mujeres.

RESUMO Objetivos: analisar as tendências da mortalidade por câncer colorretal em mulheres no Brasil, Estados e Regiões. Métodos: estudo ecológico, de séries temporais, com análise de tendência dos óbitos por câncer colorretal de mulheres, no período de 2008 a 2019. Para análise de tendência, foi utilizado o modelo de regressão polinomial. Resultados: analisaram-se 48.225 óbitos de mulheres por câncer colorretal. Houve tendência crescente da mortalidade em mulheres brasileiras, com diferenças regionais, em razão das desigualdades nos padrões socioeconômicos, políticos e culturais. Destacando um aumento na Região Sul, com as maiores taxas, de 7,32 em 2008 para 8,65 em 2019, seguida pela Região Sudeste, com taxas de mortalidade por câncer colorretal de 6,72 e 9,05 em 2008 e 2019, respectivamente. Conclusões: observa-se um aumento das taxas de mortalidade por câncer colorretal, demonstrando a necessidade do incremento das políticas públicas direcionadas às estratégias de rastreamento e diagnóstico precoce do câncer colorretal em mulheres.

Ergonomics of anatomical bra models for breastfeeding: a contribution of nursing.

OBJECTIVES: to analyze the ergonomics of two models of breastfeeding bras. METHODS: descriptive study carried out with 152 infants in a Brazilian university hospital. The prototypes were separated into two groups (A and B). To compare the two bra models, the Odds Ratio (OR) was used as a measure of the strength of the association. In subjective perceptions, the Modified Borg Scale, and the chi-square test of independence (χ2) were used. To compare the two prototypes, the Z test and logistic regression analysis were performed. A significance level of 5% was considered. RESULTS: the bra in group B was more suitable for ergonomics of physical and psycho-aesthetic comfort than the bra in group A (p < 0.0001), according to the logistic regression tests. CONCLUSIONS: modeling B was ergonomically adequate, with usability and evaluation criteria centered on breastfeeding women.

Impact of the Covid-19 Pandemic on Women's Health in Brazil.

PURPOSE: The aim is to verify the impact of the Covid-19 pandemic on women's healthcare and medical assistance in Brazil. PATIENTS AND METHODS: This exploratory cross-sectional study evaluated a non-probabilistic sample of women above 20 years old, carried out between August and September of 2020, through a snowball sampling using a Google Forms application. RESULTS: From a total of 2495 women, more than 70% have not been screened for cervical cancer (77.8% of 2244 women aged for screening), and more than 80% have not been screened for breast cancer (80.2% from 1325 women aged for mammography) during the pandemic. Also, 55.2% of the women did not undergo routine blood tests during the same period. The most frequent reasons for not performing screening and routine tests were: they were up to date; fear of contracting Covid-19; they decided to postpone it until after the end of the pandemic; they were unable to schedule the appointment at the healthcare center for whatever reason; and the healthcare center was only attending Covid-19 patients. Women with no comorbidities have performed significantly more mammograms and routine blood tests than women with comorbidities. In addition, women with comorbidities who were used to perform periodic medical follow-up have done it substantially more than women with no comorbidities during the pandemic. CONCLUSION: As observed, there was a significant decrease in women's access to the healthcare system during this pandemic. Many participants reported that they had not attended any screening tests, and some reasons included fear of getting infected and due to the public measures of social distancing. The consequences are late diagnoses and a worse prognosis. It might impact the healthcare systems around the world in the next few years. Further studies should be done to follow these consequences.

The Impact of Violence on the Anxiety Levels of Healthcare Personnel During the COVID-19 Pandemic.

Introduction: The COVID-19 pandemic stressed the importance of healthcare personnel. However, there is evidence of an increase in violence against them, which brings consequences, such as anxiety. The aim of this study was to analyze the anxiety levels of health professionals who have or not suffered violence during the COVID-19 pandemic, and verify the variables associated with the risk of starting to take medication for anxiety. Methods: We assessed the anxiety profile of health professionals in Brazil through an online questionnaire, using the Generalized Anxiety Disorder 7-item Scale (GAD-7), in relation to groups of participants who have or not suffered violence during the COVID-19 pandemic. We used Cronbach's alpha reliability coefficient to check the consistency of the responses, and the effect size using the r coefficient. Principal Component Analysis was used to verify the differences in anxiety scores between the two groups. Logistic regression analysis was also used to verify the variables associated with the risk of starting medication for anxiety and considered statistically significant when p < 0.05. Results: A total of 1,166 health professionals participated in the study, in which 34.13% had a normal anxiety profile, 40.14% mild, 15.78% moderate, and 9.95% severe. The mean score of the sum of the GAD-7 was 7.03 (SD 5.20). The group that suffered violence had a higher mean (8.40; SD 5.42) compared to the group that did not (5.70; SD 4.60). In addition, the median between both groups was significantly different (7.0 vs. 5.0; p < 0.01). Approximately 18.70% of the participants reported having started taking medication to treat anxiety during the pandemic. The factors that increased the chances of these professionals starting medication for anxiety p < 0.05 were having suffered violence during the pandemic (OR 1.97; 95% CI 1.42-2.77), being nurses (OR 1.61; 95% CI 1.04-2.47) or other types of health professionals (OR 1.58; 95% CI 1.04-2.38), and having a mild (OR 2.11; 95% CI 1.37-3.34), moderate (OR 4.05; 95% CI 2.48-6.71) or severe (OR 9.08; 95% CI 5.39-15.6) anxiety level. Conclusion: Brazilian healthcare professionals who have suffered violence during the pandemic have higher anxiety scores and higher risk to start taking anxiety medication.

Helicopter Transportation of Brazilian Trauma Patients: A Comparison of Times to Care.

OBJECTIVE: The purpose of this study was to analyze helicopter emergency medical service (HEMS) transport with secondary land ambulance transfer, comparing landings performed inside and outside the hospital complex to the emergency department. METHODS: This was a cross-sectional observational study of HEMS transports of trauma patients between 2016 and 2018 in southern Brazil. Patients were attended by the HEMS team at the trauma site or stabilized in hospitals nearby and subsequently referred to trauma centers. In this region, no trauma centers have their own helipads so helicopters land in remote areas close to the hospital, which may be inside or outside the hospital complex. Both landings require ground emergency medical service transport, with off-site landings necessitating ground emergency medical service transport via public access roads to reach the hospital. Data were analyzed using descriptive statistics, and on-site and off-site transport times were compared using a t-test for independent samples. RESULTS: Of 176 transports, 28.5% resulted in on-site landings, whereas 71.5% occurred off-site. The ground transport time when the landing zone was off-site was 5 minutes longer than on-site (P < .001). CONCLUSION: Off-site landings result in longer transports to the emergency room. The construction of helipads in trauma centers can reduce transport time, in addition to reducing the costs and sequelae of trauma.