ABSTRACT
This article aims to describe the geographical distribution of hospital mortality from COVID-19 in children and adolescents during the 2020-2021 pandemic in Brazil. Ecological, census study (SIVEP GRIPE) with individuals up to 19 years of age, hospitalized with SARS due to COVID-19 or SARS not specified in Brazilian municipalities, stratified in two ways: 1) in the five macro-regions and 2) in three urban agglomerations: capital, municipalities of the metropolitan region and non-capital municipalities. There were 44 hospitalizations/100,000 inhabitants due to COVID-19 and 241/100,000 when including unspecified SARS (estimated underreporting of 81.8%). There were 1,888 deaths by COVID-19 and 4,471 deaths if added to unspecified SARS, estimating 57.8% of unreported deaths. Hospital mortality was 2.3 times higher in the macro-regions when considering only the cases of COVID-19, with the exception of the North and Center-West regions. Higher hospital mortality was also recorded in non-capital municipalities. The urban setting was associated with higher SARS hospital mortality during the COVID-19 pandemic in Brazil. Living in the North and Northeast macro-regions, and far from the capitals offered a higher risk of mortality for children and adolescents who required hospitalization.
O objetivo deste artigo é descrever a distribuição geográfica da mortalidade hospitalar por COVID-19 em crianças e adolescentes durante a pandemia de 2020-2021 no Brasil. Estudo ecológico, censitário (SIVEP GRIPE), de indivíduos até 19 anos, internados com SRAG por COVID-19 ou SRAG não especificada, em municípios brasileiros, estratificados de duas formas: 1) nas cinco macrorregiões e 2) em três aglomerados urbanos: capital, municípios da região metropolitana e do interior. Verificou-se 44 internações/100 mil habitantes por COVID-19 e 241/100 mil ao se incluir a SRAG não especificada (subnotificação estimada de 81,8%). Ocorreram1.888 óbitos por COVID-19 e 4.471 óbitos se somados à SRAG não especificada, estimando-se subnotificação de 57,8% dos óbitos. A mortalidade hospitalar foi 2,3 vezes maior nas macrorregiões quando considerados apenas os casos de COVID-19, com exceção das regiões Norte e Centro-Oeste. Registrou-se também maior mortalidade hospitalar em municípios do interior. O contexto urbano esteve associado à maior mortalidade hospitalar por SRAG durante a pandemia de COVID-19 no Brasil. Residir nas macrorregiões Norte e Nordeste, e distante das capitais, ofereceu maior risco de mortalidade para crianças e adolescentes que necessitaram hospitalização.
Subject(s)
COVID-19 , Hospital Mortality , Hospitalization , Humans , COVID-19/mortality , COVID-19/epidemiology , Brazil/epidemiology , Adolescent , Child , Child, Preschool , Hospitalization/statistics & numerical data , Infant , Young Adult , Severity of Illness Index , Female , Male , Urban Population/statistics & numerical data , Infant, Newborn , Cities/epidemiologyABSTRACT
OBJECTIVE: To describe cases, deaths, and hospital mortality from covid-19 in children and adolescents in Brazil, according to age group, during the evolving phases of the pandemic in 2020 and 2021. METHODS: Census of patients aged up to 19 committed with severe acute respiratory syndrome, due to covid-19 or unspecified, notified to the Brazilian Influenza Epidemiological Surveillance Information System, from January 1, 2020, to December 31, 2021. The two years were divided into six phases, covering the spread of the disease-first, second and third wave-as well as the impact of vaccination. The pediatric population was categorized into infants, preschoolers, schoolchildren, and adolescents. Hospital mortality was assessed by pandemic phase and age group. RESULTS: A total of 144,041 patients were recorded in the two years, 18.2% of whom had confirmed cases of covid-19. Children under 5 years old (infants and preschoolers) accounted for 62.8% of those hospitalized. A total of 4,471 patients died, representing about 6.1 deaths per day. Infants were the ones who most progressed to the intensive care unit (24.7%) and had the highest gross number of deaths (n = 2,012), but mortality was higher among adolescents (5.7%), reaching 9.8% in phase 1. The first peak of deaths occurred in phase 1 (May/2020), and two other peaks occurred in phase 4 (March/2021 and May/2021). There was an increase in cases and deaths for younger ages since phase 4. Hospital mortality in the pediatric population was higher in phases 1, 4, and 6, following the phenomena of dissemination/interiorization of the virus in the country, beginning of the second wave and beginning of the third wave, respectively. CONCLUSION: The absolute number of cases of covid-19 in children and adolescents is significant. Although complete vaccination in descending order of age provided a natural deviation in age range, there was a greater gap between the curve of new hospitalized cases and the curve of deaths, indicating the positive impact of immunization.
Subject(s)
COVID-19 , Infant , Child , Humans , Adolescent , Child, Preschool , Aged , Hospital Mortality , Brazil/epidemiology , Vaccination , ImmunizationABSTRACT
ABSTRACT OBJECTIVE To describe cases, deaths, and hospital mortality from covid-19 in children and adolescents in Brazil, according to age group, during the evolving phases of the pandemic in 2020 and 2021. METHODS Census of patients aged up to 19 committed with severe acute respiratory syndrome, due to covid-19 or unspecified, notified to the Brazilian Influenza Epidemiological Surveillance Information System, from January 1, 2020, to December 31, 2021. The two years were divided into six phases, covering the spread of the disease—first, second and third wave—as well as the impact of vaccination. The pediatric population was categorized into infants, preschoolers, schoolchildren, and adolescents. Hospital mortality was assessed by pandemic phase and age group. RESULTS A total of 144,041 patients were recorded in the two years, 18.2% of whom had confirmed cases of covid-19. Children under 5 years old (infants and preschoolers) accounted for 62.8% of those hospitalized. A total of 4,471 patients died, representing about 6.1 deaths per day. Infants were the ones who most progressed to the intensive care unit (24.7%) and had the highest gross number of deaths (n = 2,012), but mortality was higher among adolescents (5.7%), reaching 9.8% in phase 1. The first peak of deaths occurred in phase 1 (May/2020), and two other peaks occurred in phase 4 (March/2021 and May/2021). There was an increase in cases and deaths for younger ages since phase 4. Hospital mortality in the pediatric population was higher in phases 1, 4, and 6, following the phenomena of dissemination/interiorization of the virus in the country, beginning of the second wave and beginning of the third wave, respectively. CONCLUSION The absolute number of cases of covid-19 in children and adolescents is significant. Although complete vaccination in descending order of age provided a natural deviation in age range, there was a greater gap between the curve of new hospitalized cases and the curve of deaths, indicating the positive impact of immunization.
RESUMO OBJETIVO Descrever casos, óbitos e mortalidade hospitalar por covid-19 em crianças e adolescentes no Brasil, conforme faixa etária, durante as fases de evolução da pandemia em 2020 e 2021. MÉTODOS Censo de pacientes de até 19 anos internados com síndrome respiratória aguda grave, por covid-19 ou não especificada, notificados ao Sistema de Informação de Vigilância Epidemiológica da Gripe do Brasil, entre 1 de janeiro de 2020 e 31 de dezembro de 2021. Os dois anos foram divididos em seis fases, abrangendo a disseminação da doença − primeira, segunda e terceira onda −, bem como o impacto da vacinação. A população pediátrica foi categorizada em lactentes, pré-escolares, escolares e adolescentes. A mortalidade hospitalar foi avaliada por fase da pandemia e faixa etária. RESULTADOS Foram contabilizados 144.041 pacientes nos dois anos, sendo 18,2% casos de covid-19 confirmados. Menores de 5 anos (lactentes e pré-escolares) corresponderam a 62,8% dos hospitalizados. Evoluíram a óbito 4.471, representando cerca 6,1 óbitos por dia. Os lactentes foram os que mais evoluíram para unidade de terapia intensiva (24,7%) e apresentaram o maior número bruto de óbito (n = 2.012), porém a mortalidade foi maior entre os adolescentes (5,7%), chegando a 9,8% na fase 1. O primeiro pico de óbitos ocorreu na fase 1 (maio/2020), e outros dois picos ocorreram na fase 4 (março/2021 e maio/2021). Verificou-se avanço de casos e óbitos para as idades inferiores desde a fase 4. A mortalidade hospitalar na população pediátrica foi maior nas fases 1, 4 e 6, acompanhando os fenômenos de disseminação/interiorização do vírus no país, início da segunda onda e início da terceira onda, respectivamente. CONCLUSÃO O número absoluto de casos de covid-19 em crianças e adolescentes é expressivo. Embora a vacinação completa em ordem decrescente de idade tenha proporcionado um desvio natural de faixa etária, ocorreu um distanciamento maior entre a curva de novos casos hospitalizados e a curva de óbitos, indicando o impacto positivo da imunização.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Child , Hospital Mortality , Severe Acute Respiratory Syndrome , COVID-19/epidemiologyABSTRACT
Nas últimas décadas tem se observado um aumento expressivo na prevalência de alergia alimentar (AA), com frequência estimada em adultos de 3% a 8%, sendo ainda mais relevante quando se avalia a AA autodeclarada (variação de 3% a 35%). Entretanto, são poucos os dados publicados sobre a prevalência de AA em idosos, e no Brasil tais dados são inexistentes. O objetivo principal deste protocolo de estudo é conhecer a prevalência de AA autodeclarada em idosos (≥ 60 anos) brasileiros. Trata-se de estudo epidemiológico transversal que utiliza questionário padronizado e validado para a língua portuguesa. Entre os vários aspectos investigados, serão avaliados quais alimentos e sintomas são os mais relacionados à AA nestes indivíduos. Os dados obtidos serão transcritos a planilha Excel para realização da análise estatística. A obtenção dessas informações permitirá compará-las às existentes, assim como estabelecer planos de abordagem destes pacientes.
In recent decades, there has been a significant increase in the prevalence of food allergies, reaching an estimated frequency of 3% to 8% in adults and even higher in self-reports (from 3% to 35%). However, published data on the prevalence of food allergies among older adults are scarce, and in Brazil they are non-existent. The main objective of this study was to investigate the prevalence of self-reported food allergy among older Brazilians (≥ 60 years). This cross-sectional epidemiological study protocol involves a questionnaire that was developed, standardized, and validated in Portuguese. The investigated aspects will include the foods and symptoms most commonly associated with food allergy in this population. The data will be input into an Excel spreadsheet for statistical analysis. Obtaining this data will allow comparison of the results with previous data and help establish treatment plans for these patients.
Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and overABSTRACT
OBJECTIVES: to assess the sustainability of the Breastfeeding-Friendly Primary Care Initiative by analyzing compliance with the Ten Steps in accredited units; and association with maternal satisfaction and exclusive breastfeeding. METHODS: a cross-sectional study conducted in 2016. An assessment of compliance, conducted by interviews with health professionals, pregnant women, and mothers. An association between compliance and satisfaction, analyzed by Spearman>s correlation test; and association between contextual/individual characteristics and exclusive breastfeeding, by the multilevel Poisson regression. RESULTS: compliance was 5.4-10 points and satisfaction was 36.8%-100%. Prevalence of exclusive breastfeeding was 56.7%. There was a correlation between compliance and satisfaction. Higher education, prenatal orientation, hospital discharge on exclusive breastfeeding, attendance in mixed units, and female gender of the child were associated with higher prevalence of exclusive breastfeeding; on the other hand, increasing age and pacifier use were associated with lower prevalence. CONCLUSIONS: the Initiative proved to be sustainable; compliance with the Ten Steps was high and was reflected in maternal satisfaction.
Subject(s)
Breast Feeding , Mothers , Child , Cross-Sectional Studies , Female , Health Promotion , Humans , Infant , Pregnancy , Pregnant Women , Primary Health CareABSTRACT
The Brazilian Code of Marketing of Infant and Toddlers Food, Nipples, Pacifiers, and Baby Bottles (Federal Law n. 11,265/2006) aims to control the abusive marketing of products that compete with breastfeeding. The objective was to assess the impact of an educational intervention on compliance with this law by pharmacies. A randomized intervention study was conducted in 155 pharmacies that were infringing the law in the Southern Zone of Rio de Janeiro, Brazil. The pharmacies' commercial practices were assessed before and after the intervention with the pharmacist and manager, compared to the control group. The interval between the intervention and the second assessment was one month. McNemar test was used to measure changes in the number of pharmacies infringing the law before and after the intervention. Wilcoxon test was used to compare variation in the number of violations in each group. A month after the intervention, there was a 16.1% reduction (n = 25) in the number of pharmacies committing violations. There was a decrease from 18.7% to 12.9% in products whose commercial promotion is banned by the law (p = 0.093) and from 92.9% to 80.5% in milk products (p = 0.001), but among processed complementary food there was an increase from 28.5% to 42.3% of pharmacies with illegal promotions (p = 0.006). The intervention group with the pharmacists showed a statistically significant reduction in violations related to discount prices (p = 0.022) and special displays (p = 0.002). The educational intervention reduced the number of pharmacies that infringed the law, mainly when the intervention involved the pharmacist.
A Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeiras (Lei Federal nº 11.265/2006) visa controlar o marketing abusivo de produtos que competem com o aleitamento materno. O objetivo foi avaliar o impacto de uma intervenção educativa sobre o cumprimento da Lei em farmácias. Pesquisa de intervenção randomizada conduzida em 155 farmácias que infringiam a Lei na Zona Sul do Rio de Janeiro, Brasil. A prática comercial das farmácias foi avaliada antes e depois da intervenção com o farmacêutico e com o gerente, comparados ao grupo controle. O intervalo entre a intervenção e a segunda avaliação foi de um mês. Para aferir as mudanças no quantitativo de farmácias com infração à Lei, antes e depois da intervenção, foi utilizado o teste de McNemar. O teste de Wilcoxon foi usado para comparar a variação no número de infrações em cada grupo de alocação. Um mês após a intervenção houve redução de 16,1% (n = 25) no total de farmácias com infração. Houve redução de 18,7% para 12,9% em produtos cuja promoção comercial é proibida (p = 0,093) e de 92,9% para 80,5% nos produtos lácteos (p = 0,001), mas entre alimentos de transição houve aumento de 28,5% para 42,3% de farmácias com promoção ilegal (p = 0,006). O grupo intervenção com farmacêutico apresentou redução estatisticamente significativa nas infrações relacionadas a descontos de preço (p = 0,022) e a exposições especiais (p = 0,002). A intervenção educativa reduziu a quantidade de farmácias que infringia essa Lei, principalmente quando esta intervenção foi realizada com o farmacêutico.
La Norma Brasileña de Comercialización de Alimentos para Lactantes y Niños de la Primera Infancia, Tetillas, Chupetes y Biberones (Ley Federal nº 11.265/2006) tiene como finalidad controlar el márketing abusivo de productos que compiten con la lactancia materna. El objetivo fue evaluar el impacto de una intervención educativa sobre el cumplimiento de la ley en farmacias. Se realizó una investigación de intervención aleatoria, llevada a cabo en 155 farmacias que infringían la ley en la zona sur de Río de Janeiro, Brasil. La práctica comercial de las farmacias fue evaluada antes y después de la intervención con el farmacéutico y con el gerente, comparadas con el grupo de control. El intervalo entre la intervención y la segunda evaluación fue de un mes. Para evaluar los cambios en lo cuantitativo de farmacias con infracción a la ley, antes y después de la intervención, se utilizó el test de McNemar. El test de Wilcoxon se utilizó para comparar la variación en el número de infracciones en cada grupo de asignación. Tras un mes de la intervención hubo una reducción de un 16,1% (n = 25) en el total de farmacias con infracción. Hubo una reducción desde un 18,7% a un 12,9% en productos cuya promoción comercial está prohibida (p = 0,093) y de un 92,9% a un 80,5% en productos lácteos (p = 0,001). Sin embargo, entre alimentos de transición hubo un aumento de un 28,5% a un 42,3% de farmacias con promoción ilegal (p = 0,006). El grupo de intervención con el farmacéutico presentó una reducción estadísticamente significativa en las infracciones relacionadas con descuentos de precio (p = 0,022) y respecto a exposiciones especiales (p = 0,002). La intervención educativa redujo la cantidad de farmacias que infringía esta ley, principalmente cuando la intervención educativa se realizó con el farmacéutico.
Subject(s)
Breast Feeding , Pharmacies , Brazil , Family , Female , Humans , Infant , MarketingABSTRACT
ABSTRACT Objectives: to assess the sustainability of the Breastfeeding-Friendly Primary Care Initiative by analyzing compliance with the Ten Steps in accredited units; and association with maternal satisfaction and exclusive breastfeeding. Methods: a cross-sectional study conducted in 2016. An assessment of compliance, conducted by interviews with health professionals, pregnant women, and mothers. An association between compliance and satisfaction, analyzed by Spearman›s correlation test; and association between contextual/individual characteristics and exclusive breastfeeding, by the multilevel Poisson regression. Results: compliance was 5.4-10 points and satisfaction was 36.8%-100%. Prevalence of exclusive breastfeeding was 56.7%. There was a correlation between compliance and satisfaction. Higher education, prenatal orientation, hospital discharge on exclusive breastfeeding, attendance in mixed units, and female gender of the child were associated with higher prevalence of exclusive breastfeeding; on the other hand, increasing age and pacifier use were associated with lower prevalence. Conclusions: the Initiative proved to be sustainable; compliance with the Ten Steps was high and was reflected in maternal satisfaction.
RESUMEN Objetivos: evaluar sostenibilidad de la Iniciativa Unidad Primaria Amiga de la Lactancia Materna por análisis del cumplimiento de Diez Pasos en unidades acreditadas; y asociación con satisfacción materna y lactancia materna exclusiva. Métodos: estudio transversal conducido en 2016. Evaluación del cumplimiento, realizada por entrevistas con profesionales de salud, embarazadas y madres. Asociación entre cumplimiento y satisfacción, analizada por test de correlación de Spearman; y asociación entre características contextuales/individuales y lactancia materna exclusiva, por regresión de Poisson multinivel. Resultados: el cumplimiento fue de 5,4-10 puntos y satisfacción de 36,8%-100%. Prevalencia de lactancia materna exclusiva fue 56,7%. Hubo correlación entre cumplimiento y satisfacción. Mayor escolaridad, orientación prenatal, alta hospitalaria en lactancia materna exclusiva, asistencia en unidades mistas y sexo femenino del niño se asociaron a mayores prevalencias de lactancia materna exclusiva; ya edad creciente y uso de chupete a menores prevalencias. Conclusiones: la iniciativa se mostró sustentable; el cumplimiento de los Diez Pasos elevado y se reflejó en la satisfacción materna.
RESUMO Objetivos: avaliar a sustentabilidade da Iniciativa Unidade Básica Amiga da Amamentação pela análise do cumprimento de Dez Passos nas unidades credenciadas; e associação com satisfação materna e aleitamento materno exclusivo. Métodos: estudo transversal conduzido em 2016. Avaliação do cumprimento, realizada por entrevistas com profissionais de saúde, gestantes e mães. Associação entre cumprimento e satisfação, analisada pelo teste de correlação de Spearman; e associação entre características contextuais/individuais e aleitamento materno exclusivo, por regressão de Poisson multinível. Resultados: o cumprimento foi de 5,4-10 pontos e satisfação de 36,8%-100%. Prevalência de aleitamento materno exclusivo foi 56,7%. Houve correlação entre cumprimento e satisfação. Maior escolaridade, orientação prénatal, alta hospitalar em amamentação exclusiva, assistência em unidades mistas e sexo feminino da criança se associaram a maiores prevalências de aleitamento materno exclusivo; já idade crescente e uso de chupeta, a menores prevalências. Conclusões: A Iniciativa mostrou-se sustentável; o cumprimento dos Dez Passos foi elevado e se refletiu na satisfação materna.
ABSTRACT
ABSTRACT Objectives: to assess the sustainability of the Breastfeeding-Friendly Primary Care Initiative by analyzing compliance with the Ten Steps in accredited units; and association with maternal satisfaction and exclusive breastfeeding. Methods: a cross-sectional study conducted in 2016. An assessment of compliance, conducted by interviews with health professionals, pregnant women, and mothers. An association between compliance and satisfaction, analyzed by Spearman›s correlation test; and association between contextual/individual characteristics and exclusive breastfeeding, by the multilevel Poisson regression. Results: compliance was 5.4-10 points and satisfaction was 36.8%-100%. Prevalence of exclusive breastfeeding was 56.7%. There was a correlation between compliance and satisfaction. Higher education, prenatal orientation, hospital discharge on exclusive breastfeeding, attendance in mixed units, and female gender of the child were associated with higher prevalence of exclusive breastfeeding; on the other hand, increasing age and pacifier use were associated with lower prevalence. Conclusions: the Initiative proved to be sustainable; compliance with the Ten Steps was high and was reflected in maternal satisfaction.
RESUMEN Objetivos: evaluar sostenibilidad de la Iniciativa Unidad Primaria Amiga de la Lactancia Materna por análisis del cumplimiento de Diez Pasos en unidades acreditadas; y asociación con satisfacción materna y lactancia materna exclusiva. Métodos: estudio transversal conducido en 2016. Evaluación del cumplimiento, realizada por entrevistas con profesionales de salud, embarazadas y madres. Asociación entre cumplimiento y satisfacción, analizada por test de correlación de Spearman; y asociación entre características contextuales/individuales y lactancia materna exclusiva, por regresión de Poisson multinivel. Resultados: el cumplimiento fue de 5,4-10 puntos y satisfacción de 36,8%-100%. Prevalencia de lactancia materna exclusiva fue 56,7%. Hubo correlación entre cumplimiento y satisfacción. Mayor escolaridad, orientación prenatal, alta hospitalaria en lactancia materna exclusiva, asistencia en unidades mistas y sexo femenino del niño se asociaron a mayores prevalencias de lactancia materna exclusiva; ya edad creciente y uso de chupete a menores prevalencias. Conclusiones: la iniciativa se mostró sustentable; el cumplimiento de los Diez Pasos elevado y se reflejó en la satisfacción materna.
RESUMO Objetivos: avaliar a sustentabilidade da Iniciativa Unidade Básica Amiga da Amamentação pela análise do cumprimento de Dez Passos nas unidades credenciadas; e associação com satisfação materna e aleitamento materno exclusivo. Métodos: estudo transversal conduzido em 2016. Avaliação do cumprimento, realizada por entrevistas com profissionais de saúde, gestantes e mães. Associação entre cumprimento e satisfação, analisada pelo teste de correlação de Spearman; e associação entre características contextuais/individuais e aleitamento materno exclusivo, por regressão de Poisson multinível. Resultados: o cumprimento foi de 5,4-10 pontos e satisfação de 36,8%-100%. Prevalência de aleitamento materno exclusivo foi 56,7%. Houve correlação entre cumprimento e satisfação. Maior escolaridade, orientação prénatal, alta hospitalar em amamentação exclusiva, assistência em unidades mistas e sexo feminino da criança se associaram a maiores prevalências de aleitamento materno exclusivo; já idade crescente e uso de chupeta, a menores prevalências. Conclusões: A Iniciativa mostrou-se sustentável; o cumprimento dos Dez Passos foi elevado e se refletiu na satisfação materna.
ABSTRACT
A Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeiras (Lei Federal nº 11.265/2006) visa controlar o marketing abusivo de produtos que competem com o aleitamento materno. O objetivo foi avaliar o impacto de uma intervenção educativa sobre o cumprimento da Lei em farmácias. Pesquisa de intervenção randomizada conduzida em 155 farmácias que infringiam a Lei na Zona Sul do Rio de Janeiro, Brasil. A prática comercial das farmácias foi avaliada antes e depois da intervenção com o farmacêutico e com o gerente, comparados ao grupo controle. O intervalo entre a intervenção e a segunda avaliação foi de um mês. Para aferir as mudanças no quantitativo de farmácias com infração à Lei, antes e depois da intervenção, foi utilizado o teste de McNemar. O teste de Wilcoxon foi usado para comparar a variação no número de infrações em cada grupo de alocação. Um mês após a intervenção houve redução de 16,1% (n = 25) no total de farmácias com infração. Houve redução de 18,7% para 12,9% em produtos cuja promoção comercial é proibida (p = 0,093) e de 92,9% para 80,5% nos produtos lácteos (p = 0,001), mas entre alimentos de transição houve aumento de 28,5% para 42,3% de farmácias com promoção ilegal (p = 0,006). O grupo intervenção com farmacêutico apresentou redução estatisticamente significativa nas infrações relacionadas a descontos de preço (p = 0,022) e a exposições especiais (p = 0,002). A intervenção educativa reduziu a quantidade de farmácias que infringia essa Lei, principalmente quando esta intervenção foi realizada com o farmacêutico.
The Brazilian Code of Marketing of Infant and Toddlers Food, Nipples, Pacifiers, and Baby Bottles (Federal Law n. 11,265/2006) aims to control the abusive marketing of products that compete with breastfeeding. The objective was to assess the impact of an educational intervention on compliance with this law by pharmacies. A randomized intervention study was conducted in 155 pharmacies that were infringing the law in the Southern Zone of Rio de Janeiro, Brazil. The pharmacies' commercial practices were assessed before and after the intervention with the pharmacist and manager, compared to the control group. The interval between the intervention and the second assessment was one month. McNemar test was used to measure changes in the number of pharmacies infringing the law before and after the intervention. Wilcoxon test was used to compare variation in the number of violations in each group. A month after the intervention, there was a 16.1% reduction (n = 25) in the number of pharmacies committing violations. There was a decrease from 18.7% to 12.9% in products whose commercial promotion is banned by the law (p = 0.093) and from 92.9% to 80.5% in milk products (p = 0.001), but among processed complementary food there was an increase from 28.5% to 42.3% of pharmacies with illegal promotions (p = 0.006). The intervention group with the pharmacists showed a statistically significant reduction in violations related to discount prices (p = 0.022) and special displays (p = 0.002). The educational intervention reduced the number of pharmacies that infringed the law, mainly when the intervention involved the pharmacist.
La Norma Brasileña de Comercialización de Alimentos para Lactantes y Niños de la Primera Infancia, Tetillas, Chupetes y Biberones (Ley Federal nº 11.265/2006) tiene como finalidad controlar el márketing abusivo de productos que compiten con la lactancia materna. El objetivo fue evaluar el impacto de una intervención educativa sobre el cumplimiento de la ley en farmacias. Se realizó una investigación de intervención aleatoria, llevada a cabo en 155 farmacias que infringían la ley en la zona sur de Río de Janeiro, Brasil. La práctica comercial de las farmacias fue evaluada antes y después de la intervención con el farmacéutico y con el gerente, comparadas con el grupo de control. El intervalo entre la intervención y la segunda evaluación fue de un mes. Para evaluar los cambios en lo cuantitativo de farmacias con infracción a la ley, antes y después de la intervención, se utilizó el test de McNemar. El test de Wilcoxon se utilizó para comparar la variación en el número de infracciones en cada grupo de asignación. Tras un mes de la intervención hubo una reducción de un 16,1% (n = 25) en el total de farmacias con infracción. Hubo una reducción desde un 18,7% a un 12,9% en productos cuya promoción comercial está prohibida (p = 0,093) y de un 92,9% a un 80,5% en productos lácteos (p = 0,001). Sin embargo, entre alimentos de transición hubo un aumento de un 28,5% a un 42,3% de farmacias con promoción ilegal (p = 0,006). El grupo de intervención con el farmacéutico presentó una reducción estadísticamente significativa en las infracciones relacionadas con descuentos de precio (p = 0,022) y respecto a exposiciones especiales (p = 0,002). La intervención educativa redujo la cantidad de farmacias que infringía esta ley, principalmente cuando la intervención educativa se realizó con el farmacéutico.
Subject(s)
Humans , Female , Infant , Pharmacies , Breast Feeding , Brazil , Family , MarketingABSTRACT
Objetivo: O presente artigo tem como objetivo analisar a associação entre características sociodemográficas e de saúde e o grau de dificuldade de locomoção dos idosos, no Brasil. Método: Foi utilizado o modelo de chances proporcionais parciais e os dados da Pesquisa Nacional de Saúde 2013. Resultados: Na análise ajustada, observou-se maior grau de dificuldade de locomoção entre idosos mais velhos, não casados (OR=1/0,759=1,318;p-valor<0,001), sem instrução (OR=1,433;p-valor=0,026), residentes na região Sul (OR=1,448;p-valor=0,019) e que reportaram piores níveis de saúde geral. Além disso, idosos com diagnóstico de doença crônica, física ou mental apresentaram maior chance de reportar dificuldade de locomoção (OR=1,645;p-valor<0,001). Conclusão: Devido à natureza dos fatores associados, destaca-se a necessidade de ações de promoção e educação em saúde a fim de reduzir as complicações e danos à saúde dos idosos que comprometam a sua capacidade funcional, especialmente na região Sul do Brasil
Objective: this article aims to analyze the association between sociodemographic and health characteristics and the degree of locomotion difficulty of the elderly in Brazil. Methods: the partial proportional odds model and data from the National Health Survey 2013 were used. Results: in the adjusted analysis, a greater degree of locomotion difficulty was observed among older, unmarried elderly (OR=1/0.759=1.318; p-valor<0,001), without education level (OR=1.433, p-value=0.026), who were in the southern region (OR=1.448, p-value=0.019) and reported worse overall health. In addition, the elderly with a diagnosis of chronic, physical or mental illness had a greater odds of reporting difficulty in locomotion (OR=1.645; p-value<0.001). Conclusion: due to the types of factors associated, health promotion and education actions are necessary to reduce the complications and damages to the health of the elderly that compromise their functional capacity, especially in the Southern region of Brazil
Objetivo: el presente artículo tiene como objetivo analizar la asociación entre características sociodemográficas y de salud y el grado de dificultad de locomoción de los ancianos en Brasil. Métodos: se utilizó el modelo de odds proporcionales parciales y los datos de la Encuesta Nacional de Salud 2013. Resultados: en el análisis ajustado, se observó mayor grado de dificultad de locomoción entre ancianos mayores, no casados (OR =1/0,759=1,318; p-valor r<0,001). sin instrucción (OR=1,433; p-valor=0,026), residentes en la región Sur (OR=1,448; p-valor=0,019) y que reportaron peor salud general. Además, ancianos con diagnóstico de enfermedad crónica, física o mental presentaron mayor odds de reportar dificultad de locomoción (OR =1,645;p-valor<0,001). Conclusión: debido a la naturaleza de los factores asociados, se destaca la necesidad de acciones de promoción y educación en salud para reducir las complicaciones y daños a la salud de los ancianos que comprometen su capacidad funcional, especialmente en la región Sur de Brasil
Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Health of the Elderly , Mobility Limitation , Health PromotionABSTRACT
Objetivo: O objetivo deste trabalho foi avaliar o impacto da incontinência urinária feminina sobre a qualidade de vida (QV), levando em consideração o resultado do estudo urodinâmico. A incontinência urinária é queixa frequente em mulheres, afetando negativamente a QV. Métodos: Trata-se de estudo transversal, retrospectivo, em banco de dados contendo informações sociodemográficas, clínicas e do estudo urodinâmico e os escores de QV da versão brasileira do King's Health Questionnaire de pacientes atendidas em hospital universitário. Resultados: Não foi observada diferença no impacto dos diferentes diagnósticos urodinâmicos, inclusive exames normais, sobre os domínios percepção geral de saúde e impacto da incontinência. Conclusão: Comparada com a incontinência de esforço e exames normais, a incontinência mista mostrou piores escores nos domínios limitações físicas e limitações das atividades diárias. Já a hiperatividade do detrusor esteve associada a piores escores de limitações das atividades diárias e sono, comparada com a incontinência de esforço, e de limitações físicas, comparada com exames normais.(AU)
Objective: This study aimed to assess the impact of female urinary incontinence on quality of life, according to urodynamic diagnosis. Urinary incontinence is a frequent complaint among women and affects the quality of life negatively. Methods: A retrospective cross-sectional study using a database containing sociodemographic and clinical information, the results from urodynamics and the scores of the Brazilian version of the King's Health Questionnaire of patients attended at a university hospital was performed. Results: There was no difference in the impact of urodynamics diagnosis, including normal exams, in the scores of the general health perception and incontinence impact domains. Conclusion: When compared to normal exams and urinary stress incontinence, mixed incontinence showed lower scores in the role limitations and physical limitations domains. Detrusor overactivity was associated with lower scores in the sleep and role limitations domains, in comparison with urinary stress incontinence, and in the physical limitation domain, compared to normal exams.(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Urinary Incontinence/epidemiology , Sickness Impact Profile , Quality of Life , Urodynamics , Brazil/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires , Women's HealthABSTRACT
OBJECTIVE: to analyze the association between sociodemographic, behavioral and health characteristics and the prevalence of violence against the elderly committed by strangers. METHODS: cross-sectional study with data from the 2013 National Health Survey on individuals aged 60 years and over; a log-linear Poisson model was used. RESULTS: 11,143 elderly individuals were included in the study; the prevalence of violence committed by strangers in the 12 months prior to the interview was 1.61 (95%CI 1.28;1.94); in the multivariate analysis, a higher prevalence of violence committed by strangers was observed among elderly individuals aged 60-69 years (PR=2.03; 95%CI 1.02;4.06), with higher education degree compared to those without schooling (RP=4.00; 95%CI 1.89;8.33), residents of the Midwest versus Southeast (PR=2.00; 95%CI 1.16;3.45), and in households not registered in the Family Health Strategy (FHS) (PR=1.57; 95%CI 1.00;2.48). CONCLUSION: sociodemographic characteristics and region of residence were associated with violence against the elderly, committed by strangers.
Subject(s)
Crime Victims/statistics & numerical data , Family Characteristics , Violence/statistics & numerical data , Aged , Aged, 80 and over , Brazil/epidemiology , Cross-Sectional Studies , Educational Status , Female , Health Surveys , Humans , Male , Middle Aged , Multivariate Analysis , Poisson Distribution , PrevalenceABSTRACT
Objetivo: analisar a associação entre características sociodemográficas, comportamentais e de saúde e a prevalência de violência contra o idoso cometida por pessoa desconhecida. Métodos: estudo transversal, com dados da Pesquisa Nacional de Saúde 2013, sobre indivíduos com 60 anos ou mais de idade; utilizou-se o modelo log-linear de Poisson. Resultados: foram incluídos no estudo 11.143 idosos; a prevalência de violência por desconhecidos nos 12 meses anteriores à entrevista foi de 1,61 (IC95% 1,28;1,94); na análise multivariável, observou-se maior prevalência de violência cometida por desconhecidos entre idosos de 60 a 69 anos (RP=2,03; IC95% 1,02;4,06), com ensino superior comparativamente aos sem instrução (RP=4,00; IC95% 1,89;8,33), residentes no Centro-Oeste versus Sudeste (RP=2,00; IC95% 1,16;3,45) e em domicílios não cadastrados na Estratégia Saúde da Família (RP=1,57; IC95% 1,00;2,48). Conclusão: características sociodemográficas e macrorregião nacional de residência mostraram-se associadas à violência contra idosos cometida por pessoas desconhecidas.
Objetivo: analizar la asociación entre características sociodemográficas, comportamentales y de salud y la prevalencia de violencia contra ancianos cometida por desconocidos. Métodos: estudio transversal, con datos de la Encuesta Nacional de Salud 2013, sobre individuos con 60 años o más de edad; se utilizó el modelo log-lineal de Poisson. Resultados: se incluyeron 11.143 ancianos; la prevalencia de violencia por desconocidos en los 12 meses anteriores a la entrevista fue 1,61 (IC95% 1,28;1,94); en el análisis multivariable, se observó mayor prevalencia de violencia entre ancianos de 60 a 69 años (RP=2,03; IC95% 1,02;4,06), personas con enseñanza superior en comparación con los sin instrucción (RP=4,00; IC95% 1,89;8,33), residentes en el Centro-Oeste versus Sudeste (RP=2,00; IC95% 1,16;3,45) y en domicilios no registrados en la Estrategia Salud de la Familia (ESF) (RP=1,57; IC95% 1,00;2,48). Conclusión: las características sociodemográficas y la región de residencia se mostraron asociadas a la violencia contra los ancianos cometida por personas desconocidas.
Objective: to analyze the association between sociodemographic, behavioral and health characteristics and the prevalence of violence against the elderly committed by strangers. Methods: cross-sectional study with data from the 2013 National Health Survey on individuals aged 60 years and over; a log-linear Poisson model was used. Results: 11,143 elderly individuals were included in the study; the prevalence of violence committed by strangers in the 12 months prior to the interview was 1.61 (95%CI 1.28;1.94); in the multivariate analysis, a higher prevalence of violence committed by strangers was observed among elderly individuals aged 60-69 years (PR=2.03; 95%CI 1.02;4.06), with higher education degree compared to those without schooling (RP=4.00; 95%CI 1.89;8.33), residents of the Midwest versus Southeast (PR=2.00; 95%CI 1.16;3.45), and in households not registered in the Family Health Strategy (FHS) (PR=1.57; 95%CI 1.00;2.48). Conclusion: sociodemographic characteristics and region of residence were associated with violence against the elderly, committed by strangers.
Subject(s)
Humans , Male , Female , Aged , Aging , Elder Abuse , Linear Models , Cross-Sectional StudiesABSTRACT
A cross-sectional study was conducted in the 15 hospitals with over 1000 deliveries/year in Rio de Janeiro, Brazil, to verify the association between training of health professionals in breastfeeding and professional knowledge, skills and practices. Interviews were staged with 215 health professionals, 48.4% working in Baby-Friendly Hospitals, by means of a questionnaire adapted from the revalidation instrument of the initiative. The three dichotomized outcomes were subjected to bivariate and multivariate analysis. Adjusted prevalence ratios were obtained by the Poisson regression model: 48.1% of the professionals had adequate knowledge, 58.9% adequate skills and 74.9% reported adequate practice. Theoretical and practical training ≥ 18 hours considered adequate (by 65.6% of the professionals) showed a significant association with professional knowledge (aPR = 1.575), skills (aPR = 1.530) and practices (aPR = 1.312). Less working experience was associated with less knowledge (aPR = 0.723), but with better practices (aPR = 1.183). Nursing staff reported better practices than physicians (aPR = 0.808) and other categories (aPR = 0.658). The study concludes that training contributes to improved breastfeeding knowledge, skills and practices that are essential for maternal and child care.
Subject(s)
Breast Feeding , Clinical Competence , Health Knowledge, Attitudes, Practice , Personnel, Hospital/education , Brazil , Cross-Sectional Studies , Female , Humans , Interviews as Topic , Male , Multivariate Analysis , Surveys and QuestionnairesABSTRACT
Resumo Para verificar a associação entre capacitação em aleitamento materno e conhecimentos, habilidades e práticas profissionais, foi conduzido estudo transversal nos 15 hospitais com mais de 1000 partos/ano do município do Rio de Janeiro. Foram entrevistados 215 profissionais, sendo 48,4% em Hospitais Amigos da Criança, por adaptação de questionário de reavaliação desta iniciativa. Os três desfechos, dicotomizados, foram utilizados em análises bivariadas e multivariadas, sendo obtidas razões de prevalência ajustadas por modelo de regressão de Poisson. Dos profissionais, 48,1% tinham conhecimentos; 58,9% habilidades e 74,9% práticas adequadas. A capacitação teórico-prática ≥ 18 horas, considerada adequada, presente em 65,6% dos profissionais, mostrou associação significativa com conhecimentos (RPa = 1,575), habilidades (RPa = 1,530) e práticas (RPa = 1,312). Profissionais com menor tempo de trabalho apresentaram menos conhecimentos (RPa = 0,723), mas relataram melhores práticas (RPa = 1,183). A enfermagem relatou melhores práticas em relação aos médicos (RPa = 0,808) e a outras categorias (RPa = 0,658). Conclui-se que a capacitação contribui para o aprimoramento de conhecimentos, habilidades e práticas em aleitamento materno, fundamentais à assistência materno-infantil.
Abstract A cross-sectional study was conducted in the 15 hospitals with over 1000 deliveries/year in Rio de Janeiro, Brazil, to verify the association between training of health professionals in breastfeeding and professional knowledge, skills and practices. Interviews were staged with 215 health professionals, 48.4% working in Baby-Friendly Hospitals, by means of a questionnaire adapted from the revalidation instrument of the initiative. The three dichotomized outcomes were subjected to bivariate and multivariate analysis. Adjusted prevalence ratios were obtained by the Poisson regression model: 48.1% of the professionals had adequate knowledge, 58.9% adequate skills and 74.9% reported adequate practice. Theoretical and practical training ≥ 18 hours considered adequate (by 65.6% of the professionals) showed a significant association with professional knowledge (aPR = 1.575), skills (aPR = 1.530) and practices (aPR = 1.312). Less working experience was associated with less knowledge (aPR = 0.723), but with better practices (aPR = 1.183). Nursing staff reported better practices than physicians (aPR = 0.808) and other categories (aPR = 0.658). The study concludes that training contributes to improved breastfeeding knowledge, skills and practices that are essential for maternal and child care.
Subject(s)
Humans , Male , Female , Personnel, Hospital/education , Breast Feeding , Cross-Sectional Studies , Clinical Competence , Brazil , Health Knowledge, Attitudes, Practice , Interviews as Topic , Multivariate Analysis , Surveys and QuestionnairesABSTRACT
ABSTRACT CONTEXT AND OBJECTIVES: Urinary tract infections are the most common cause of hospital-acquired infections, and the use of indwelling urinary catheters is a predisposing factor for their development. The aims of this study were to estimate the frequency of pre and postoperative bacteriuria, identify the microorganisms involved, count the colony-forming units, determine the antibiotic sensitivity profile and compare the results from pre and postoperative urinalyses among women undergoing gynecological surgery with implantation of a urinary catheter. DESIGN AND SETTING: Non-controlled prospective observational single-cohort epidemiological study carried out at a university hospital. METHODS: Urine samples were collected before and 24 hours after catheterization for urinalysis, culturing and antibiotic sensitivity testing. Pre and postoperative urinalyses were compared using Wilcoxon and McNemar non-parametric tests. RESULTS: Fifty-one women participated in the study. Escherichia coligrew in six preoperative samples (11.8%) and Klebsiella pneumoniae in one (1.9%), but bacterial growth did not occur in any postoperative sample. Urinalysis showed lower number of pus cells in the postoperative urine samples (P < 0.05). There were no differences in red blood cell counts or in the nitrite and leukocyte esterase tests, between the samples. CONCLUSION: Bacteriuria was found in 13.7% of the preoperative samples. Gram-negative bacteria sensitive to most antibiotics were identified. In the postoperative samples, no bacterial growth was observed. Urinalysis only showed significant reduction of leukocyturia in the postoperative period.
RESUMO CONTEXTO E OBJETIVOS: As infecções urinárias são a causa mais comum de infecções hospitalares, e o uso de cateteres de demora é fator predisponente para o seu desenvolvimento. Os objetivos deste estudo foram estimar a frequência de bacteriúria pré e pós-operatória, identificar os germes encontrados, a contagem de unidades formadoras de colônias e o perfil de sensibilidade aos antibióticos, além de comparar os resultados dos exames de urina pré- e pós-operatórios em mulheres submetidas a cirurgias ginecológicas com cateterismo vesical. TIPO DE ESTUDO E LOCAL: Estudo epidemiológico, observacional, de coorte única, prospectivo, não controlado, realizado em hospital universitário. MÉTODOS: Amostras de urina foram colhidas antes da cateterização e após 24 horas para urinálise, cultura e antibiograma. Os resultados da urinálise no pré- e pós-operatório foram comparados utilizando-se os testes não paramétricos de Wilcoxon e McNemar. RESULTADOS: Participaram do estudo 51 mulheres. Houve crescimento de Escherichia coli em seis amostras pré-operatórias (11,8%) e deKlebsiella pneumoniae em uma (1,9%), mas não houve crescimento bacteriano em nenhuma amostra pós-operatória. A urinálise mostrou menor quantidade de piócitos na amostra de urina pós-cirúrgica (P < 0,05). Não houve diferença quanto ao número de hemácias e às reações para nitrito e leucocitesterase, entre as amostras. CONCLUSÃO: Houve bacteriúria em 13,7% das amostras pré-operatórias, sendo identificadas bactérias Gram-negativas sensíveis à maioria dos antibióticos. Não foi observado crescimento bacteriano nas amostras pós-operatórias. A urinálise mostrou somente redução significativa da leucocitúria no pós-operatório.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Middle Aged , Young Adult , Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis/methods , Bacteriuria/microbiology , Bacteriuria/prevention & control , Gynecologic Surgical Procedures/adverse effects , Urinary Catheterization/adverse effects , Urinary Catheters/adverse effects , Colony Count, Microbial , Cross Infection/microbiology , Escherichia coli/isolation & purification , Klebsiella/isolation & purification , Microbial Sensitivity Tests , Postoperative Period , Preoperative Period , Prospective Studies , Statistics, Nonparametric , Time Factors , UrinalysisABSTRACT
CONTEXT AND OBJECTIVES: Urinary tract infections are the most common cause of hospital-acquired infections, and the use of indwelling urinary catheters is a predisposing factor for their development. The aims of this study were to estimate the frequency of pre and postoperative bacteriuria, identify the microorganisms involved, count the colony-forming units, determine the antibiotic sensitivity profile and compare the results from pre and postoperative urinalyses among women undergoing gynecological surgery with implantation of a urinary catheter. DESIGN AND SETTING: Non-controlled prospective observational single-cohort epidemiological study carried out at a university hospital. METHODS: Urine samples were collected before and 24 hours after catheterization for urinalysis, culturing and antibiotic sensitivity testing. Pre and postoperative urinalyses were compared using Wilcoxon and McNemar non-parametric tests. RESULTS: Fifty-one women participated in the study. Escherichia coligrew in six preoperative samples (11.8%) and Klebsiella pneumoniae in one (1.9%), but bacterial growth did not occur in any postoperative sample. Urinalysis showed lower number of pus cells in the postoperative urine samples (P < 0.05). There were no differences in red blood cell counts or in the nitrite and leukocyte esterase tests, between the samples. CONCLUSION: Bacteriuria was found in 13.7% of the preoperative samples. Gram-negative bacteria sensitive to most antibiotics were identified. In the postoperative samples, no bacterial growth was observed. Urinalysis only showed significant reduction of leukocyturia in the postoperative period.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis/methods , Bacteriuria/microbiology , Bacteriuria/prevention & control , Gynecologic Surgical Procedures/adverse effects , Urinary Catheterization/adverse effects , Urinary Catheters/adverse effects , Adolescent , Adult , Aged , Colony Count, Microbial , Cross Infection/microbiology , Escherichia coli/isolation & purification , Female , Humans , Klebsiella/isolation & purification , Microbial Sensitivity Tests , Middle Aged , Postoperative Period , Preoperative Period , Prospective Studies , Statistics, Nonparametric , Time Factors , Urinalysis , Young AdultABSTRACT
PURPOSE: To identify the impact of urinary incontinence (UI) on quality of life (QoL), to compare the scores of QoL domains in women with stress urinary incontinence (SUI), overactive bladder (OAB) and mixed incontinence (MUI) and to establish the association between the clinical type of UI and the impact on QoL. METHODS: Data of 181 incontinent women attended at a public hospital were collected regarding age, body mass index (BMI) and co-morbidities. King's Health Questionnaire (KHQ) was applied and patients were classified into two groups according to the self-assessment of incontinence impact. KHQ scores were compared by the Mann-Whitney test. Depending on their urinary symptoms, women were divided into SUI, OAB and MUI groups and their scores in the KHQ domains were compared by the Kruskal-Wallis and Dunn tests. The odds ratio (OR) of a woman reporting a worse effect of UI on QoL was estimated using the binary logistic model. The control variables were: age, BMI and number of co-morbidities. RESULTS: A significant difference was found between the two groups of self-assessment of UI impact for all KHQ domains. The MUI group showed worse scores than the SUI group for all domains, and OAB group, for limitation of physical and daily activities. There was a significant difference between the odds of the women in the SUI and MUI groups reporting worse effects of UI on QoL (OR=2.9; p=0.02). CONCLUSION: As reported at other reference services, MUI was the most commom type, and urinary loss had a moderate/major impact on QoL, affecting mainly role limitations domain. The adjusted analysis showed that women with MUI had almost three times greater odds of reporting worse impact on QoL than women with SUI.
Subject(s)
Quality of Life , Urinary Bladder, Overactive , Urinary Incontinence , Body Mass Index , Brazil , Cross-Sectional Studies , Female , Humans , Middle Aged , Self Report , Urinary Bladder, Overactive/complications , Urinary Bladder, Overactive/physiopathology , Urinary Incontinence/classification , Urinary Incontinence/complications , Urinary Incontinence/physiopathologyABSTRACT
Identificar o impacto da incontinência urinária (IU) sobre a qualidade de vida (QV), comparar os escores dos domínios de QV em mulheres com incontinência de esforço (IUE), bexiga hiperativa (BH) e incontinência mista (IUM) e estabelecer a associação entre o tipo clínico de IU e o impacto sobre a QV. Foram coletadas informações sobre idade, índice de massa corpórea (IMC) e comorbidades de 181 mulheres incontinentes atendidas em serviço público. O Observou-se diferença significante entre os dois grupos de autoavaliação do impacto da IU para todos os domínios do KHQ. O grupo IUM apresentou piores escores que o grupo IUE para todos os domínios, e o grupo BH, para limitações de atividades diárias e físicas. Houve diferença significante entre as chances de as mulheres dos grupos IUE e IUM reportarem pior impacto de IU na QV (OR=2,9; p=0,02). Assim como em outras populações de serviços especializados, a IUM foi o subtipo mais comum, e a perda urinária comprometeu de forma moderada/grave a QV, afetando o domínio limitações das atividades diárias com maior intensidade. A análise ajustada mostrou que mulheres com IUM apresentam chance aproximadamente três vezes maior de reportarem pior impacto sobre ...
To identify the impact of urinary incontinence (UI) on quality of life (QoL), to compare the scores of QoL domains in women with stress urinary incontinence (SUI), overactive bladder (OAB) and mixed incontinence (MUI) and to establish the association between the clinical type of UI and the impact on QoL. Data of 181 incontinent women attended at a public hospital were collected regarding age, body mass index (BMI) and co-morbidities. King's Health Questionnaire (KHQ) was applied and patients were classified into two groups according to the self-assessment of incontinence impact. KHQ scores were compared by the Mann-Whitney test. Depending on their urinary symptoms, women were divided into SUI, OAB and MUI groups and their scores in the KHQ domains were compared by the Kruskal-Wallis and Dunn tests. The odds ratio (OR) of a woman reporting a worse effect of UI on QoL was estimated using the binary logistic model. The control variables were: age, BMI and number of co-morbidities. A significant difference was found between the two groups of self-assessment of UI impact for all KHQ domains. The MUI group showed worse scores than the SUI group for all domains, and OAB group, for limitation of physical and daily activities. There was a significant difference between the odds of the women in the SUI and MUI groups reporting worse effects of UI on QoL (OR=2.9; p=0.02). As reported at other reference services, MUI was the most commom type, and urinary loss had a moderate/major impact on QoL, affecting mainly role limitations domain. The adjusted analysis showed that women with MUI had almost three times greater odds of reporting worse impact on QoL than women with SUI.
Subject(s)
Humans , Female , Middle Aged , Quality of Life , Urinary Bladder, Overactive , Urinary Incontinence , Body Mass Index , Brazil , Cross-Sectional Studies , Self Report , Urinary Bladder, Overactive/complications , Urinary Bladder, Overactive/physiopathology , Urinary Incontinence/classification , Urinary Incontinence/complications , Urinary Incontinence/physiopathologyABSTRACT
OBJETIVO : Analisar a prevalência do aleitamento materno exclusivo e sua associação com a assistência pela Iniciativa Unidade Básica Amiga da Amamentação. MÉTODOS : Estudo transversal, com dados da pesquisa sobre práticas alimentares no primeiro ano de vida conduzida nas campanhas de vacinação em Barra Mansa, RJ, em 2003 e 2006. Foram selecionadas as crianças < 6 meses, no total 589 em 2003 e 707 em 2006. Tomou-se por base o inquérito de 2006 para estimar a relação entre ser assistido pela Iniciativa Unidade Básica Amiga da Amamentação e a prática do aleitamento materno exclusivo. Variáveis de exposição que se mostraram associadas (p ≤ 0,20) ao desfecho na análise bivariada foram selecionadas para a análise múltipla. As razões de prevalência ajustadas foram obtidas por modelo de regressão de Poisson com variância robusta, segundo modelo conceitual hierarquizado. O modelo final foi composto por variáveis de exposição que obtiveram p ≤ 0,05. RESULTADOS : A prevalência do aleitamento materno exclusivo aumentou de 30,2% em 2003 para 46,7% em 2006. Baixa escolaridade materna reduziu o aleitamento materno exclusivo em 20,0% (RP = 0,798; IC95% 0,684;0,931), o parto cesariano em 16,0% (RP = 0,838; IC95% 0,719;0,976), o uso de chupeta em 41,0% (RP = 0,589; IC95% 0,495;0,701) e a prevalência de aleitamento materno exclusivo foi 1,0% menor a cada dia de vida da criança (RP = 0,992; IC95% 0,991;0,994) na análise múltipla. O acompanhamento do bebê por unidade credenciada na Iniciativa Unidade Básica Amiga da Amamentação aumentou o desfecho em 19,0% (RP = 1,193; IC95% 1,020;1,395). CONCLUSÕES : A Iniciativa Unidade Básica Amiga da Amamentação contribuiu para a prática do aleitamento materno exclusivo ...
OBJETIVO : Analizar la prevalencia de la lactancia materna exclusiva y su asociación con la asistencia por la Iniciativa Unidad Básica Amiga de la Lactancia. MÉTODOS : Estudio transversal, con datos de la investigación sobre prácticas alimenticias en el primer año de vida conducida en las campañas de vacunación en Barra Mansa, RJ, Brasil, en 2003 y 2006. Se seleccionaron los niños < 6 meses, en total 589 en 2003 y 707 en 2006. Se consideró como base la investigación de 2006 para estimar la relación entre ser asistido por la Iniciativa Unidad Básica Amiga de la Lactancia y la práctica de la lactancia materna exclusiva. Variables de exposición que se mostraron asociadas (p ≤ 0,20) al resultado en el análisis bivariado y se seleccionaron para el análisis múltiple. Los cocientes de prevalencia ajustados fueron obtenidos por modelo de regresión de Poisson con varianza robusta, según modelo conceptual jerarquizado. El modelo final estuvo compuesto por variables de exposición que obtuvieron p ≤ 0,05. RESULTADOS : La prevalencia de la lactancia materna exclusiva aumentó de 30,2% en 2003 a 46,7% en 2006. La baja escolaridad materna redujo la lactancia materna exclusiva en 20% (RP = 0,798; IC95% 0,684;0,931), el parto por cesárea en 16,0% (RP = 0,838; IC95% 0,719;0,976), el uso de chupón en 41,0% (RP = 0,589; IC95% 0,495;0,701) y la prevalencia de lactancia materna exclusiva fue 1,0% menor a cada día de vida del niño (RP = 0,992; IC95% 0,991;0,994) en el análisis múltiple. El acompañamiento del bebé por unidad autorizada en la Iniciativa Unidad Básica Amiga de la Lactancia aumentó el resultado en 19,0% (RP = 1,193; IC95% 1,020;1,395). CONCLUSIÓN : La Iniciativa Unidad Básica Amiga de la Lactancia contribuyó para la práctica de la lactancia materna ...
OBJECTIVE : To analyze the prevalence of exclusive breastfeeding and the association with the Breastfeeding-Friendly Primary Care Unit Initiative. METHODS : Cross-sectional study, whose data source were research on feeding behaviors in the first year of life conducted in the vaccination campaigns of 2003 and 2006, at the municipality of Barra Mansa, RJ, Southeastern Brazil. For the purposes of this study, infants under six months old, accounting for a total of 589 children in 2003 and 707 children in 2006, were selected. To verify the relationship between being followed-up by Breastfeeding-Friendly Primary Care Unit Initiative units and exclusive breastfeeding practice, only data from the 2006 inquiry was used. Variables that in the bivariate analysis were associated (p-value ≤ 0.20) with the outcome (exclusive breastfeeding practice) were selected for multivariate analysis. Prevalence ratios (PR) of exclusive breastfeeding were obtained by Poisson Regression with robust variance through a hierarchical model. The final model included the variables that reached p-value ≤ 0.05. RESULTS : The prevalence of exclusive breastfeeding increased from 30.2% in 2003 to 46.7% in 2006. Multivariate analysis showed that mother’s low education level reduced exclusive breastfeeding practice by 20.0% (PR = 0.798; 95%CI 0.684;0.931), cesarean delivery by 16.0% (PR = 0.838; 95%CI 0.719;0.976), and pacifier use by 41.0% (PR = 0.589; 95%CI 0.495;0.701). In the multiple analysis, each day of the infant’s life reduced exclusive breastfeeding prevalence by 1.0% (PR = 0.992; 95%CI 0.991;0.994). Being followed-up by Breastfeeding-Friendly Primary Care Initiative units increased exclusive breastfeeding by 19.0% (PR = 1.193; 95%CI 1.020;1.395). CONCLUSIONS : Breastfeeding-Friendly Primary Care Unit Initiative contributed to the practice of exclusive breastfeeding and to the advice for pregnant women and nursing mothers when implemented ...
