Is Binge Drinking Associated With Specific Types of Exercise and Free Time Sports? A Pooled Analysis With 718,147 Adults.

OBJECTIVE: To verify the association between exercise and free time sport types and binge drinking in a large sample of adults. METHODS: Data of 718,147 adults from the "Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey" were used. We described the demographic and behavioral variables, and negative binomial regression analyzed the association between exercise and free time sport types and binge drinking adjusted by demographics variables, body mass index status, and television time. RESULTS: Outdoor walking/running was the most common exercise reported (20.0%, 95% confidence interval [CI], 19.8%-20.2%), followed by team sports (8.1%; 95% CI, 8.0%-8.2%) and strengthening (8.0%; 95% CI, 7.9%-8.1%). The prevalence of binge drinking for each exercise and free time sport type ranged from 6.9% (water aerobics) to 31.9% (team sports). Participants engaging in strengthening (prevalence ratio = 1.12; 95% CI, 1.04-1.21, P = .002) and team sports (prevalence ratio = 1.11; 95% CI, 1.07-1.17, P < .001) were more likely to binge drink more frequently in the past 30 days than inactive participants. CONCLUSIONS: It appears that the participants' profile plays an important role in the underlying social context of this association. Participants with more frequent strengthening and less frequent team sports practice, who were primarily younger and single, were more likely to binge drink frequently.

Impact of hepatitis C virus eradication with direct-acting antivirals on glycidic metabolism

ABSTRACT Objective: To compare the glucose metabolism of patients with chronic hepatitis C virus infection treated with direct-acting antivirals (DAAs) in pretreatment and sustained viral response (SVR) periods. Materials and methods: This was an intervention pre-post study of 273 patients with chronic hepatitis C virus infection treated with DAAs from March 2018 to December 2019. Glycidic metabolism was evaluated through homeostasis model assessment (HOMA) - insulin resistance (IR) and HOMA-β indices and assessments of insulinemia and HbA1c levels. These parameters were analyzed with a T test by paired comparison of the means of the variables and Wilcoxon's test paired for the median; in the variables with an abnormal distribution, the Z score was generated for the mean in both the pretreatment and SVR periods. Statistical significance was considered at p ≤ 0.05. Results: Among 273 participants, 125 (45.8%) had prediabetes, and 50 (18.3%) had diabetes. In SVR, there was a significant increase in platelets, albumin, alkaline phosphatase, cholesterol and triglycerides and a significant decrease in aspartate aminotransferase, alanine aminotransferase, gamma GT and bilirubin. The HOMA-IR and HOMA-β indices increased in SVR from 1.95 to 2.29 (p = 0.087) and 71.20 to 82.60 (p = 0.001), respectively. Insulinemia increased from 7.60 μU/mL to 8.90 μU/mL (p = 0.011). HbA1c decreased from 5.6 to 5.4 (p < 0.001). Among patients with prediabetes and those with diabetes, the reduction in HbA1c values was significant (p = 0.006 and p = 0.026, respectively). Conclusion: SVR significantly impacts and leads to improvement in glucose metabolism in patients with chronic liver disease induced by hepatitis C virus.

Determinantes sociais da qualidade de vida entre estudantes de graduação e sua associação com o risco de suicídio / Social determinants of quality of life among undergraduate students and their association with suicide risk

Objetivo: avaliar a qualidade de vida e a relação com o risco de suicídio. Métodos: estudo transversal com graduandos de uma universidade pública do Brasil. A qualidade de vida foi mensurada pelo WHOQOL-Bref. Um modelo hierarquizado foi testado através de regressão linear simples. A associação da qualidade de vida com risco de suicídio foi avaliada pela Regressão de Poisson. Resultados: participaram 996 estudantes com escore médio de qualidade de vida de 61,0±13,8. Sexo feminino, cor da pele não branca, orientação sexual não heterossexual, mais pobres, com insegurança alimentar, que utilizam transporte público, com medo de violência no bairro, histórico de discriminação e insatisfeitos com o curso de graduação tiveram pior qualidade de vida, que levou à probabilidade 11 vezes maior de risco de suicídio. Conclusão: o nível de qualidade de vida da amostra estudada foi baixo, estando associado a maior vulnerabilidade socioeconômica, o que contribui para o aumento no risco de suicídio. Sugere-se o fortalecimento dos serviços de assistência estudantil das universidades como forma de promover maior qualidade de vida por meio de ações de promoção de bem-estar social, o que poderá produzir efeitos na saúde mental dos estudantes

Objective: to evaluate the quality of life and the relationship with the risk of suicide. Methods: crosssectional study with undergraduates from a public university in Brazil. Quality of life was measured by the WHOQOL-Bref. A hierarchical model was tested using simple linear regression. The association of quality of life with suicide risk was assessed by Poisson regression. Results: 996 students participated with an average quality of life score of 61.0±13.8. Female gender, non-white, non-heterosexual sexual orientation, poorer, food insecure, using public transport, fear of violence in the neighborhood, history of discrimination and dissatisfied with the undergraduate course had a worse quality of life, which led to an 11-fold increased likelihood of suicide risk. Conclusion: the level of quality of life of the sample studied was low, being associated with greater socioeconomic vulnerability, which contributes to the increased risk of suicide. It is suggested to strengthen student assistance servi-ces at universities to promote improvements in quality of life through actions to promote social wellbeing, which may have effects on students' mental health

Uso de suplementos alimentares combinado com a prática de atividade física entre universitários do extremo sul do Brasil / Food supplement use combined to physical activity practice among college students from extreme South of Brazil

Resumo Introdução O consumo de suplementos alimentares vem aumentando e se popularizando, especialmente em conjunto com a prática de atividade física. Objetivo Investigar o uso de suplementos alimentares combinado com a prática de atividades físicas em universitários do extremo sul do Brasil. Método Estudo de delineamento transversal realizado em uma universidade pública de Rio Grande/RS, com uma amostra de 1.401 universitários. Resultados 29,7% (IC95%: 27,3-32,1) dos universitários relataram o uso de algum tipo de suplemento alimentar ao praticar atividades físicas. Os suplementos que predominaram foram: Whey Protein (79%), Maltodextrina (48%) e isotônicos (45%). As principais fontes de orientação para o uso de suplementos foram amigos e outros praticantes de academias. A análise multivariável apontou que atuais participantes de academias têm uma probabilidade 158% maior de usar suplementos em comparação a não participantes de atividades físicas em academias. Outros grupos associados ao uso de suplementos foram: universitários do sexo masculino, jovens entre 20 e 29 anos, com maior renda familiar e consumidores de álcool. Conclusão Um em cada três estudantes universitários já consumiu suplementos alimentares, e tal conduta pode estar disseminada nos espaços das academias, sem maior detalhamento dos cuidados e das necessidades para individuais para o uso.

Background Background The consumption of dietary supplements has been increasing and becoming popular, especially combined with the practice of physical activity. Objective The aim of the study was to investigate the use of dietary supplements combined with the practice of physical activities in university students in the extreme south of Brazil. Method A cross-sectional study conducted at a public university in Rio Grande/Rio Grande do Sul (Brazil), with a sample of 1,401 university students. Results A total of 29.7% (95% CI: 27.3-32.1) of university students reported having used some kind of dietary supplement when practicing physical activities. The predominant supplements were: Whey Protein (79%), Maltodextrin (48%) and isotonic (45%). The main sources of guidance for using supplements were friends and other practitioners of fitness centers. The multivariate analysis showed that current gym center users are 158% more likely to use supplements compared to non-participants in physical activities at such centers. Other groups associated with the use of supplements were: male college students, young people from 20 to 29 years of age, with higher family income and alcohol users. Conclusion One in three college students have already used dietary supplements and such behavior may be widespread in gyms, without further details on the care and needs for using them.

Income inequality and risk of infection and death by COVID-19 in Brazil. / Desigualdade econômica e risco de infecção e morte por COVID-19 no Brasil.

OBJECTIVE: To assess, through space-time analyses, whether the income inequality of the Federative Units (FUs) in Brazil can be associated with the risk of infection and death by COVID-19. METHODS: This was an ecological study, based on secondary data on incidence and mortality rates for COVID-19. Data were analyzed at the state level, having the Gini coefficient as the main independent variable. Records of twelve days were used, spaced one week each, between April 21th and June 7th, 2020. The weekly variation in the rates was calculated through Prais-Winsten regression, aiming at measuring the evolution of the pandemic in each FU. Spearman's correlation test was used to assess correlation between the rates and their weekly evolution and the independent variables. Lastly, a spatial dependence diagnosis was conducted, and a Spatial Regression lag model was used when applicable. RESULTS: Incidence and mortality rates of COVID-19 increased in all Brazilian FUs, being more pronounced among those with greater economic inequality. Association between Gini coefficient and COVID-19 incidence and mortality rates remained even when demographic and spatial aspects were taken into account. CONCLUSION: Income inequality can play an important role in the impact of COVID-19 on the Brazilian territory, through absolute and contextual effects. Structural policies to reduce inequality are essential to face this and future health crises in Brazil.

OBJETIVO: Avaliar, por meio de análise espaçotemporal, se a desigualdade econômica das Unidades Federativas (UF) do Brasil pode estar associada com o risco de infecção e morte por COVID-19. MÉTODOS: Trata-se de um estudo ecológico, baseado em dados secundários das taxas de incidência e mortalidade para COVID-19. Os dados foram analisados em nível estadual, tendo como principal variável independente o coeficiente de Gini. Foram utilizados os registros de 12 dias, espaçados em uma semana cada, entre 21 de abril e 7 de julho de 2020. A variação semanal das taxas foi calculada pela regressão de Prais-Winsten, com o objetivo de medir a evolução da pandemia em cada UF. O teste de correlação de Spearman foi empregado para avaliar a correlação entre as taxas e suas evoluções semanais e as variáveis independentes. Por fim, realizou-se diagnóstico de dependência espacial dos dados e usou-se o modelo de defasagem da regressão espacial, quando aplicável. RESULTADOS: As taxas de incidência e mortalidade por COVID-19 foram crescentes em todas as UF brasileiras, tendo sido mais acentuada entre aquelas com maior desigualdade econômica. A associação entre coeficiente de Gini e incidência e mortalidade por COVID-19 manteve-se mesmo quando levados em consideração aspectos demográficos e espaciais. CONCLUSÃO: A desigualdade econômica pode exercer papel importante no impacto da COVID-19 em território brasileiro, por meio de efeitos absolutos e contextuais. Políticas estruturais para a redução da desigualdade são fundamentais para o enfrentamento dessa e de futuras crises sanitárias no Brasil.

Food insecurity in a city in the extreme south of Rio Grande do Sul, Brazil, 2016: a population-based study. / Insegurança alimentar em um município do extremo sul do Rio Grande do Sul, 2016: um estudo de base populacional.

OBJECTIVE: to analyze the occurrence of food insecurity and associated factors in Rio Grande, Rio Grande do Sul, Brazil, in 2016. METHODS: this was a cross-sectional population-based study using data obtained by interviewing heads of household; Poisson regression with robust variance adjustment was used. RESULTS: 675 households were included; food insecurity prevalence was 35.2% (95%CI31.6;39.0) and its occurrence was associated with heads of household being female (PR=1.49 - 95%CI1.17;1.90), not being white-skinned (PR=1.49 - 95%CI1.18;1.88), being younger, unmarried (PR=1.39 - 95%CI 1.07;1.81), belonging to the lowest education bracket (PR=1.58; 95%CI 1.17;2,12), belonging to the first and second assets index tertiles, having insufficient money to meet expenses (PR=2.22 - 95%CI 1.76;2.80), being obese (PR=1.39 - 95%CI 1.13;1.71), and being a smoker (PR=1.28 - 95%CI 1.05;1.56). CONCLUSION: food insecurity was associated with all factors studied except alcohol abuse.

Insegurança alimentar em um município do extremo sul do Rio Grande do Sul, 2016: um estudo de base populacional / Inseguridad alimentaria en un municipio del extremo sur de Rio Grande do Sul, Brasil, 2016: un estudio de base poblacional / Food insecurity in a city in the extreme south of Rio Grande do Sul, Brazil, 2016: a population-based study

Objetivo: analisar a ocorrência de insegurança alimentar e fatores associados em Rio Grande, RS, Brasil, em 2016. Métodos: estudo transversal de base populacional, cujos dados foram coletados mediante entrevista com os responsáveis pelos domicílios; empregou-se regressão de Poisson, com ajuste robusto da variância. Resultados: foram incluídos 675 domicílios; a prevalência de insegurança alimentar foi de 35,2% (IC95%31,6;39,0) e sua ocorrência esteve associada ao responsável pelo domicílio ser do sexo feminino (RP=1,49 - IC95%1,17;1,90), de raça/cor da pele não branca (RP=1,49 - IC95%1,18;1,88), apresentar menor faixa etária, não ser casado (RP=1,39 - IC95%1,07;1,81), pertencer ao grupo de menor escolaridade (RP=1,58 - IC95%1,17;2,12), encontrar-se no primeiro ou segundo tercil de índice de bens, não ter dinheiro suficiente para as despesas (RP=2,22 - IC95%1,76;2,80), ser obeso (RP=1,39 - IC95%1,13;1,71) e ser fumante (RP=1,28 - IC95%1,05;1,56). Conclusão: a insegurança alimentar esteve associada a todos os fatores estudados, exceto consumo abusivo de álcool.

Objetivo: analizar la ocurrencia de inseguridad alimentaria y factores asociados en Rio Grande, Rio Grande do Sul, Brasil, en 2016. Métodos: un estudio transversal de base poblacional obtuvo información mediante la aplicación de un cuestionario a los responsables por las residencias; se utilizó la regresión de Poisson, con ajuste robusto de la varianza. Resultados: se evaluaron 675 hogares, la inseguridad alimentaria fue del 35,2% (IC95%31,6;39,0) y se asoció con que el responsable por la casa fuera del sexo femenino (RP=1,49 - IC95%1,17;1,90), de raza/color de piel no blanca (RP=1,49 - IC95%1,18;1,88), ser del grupo de edad más joven, no ser casada (RP=1,39 - IC95%1,07;1,81), pertenecer al grupo de menor escolaridad (RP=1,58 - IC95%1,17;2,12), estar en el primero o segundo tercil de índice de bienes, no tener dinero suficiente para los gastos de la casa (RP=2,22 - IC95%1,76;2,80), ser obeso (RP=1,39 - IC95%1,13;1,71) y ser fumador (RP=1,28 - IC95%1,05;1,56). Conclusión: la inseguridad alimentaria estuvo asociada a todos los factores estudiados, excepto el abuso de alcohol.

Objective: to analyze the occurrence of food insecurity and associated factors in Rio Grande, Rio Grande do Sul, Brazil, in 2016. Methods: this was a cross-sectional population-based study using data obtained by interviewing heads of household; Poisson regression with robust variance adjustment was used. Results: 675 households were included; food insecurity prevalence was 35.2% (95%CI31.6;39.0) and its occurrence was associated with heads of household being female (PR=1.49 - 95%CI1.17;1.90), not being white-skinned (PR=1.49 - 95%CI1.18;1.88), being younger, unmarried (PR=1.39 - 95%CI 1.07;1.81), belonging to the lowest education bracket (PR=1.58; 95%CI 1.17;2,12), belonging to the first and second assets index tertiles, having insufficient money to meet expenses (PR=2.22 - 95%CI 1.76;2.80), being obese (PR=1.39 - 95%CI 1.13;1.71), and being a smoker (PR=1.28 - 95%CI 1.05;1.56). Conclusion: food insecurity was associated with all factors studied except alcohol abuse.

Desigualdade econômica e risco de infecção e morte por COVID-19 no Brasil / Income inequality and risk of infection and death by COVID-19 in Brazil

RESUMO: Objetivo: Avaliar, por meio de análise espaçotemporal, se a desigualdade econômica das Unidades Federativas (UF) do Brasil pode estar associada com o risco de infecção e morte por COVID-19. Métodos: Trata-se de um estudo ecológico, baseado em dados secundários das taxas de incidência e mortalidade para COVID-19. Os dados foram analisados em nível estadual, tendo como principal variável independente o coeficiente de Gini. Foram utilizados os registros de 12 dias, espaçados em uma semana cada, entre 21 de abril e 7 de julho de 2020. A variação semanal das taxas foi calculada pela regressão de Prais-Winsten, com o objetivo de medir a evolução da pandemia em cada UF. O teste de correlação de Spearman foi empregado para avaliar a correlação entre as taxas e suas evoluções semanais e as variáveis independentes. Por fim, realizou-se diagnóstico de dependência espacial dos dados e usou-se o modelo de defasagem da regressão espacial, quando aplicável. Resultados: As taxas de incidência e mortalidade por COVID-19 foram crescentes em todas as UF brasileiras, tendo sido mais acentuada entre aquelas com maior desigualdade econômica. A associação entre coeficiente de Gini e incidência e mortalidade por COVID-19 manteve-se mesmo quando levados em consideração aspectos demográficos e espaciais. Conclusão: A desigualdade econômica pode exercer papel importante no impacto da COVID-19 em território brasileiro, por meio de efeitos absolutos e contextuais. Políticas estruturais para a redução da desigualdade são fundamentais para o enfrentamento dessa e de futuras crises sanitárias no Brasil.

ABSTRACT: Objective: To assess, through space-time analyses, whether the income inequality of the Federative Units (FUs) in Brazil can be associated with the risk of infection and death by COVID-19. Methods: This was an ecological study, based on secondary data on incidence and mortality rates for COVID-19. Data were analyzed at the state level, having the Gini coefficient as the main independent variable. Records of twelve days were used, spaced one week each, between April 21th and June 7th, 2020. The weekly variation in the rates was calculated through Prais-Winsten regression, aiming at measuring the evolution of the pandemic in each FU. Spearman's correlation test was used to assess correlation between the rates and their weekly evolution and the independent variables. Lastly, a spatial dependence diagnosis was conducted, and a Spatial Regression lag model was used when applicable. Results: Incidence and mortality rates of COVID-19 increased in all Brazilian FUs, being more pronounced among those with greater economic inequality. Association between Gini coefficient and COVID-19 incidence and mortality rates remained even when demographic and spatial aspects were taken into account. Conclusion: Income inequality can play an important role in the impact of COVID-19 on the Brazilian territory, through absolute and contextual effects. Structural policies to reduce inequality are essential to face this and future health crises in Brazil.

Prevalence and factors associated to the use of illicit drugs and psychotropic medications among brazilian undergraduates

The aim of this study was to verify the prevalence of use of psychoactive substances (PS) and its associated factors in undergraduate students of a university in southern Brazil. The study was carried out with 830 undergraduate students in the year 2016. The individuals answered a self-administered questionnaire about the PS and its prevalence of daily use, in the last 30 days or at any time of their lives, as well as socioeconomic conditions and academic variables. Caffeine-based energy drinks was the most consumed psychoactive substance (96.3%) among undergraduates in the last 30 days, followed by alcohol (64.0%). Among the illicit drugs most consumed in the last 30 days was marijuana (17.3%), while anxiolytics and amphetamines were the most prevalent psychoactive medicaments in the last 30 days. The prevalence of lifetime illicit drugs used by these students was 41.5%, where we highlight besides marijuana (38.6%) the high consumption of cocaine (7.8%), ecstasy (9.3%) and solvents. Socioeconomic and demographic factors such as gender, have children, religion, and financial background as well as academic variables were associated to recent consumption of these substances. This study concluded there is a high prevalence of use of PS among the undergraduate students, including illicit drugs.

How Do Tracking and Changes in Dietary Pattern during Adolescence Relate to the Amount of Body Fat in Early Adulthood?

BACKGROUND: Few studies have addressed the influence of dietary patterns (DP) during adolescence on the amount of body fat in early adulthood. OBJECTIVE: To analyze the associations between DP tracking and changes in the period between 15 and 18 years of age and the percentage of body fat (%BF) at age 18 years. METHODS: We used data from 3,823 members of the 1993 Pelotas (Brazil) birth cohort. Body density was measured at age 18 years by air displacement plethysmograph (BOD POD) and the %BF was calculated applying the Siri equation. Based on the estimates from the FFQ, we identified DP at ages 15 ("Varied", "Traditional", "Dieting" and "Processed meats") and 18 years ("Varied", "Traditional", "Dieting" and "Fish, fast food and alcohol"). The DP tracking was defined as the individual's adherence to the same DP at both ages. Associations were tested using multiple linear regression models stratified by sex. RESULTS: The mean %BF was 25.0% (95% CI: 24.7 to 25.4), significantly greater for girls than boys (p<0.001). The adherence to any DP at age 15 years was not associated with the %BF at age 18 years. However, individuals who adhered to a "Dieting" DP at age 18 years showed greater %BF (1.30 and 1.91 percentage points in boys and girls, respectively) in comparison with those who adhered to a "Varied" DP. Boys who presented tracking of a "Dieting" DP presented greater average %BF in comparison with others DP, as well as girls who changed from the "Traditional" or "Processed meats" DP to a "Dieting" DP. CONCLUSION: These results may support public health policies and strategies focused on improving dietary habits of adolescents and young adults and preventing accumulation of body fat, especially among the adolescents with restrictive dietary habits.

[Stressor events in the family environment that are indicative of mental health problems in children of school age]. / Eventos estressores na família e indicativos de problemas de saúde mental em crianças com idade escolar.

The scope of this article is to evaluate the relationship between stressor events that occurred last year in the family of children and adolescents that are indicative of mental health problems in a sample of students from two schools in a city in southern Brazil. It involved a cross-sectional study with 1,075 students enrolled in two public elementary schools. The Strengths and Difficulties Questionnaire was used to assess emotional and behavioral factors of the child and the Social Readjustment Rating Scale (SRRS) of Holmes and Rahe (1967) to assess stressor events. The chi-square and Poisson regression test with robust variance adjustment for expressing the results in the prevalence ratio (PR) and confidence intervals of 95% were used. The chances of presenting problems of hyperactivity were 1.42 (95% CI 1.10 to 1.83) times higher in the intermediate tercile and 1.37 (95% CI 1.06-1.78) in the higher tercile compared with the lower tercile. With respect to relationship problems the chances were of 1.49 (95% CI 1.15 to 1.93) times higher in the higher tercile when compared with the lower tercile. The results suggest that environmental factors may be strongly related to the etiology of mental disorders in childhood and adolescence.

Eventos estressores na família e indicativos de problemas de saúde mental em crianças com idade escolar / Stressor events in the family environment that are indicative of mental health problems in children of school age

Resumo O objetivo deste artigo é avaliar a relação entre eventos estressores ocorridos no último ano na família de crianças e adolescentes com indicativos de problemas de saúde mental em uma amostra de estudantes de duas escolas de uma cidade no sul do Brasil. Estudo transversal com 1.075 estudantes matriculados em duas escolas públicas de ensino fundamental (uma estadual e outra municipal). Foi utilizado o Strengths and Difficulties Questionnaire para avaliação de fatores emocionais e comportamentais da criança, e a Escala de Avaliação de Reajustamento Social de Holmes e Rahe (1967) para avaliar os eventos estressores. Foram utilizados o teste qui-quadrado e a regressão de Poisson, com ajuste robusto para variância, expressando os resultados em razão de prevalências (RP) e intervalos de confiança de 95%. As chances de apresentar problemas de hiperatividade foram 1,42 (IC 95% 1,10-1,83) vezes maiores no tercil intermediário e 1,37 (IC 95% 1,06-1,78) no tercil superior, quando comparados ao tercil inferior. Quanto aos problemas de relacionamento, as chances foram de 1,49 (IC 95% 1,15-1,93) vezes maiores no tercil superior ao serem comparados com o tercil inferior. Os resultados sugerem que fatores ambientais podem ser fortemente relacionados à etiologia dos transtornos mentais na infância e adolescência.

Abstract The scope of this article is to evaluate the relationship between stressor events that occurred last year in the family of children and adolescents that are indicative of mental health problems in a sample of students from two schools in a city in southern Brazil. It involved a cross-sectional study with 1,075 students enrolled in two public elementary schools. The Strengths and Difficulties Questionnaire was used to assess emotional and behavioral factors of the child and the Social Readjustment Rating Scale (SRRS) of Holmes and Rahe (1967) to assess stressor events. The chi-square and Poisson regression test with robust variance adjustment for expressing the results in the prevalence ratio (PR) and confidence intervals of 95% were used. The chances of presenting problems of hyperactivity were 1.42 (95% CI 1.10 to 1.83) times higher in the intermediate tercile and 1.37 (95% CI 1.06-1.78) in the higher tercile compared with the lower tercile. With respect to relationship problems the chances were of 1.49 (95% CI 1.15 to 1.93) times higher in the higher tercile when compared with the lower tercile. The results suggest that environmental factors may be strongly related to the etiology of mental disorders in childhood and adolescence.

Iron supplementation among pregnant women: results from a population-based survey study / Suplementacao com sulfato ferroso entre gestantes: resultados de estudo transversal de base populacional

Objectives: To measure the prevalence and risk factors associated with iron supplementation among pregnant women in the municipality of Rio Grande, Southern Brazil. Methods: All mothers living in this municipality who had children in 2007 were surveyed for demographic, socioeconomic and health care received during pregnancy and childbirth. The statistical analysis consisted of Poisson regression with robust adjustment of variance, and the measure of effect was prevalence ratio (PR). Results: Among the 2,557 mothers interviewed (99% of total), 59% were supplemented with iron during pregnancy period. After adjusting for various confounding factors, a higher PR to iron supplementation was observed among teenagers, women with black skin color, primigravidae, who had six or more antenatal visits, who performed prenatal care in public sector and received vitamin during pregnancy. Conclusion: There is a clear need to increase the iron supplementation coverage of all pregnant women, especially among those currently considered with low gestational risk. .

Objetivos: Medir a prevalência e identificar fatores associados à suplementação com sulfato ferroso entre gestantes residentes no município de Rio Grande, RS. Métodos: Mães residentes neste município que tiveram filho em 2007 foram investigadas quanto a características demográficas, nível socioeconômico e assistência recebida durante a gestação e o parto. Na análise estatística, foi utilizada regressão de Poisson com ajuste robusto da variância, e a medida de efeito foi razão de prevalências (RP). Resultados: Dentre as 2.557 mães entrevistadas (99% do total), 59% foram suplementadas com sulfato ferroso durante a gestação. Após análise ajustando para diversos fatores de confusão, mostraram maior RP à suplementação com sulfato ferroso as gestantes adolescentes, de cor da pele preta, primigestas, que realizaram seis ou mais consultas de pré-natal, que fizeram essas consultas na rede pública e que receberam complexo vitamínico durante a gestação. Conclusão: Há evidente necessidade de aumentar a cobertura da suplementação com sulfato ferroso entre todas as gestantes, sobretudo entre aquelas tidas, em geral, como de menor risco gestacional. .

[Agreement between data from prenatal care cards and maternal recall in a medium-sized Brazilian city]. / Concordância entre informações do Cartão da Gestante e do recordatório materno entre puérperas de uma cidade brasileira de médio porte.

Prenatal care is a key indicator of the quality of health services. The current study aimed to evaluate the correlation between data from prenatal care cards and maternal recall in the city of Rio Grande, Rio Grande do Sul State, Brazil. The cross-sectional study included all mothers from 2010 who had received prenatal care. Interviews were conducted with a pre-coded questionnaire in the maternity hospital. Of the 2,288 mothers interviewed, 1,228 (53.7%) had the prenatal care card with them and thus comprised the group for comparison. The analysis used kappa correlation and confidence interval. The variables six or more prenatal visits, clinical breast and gynecological examination, two blood tests, VDRL, HIV serology, urine test, and tetanus vaccination showed statistically significant differences between annotated and maternal recall data (p ≤ 0.001). Adequacy of prenatal care based on the guidelines of the Program for Humanization of Prenatal Care (PHPN) was 23.9% according to information provided by the patients and 4.4% according to information recorded on the prenatal cards (p ≤ 0.001). The prenatal care card showed underreporting, which limited the quality assessment of prenatal care.

Concordância entre informações do Cartão da Gestante e do recordatório materno entre puérperas de uma cidade brasileira de médio porte / Agreement between data from prenatal care cards and maternal recall in a medium-sized Brazilian city / Correspondencia entre la información de la cartilla de gestante y el diario materno entre puérperas de una ciudad media brasileña

Prenatal care is a key indicator of the quality of health services. The current study aimed to evaluate the correlation between data from prenatal care cards and maternal recall in the city of Rio Grande, Rio Grande do Sul State, Brazil. The cross-sectional study included all mothers from 2010 who had received prenatal care. Interviews were conducted with a pre-coded questionnaire in the maternity hospital. Of the 2,288 mothers interviewed, 1,228 (53.7%) had the prenatal care card with them and thus comprised the group for comparison. The analysis used kappa correlation and confidence interval. The variables six or more prenatal visits, clinical breast and gynecological examination, two blood tests, VDRL, HIV serology, urine test, and tetanus vaccination showed statistically significant differences between annotated and maternal recall data (p≤ 0.001). Adequacy of prenatal care based on the guidelines of the Program for Humanization of Prenatal Care (PHPN) was 23.9% according to information provided by the patients and 4.4% according to information recorded on the prenatal cards (p ≤ 0.001). The prenatal care card showed underreporting, which limited the quality assessment of prenatal care.

A assistência pré-natal é um indicativo da qualidade dos serviços de saúde. Esse estudo objetivou avaliar a concordância entre os dados do pré-natal da memória materna e do cartão da gestante no Município do Rio Grande, Rio Grande do Sul, Brasil. Estudo transversal incluindo todas puérperas do ano de 2010 que realizaram pré-natal. As entrevistas e a coleta dos dados do cartão ocorreram nas maternidades. Das 2.288 puérperas entrevistadas, 1.228 (53,7%) portavam o cartão da gestante, sendo a comparação realizada nesse grupo. A análise foi feita utilizando-se o teste de concordância kappa e o intervalo de confiança. A realização de seis ou mais consultas de pré-natal, exame das mamas e ginecológico, dois exames de sangue, VDRL, anti-HIV, urina e a vacinação antitetânica demonstraram diferença estatística entre os dados referidos e anotados (p ≤ 0,001). A adequação do pré-natal pelo índice do Programa de Humanização do Pré-Natal (PHPN) nos dados referidos foi de 23,9% e de 4,4% nos dados anotados (p ≤ 0,001). Observamos um sub-registro no cartão da gestante, o qual influenciou negativamente na avaliação da qualidade do pré-natal.

La asistencia prenatal es un indicativo de la calidad de los servicios de salud. Este estudio tuvo por objetivo evaluar la correspondencia entre los datos prenatales del diario materno y de la cartilla de gestante en el municipio de Río Grande, Rio Grande do Sul, Brasil. Es un estudio transversal incluyendo a todas las puérperas del año 2010 que recibieron asistencia prenatal. Las entrevistas y la recogida de los datos de la cartilla se produjeron en las maternidades. De las 2.288 puérperas entrevistadas, 1.228 (53,7%) llevaban la cartilla de gestante, realizándose la comparación en ese grupo. El análisis se ejecutó utilizándose el test de concordancia kappa y el intervalo de confianza. La realización de seis o más consultas de prenatal, examen de mamas y ginecológico, de los exámenes de sangre, VDRL, anti-VIH, orina y la vacunación antitetánica demostraron una diferencia estadística entre los datos proporcionados y los anotados (p ≤ 0,001). La adecuación del servicio prenatal por el índice del Programa de Humanización de Prenatal (PHPN) en los datos recogidos fue de un 23,9% y de un 4,4% en los datos anotados (p ≤ 0,001). Observamos un subregistro en la cartilla de la gestante, el cual influenció negativamente en la evaluación de la calidad de prenatal.

Iron supplementation among pregnant women: results from a population-based survey study.

OBJECTIVES: To measure the prevalence and risk factors associated with iron supplementation among pregnant women in the municipality of Rio Grande, Southern Brazil. METHODS: All mothers living in this municipality who had children in 2007 were surveyed for demographic, socioeconomic and health care received during pregnancy and childbirth. The statistical analysis consisted of Poisson regression with robust adjustment of variance, and the measure of effect was prevalence ratio (PR). RESULTS: Among the 2,557 mothers interviewed (99% of total), 59% were supplemented with iron during pregnancy period. After adjusting for various confounding factors, a higher PR to iron supplementation was observed among teenagers, women with black skin color, primigravidae, who had six or more antenatal visits, who performed prenatal care in public sector and received vitamin during pregnancy. CONCLUSION: There is a clear need to increase the iron supplementation coverage of all pregnant women, especially among those currently considered with low gestational risk.

Citopatológico de colo uterino entre gestantes no Sul do Brasil: um estudo transversal de base populacional / Pap smears among pregnant women in Southern Brazil: a representative cross-sectional survey

OBJETIVO: Determinar a prevalência e identificar fatores associados ao não rastreamento voluntário para citopatológico (CP) de colo uterino entre puérperas em Rio Grande (RS). MÉTODOS: Entrevistadores previamente treinados aplicaram questionário padronizado, ainda na maternidade, em busca de informações sobre características demográficas da gestante, nível socioeconômico da família e tipo de assistência recebida durante o pré-natal para todas aquelas residentes nesse município que tiveram filhos entre 1º de janeiro e 31 de dezembro de 2010. Foram utilizados o teste do χ² para comparar proporções e a regressão de Poisson com ajuste robusto da variância na análise multivariável. RESULTADOS: Dentre as 2.288 entrevistadas, 33% não se submeteram ao CP de colo uterino. Destas, dois terços disseram desconhecer a necessidade de realizá-lo, 18% não fizeram este exame por medo ou vergonha e as demais por outras razões. Após ajuste para diversos fatores de confusão, as maiores razões de prevalência (RP) para não buscar por CP ocorreram entre aquelas de menor idade (RP=1,5; IC95% 1,25 - 1,80) e escolaridade (RP=1,5; IC95% 1,12 - 2,12), que viviam sem companheiro (RP=1,4; IC95% 1,24 - 1,62), fumantes (RP=1,2; IC95% 1,07 - 1,39), que não planejaram a gravidez (RP=1,3; IC95% 1,21 - 1,61), que completaram menos de seis consultas durante pré-natal (RP=1,4; IC95% 1,32 - 1,69) e usuárias de contraceptivo oral (RP=1,2; IC95% 1,04 - 1,38). CONCLUSÕES: Quanto maior o risco para câncer de colo uterino, menor a probabilidade de a gestante se submeter ao CP de colo uterino. Isso, certamente, tem contribuído para o aumento da morbimortalidade por esta doença nesta localidade.

PURPOSE: To determine the prevalence and risk factors associated with failure of voluntary screening for cervical cancer during the gestational period in Rio Grande, Rio Grande do Sul State, Southern Brazil. METHODS: Previously trained interviewers applied a standardized questionnaire in the maternity to all mothers from this municipality who had delivered from January 1st to December 31st 2010 to obtain information about the demographic characteristics of the pregnant women, family socioeconomic status, and prenatal care received. The χ² test was used to compare proportions and Poisson regression with robust adjustment of variance was used in the multivariate analysis. RESULTS: Among the 2,288 respondents, 33% were not submitted to the Pap smear during pregnancy. Two thirds of these women stated that they were not aware of the need to perform it, 18% were not screened out of fear or shame, and the rest for other reasons. After adjustment, the highest prevalence ratios (PR) for noncompliance with the Pap smear occurred among young women (PR=1.5; 95%CI 1.25 - 1.80), with lower educational level (PR=1.5; 95%CI 1.12 - 2.12), who were living without a partner (PR=1.4; 95%CI 1.24 - 1.62), smokers (PR=1.2; 95%CI 1.07 - 1.39), who did not plan the current pregnancy (PR=1.3; 95%CI 1,21 - 1.61), who had attended less than six medical visits during the prenatal period (PR=1.4; 95%CI 1.32 - 1.69) and among users of oral contraceptives (PR=1.2; 95%CI 1.04 - 1.38). CONCLUSIONS: The higher the risk for uterine cervical cancer, the less likely a pregnant woman is to undergo a Pap smear. This definitely contributed to the increased morbidity and mortality from this disease in this setting.

[Body dissatisfaction among adolescents: a population-based study]. / Insatisfação corporal em adolescentes: um estudo de base populacional.

The scope of this study was to evaluate body dissatisfaction among adolescents, and to explore differences according to sex, socioeconomic status and body mass index. 4325 individuals aged 14-15 years old from Pelotas, Brazil, were studied. Body dissatisfaction was evaluated comparing the desired image with the perceived image, according to the Tiggemann & Wilson-Barret silhouette scale. The nutritional status was categorized in accordance with World Health Organization criteria, whereas socioeconomic status was evaluated using classifications of the Brazilian Association of Research Institutes. It was found that 27.6% of teens were overweight. Body dissatisfaction, appraised by the silhouette scale, affected 51% of boys and 65.6% of girls. The economic and nutritional status was associated with the outcome. Most overweight adolescents wished to have a slimmer silhouette than the perceived one. The economic level modified the effect of nutritional status on body dissatisfaction. Adolescents from the wealthier economic classes who were not in the ideal weight range manifested greater body dissatisfaction than the less affluent individuals and, irrespective of economic status, girls are more dissatisfied with excess body weight and boys with slimness.

Insatisfação corporal em adolescentes: um estudo de base populacional / Body dissatisfaction among adolescents: a population-based study

O propósito deste estudo foi avaliar a insatisfação corporal em adolescentes e explorar diferenças conforme sexo, nível econômico e índice de massa corporal. Foram estudados 4.325 indivíduos de 14 a 15 anos da cidade de Pelotas, Brasil. A insatisfação corporal foi avaliada comparando a imagem desejada com a imagem percebida, de acordo com escala de silhuetas de Tiggemann e Wilson-Barret. O estado nutricional foi categorizado conforme proposto pela Organização Mundial da Saúde, enquanto o nível socioeconômico foi avaliado segundo classificação da Associação Brasileira de Empresas de Pesquisas. Verificou-se que 27,6% dos adolescentes estavam acima do peso. A insatisfação corporal, avaliada pela escala de silhuetas, atingiu 51,0% dos meninos e 65,6% das meninas. O nível econômico e o estado nutricional estiveram associados com o desfecho. A maioria dos adolescentes com excesso de peso desejava ter uma silhueta menor do que a percebida. O nível econômico modificou o efeito do estado nutricional sobre a insatisfação corporal. Adolescentes das classes econômicas mais altas fora do peso ideal mostraram maior insatisfação corporal do que os mais pobres e, independente do nível econômico, as meninas estão mais insatisfeitas com o excesso de peso e os meninos com a magreza.

The scope of this study was to evaluate body dissatisfaction among adolescents, and to explore differences according to sex, socioeconomic status and body mass index. 4325 individuals aged 14-15 years old from Pelotas, Brazil, were studied. Body dissatisfaction was evaluated comparing the desired image with the perceived image, according to the Tiggemann & Wilson-Barret silhouette scale. The nutritional status was categorized in accordance with World Health Organization criteria, whereas socioeconomic status was evaluated using classifications of the Brazilian Association of Research Institutes. It was found that 27.6% of teens were overweight. Body dissatisfaction, appraised by the silhouette scale, affected 51% of boys and 65.6% of girls. The economic and nutritional status was associated with the outcome. Most overweight adolescents wished to have a slimmer silhouette than the perceived one. The economic level modified the effect of nutritional status on body dissatisfaction. Adolescents from the wealthier economic classes who were not in the ideal weight range manifested greater body dissatisfaction than the less affluent individuals and, irrespective of economic status, girls are more dissatisfied with excess body weight and boys with slimness.