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1.
BMC Pregnancy Childbirth ; 19(1): 410, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703634

RESUMO

BACKGROUND: Studies of healthcare service use during the pregnancy-postpartum cycle often rely on self-reported data. The reliability of self-reported information is often questioned as administrative data or medical records, such as antenatal care cards, are usually preferred. In this study, we measured the agreement of antenatal care indicators from self-reported information and antenatal care cards of pregnant women in the 2015 Pelotas Birth Cohort, Brazil. METHODS: In a sample of 3923 mothers, indicator agreement strengths were estimated from Kappa and prevalence-and-bias-adjusted Kappa (PABAK) coefficients. Maternal characteristics associated with indicator agreements were assessed with heterogeneity chi-squared tests. RESULTS: The self-reported questionnaire and the antenatal care card showed a moderate to high agreement in 10 of 21 (48%) antenatal care indicators that assessed care service use, clinical examination and diseases during pregnancy. Counseling indicators performed poorly. Self-reported information presented a higher frequency data and a higher sensitivity but slightly lower specificity when compared to the antenatal card. Factors associated with higher agreement between both data sources included lower maternal age, higher level of education, primiparous status, and being a recipient of health care in the public sector. CONCLUSIONS: Self-reported questionnaire and antenatal care cards provided substantially different information on indicator performance. Reliance on only one source of data to assess antenatal care quality may be questionable for some indicators. From a public health perspective, it is recommended that antenatal care programs use multiple data sources to estimate quality and effectiveness of health promotion and disease prevention in pregnant women and their offspring.

2.
Int J Qual Health Care ; 31(7): 497-505, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30295805

RESUMO

PURPOSE: To describe indicators used for the assessment of antenatal care (ANC) quality worldwide under the World Health Organization (WHO) framework and based on a systematic review of the literature. DATA SOURCES: Searches were performed in MEDLINE, SciELO, BIREME and Web of Science for eligible studies published between January 2002 and September 2016. STUDY SELECTION: Original articles describing women who had received ANC, any ANC model and, any ANC quality indicators were included. DATA EXTRACTION: Publication date, study design and ANC process indicators were extracted. RESULTS OF DATA SYNTHESIS: Of the total studies included, 69 evaluated at least one type of ANC process indicator. According to WHO ANC guidelines, 8.7% of the articles reported healthy eating counseling and 52.2% iron and folic acid supplementation. The evaluation indicators on maternal and fetal interventions were: syphilis testing (55.1%), HIV testing (47.8%), gestational diabetes mellitus screening (40.6%) and ultrasound (27.5%). Essential ANC activities assessment ranged from 26.1% report of fetal heart sound, 50.7% of maternal weight and 63.8% of blood pressure. Regarding preventive measures recommended by WHO, tetanus vaccine was reported in 60.9% of the articles. Interventions performed by health services to improve use and quality of ANC care, promotion of maternal and fetal health, and the number of visits to the ANC were evaluated in 65.2% of the studies. CONCLUSION: Numerous ANC content indicators are being used to assess ANC quality. However, there is a need to use standardized indicators across countries and efforts to improve quality evaluation.

3.
Acta otorrinolaringol. cir. cabeza cuello ; 45(1): 28-35, 20170000. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-969203

RESUMO

Objetivo: Describir y comparar los resultados audiológicos pre y postquirúrgicos de los pacientes que fueron sometidos a implante de conducción ósea osteointegrado en el Hospital Universitario de la Samaritana, Bogotá D.C. Diseño: Estudio tipo Cohorte descriptiva. Métodos: Se evaluaron los resultados audiológicos pre y postquirúrgicos de 36 pacientes sometidos a Implante de audífono de conducción ósea osteointegrado. Resultados: Se observó una disminución estadísticamente significativa entre el valor de PTA pre y postquirúrgico (Diferencia = 36.94 dB; IC95% 35.2 a 38.7; p<0.001) Mejoría en la brecha Ósea ­ Aérea con una diferencia entre el valor previo y posterior a la intervención de 35.93 dB (IC95% 33.23 a 38.63; p<0.001). La diferencia entre el porcentaje de discriminación verbal antes y después del procedimiento quirúrgico fue de 6.67% (IC95% 1.41 a 11.92; p=0.008), con una reducción en los niveles de intensidad de sonido en la discriminación que fue de 32.26 dB (IC95% 29.21 a 35.32; p<0.001). Conclusión: Los resultados audiológicos esperados en pacientes con hipoacusia conductiva, mixta o neurosensorial unilateral que fueron sometidos a implante de audífono de conducción ósea osteointegrado muestran que el sistema ofrece un alto porcentaje de éxito y bajas tasas de complicaciones.


Objective: To describe and compare pre and postoperative audiological results in patients who received a bone conduction hearing aid implant and the Hospital Universitario de la Samaritana, Bogotá D.C. Design: A descriptive cohort study. Methods: A descriptive cohort study was conducted. We evaluated audiological results before and after the bone conduction hearing aid implant procedure in 36 patients. Results: A statistically significant decrease in the PTA value was observed after the implant procedure (difference= 36.94 dB; 95CI% 35.2 - 38.7; p<0.001) The bone-air gap also presented improvement after the intervention with a decrease of 35.93 dB (95%CI 33.23 - 38.63; p<0.001). The difference in verbal discrimination percentage after the surgical procedure was 6.67% (95%CI 1.41 - 11.92; p=0.008), with a decrease in sound intensity discrimination levels of 32.26 db (95%CI 29.21 - 35.32; p<0.001). Conclusion: The audiological results in patients with conductive, mixed or unilateral sensorineural hearing loss that received a bone conduction hearing aid implant show that this intervention offers a high success rate and low postoperative complications.


Assuntos
Humanos , Perda Auditiva , Condução Óssea , Auxiliares de Audição
4.
Acta otorrinolaringol. cir. cabeza cuello ; 42(4): 216-221, oct.-dic. 2014. ilus
Artigo em Espanhol | LILACS | ID: lil-753413

RESUMO

La perforación timpánica es un problema común que puede causar secuelas como hipoacusia e infecciones recurrentes del oído; requiere de intervención quirúrgica, timpanoplastia, para mejorar la audición y otras funciones, siendo la causa más común de fracaso la reperforación. Objetivo: Describir los factores asociados a las fallas de timpanoplastia en el Hospital Universitario de la Samaritana enre Enero 2005 a Diciembre 2012. Diseño: Estudio observacional analítico tipo cohorte histórica. Métodos: Revisión retrospectiva de 177 historias de pacientes sometidos a timpanoplastia primaria; se dividieron los pacientes en éxito y falla, analizando cada una de las variables buscando relación entre ellas. Se aceptó un valor de 0.05 como máximo error tipo I permitido. El análisis estadístico de los datos fue realizado con el software SPSS versión 20 para Windows. Resultados: Se incluyeron 141 historias, se encontró ganancia auditiva media de 14,83; éxito del procedimiento de 53,9% y asociaciones estadísticamente significativas con: Sexo, exposición al humo de leña, estado del oído en el momento del procedimiento, causa de la perforación, tipo de injerto utilizado y localización de la perforación. Conclusión: Se encontró un bajo porcentaje de éxito en la timpanoplastia, comparado con la literatura mundial y nacional; según las asociaciones encontradas podemos relacionarlo con reperforación; infección crónica, grandes perforaciones, exposición al humo de leña, localización inferior y a que parte de los procedimiento fueron realizados por residentes en entrenamiento. Se considera que la modificación de factores en la técnica y los posoperatorios mejorará la tasa de éxito...


The tympanic perforation is a common problem that can cause sequelae such as hearing loss and recurrent ear infections; it requires surgery, tympanoplasty, to improve hearing and other functions, the most common cause of recurrent failure is perforation. Objective: To analyze the factors associated with tympanoplasty in the Hospital Universitario de la Samaritana from January 2005 to December 2012. Design: Historical cohort study. Methods: An observational historic cohort study, retrospectively review 177 primary tympanoplasty for medical and statistical variables of patients who underwent tympanoplasty, between January 2005 and December 2012 at the Hospital Universitario de la Samaritana. We separated patients according to result, success or failure. Type I error of 0.05 value was accepted. All statistical analyses were performed using statistical software SPSS 20 for Windows. Results: 141 charts were included with a main hearing average improvement of 14,83, successful rate of 53,9%, statistical significant association with gender, exposure to wood smoke, infection of the ear at the surgery, cause of the perforation, and localization of the perforation. Conclusion: It was found a lower tympanoplasty success rate compared with the global literature, according to the associations that were found it can be related with the principal cause of tympanic perforation, chronic ear infection, a bigger size of perforation, the wood smoke exposure, localization at the inferior quadrant, and some parts of the procedures were performed by residents in training. Modifications of these factors can improve the succesful rate...


Assuntos
Humanos , Orelha Média , Perda Auditiva , Otolaringologia , Timpanoplastia
5.
Rev Panam Salud Publica ; 36(3): 179-84, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25418768

RESUMO

OBJECTIVE: To identify risk factors for adolescent pregnancy among female students in Bogotá, Colombia. METHODS: This was a retrospective study of cases and controls matched by age, identified by means of a survey on the sexual behavior of adolescent students in Bogotá (Encuesta sobre el Comportamiento Sexual de los Adolescentes Escolarizados en Bogotá) conducted in the first semester of 2010. All 272 cases and 544 randomly-selected controls were taken from 39 044 total records. Variables considered were sociodemographics, household structure, and family environment; sexual relationships and pregnancy; and knowledge of sexual and reproductive health. Matching and conditional logistic regression were used to adjust for possible confounding factors. RESULTS: The factors associated with increased risk of adolescent pregnancy based on multivariate analyses were: attending public school (odds ratio [OR]=2.25; 95% confidence interval [95% CI]: 1.45-3.51); history of siblings with adolescent pregnancy (OR =1.98; 95% CI: 1.55-2.76); early first sexual intercourse (12 years of age or less) (OR =2.34; 95% CI: 1.01-5.40); having a self-reported low- or average-level of contraceptive knowledge (OR =3.92; 95% CI: 1.96-7.83); previous pregnancy (OR =14.09; 95% CI: 8.74- 22.70); and not living with both parents (OR 3.58; 95% CI: 2.10-6.16). CONCLUSIONS: Factors related to individual, family, and social environments that influence the incidence of adolescent pregnancy must be considered and addressed when designing interventions. The existing sex education curriculum is an important component in preventing adolescent pregnancy, however, parent/caregiver participation is required for success.


Assuntos
Gravidez na Adolescência , Adolescente , Estudos de Casos e Controles , Abuso Sexual na Infância , Colômbia/epidemiologia , Comportamento Contraceptivo , Características da Família , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Gravidez , Estudos Retrospectivos , Fatores de Risco , Comportamento Sexual , Fatores Socioeconômicos , Adulto Jovem
6.
Rev. panam. salud pública ; 36(3): 179-184, sep. 2014. tab
Artigo em Inglês | LILACS | ID: lil-728930

RESUMO

OBJECTIVE: To identify risk factors for adolescent pregnancy among female students in Bogotá, Colombia METHODS: This was a retrospective study of cases and controls matched by age, identified by means of a survey on the sexual behavior of adolescent students in Bogotá (Encuesta sobre el Comportamiento Sexual de los Adolescentes Escolarizados en Bogotá) conducted in the first semester of 2010. All 272 cases and 544 randomly-selected controls were taken from 39 044 total records. Variables considered were sociodemographics, household structure, and family environment; sexual relationships and pregnancy; and knowledge of sexual and reproductive health. Matching and conditional logistic regression were used to adjust for possible confounding factors RESULTS: The factors associated with increased risk of adolescent pregnancy based on multivariate analyses were: attending public school (odds ratio [OR]=2.25; 95% confidence interval [95% CI]: 1.45-3.51); history of siblings with adolescent pregnancy (OR =1.98; 95% CI: 1.55-2.76); early first sexual intercourse (12 years of age or less) (OR =2.34; 95% CI: 1.01-5.40); having a self-reported low- or average-level of contraceptive knowledge (OR =3.92; 95% CI: 1.96-7.83); previous pregnancy (OR =14.09; 95% CI: 8.74- 22.70); and not living with both parents (OR 3.58; 95% CI: 2.10-6.16 CONCLUSIONS: Factors related to individual, family, and social environments that influence the incidence of adolescent pregnancy must be considered and addressed when designing interventions. The existing sex education curriculum is an important component in preventing adolescent pregnancy, however, parent/caregiver participation is required for success.


OBJETIVO: Identificar los factores de riesgo de embarazo adolescente entre las estudiantes de Bogotá, Colombia MÉTODOS: Estudio retrospectivo de casos y testigos pareados por edad e identificados por medio de una encuesta sobre el comportamiento sexual de los adolescentes escolarizados en Bogotá (Encuesta sobre el Comportamiento Sexual de los Adolescentes Escolarizados en Bogotá) realizada el primer trimestre del 2010. Los 272 casos y 544 testigos seleccionados aleatoriamente se tomaron de un total de 39 044 registros. Se consideraron variables sociodemográficas, estructura de los hogares y entorno familiar; relaciones sexuales y embarazo, y conocimientos sobre salud sexual y reproductiva. Los métodos utilizados para el ajuste por posibles factores de confusión fueron pareamiento y regresión logística condicional RESULTADOS: Sobre la base de los análisis multifactoriales, los factores asociados con mayor riesgo de embarazo adolescente fueron: asistencia a una escuela pública (razón de posibilidades [OR]=2,25; intervalo de confianza [IC] 95%: 1,45-3,51); antecedentes de embarazo adolescente de una hermana (OR =1,98; IC 95%: 1,55-2,76); primera relación sexual a edad temprana (a los 12 años o antes) (OR =2,34; IC 95%: 1,01-5,40); nivel bajo o medio de conocimiento autoinformado sobre anticonceptivos (OR =3,92; IC 95%: 1,96-7,83); embarazo anterior (OR =14,09; IC 95%: 8,74-22,70), y hogar monoparental (OR=3,58; IC 95%: 2,10-6,16 CONCLUSIONES: Los factores relacionados con el entorno individual, familiar y social que influyen en la incidencia del embarazo adolescente se deben tomar en consideración y abordar cuando se diseñen intervenciones. La inclusión de la educación sexual en el programa de estudios es un componente importante para prevenir el embarazo adolescente; sin embargo, para lograr el éxito es necesaria la participación de los padres o cuidadores.


Assuntos
Gravidez na Adolescência/prevenção & controle , Fatores de Risco , Colômbia
8.
Rev. med. Risaralda ; 19(2): 107-113, jul.-dic. 2013. tab
Artigo em Espanhol | LILACS-Express | ID: lil-729622

RESUMO

Introducción: El embarazo en adolescentes continúa siendo uno de los grandes problemas de Salud Pública en Colombia. Aunque existe un mayor reconocimiento de las medidas preventivas, más educación en salud sexual y reproductiva y fácil acceso a los anticonceptivos, las cifras de embarazos en adolescentes siguen siendo altas debido a múltiples factores agravados por la pérdida de valores, diferentes formas de maltrato y discriminación a nivel familiar, de la pareja, de los vecinos y/o de los profesores y compañeros dentro de los ambientes escolares y malas condiciones socioeconómicas. Materiales y métodos: Se estudió la percepción de los adolescentes escolarizados sobre actos de intimidación que rodean a las adolescentes embarazadas en colegios de educación media. Se realizó un estudio descriptivo en el que se utilizaron las respuestas de 39.044 adolescentes matriculados en los grados noveno a once en 273 colegios, a cinco preguntas que indagaban sobre actos de intimidación en la Encuesta sobre el Comportamiento Sexual de Adolescentes Escolarizados en Bogotá (ECSAE), efectuada en Bogotá durante el primer semestre de 2010. Resultados: Del total de registros, el 45,4% (17.737) pertenecían a adolescentes hombres, el 23% de la muestra eran estudiantes de colegios privados. Doscientas setenta y dos niñas (0,69%) estaban embarazadas en el momento de realizar la encuesta; de ese grupo, el 10,3% estudiaba en colegios privados El acto de intimidación más percibido fue: los profesores dicen en público que las niñas cometieron un gran error al quedar embarazadas. Discusión: Se estableció que las adolescentes embarazadas son objeto de actos de intimidación por parte de sus compañeros y profesores.


Introduction: Adolescent pregnancy continues to be a public health issue in Colombia. Although there has been an increase on sexual and reproductive health education, and facilitation of access to both health services and contraceptive methods, the number of adolescent pregnancies continues to be high. Other studies have shown that pregnancy is related to other social determinants such as loss of values, human rights violations, cultural characteristics and socioeconomic conditions. Methods: The study inquired about adolescent perception on bullying surrounding pregnant adolescents at school. A descriptive study was conducted upon the answer of 39,044 adolescent students enrolled on grades ninth to eleventh at 273 schools in Bogota on a survey regarding their sexual behavior during the first semester of 2010. Five questions related to pregnant girls bullying were analyzed. Results: 45% (17,737) of the subjects were male, and 23% of the attended private schools. Two hundred seventy two girls (0.69%) were pregnant at the moment of the survey 10.3% from private schools. Discussion: The main intimidation act perceived was: teachers publicly tell their students that the girls made a big mistake getting pregnant. Answers showed that pregnant girls suffer bullying by their teachers and classmates.

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