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1.
Preprint em Português | SciELO Preprints | ID: pps-993

RESUMO

Objective: to analyze the association between the spreading potential of SARS-CoV-2 and the decision-making of the municipal government of Florianópolis (Brazil) regarding social distance. Methods: We analyzed new cases of COVID-19 with nowcasting treatment identified in Florianópolis residents between February 1 and July 14, 2020. Decrees related to COVID-19 published in the Official Gazette of the Municipality between February 1 and July 14, 2020 were also analyzed. Based on the actions proposed in the decrees, it was analyzed whether they relaxed social isolation, increased or maintained existing restrictions, thus creating the Social Distancing Index. Time-dependent reproduction numbers (Rt) for the period of 14 days prior to each decree were calculated. A matrix was constructed associating the classification of each decree and the Rt values, analyzing the consonance or dissonance between the potential dissemination of SARS-CoV-2 and the actions of the decrees. Results: 5,374 cases of COVID-19 and 26 decrees were analyzed. Nine decrees increased measures of social distance, nine maintained them and eight made them more flexible. Of the 26 actions, 9 were consonant and 17 dissonant with the tendency indicated by the Rt. Dissonances were observed in all the decrees that maintained the distance measures or made them more flexible. In the last two months analyzed there was the fastest expansion in the number of new cases and the greatest amount of dissonant decrees. Conclusion: There was an important divergence between municipal measures of social distance with epidemiological indicators at the time of each political decision.   Key-words: Coronavirus Infections. Epidemiology. Decision Making. Government.


Objetivo: analisar a relação entre o potencial de propagação do SARS-CoV-2 e as tomadas de decisão do governo municipal de Florianópolis (Brasil) quanto ao distanciamento social. Métodos: Foram analisados casos novos de COVID-19 com tratamento de nowcasting identificados em residentes de Florianópolis entre 01 de fevereiro e 14 de julho de 2020. Também foram analisados os decretos relacionados à COVID-19 publicadas no Diário Oficial do Município entre 01 de fevereiro e 14 de julho de 2020. Com base nas ações dispostas nos decretos, analisou-se se elas promoviam o relaxamento, o aumento ou a manutenção das restrições vigestes, criando-se o Índice de Distanciamento Social. Para o período de cinco dias anteriores a cada decreto calcularam-se os números de reprodução dependente do tempo (Rt). Construiu-se matriz entre a classificação de cada decreto e os valores de Rt, verificando-se a consonância ou a dissonância entre o potencial de disseminação do SARS-CoV-2 e as ações dos decretos. Resultados: Foram analisados 5.374 casos de COVID-19 e 26 decretos. Nove decretos aumentaram as medidas de distanciamento social, nove mantiveram e oito as flexibilizaram. Das 26 ações, 9 eram consonantes e 17 dissonantes com a tendência indicada pelos Rt. Dissonâncias foram observadas com todos os decretos que mantiveram as medidas de distanciamento e que as flexibilizavam. No segundo bimestre da análise houve a mais rápida expansão do número de casos novos e a maior quantidade de dissonâncias dos decretos. Conclusão: Observou-se importante divergência entre as medidas de distanciamento social com indicadores epidemiológicos no momento da decisão política.

3.
Rev Bras Epidemiol ; 23: e200054, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520104

RESUMO

OBJECTIVE: To verify the internal construct validity of the Brazilian Portuguese version of a tool for measuring the general population's knowledge of human papillomavirus (HPV). MATERIALS AND METHODS: A cross-culturally adapted Brazilian Portuguese version of a measurement tool originally designed for English speaking populations was administered to 330 adults in Tubarão, Santa Catarina, Southern Brazil. After examining the overall suitability of the method, we performed investigations based on the item response theory and exploratory factor analysis. RESULTS: Ten of the 29 items presented a low contribution to the construct and were excluded from subsequent analysis. The factor analysis yielded three factors, which explained approximately 51% of the variance variability. A different arrangement from the original measurement tool was found: general HPV knowledge, with six items; HPV vaccination knowledge, with five items; HPV transmission and testing knowledge, with eight items. CONCLUSION: The Brazilian Portuguese version under study presented a different behavior from the original measurement tool, but proved to be a reliable and valid instrument in assessing the Brazilian population's knowledge about HPV.


Assuntos
Comparação Transcultural , Conhecimentos, Atitudes e Prática em Saúde , Papillomaviridae , Inquéritos e Questionários , Traduções , Adulto , Brasil , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
4.
Allergol. immunopatol ; 48(3): 270-280, mayo-jun. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-192030

RESUMO

INTRODUCTION: The first thousand days of life are a critical stage for the development of respiratory and immune systems. Many events in this period may be associated with wheezing in childhood. OBJECTIVE: This study aimed to investigate the association between early life determinants and wheezing in children aged 6-7 years. MATERIALS AND METHODS: Population-based case-control study using early-life related questions. We used the International Study of Asthma and Allergies in Childhood questionnaire to assess wheezing symptoms. Multiple logistic regressions were performed according to a hierarchical framework, considering the complex dynamic of wheezing/asthma and potential interaction between different levels of determination. RESULTS: A total of 820 children were included, from which 162 reported wheezing symptoms (19.7%). Multivariable analysis identified socioeconomic conditions (OR 2.08, 95% CI 1.08-4.00), family history of asthma (OR 2.28, 95% CI 1.37-3.75), vaginal discharge that required treatment during pregnancy (OR 1.68, 95% CI 1.00-2.83), neonatal hyperbilirubinemia (OR 2.00, 95% CI 1.17-3.42), anemia and intestinal parasitosis in the first two years (OR 2.28, 95% CI 1.22-4.25; OR 1.72, 95% CI 1.02-2.92, respectively) independently associated to wheezing at 6-7 years. Intended pregnancy was associated with reduced wheezing (OR 0.47, 95% CI 0.28-0.77). CONCLUSIONS: Several factors were associated with wheezing in childhood. Considering that intended pregnancy reduced wheezing and other associated exposures are considered modifiable, these findings may guide the planning of strategies to decrease the susceptibility to asthma symptoms in childhood


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Assuntos
Humanos , Masculino , Feminino , Criança , Sons Respiratórios/fisiopatologia , Doenças Respiratórias/epidemiologia , Transtornos Respiratórios/fisiopatologia , Inquéritos e Questionários , Asma/fisiopatologia , Modelos Logísticos , Análise Multivariada
5.
Artigo em Inglês | MEDLINE | ID: mdl-32441407

RESUMO

BACKGROUND: Some techniques in implant dentistry have been suggested that may potentially alter peri-implant soft and hard tissue parameters. PURPOSE: To evaluate the peri-implant soft tissue inflammatory parameters and crestal bone loss around titanium base abutments. MATERIALS AND METHODS: Fifty two implants were placed in 21 patients and restored by single crowns. Subjects were randomly allocated into two groups: cement-retained abutment (n = 24) and titanium base (n = 28). Peri-implant probing depth, and mesial and distal marginal bone loss (MBL) were evaluated at implant loading (T1), 6 and 12 months (T2 and T3, respectively). Peri-implant bleeding-on-probing was evaluated at T2 and T3. Two-way repeated measures analysis of variance, Tukey test, Man Whitney, and Pearson correlation were performed for statistical analysis at P < .05. RESULTS: The mean difference of peri-implant MBL from implant installation to 12 months in function was 1.15 ± 0.82 mm for the cement-retained group, and 1.23 ± 0.79 mm for the titanium base group. No statistically significant difference was found between the two groups for clinical and radiographic peri-implant evaluation. CONCLUSIONS: Titanium base abutments present no negative effect on peri-implant soft tissue and MBL. When used to support single crowns, both approaches performed likewise regarding clinical and radiographic parameters.

6.
Rev Assoc Med Bras (1992) ; 66(2): 139-145, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32428147

RESUMO

OBJECTIVE: To evaluate two different criteria, one or two cut-off values, of oral glucose tolerance test with 75g of glucose for the diagnosis of gestational diabetes mellitus. METHODS: A cross-sectional study involving 120 records of pregnant women who received prenatal care at the service of a Brazilian university was carried out. Bivariate analysis of obstetric and perinatal outcomes was performed using the chi-square test. RESULTS: Considering criterion I, 12.5% of patients were diagnosed with gestational diabetes mellitus. Patients were 3.57 times more likely to have a large fetus for the gestational age at birth (p=0.038). Using criterion II, gestational diabetes mellitus was diagnosed in 5.8% of patients, macrosomia was 7.73 times more likely to be found in the presence of gestational diabetes mellitus (p=0.004), and a large fetus for the gestational age at birth was 8.17 times more likely (p=0.004). CONCLUSIONS: There was a difference in the prevalence of gestational diabetes mellitus between the two criteria analyzed. The new criterion proposed increased prevalence.


Assuntos
Diabetes Gestacional/diagnóstico , Teste de Tolerância a Glucose/normas , Adulto , Brasil/epidemiologia , Estudos Transversais , Diabetes Gestacional/epidemiologia , Feminino , Idade Gestacional , Teste de Tolerância a Glucose/métodos , Humanos , Gravidez , Cuidado Pré-Natal/métodos , Prevalência , Padrões de Referência , Fatores de Risco , Fatores de Tempo , Adulto Jovem
7.
Allergol Immunopathol (Madr) ; 48(3): 270-280, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32284262

RESUMO

INTRODUCTION: The first thousand days of life are a critical stage for the development of respiratory and immune systems. Many events in this period may be associated with wheezing in childhood. OBJECTIVE: This study aimed to investigate the association between early life determinants and wheezing in children aged 6-7 years. MATERIALS AND METHODS: Population-based case-control study using early-life related questions. We used the International Study of Asthma and Allergies in Childhood questionnaire to assess wheezing symptoms. Multiple logistic regressions were performed according to a hierarchical framework, considering the complex dynamic of wheezing/asthma and potential interaction between different levels of determination. RESULTS: A total of 820 children were included, from which 162 reported wheezing symptoms (19.7%). Multivariable analysis identified socioeconomic conditions (OR 2.08, 95% CI 1.08-4.00), family history of asthma (OR 2.28, 95% CI 1.37-3.75), vaginal discharge that required treatment during pregnancy (OR 1.68, 95% CI 1.00-2.83), neonatal hyperbilirubinemia (OR 2.00, 95% CI 1.17-3.42), anemia and intestinal parasitosis in the first two years (OR 2.28, 95% CI 1.22-4.25; OR 1.72, 95% CI 1.02-2.92, respectively) independently associated to wheezing at 6-7 years. Intended pregnancy was associated with reduced wheezing (OR 0.47, 95% CI 0.28-0.77). CONCLUSIONS: Several factors were associated with wheezing in childhood. Considering that intended pregnancy reduced wheezing and other associated exposures are considered modifiable, these findings may guide the planning of strategies to decrease the susceptibility to asthma symptoms in childhood.

8.
An Acad Bras Cienc ; 92(1): e20190833, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32321028

RESUMO

Malocclusions are changes in the development of craniofacial structures of high prevalence. Associated risk factors are diverse and nutritional and non-nutritional suction habits are the most reported. The aim of this study was to estimate the prevalence of malocclusions in the mixed dentition and to study possible association with practices of breastfeeding and suction habits among Brazilian schoolchildren. A cross-sectional study involving a sample of 664 6-year-old children and their families was carried out. Data collection was done through interviews with mothers in the homes and oral examinations of children in schools. Multivariate analyses were performed using the Poisson regression with a robust estimator. The prevalence of overjet over 4 mm was 21.1% and of posterior crossbite was 12.2%; 91.9% of the children were breastfed, 79.0% used a nursing bottle and 49.4% used a pacifier. Significant and independent associations were observed between father's unemployment, private school, interruption of breastfeeding before the fourth month and pacifier use with certain malocclusions. High rates of malocclusion were found in the studied sample. Socioeconomic conditions, breastfeeding practices and suction habits were shown to be statistically associated with their occurrence.


Assuntos
Alimentação Artificial/efeitos adversos , Aleitamento Materno/estatística & dados numéricos , Dentição Mista , Hábitos , Má Oclusão/epidemiologia , Chupetas/efeitos adversos , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Má Oclusão/etiologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Fatores de Tempo
9.
Rev. bras. epidemiol ; 23: e200054, 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1101579

RESUMO

ABSTRACT: Objective: To verify the internal construct validity of the Brazilian Portuguese version of a tool for measuring the general population's knowledge of human papillomavirus (HPV). Materials and methods: A cross-culturally adapted Brazilian Portuguese version of a measurement tool originally designed for English speaking populations was administered to 330 adults in Tubarão, Santa Catarina, Southern Brazil. After examining the overall suitability of the method, we performed investigations based on the item response theory and exploratory factor analysis. Results: Ten of the 29 items presented a low contribution to the construct and were excluded from subsequent analysis. The factor analysis yielded three factors, which explained approximately 51% of the variance variability. A different arrangement from the original measurement tool was found: general HPV knowledge, with six items; HPV vaccination knowledge, with five items; HPV transmission and testing knowledge, with eight items. Conclusion: The Brazilian Portuguese version under study presented a different behavior from the original measurement tool, but proved to be a reliable and valid instrument in assessing the Brazilian population's knowledge about HPV.


RESUMO: Objetivo: Verificar a validade interna do construto da versão em português de uma ferramenta para aferir o conhecimento da população sobre o papilomavírus humano (HPV). Materiais e métodos: Uma versão brasileira transculturalmente adaptada de uma ferramenta de aferição de conhecimento sobre HPV originalmente projetada para ser utilizada em populações de língua inglesa foi aplicada a 330 adultos em Tubarão/SC, Brasil. Após examinar a adequação geral do método, foram realizadas análises baseadas na Teoria de Resposta ao Item e na Análise Fatorial Exploratória. Resultados: Dez dos 29 itens apresentaram baixa contribuição para o construto e foram excluídos das análises subsequentes. Três fatores foram gerados pela análise fatorial e explicaram aproximadamente 51% da variabilidade da variância. Um arranjo diferente em relação ao instrumento de medida original foi encontrado, baseado em: conhecimento geral do HPV, com seis perguntas; conhecimento sobre vacinação contra o HPV, com cinco perguntas; e conhecimento sobre transmissão e teste de HPV com oito perguntas. Conclusão: A versão brasileira em estudo apresentou um comportamento diferente da ferramenta de aferição original, mas demonstrou ser um instrumento confiável e válido para acessar o conhecimento da população brasileira sobre o HPV.

10.
J Dent ; 93: 103267, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31866414

RESUMO

OBJECTIVE: To be fit-for-purpose, oral health-related quality of life instruments must possess a range of psychometric properties which had not been fully examined in the 16-item Short Form Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11-14 ISF-16). We used advanced statistical approaches to determine the CPQ's measurement accuracy, precision, invariance and dimensionality and analyzed whether age range could be extended from 8 to 15 years. METHODS: Fit to the Rasch model was examined in 6648 8-to-15-year-olds from Australia, New Zealand, Brunei, Cambodia, Hong Kong, Malaysia, Thailand, Germany, United Kingdom, Brazil and Mexico. RESULTS: In all but two items, the initial five answer options were reduced to three or four, to increase precision of the children's selection. Items 10 (Shy/embarrassed) and 11 (Concerned what others think) showed an 'extra' dependency between item scores beyond the relationship related to the underlying latent construct represented by the instrument, and so were deleted. Without these two items, the CPQ was unidimensional. The three oral symptoms items (4 Food stuck in teeth, 3 Bad breath and 1 Pain) were required for a sufficient person-item coverage. In three out of 14 items (21 %), Europe and South America showed regional differences in the patterns of how the answer options were selected. No differential item functioning was detected for age. CONCLUSION: Except for a few modifications, the present analysis supports the combination of items, the cross-cultural validity of the CPQ with 14 items and the extension of the age range from 8 to 15 years. CLINICAL SIGNIFICANCE: The valid, reliable, shortened and age-extended version of the CPQ resulting from this study should be used in routine care and clinical research. Less items and a wider age range increase its usability. Symptoms items are needed to precisely differentiate between children with higher and lower quality of life.

11.
ACM arq. catarin. med ; 48(4): 16-25, out.-set. 2019.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1048201

RESUMO

A prematuridade é a segunda causa de morte infantil. Há certa evidência de possível associação entre infecção pelo vírus HIV e o trabalho de parto prematuro. Este estudo tem como objetivo analisar os fatores associados à prematuridade em gestantes portadoras do vírus HIV. Um estudo transversal foi realizado envolvendo 1.845 parturientes do ano de 2010 a 2015 no estado de Santa Catarina, com dados advindos de dois sistemas de informações de domínio público. Utilizou-se análise de regressão de Poisson com estimador robusto. As variáveis que apresentaram p < 0,25 foram incluídas em um modelo multivariado permanecendo aquelas com p < 0,05. A idade média das parturientes foi de 26 anos, a idade gestacional variou de 37 a 41 semanas e o peso médio do recém-nascido de 2.894g. Os resultados apontaram que a zona de moradia urbana [RP 0,91 (IC95% 0,85-0,96)], peso do recém-nascido menor de 2.500g [RP 0,67 (IC95% 0,62-0,72)] e Apgar do 1º minuto <7 [RP 0,90 (IC95% 0,83-0,98)] estiveram associados à menor ocorrência de trabalho de parto prematuro.


Prematurity is the second cause of infant death and there are research who correlate HIV infection and preterm birth. This research has the objective to analyse risk of factores associated with prematurity in pregnant women with HIV infection. A transversal study was made with 1.845 parturient during years 2010 to 2015 at Santa Catarina state, with datas from two public systems, crossing them. Data analyses were performed by Poisson Regression. Multivariate analyses was used when variances had p<0.25 and were statistical significant when p < 0.05. Medium parturient's age was 26 years, medium gestational age was between 37 to 41 complete weeks and newborn medium weight was 2895g. Results pointed that urban dwelling area [RP 0.91 (IC95% 0.85-0.96)], newborn weight less than 2500g [RP 0.67 (IC95% 0.62-0.72)] and Apgar score less than 7 at first minute [RP 0.90 (IC95% 0.83-0.98)] were less associated with preterm birth.

12.
ACM arq. catarin. med ; 48(4): 75-87, out.-set. 2019.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1048209

RESUMO

Objetivo: Identificar fatores associados à baixa qualidade de vida de gestantes com gravidez de alto risco. Método: Trata-se de um estudo transversal, que incluiu 104 pacientes, atendidas no ambulatório de cuidado pré-natal de alto risco em um hospital público, de agosto a novembro de 2017, por meio do Índice de Qualidade de Vida de Ferrans e Powers. Foram avaliadas as associações das características sociodemográficas e clínico-obstétricas com a qualidade de vida destas gestantes, utilizando-se as razões de prevalência e seus respectivos intervalos de confiança de 95%, através do teste qui-quadrado ou a prova exata de Fisher. Uma análise multivariada foi realizada por meio da regressão de Poisson entre as variáveis com p ≤ 0,25. Foi utilizado como nível de significância p < 0,05. Resultados: Mulheres sem cônjuges apresentaram 1,28 (IC95% 1,10-1,49) vez maior probabilidade de estarem associadas à baixa qualidade (p=0,001), quando comparadas às mulheres com parceiro. As demais variáveis não apresentaram significância estatística de forma geral. As comorbidades mais prevalentes entre as gestantes foram as doenças obstétricas. Conclusão: A ausência de um parceiro fixo foi a única variável diretamente associada à baixa qualidade de vida em gestantes de alto risco.


Objective: To identify factors associated with a low quality of life in high-risk pregnant women. Methods: This is a cross-sectional study involving 104 patients of a high-risk prenatal clinic in a public hospital from August to November 2017, using the Ferrans and Powers Quality of Life Index. The associations between sociodemographic and clinical-obstetric characteristics and the quality of life were evaluated, using the prevalence ratios and their respective confidence intervals (95%), using the chi-square test or Fisher exact test. A multivariate analysis was performed using the Poisson regression among variables with p-value ≤ 0.25. The significance level was p <0.05. Results: Women with no spouses were 1.28 (95% CI 1.10-1.49) times more likely to be associated with low quality (p = 0.001), when compared to women with partners. The other variables did not present statistical significance. The most prevalent comorbidities were obstetric diseases. Conclusion: The absence of a partner was the only variable directly associated to the low quality of life in high-risk pregnant women.

13.
Cad Saude Publica ; 35(10): e00155018, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618384

RESUMO

This paper will report the findings of an education intervention performed by a workshop aimed to provide pregnant women with knowledge about pregnancy, delivery, breastfeeding and newborn care. A cross-sectional study, using a pre and post-intervention research design, was performed with 105 pregnant women from an obstetric service for a two-year period. Time points (pre and post) were compared using either Student t test and ANOVA. Significance was set at p ≤ 0.05. After the intervention all items increased their level from the three stations: antenatal care (20.4%), labor and delivery (36.8%) and postnatal and breastfeeding (32.1%). The total score of the surveys also increased 31.7% when comparing the pre and post applications (p < 0.001). It was evidenced the importance of strategies to improve knowledge about pregnancy and its surroundings to pregnant women. The workshop proposal presented increases in its knowledge and can most likely bring better results in short and long-term outcomes.

14.
Rev Assoc Med Bras (1992) ; 65(6): 880-885, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340320

RESUMO

OBJECTIVE: To analyze the temporal trend and factors associated with adolescent pregnancy during ten years in Brasil. METHODS: Data were extracted from the Live Births Information System, of the Brazilian Health System and included information regarding live births from adolescent mothers from 2006 to 2015. The overall proportion of gestation in adolescence and the specific proportions according to the characteristics analyzed were calculated using the standardized reporting coefficients and the simple linear regression method. The study was approved by the ethics committee of the University of Southern Santa Catarina (UNISUL). RESULTS: The general proportion of Live Births from adolescent mothers varied from 21.4% in 2006 to 18.1% in 2015. This reduction occurred because of the negative variation observed among mothers aged 15 to 19 years. The indigenous group was the only that did not present a reduction. There was an increase in the proportion of adolescents with between four and seven years of formal education and in the proportion of adolescents living with partners. There was a reduction in all Brazilian Regions and in large part of the Federation Units. CONCLUSION: The analysis of the temporal trend identifies a reduction in the proportion of live births among adolescent mothers in Brasil. However, there is a growing trend among some specific groups.


Assuntos
Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Distribuição por Idade , Brasil/epidemiologia , Feminino , Humanos , Nascimento Vivo/epidemiologia , Idade Materna , Gravidez , Fatores Socioeconômicos , Análise Espaço-Temporal , Fatores de Tempo
15.
Rev. Assoc. Med. Bras. (1992) ; 65(6): 880-885, June 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1012985

RESUMO

SUMMARY OBJECTIVE: To analyze the temporal trend and factors associated with adolescent pregnancy during ten years in Brasil. METHODS: Data were extracted from the Live Births Information System, of the Brazilian Health System and included information regarding live births from adolescent mothers from 2006 to 2015. The overall proportion of gestation in adolescence and the specific proportions according to the characteristics analyzed were calculated using the standardized reporting coefficients and the simple linear regression method. The study was approved by the ethics committee of the University of Southern Santa Catarina (UNISUL). RESULTS: The general proportion of Live Births from adolescent mothers varied from 21.4% in 2006 to 18.1% in 2015. This reduction occurred because of the negative variation observed among mothers aged 15 to 19 years. The indigenous group was the only that did not present a reduction. There was an increase in the proportion of adolescents with between four and seven years of formal education and in the proportion of adolescents living with partners. There was a reduction in all Brazilian Regions and in large part of the Federation Units. CONCLUSION: The analysis of the temporal trend identifies a reduction in the proportion of live births among adolescent mothers in Brasil. However, there is a growing trend among some specific groups.


RESUMO OBJETIVO: Analisar a tendência temporal da gestação na adolescência e de fatores associados durante dez anos no Brasil. MÉTODO: Estudo ecológico de séries temporais realizado com base no banco de dados do Sistema de Informações sobre Nascidos Vivos (Sinasc). Fizeram parte do estudo informações referentes a nascidos vivos filhos de mães adolescentes no período de 2006 a 2015. A proporção geral de gestação na adolescência e as proporções específicas conforme as características analisadas foram calculadas pelos coeficientes de notificação padronizados e o método de regressão linear simples. Aprovado pelo comitê de ética da Universidade do Sul de Santa Catarina (Unisul). RESULTADOS: A proporção de nascidos vivos de mães adolescentes variou de 21,4% em 2006 para 18,1% em 2015, e essa redução ocorreu à custa da variação negativa observada entre mães na faixa de 15 a 19 anos de idade. A população indígena foi a única que não apresentou redução. Houve aumento das proporções de adolescentes com escolaridade entre quatro e sete anos de estudo e das proporções de adolescentes que vivem com parceiro. Houve redução em todas as regiões brasileiras e em grande parte das Unidades da Federação. CONCLUSÃO: A análise de tendência identifica redução das proporções de nascidos vivos entre mães adolescentes no Brasil. Porém, há uma tendência de aumento entre alguns grupos específicos.

16.
Midwifery ; 75: 97-102, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31071587

RESUMO

Objective The purpose of this study was to perform the translation, cross-cultural adaptation and validation of the Tilburg Pregnancy Distress Scale (TPDS) in the Brazilian cultural context and to verify its psychometric properties. Design Cross-cultural adaptation and validation of a distress scale. Setting The study was carried out in a prenatal clinic of a reference maternity hospital in southern Brazil. Participants 160 childbearing women. Methods The adaptation of the TPDS to the Portuguese language in its Brazilian version met the methodological criteria proposed by the International Society for Pharmacoeconomics and Outcomes Research. To validate the proposed Brazilian version, the questionnaire was applied to 160 childbearing women from the prenatal clinic of a reference maternity hospital in southern Brazil on two occasions between February and May 2018. The stability of the instrument, its internal consistency through Cronbach's alpha and the construct validity were all evaluated through exploratory factorial analysis. The extraction of main components by rotation of Varimax enabled definition of the communalities of the items of the proposed Brazilian version. The study was approved by the local Ethics Committee. Findings The test-retest technique demonstrated strong stability, with a Pearson correlation coefficient of 0.93 (p < 0.001) and an intraclass correlation coefficient of 0.92 (p < 0.001). The general Cronbach's alpha was found to be 0.73. All items presented a factorial load > 0.44 populations in the factorial analysis. Through the method of extracting components, three domains were obtained among the 16 issues of the proposed tool: (1) affection and involvement of the partner, (2) feelings about childbirth and (3) feelings about the future. Key Conclusions The proposed Brazilian version of the Tilburg Pregnancy Distress Scale to evaluate stress and anxiety in pregnancy maintained the original context of the instrument while adding features specific to Brazilian reality. Implications for Practice This is an easily understood scale that is reliable, valid and adequate to the Brazilian social context; it will aid in the assessment of anxiety and stress in childbearing women during prenatal care.


Assuntos
Ansiedade/diagnóstico , Psicometria/normas , Adolescente , Adulto , Ansiedade/psicologia , Brasil , Comparação Transcultural , Feminino , Humanos , Assistência Perinatal/normas , Gravidez , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tradução
17.
J. pediatr. (Rio J.) ; 95(2): 194-200, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1002462

RESUMO

Abstract Objectives: To analyze the risk factors for neonatal death in Florianópolis, the Brazilian city capital with the lowest infant mortality rate. Method: Data were extracted from a historical cohort with 15,879 live births. A model was used that included socioeconomic, behavioral, and health service use risk factors, as well as the Apgar score and biological factors. Risk factors were analyzed by hierarchical logistic regression. Results: Based on the multivariate analysis, socioeconomic factors showed no association with death. Insufficient prenatal consultations showed an OR of 3.25 (95% CI: 1.70-6.48) for death. Low birth weight (OR 8.42; 95% CI: 3.45-21.93); prematurity (OR 5.40; 95% CI: 2.22-13.88); malformations (OR 4.42; 95% CI: 1.37-12.43); and low Apgar score at the first (OR 6.65; 95% CI: 3.36-12.94) and at the fifth (OR 19.78; 95% CI: 9.12-44.50) minutes, were associated with death. Conclusion: Differing from other studies, socioeconomic conditions were not associated with neonatal death. Insufficient prenatal consultations, low Apgar score, prematurity, low birth weight, and malformations showed an association, reinforcing the importance of prenatal access universalization and its integration with medium and high-complexity neonatal care services.


Resumo Objetivos: Analisar os fatores de risco para o óbito neonatal em Florianópolis, capital brasileira com a menor taxa de mortalidade infantil. Método: Os dados foram extraídos de coorte histórica, contando com 15.879 nascidos vivos. Utilizou-se modelo ordenando fatores de risco socioeconômicos, comportamentais e de utilização dos serviços de saúde, além do escore de Apgar e de fatores biológicos. Os fatores de risco foram analisados por regressão logística hierarquizada. Resultados: Com base na análise multivariada, os fatores socioeconômicos não mostraram associação com o óbito. Consultas pré-natais insuficientes apresentaram um OR 3,25 (IC95% 1,70-6,48) para óbito. Baixo peso ao nascer (OR 8,42; IC95% 3,45-21,93); prematuridade (OR 5,40; IC95% 2,22-13,88); malformações (OR 4,42; IC95% 1,37-12,43); baixo escore de Apgar no 1o (OR 6,65; IC95% 3,36-12,94) e no 5o (OR 19,78; IC95% 9,12-44,50) minutos associaram-se ao óbito. Conclusão: Diferente de outros estudos, as condições socioeconômicas não se associaram ao óbito neonatal. Pré-natal insuficiente, baixo escore de Apgar, prematuridade, baixo peso e malformações mostraram associação, reforçando a importância da universalização do acesso ao pré-natal e da integração deste com serviços de atenção ao recém-nascido, de média e alta complexidade.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Mortalidade Infantil , Índice de Apgar , Fatores Socioeconômicos , Brasil/epidemiologia , Fatores de Risco
18.
ACM arq. catarin. med ; 48(1): 118-130, jan.-mar. 2019.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1023420

RESUMO

O ciclo lunar sempre foi alvo de crenças populares, principalmente relacionado a ocorrência de maior número de nascimentos durante a fase de lua cheia. Influências externas como baixa pressão atmosférica estão ligadas à rotura de membrana corioamniótica e parece existir um mecanismo biológico para o desencadeamento do trabalho de parto prematuro. Este estudo tem como objetivo estudar a influência do ciclo lunar e da sazonalidade na ocorrência de rotura prematura de membranas e de trabalho de parto prematuro. Realizado um estudo transversal envolvendo dados do livro de partos de uma maternidade localizada no sul do Brasil por um período de 4 anos, totalizando 13.291 nascimentos. Utilizados dois sites, um para estimativa do ciclo lunar à época do nascimento e outro para determinar o dia da semana. Um banco de dados foi criado e exportado para o SPSS18.0 onde foi analisado. Utilizada a análise de Poisson. As variáveis que apresentaram p < 0,25 foram incluídas em uma análise multivariada para observar a independência das associações. A significância estatística estabelecida foi p < 0,05. Houveram maior prevalência de nascimentos durante a fase de lua crescente, meses de novembro e junho, estação de verão e terças-feiras. Encontrada associação estatisticamente significativa entre rotura prematura de membranas, mês de outubro e sexta-feira. Não encontrou-se associação entre a fase do ciclo lunar com rotura prematura de membranas e prematuridade, assim como, fatores sazonais e prematuridade. Observou-se menor prevalência de rotura prematura de membranas no mês de outubro e na sexta feira.


The lunar cycle has always been the target of popular beliefs, mainly related to the occurrence of more births during the full moon phase. External influences such as low atmospheric pressure are associated with rupture of the chorioamniotic membrane and there seems to be a biological mechanism for the onset of preterm labor. This study aims to study the influence of the lunar cycle and seasonality on the occurrence of premature rupture of membranes and preterm labor. A cross-sectional study was carried out involving data from the birth book of a maternity unit located in the south of Brazil for a period of 4 years, totaling 13,291 births. Two sites were used, one to estimate the lunar cycle at the time of birth and another to determine the day of the week. A database was created and exported to SPSS18.0 where it was parsed. Poisson analysis was used. The variables that presented p <0.25 were included in a multivariate analysis to observe the independence of the associations. Statistical significance was set at p <0.05. There was a higher prevalence of births during the growing moon phase, months of November and June, summer season and Tuesday. We found a statistically significant association between premature rupture of membranes, from October to Friday. There was no association between the lunar cycle phase with premature rupture of membranes and prematurity, as well as seasonal factors and prematurity. It was observed a lower prevalence of premature rupture of membranes in the month of October and on Friday.

19.
Rev Saude Publica ; 53: 18, 2019 Jan 31.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30726499

RESUMO

OBJECTIVE: To perform a cross-cultural adaptation of the Prenatal Diagnostic Procedures Anxiety Scale questionnaire for application in the Brazilian cultural context. METHODS: The translation and back translation processes followed internationally accepted criteria. A committee of experts evaluated the semantic, idiomatic, experimental and conceptual equivalence, proposing a pre-final version that was applied in 10.0% of the final sample. Afterwards, the final version was approved for the psychometric analysis. At that stage, 55 pregnant women participated which responded to the proposed Brazilian version before taking an ultrasound examination at a public hospital in Santa Catarina, in the year of 2017. The Edinburgh Postnatal Depression Scale was used as an external reliability parameter. The internal consistency of the instrument was obtained by Cronbach's alpha. Validation was performed by exploratory factorial analysis with extraction of principal components by the Kaiser-Guttman method and Varimax rotation. RESULTS: The Cronbach's alpha value of the total instrument was 0.886, and only the percentage of variance from item 2 (0.183) was not significant. The Kaiser-Guttman criterion defined three factors responsible for explaining 78.5% of the variance, as well as the Scree plot. Extraction of the main components by the Varimax method presented values from 0.713 to 0.926, with only item 2 being allocated in the third component. CONCLUSIONS: The Brazilian version is reliable and valid for use in the diagnosis of anxiety related to the performance of ultrasound procedures in prenatal care. Due to the lack of correlation with the rest of the construct, it is suggested that item 2 be removed from the final version.


Assuntos
Ansiedade/diagnóstico , Inquéritos e Questionários , Ultrassonografia Pré-Natal/psicologia , Adulto , Ansiedade/psicologia , Brasil , Estudos Transversais , Características Culturais , Feminino , Humanos , Gravidez , Reprodutibilidade dos Testes , Traduções , Adulto Jovem
20.
Rev. saúde pública (Online) ; 53: 18, jan. 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-985832

RESUMO

ABSTRACT OBJECTIVE: To perform a cross-cultural adaptation of the Prenatal Diagnostic Procedures Anxiety Scale questionnaire for application in the Brazilian cultural context. METHODS: The translation and back translation processes followed internationally accepted criteria. A committee of experts evaluated the semantic, idiomatic, experimental and conceptual equivalence, proposing a pre-final version that was applied in 10.0% of the final sample. Afterwards, the final version was approved for the psychometric analysis. At that stage, 55 pregnant women participated which responded to the proposed Brazilian version before taking an ultrasound examination at a public hospital in Santa Catarina, in the year of 2017. The Edinburgh Postnatal Depression Scale was used as an external reliability parameter. The internal consistency of the instrument was obtained by Cronbach's alpha. Validation was performed by exploratory factorial analysis with extraction of principal components by the Kaiser-Guttman method and Varimax rotation. RESULTS: The Cronbach's alpha value of the total instrument was 0.886, and only the percentage of variance from item 2 (0.183) was not significant. The Kaiser-Guttman criterion defined three factors responsible for explaining 78.5% of the variance, as well as the Scree plot. Extraction of the main components by the Varimax method presented values from 0.713 to 0.926, with only item 2 being allocated in the third component. CONCLUSIONS: The Brazilian version is reliable and valid for use in the diagnosis of anxiety related to the performance of ultrasound procedures in prenatal care. Due to the lack of correlation with the rest of the construct, it is suggested that item 2 be removed from the final version.


RESUMO OBJETIVO: Proceder à adaptação transcultural do questionário Prenatal Diagnostic Procedures Anxiety Scale para aplicação no contexto cultural brasileiro. MÉTODOS: Os processos de tradução e retrotradução seguiram critérios aceitos internacionalmente. Um comitê de especialistas avaliou as equivalências semântica, idiomática, experimental e conceitual, propondo uma versão pré-final que foi aplicada em 10,0% da amostra final. Em seguida, foi aprovada a versão final para a análise psicométrica. Nessa etapa participaram 55 gestantes que responderam à versão brasileira proposta antes de realizarem um exame ultrassonográfico em um hospital público de Santa Catarina, no ano de 2017. A Edinburgh Postnatal Depression Scale foi utilizada como parâmetro de confiabilidade externa. A consistência interna do instrumento foi obtida pelo alfa de Cronbach. A validação foi realizada por análise fatorial exploratória com extração de componentes principais pelo método de Kaiser-Guttman e rotação Varimax. RESULTADOS: O alfa de Cronbach do instrumento total foi 0,886, e apenas o percentual de variância do item 2 (0,183) não foi significativo. O critério de Kaiser-Guttman definiu três fatores responsáveis por explicar 78,5% da variância, assim como o gráfico de Escarpa. A extração dos componentes principais pelo método Varimax apresentou valores de 0,713 a 0,926, sendo apenas o item 2 alocado no terceiro componente. CONCLUSÕES: A versão brasileira é confiável e válida para uso no diagnóstico de ansiedade relacionada à realização de procedimentos ultrassonográficos no pré-natal. Devido à falta de correlação com o restante do construto, sugere-se a retirada do item 2 da versão final.

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