Conhecimento materno sobre os cuidados bucais das crianças na primeira infância / Maternal knowledge about children's oral care in early childhood / Conocimiento materno sobre elcuidado bucal de los niños en la primera infância

Introdução:Os pais exercem um importante papel no estabelecimento dos hábitos saudáveis durante a infância.Aoprestarem cuidados bucais necessários às suas crianças, observa-se um significativo resultado na prevenção dos agravos.Objetivo:Identificaroconhecimento materno sobre os cuidados bucais das crianças na primeira infância. Metodologia:Trata-se de um estudo de natureza quantitativa do tipo exploratório e observacional. A coleta ocorreu através da aplicação de um questionário semiestruturado, com questões sobre o conhecimento materno em relação à higiene bucal, hábitos alimentares, acometimento de cárie e perfil socioeconômico. Realizou-se uma análise descritiva dos dados, seguida de análise bivariada pelo teste do Qui-quadrado de Pearson, considerando-se um nível de significância de 5%. Resultados:Sobre o conhecimento dos cuidados bucais dos filhos, o mesmo encontrou-se insatisfatório em relação à idade em que as crianças devem começar a escovar seus dentes sozinhas,quanto ao uso de escova e docreme dental fluoretado como método de higiene após a erupção do primeiro dente e quanto à inexistência do dente decíduo antes do nascimento dos molares permanentes. Observou-se conhecimento satisfatório em relação à importância de se realizar restauraçãoem dente decíduo acometido por cárie,à idade em que a criança troca os dentes decíduos pelos permanentes e, à realização de algum cuidado bucal (fralda e gaze) antes do nascimento do primeiro dente.Conclusões:Há uma lacuna quanto às orientações de saúde bucal providas pelos dentistasdirecionadas às mães. As mães/gestantes têm o conhecimento adequado sobre os cuidados bucais do bebê, porém, quanto aos cuidados após o nascimento do primeiro dente, os resultados foram desfavoráveis. Faz-se necessário a maior participação do cirurgião-dentista nas consultas de pré-natal e de crescimento e desenvolvimento praticando educaçãoem saúde (AU).

Introduction:Parents play an important role in establishing healthy habits during childhood. Providing necessary oral care to their children significantly contributes to preventing oral health issues.Objective: To verify maternal knowledge about children's oral care in early childhood.Methodology:Thisis a quantitative, exploratoryandobservationalstudy. Data werecollectedthroughtheapplicationof a semistructuredquestionnaire, withquestionsabout maternal knowledgeregarding oral hygiene, eatinghabits, caries involvementandsocioeconomic profile. A descriptivedata analysiswasperformed, followedby a bivariate analysis, usingPearson's chi-square test, considering a 5% significance level. Results:Regardingmothers' knowledge about their children's oral care, it was unsatisfactory in relation to the age at which children should start brushing their teeth by themselves; regarding the use of a toothbrush and fluoride toothpaste as hygiene methods, after the first tooth's eruption, and regarding the absence of the deciduous tooth before the permanent molars eruption. Satisfactory knowledge was observed regarding the importance of carrying out restoration in decayed deciduous teeth; the age at which children begin to change deciduous teeth for permanent ones and, carrying out some oral care (fabric and gauze) before the first tooth's eruption. Conclusions:There is a gap in the oral health guidelines provided by dentists, aimed to mothers. The mothers/pregnant women have sufficient knowledge about their baby's oral care, but considering the oral care after the first tooth eruption, the results were critical. It is necessary a greater participation of the dentist in prenatal and growth and development consultations, practicing Health Education (AU).

Introducción: Los padres ejercen un papel importante en el establecimiento de hábitos saludables durante la infancia. Al proporcionar el cuidado bucal necesario a sus hijos, se obtienen resultados importantes en la prevención de enfermedades. Objetivo: Identificar el conocimiento materno sobre el cuidado bucal de los niños en la primera infancia. Metodología:Se trata de un estudio cuantitativo de carácter exploratorio yobservacional. La colecta ocurrió mediante la aplicación de un cuestionario semiestructurado, con preguntas sobre conocimientos maternos sobre higiene bucal, hábitos alimentarios, caries y perfil socioeconómico. Se realizó un análisis descriptivo de los datos, seguido de un análisis bivariado mediante la prueba Chi-cuadrado de Pearson, considerando un nivel de significancia del 5%. Resultados:En cuanto al conocimiento sobre el cuidado bucal de los niños, se encontró insatisfactorio en relación a la edad en la que los niños deben comenzar a cepillarse los dientes solos, en cuanto al uso de cepillos dentales y pasta dental fluorada como método de higiene después de la erupción del primer diente y la ausencia de un diente temporal antes del nacimiento de los molares permanentes. Se observó conocimiento satisfactorio sobre la importancia de restaurar un diente temporal afectado por caries, la edad en que el niño cambia los dientes temporales por permanentes y la provisión de algunos cuidados bucales (pañal y gasa) antes del nacimiento del primer diente. Conclusiones:Existe un vacío en la orientación sobre salud bucal proporcionada por los odontólogos dirigida a las madres. Las madres/gestantes tienen conocimientos adecuados sobre el cuidado bucal de su bebé, sin embargo, en relación a los cuidados después del nacimiento del primer diente los resultados fueron desfavorables. Es necesaria una mayor participación del odontólogo en las consultas prenatales y de crecimiento y desarrollo, practicando la educación para la salud (AU).

Dependência funcional dentro e fora de casa em pessoas idosas com 75 anos ou mais: diferenças entre os sexos / Functional disability inside and outside of home of older adults aged 75 years and older: differences between males and females / Dependencia funcional dentro y fuera del hogar en ancianos de 75 años o más: diferencias entre sexos

O sexo é um importante fator a ser considerado na compreensão da dependência de cuidados na velhice. Objetivo:Verificar fatores associados à dependência, dentro e fora de casa, em pessoas idosas com 75 anos ou mais, com ênfase na diferença entre os sexos. Metodologia:Pesquisa transversal com dados do estudo FIBRA. A capacidade funcional nas Atividades Instrumentais de Vida Diária (AIVD) foi dividida em atividades realizadas dentro de casa (uso do telefone, manejo da medicação, tarefas domésticas e preparo da refeição) e atividades realizadas fora de casa (fazer compras, utilizar transporte e manejo do dinheiro). As variáveis independentes incluíram aspectos sociodemográficas e de saúde. Foram estimadas razões de prevalência por meio de modelos de regressão múltipla de Poisson a fim de verificar as variáveis associadas com dependência dentro e fora de casa. Resultados:A amostra foi composta por 804 idosos. Dentro de casa, não houve fatores associados à dependência para o sexo masculino. Enquanto para o sexo feminino, os fatores associados foram fragilidade (RP = 1,99; 95%IC: 1,26-3,15) e 80 anos e mais (RP = 1,41; 95%IC: 1,05-1,89). Quanto à dependência fora de casa, a fragilidade destacou-se como um fator associado a ambos os sexos, masculino (RP = 2,80 95%IC: 1,17-6,64) e feminino (RP = 1,98 95%IC: 1,24-3,17). Conclusões:Para o sexo feminino, a idade avançada e a fragilidade foram os fatores de maior associação com dependência, tanto para o ambiente dentro quanto fora de casa. Para o sexo masculino, a fragilidade foi o único e grande determinante de dependência nas atividades fora de casa, apresentando prevalência maior do que a encontrada na amostra do sexo feminino (AU).

Sexis an important factor to be considered tocomprehendoldage care dependencyObjective:Verify associated factors to dependency, in and out of home, in persons with 75 years or more, with emphasis on sexdifferences. Methodology:Cross-sectional research with data from the FIBRA Study. The functional dependence in Instrumental Activities of Daily Living (IADL) was divided in activities performed inside home (using telephone, managing medicine, housework and meal preparation) and activities performed outside home (shopping, transportation and managing finances).The independent variable included health and sociodemographic aspects. Estimates on prevalence ratios were made using multiple Poisson regression models to verify the many variables associated with dependency inside and outside home. Results:The sample was composed of 804 older people. Inside home there were not any factors associated with dependency in the males. However, in the females the associated factors were frailty (PR = 1.99; 95%CI: 1.26-3.15) and 80 and older (PR = 1.41; 95%CI: 1.05-1.89). As to dependency outside home, frailty was a factor that stood out in both sexes, male (PR = 2.80 95%CI: 1.17-6.64) and female (PR = 1.98 95%CI: 1.24-3.17). Conclusions:To women, older age and frailty were the strongest factors of dependency, to both inside and outside home. To men, frailty was the strongest and single dependency factor for dependency in outside activities, showing a higher prevalence than that of the female sex (AU).

El sexo es un factor importante queconsiderar en la comprensión de la dependencia del cuidado en la vejez. Objetivo:Verificar los factores vinculados a la dependencia, dentro y fuera del hogar, en ancianos de 75 años o más, con énfasis en la diferencia entre los sexos. Metodología:Investigación transversal con datos del estudio FIBRA. La capacidad funcional en las Actividades Instrumentales de la Vida Diaria (AIVD) se dividió en actividades realizadas dentro del hogar (uso del teléfono, administración de medicamentos, tareas domésticas y preparación de comidas) y actividades realizadas fuera del hogar (hacer compras, uso del transporte y manejo del dinero). Las variables independientes incluyeron aspectos sociodemográficos y de salud. Las razones de prevalencia se estimaron utilizando modelos de regresión múltiple de Poisson con el fin de verificarlas variables vinculadas con la dependencia dentro y fuera del hogar. Resultados:El muestreofue constituidopor 804 ancianos. Dentro del hogar, no hubo factores asociados con la dependencia de los hombres. Mientras que, para las mujeres, los factores asociados fueron fragilidad (RP = 1,99; IC95%: 1,26-3,15) y 80 años y más (RP = 1,41; IC95%: 1,05-1,89). En cuanto a la dependencia fuera del hogar, la fragilidad se destacó como un factor asociado a ambos sexos, masculino (RP = 2,80 IC95%: 1,17-6,64) y femenino (RP = 1,98 IC95%: 1,24-3,17). Conclusiones: Para el sexo femenino, la edad avanzada y la fragilidad fueron los factores más vinculados a la dependencia, tanto para el ambiente dentro como fuera del hogar. Para los varones, la fragilidad fue el único determinante importante de dependencia en actividades fuera del hogar, con una prevalencia mayor que la encontrada en elmuestreofemenino (AU).

First Thousand Days of Child Life and the Development of Risk Factors for Malocclusions

ABSTRACT Objective: To identify the association between individual and socioeconomic factors during the first thousand days of the child's life and the occurrence of risk behaviors for the development of malocclusions. Material and Methods: Cross-sectional study. A sample of 655 6-year-old schoolchildren and families was included. Interviews with mothers were performed at home. The dependent variables were risk behaviors to the development of malocclusions. Independent variables were socioeconomic conditions, aspects of gestation, birth and health of the child up to two years of age. Bivariate and multivariate analyzes were performed through Poisson regression. Results: Maternal education of less than eight years was independently associated with the interruption of exclusive breastfeeding until the fourth month (PR=1.58 CI 95%; 1.07; 2.37). Occupation of the mother with income [PR=1.26; 1.02; 1.56)], occupation of the father without income [PR=1.46 (1.01; 2.14)] were associated fwith interruption of breastfeeding until the sixth month. Pregnancy in adolescence [PR=0.83 (0.70; 0.98)] and nursery attendance [PR=1.15 (1.02; 1.28)] were associated with bottle use. Nursery attendance [PR=1.27 (1.01; 1.59)], hospitalization in the first 29 days of life [PR=1.34 (1.01; 1.80)], occurrence of reflux [PR=1.30 (1.01; 1.70)] were associated with pacifier using. Conclusion: Variables related to the period of the first thousand days of life are associated with higher risk behaviors for the occurrence of malocclusions.

Self-Medication for Toothache in Children: A Cross-Sectional Study

ABSTRACT Objective: To construct, validate, and apply a questionnaire to assess and characterize the practice of self-medication performed by parents or children's guardians undergoing dental care. Material and Methods: A questionnaire was constructed, validated, and applied through personal interviews in the teaching clinics of two higher education institutions in the Federal District. Absolute and relative frequencies of categorical variables were calculated using descriptive statistics. Quantitative data were presented as mean and standard deviation. The chi-square test measured the association between the studied variables and self-medication. Results: One hundred and five participants were interviewed between August 2019 and November 2020. The average age of the participants was 37 (± 9) years, and most were mothers of the children who attended (78%) and users of the public health system (94.2%). The average family income was 1.88 minimum wage, and the most prevalent educational level was complete high school (40%). Conclusion: Despite the high level of knowledge about medication safety in children, self-medication was practiced in 50% of them. Difficulty in accessing dental treatment was mentioned by most as a justification. Self-medication was associated with dental pain, continuous medication use, and family self-medication habits.

Dental Fear/Anxiety in Children and Child Emotional and Behavioural Problems

ABSTRACT Objective: To investigate the association between emotional and behavioural problems and dental fear/anxiety (DFA) in children aged four to 12 years treated at a clinic in southern Brazil. Material and Methods: In this cross-sectional study where mother-child dyads were interviewed, emotional and behavioural problems were investigated using the Strengths and Difficulties Questionnaire (SDQ) (considering five subscales). Children's DFA was evaluated through the Venham Picture Test. For each SDQ subscale, Poisson regression model was explored. Prevalence ratios (PR) were estimated, considering a significant level of p ≤ 0.05. Results: Overall, 128 children participated in this study. Most children were female (54.7%) and aged between 7 and 9 years (39.8%). The prevalence of emotional problems was 47.7% and behavioural problems were 46.1%. The prevalence of DFA was 18.8%. Children with emotional problems had a 2.3 higher prevalence of DFA (95%CI 1.06-5.04). In general, behavioural problems were not associated with DFA (95%CI 0.84-3.34) only when conduct problems were considered (2.20; 95%CI 1.02-4.70). Conclusion: Children aged between 4 and 12 years who present emotional and conduct problems tend to show higher DFA.

Factors associated with food insecurity among pregnant women assisted by Universal Health Care in Lavras - Minas Gerais State / Fatores associados à insegurança alimentar em gestantes atendidas na rede pública de saúde de Lavras - Minas Gerais

Abstract Objectives: to investigate sociodemographic and economic factors associated with food insecurity among pregnant women assisted by the universal healthcare network of Lavras, Minas Gerais. Methods: a cross-sectional study investigated socioeconomic and demographic, obstetric, and nutritional conditions experienced by pregnant women. Households in which pregnant women lived were classified as food secure or food insecure using the Brazilian Food Insecurity Scale. Prevalence estimates and prevalence ratios with 95% confidence intervals were generated to test for associations between food insecurity and several socioeconomic and demographic indicators using Poisson regression analysis. Results: among 173 pregnant women who participated in the study, 48% lived in households with some level of food insecurity. Adjusted models showed that pregnant women living in food-insecure households had higher prevalence ratios of lower education attainment (aPR = 1.43, CI95% = 1.07-1.91), woman being the head of the household (aPR = 1.39, CI95% = 1.02-1.87), having family monthly income lower than 1 ½ MW (aPR = 1.68, CI95% = 1.11-2.52) and participating in the government cash transfer program (aPR = 1.47, CI95% = 1.08-1.99). Conclusions: the high prevalence of food insecurity in pregnant women assisted by the public healthcare system was associated with structural social factors. Results of this study will contribute to develop an intersectoral health and nutrition policy in order to promote food security among marginalized communities and vulnerable populations, such as pregnant women.

Resumo Objetivos: investigar fatores sociodemográficos e econômicos associados à insegurança alimentar entre gestantes atendidas pelo sistema único de saúde de Lavras - Minas Gerais. Métodos: características socioeconômicas, demográficas, obstétricas e nutricionais de gestantes foram coletadas em estudo transversal. Os domicílios das gestantes foram classificados em segurança ou insegurança alimentar utilizando a Escala Brasileira de Insegurança Alimentar. Estimativas de prevalência e razão de prevalência com intervalos de confiança de 95%, testaram associações entre insegurança alimentar e indicadores socioeconômicos e demográficos utilizando modelos de Poisson. Resultados: entre as 173 gestantes participantes deste estudo, 48% viviam em domicílios com algum nível insegurança alimentar (IA). Modelos ajustados indicaram que gestantes em IAapresentaram maior prevalência de escolaridade inferior a oito anos de estudo (aRP = 1.39, IC95% = 1.07-1.91), ser chefe de família (aRP = 1.39, IC95% = 1.02-1.87), ter renda mensal inferior a 1½ salário mínimo (aRP = 1.68, IC95% =1.11-2.25), e ser participante do Bolsa Família (aRP = 1.47, IC95% = 1.08-1.99). Conclusão: a alta prevalência de insegurança alimentar em gestantes do sistema público de saúde de Lavras está associado a fatores socio-estruturais. Os resultados desta pesquisapoderão contribuir com o desenvolvimento de políticas intersetoriais de saúde e nutrição para a promoção da segurança alimentar entre comunidades marginalizadas e populações vulneráveis.

Factores de riesgo cardiovascular en pacientes en hemodiálisis / Cardiovascular risk factors in patients on hemodialysis

Introducción: La enfermedad cardiovascular es la primera causa de muerte en los pacientes con enfermedad renal crónica. En los hipertensos, la enfermedad renal crónica es la segunda causa de muerte, el daño vascular sistémico es la norma. Objetivo: Identificar los factores de riesgo cardiovascular tradicionales y no tradicionales y su asociación con la enfermedad cardiovascular en pacientes en hemodiálisis. Material y Métodos: Estudio de corte transversal en 247 pacientes en hemodiálisis crónica. Las variables analizadas fueron: causas de enfermedad renal crónica, factores de riesgo cardiovascular tradicionales y no tradicionales y enfermedades cardiovasculares. Se determinaron tablas de frecuencias y estadísticas de asociación mediante Chi cuadrado. Para determinar el riesgo de mortalidad se utilizó la razón de prevalencia (RP). Se consideró como nivel de significación estadística a p<0,05 con 95 % de confiabilidad. Resultados: Las causas de enfermedad renal crónica predominantes fueron la hipertensión arterial con 35,6 por ciento y la Diabetes Mellitus tipo 2 con 33,1 por ciento. Los pacientes hipertensos tuvieron más probabilidades de presentar una enfermedad cardiovascular con 2,63 veces mayor que el grupo de referencia. En los factores de riesgo cardiovascular no tradicionales la mayor probabilidad la presentaron los pacientes con proteína C reactiva elevada con 5,19 veces, seguido de la hiperuricemia con 3,79 veces y las alteraciones del producto calcio-fósforo con una probabilidad de 3,27 veces. Conclusiones: Los factores de riesgo cardiovasculares tradicionales se relacionan significativamente con la presencia de enfermedad cardiovascular(AU)

Introduction: Cardiovascular disease is the leading cause of death in patients with chronic kidney disease. In hypertensive patients, chronic kidney disease is the second cause of death, and systemic vascular damage has become the norm. Objective: To identify traditional and non-traditional cardiovascular risk factors and their association with cardiovascular disease in patients on hemodialysis. Material and Methods: Cross-sectional study conducted on 247 patients on chronic hemodialysis. The variables analyzed included: causes of chronic kidney disease, traditional and non-traditional cardiovascular risk factors, and cardiovascular diseases. Frequency tables and association statistics were determined by the chi-square test. The prevalence ratio (PR) was used to determine the risk of mortality. The level of statistical significance was considered to be at p value of less than 0,05 with a reliability of 95 percentResults: The most frequent causes of chronic kidney disease were arterial hypertension (35,6 percent) and type 2 diabetes mellitus (33,1 percen). Hypertensive patients were 2,63 times more likely to present cardiovascular disease than the reference group. In the case of non-traditional cardiovascular risk factors, the patients with elevated C-reactive protein were 5,19 more likely to develop cardiovascular disease, followed by those with hyperuricemia that were 3,79 more likely, and the patients with alterations in calcium and phosphorous who were 3,27 times more likely to suffer from this disease. Conclusions: Traditional cardiovascular risk factors are significantly related to the presence of cardiovascular disease(AU)

Prevalencia de artrosis sintomática en España: Estudio EPISER2016 / Prevalence of symptomatic osteoarthritis in Spain: EPISER2016 study

Introducción: La Sociedad Española de Reumatología elaboró en el año 2000 el estudio EPISER2000 para conocer la prevalencia de la artrosis y otras enfermedades reumáticas en España. Los cambios sociodemográficos y en los hábitos de vida ocurridos en los últimos años en España justifican actualizar los datos de las enfermedades reumáticas (EPISER2016). Objetivo: Estimar la prevalencia de artrosis sintomática de columna cervical, columna lumbar, cadera, rodilla y mano, en población adulta en España. Material y métodos: Estudio transversal de base poblacional. Se realizó un muestreo aleatorizado polietápico estratificado y por conglomerados. Los participantes fueron contactados por teléfono para cumplimentar un cuestionario de cribado de artrosis. El reumatólogo confirmaba o descartaba el diagnóstico. Se utilizaron los criterios-clínicos-ACR para diagnosticar artrosis de manos y los criterios clínico-radiológicos-ACR para diagnosticar la artrosis de rodilla y cadera. Resultados: La prevalencia de artrosis en España en una o más de las localizaciones estudiadas fue de 29,35%. La prevalencia de artrosis-cervical fue del 10,10% y de artrosis-lumbar del 15,52%. Ambas son más frecuentes en mujeres y a mayor edad, así como en personas con niveles de estudios bajos y obesidad. La prevalencia de artrosis de cadera fue del 5,13% y la de artrosis de rodilla del 13,83%; estas se asocian con el sexo femenino, sobrepeso y obesidad, menor frecuencia en nivel de estudios alto y con la edad. La prevalencia de la artrosis de mano fue del 7,73%. Es más frecuente en mujeres, obesas, con bajo nivel de estudios y mayor edad. Conclusiones: El estudio EPISER2016 es el primero que analiza la prevalencia de artrosis sintomática en 5 localizaciones (columna cervical, lumbar, rodilla, cadera y manos) en España. La artrosis de la columna lumbar es la más prevalente.(AU)

Introduction: The Spanish Society of Rheumatology carried out the EPISER2000 study in 2000 to determine the prevalence of osteoarthritis and other rheumatic diseases in the Spanish population. Recent sociodemographic changes and lifestyle habits in Spain justified updating the epidemiological data on osteoarthritis and other rheumatic diseases (EPISER2016-study). Objective: To estimate the prevalence of symptomatic osteoarthritis of the cervical spine, lumbar spine, hip, knee and hand in the adult population in Spain. Material and methods: Cross-sectional population-based study. A multistage and stratified random cluster sampling was carried out. The participants were contacted by telephone to complete an osteoarthritis screening questionnaire. A rheumatologist confirmed or discarded the diagnosis. The ACR-clinical-criteria were used to diagnose hand-osteoarthritis and the ACR-clinical-radiological criteria to diagnose knee- and hip-osteoarthritis. To estimate the prevalence and its 95% confidence interval, weights were calculated according to the probability of selection in each of the sampling stages. Results: The prevalence of osteoarthritis in Spain in one or more of the locations studied was 29.35%. The prevalence of cervical-osteoarthritis was 10.10% and of lumbar-osteoarthritis 15.52%. Both are more frequent in women and at older ages, as well as in people with low levels of education and obesity. The prevalence of hip-osteoarthritis was 5.13%, that of knee-osteoarthritis 13.83%, these are associated with female sex, overweight and obesity. The prevalence of hand osteoarthritis was 7.73%. It is more frequent in women, who are obese, with a low educational level and who are older. Conclusion: The EPISER2016 study is the first to analyse the prevalence of symptomatic osteoarthritis in 5 locations (cervical, lumbar, knee, hip and hands) in Spain. Lumbar spine osteoarthritis is the most prevalent.(AU)

Factores de riesgo asociados a colonización nasofaríngea en niños vacunados con vacunas antineumocócicas. Cienfuegos 2015-16 / Risk factors associated with nasopharyngeal colonization in children vaccinated with pneumococcal vaccines. Cienfuegos, 2015-16

Introducción: La colonización nasofaríngea por neumococo se define como el momento inicial en el que la bacteria se aloja en la nasofaringe del individuo. Objetivo: Estimar la proporción de factores de riesgo asociados a la colonización nasofaríngea por neumococo en niños vacunados con vacunas conjugadas antineumocócicas (PCV). Material y Métodos: Un año después de la vacunación antineumócocica mediante un ensayo clínico fase II/III, controlado, aleatorizado y doble ciego en niños de 1 a 5 años, se ejecutó un estudio de seguimiento con un diseño casos y controles, tipo caso-caso. El horizonte temporal fue desde noviembre de 2015 hasta abril de 2016. Se incluyó 50 por ciento del total de vacunados en el estudio experimental. El universo lo constituyó los 1 135 niños vacunados en el ensayo clínico. Se siguió un muestreo aleatorio simple y se incluyeron 555 sujetos. Se realizó una encuesta y una toma de muestra de exudado nasofaríngeo. Se presentaron tablas de frecuencias. Se utilizó la razón de prevalencia como medida de asociación. Se calcularon los intervalos de confianza a 95 por ciento para cada proporción. Resultados: Tener entre 2 y 5 años actúa como factor protector para la colonización nasofaríngea con respecto al niño pequeño. Convivir con personas mayores de 65 años constituye un factor de riesgo significativamente relacionado con la colonización nasofaríngea. Conclusiones: La introducción de vacunas antineumocócicas en niños preescolares puede impactar de manera significativa la carga de colonización y en la trasmisión de la enfermedad neumocócica(AU)

Introduction: Nasopharyngeal colonization by pneumococci is defined as the initial moment when the bacterium lodges in the nasopharynx of the person. Objective: To estimate the proportion of risk factors associated with nasopharyngeal colonization by pneumococci in children vaccinated with conjugate pneumococcal vaccines (CPV). Material and Methods: One year after pneumococcal vaccination, a follow-up case-case-control study was conducted in children aged 1-5 years by means of a phase II/III controlled, randomized, double-blind clinical trial. The time horizon was from November 2015 to April 2016. The study included 50 percent of the total of children vaccinated during the experimental study. The universe consisted of 1135 children who were vaccinated during the clinical trial. A simple random sampling that included 555 persons was applied. A survey was conducted and nasopharyngeal exudate samples were taken. Tables of frequencies were presented. Prevalence ratio was used as a measure of association. Also, 95 percent confidence intervals were calculated for each proportion. Results: Being between the ages of 2-5 years acts as protective factor against nasopharyngeal colonization with respect to the young child. Living with persons older than 65 years is a significantly associated risk factor with nasopharyngeal colonization. Conclusions: The introduction of pneumococcal vaccines in pre-school children can have a significant impact on colonization burden and the transmission of pneumococcal diseases(AU)

Association between non-typhoidal Salmonella isolated from commercial poultry sheds and associated factors in Paraná, Brazil: Cross-sectional retrospective study

The epidemiology of salmonellosis in poultry is complex, which makes it difficult to identify the origin and spread of this disease in poultry farms. The aims of this study were to characterize the spatial distribution of Salmonella enterica in epidemiological units in Paraná, Brazil; and to investigate correlations between this microorganism and associated factors. Among the epidemiological units, 78 of 243 (32.10%) were positive. Spatially, the northwestern and western regions had higher concentrations of positive cases than the other regions. In bivariate analyses, the presence of other animal species in the epidemiological unit (prevalence ratio, PR = 0.64; 95% confidence interval, CI = 0.43­0.95; p = 0.022) and proximity to establishments at risk (PR = 0.51; 95% CI = 0.32­0.81; p = 0.001) did not influence positivity, but the average population per poultry shed (between 30,501 and 32,500; PR = 2.57; 95% CI = 1.72­3.83; p = 0.001) was associated with Salmonella positivity. Multiple logistic regression demonstrated that the average population per poultry shed, presence of surrounding risk-posing establishments and presence of surrounding poultry sheds produced a significant multiple model for S. enterica. The results indicated that the presence of S. enterica may be related to higher density broiler in poultry sheds, presence of surrounding poultry sheds, proximity between positive and negative epidemiological units and altitude of the municipality. The information obtained showed that some factors were related to positivity for this microorganism and emphasizes the importance of serotyping to obtain other epidemiological data.

Impact on the Quality of Life of Older Adults Who Use Inadequate Dental Prostheses: A Cross-Sectional Study

Abstract Objective: To investigate the impact of inadequate prostheses on older adult's quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in João Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher's exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p<0.05). Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85-4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14). Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual.

Medidas de frecuencia utilizadas en estudios de cohortes para evaluar el comportamiento suicida en jóvenes (12-26 años): una revisión sistemática / Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): a systematic review

Introducción: La OMS prioriza para el año 2020 reducir las tasas de suicidio señalando dificultades para dar estimaciones precisas debido a una amplia variedad de factores, entre ellos, aspectos relativos a la propia medición estadística de la conducta suicida. La proporción de muertes por suicidio es del 8,5% para los jóvenes de entre 15-29 años. Objetivo: Revisar la metodología empleada para expresar la frecuencia de la conducta suicida en población joven y describir las características metodológicas de los estudios examinados. Método: Revisión sistemática de estudios longitudinales registrada en PROSPERO. La información extraída fue: año de publicación, revista, tamaño poblacional, muestra, país, diseño, edad, porcentaje de hombres, tiempo de seguimiento y pérdidas, comportamiento suicida, factores de riesgo, aspectos éticos y evaluándose fundamentalmente las medidas de frecuencia empleadas. Resultados: Se identificaron 37.793 documentos, de los cuales fueron seleccionados 82. Ningún estudio define la medida de frecuencia empleada para la conducta suicida, encontrándose hasta 9 formas diferentes de medirla. La población son estudiantes o población general (66%), cohortes de nacimiento (16%) y colectivos específicos. El seguimiento fue de 24 semanas hasta 30 años. Solo un 24,1% de los estudios consideró los aspectos éticos. Conclusiones: Se constata que no existe una sistematización a la hora de medir la frecuencia de presentación de la conducta suicida. La variabilidad metodológica y terminológica utilizada dificulta hacer comparaciones entre los estudios y conocer la verdadera dimensión del problema. Se insta a los investigadores a realizar un esfuerzo para consensuar las medidas de frecuencia empleadas en los estudios de cohortes

Introduction: A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. Objective: To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. Method: A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. Results: Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. Conclusions: Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem

Ocorrência de distúrbio musculoesquelético em pescadoras artesanais/ marisqueiras na Baía de Todos os Santos: uma análise sobre horas dedicadas ao trabalho / Occurrence of musculoskeletal disorders in artisanal /shellfish fisherwomen in Baía de Todos os Santos: an analysis of hours dedicated to work

Introdução: os distúrbios musculoesqueléticos são caracterizados por comprometimentos inflamatórios e/ou degenerativos, em diversos segmentos corporais, e atingem diversos grupos de trabalhadores, no entanto, ainda existem poucas evidências científicas que verificam possíveis relações desses distúrbios e horas de trabalho diárias dos pescadores artesanais. Objetivo: analisar as horas diárias dedicadas ao trabalho de pescadora e a prevalência de distúrbio musculoesquelético em regiões de membros superiores (ombro) e pescoço. Metodologia: realizou-se um estudo de corte transversal, envolvendo amostra probabilística da população de pescadoras artesanais/marisqueiras do município de Saubara, totalizando 209 pessoas. Utilizaram-se instrumentos validados para população brasileira, tais como: o Nordic Musculoskeletal Questionnaire, Job Content Questionnaire e Demandas físicas adaptadas para o trabalho. Resultados: evidenciou-se a prevalência de distúrbios musculoesqueléticos em região de pescoço ou ombro, em 71,2% (n=146) das marisqueiras. Ressalta-se que não houve interação entre as variáveis horas trabalhadas/dia e idade, com o p-valor = 0,1807. Verificaram-se associações positivas entre as marisqueiras que trabalhavam mais que 11h por dia com razão de prevalência de 1,23 e intervalo de confiança 95%: [1,04; 1,45] em relação às que trabalhavam menos que 11h, bem como a razão de prevalência de 1,38 e intervalo de confiança 95%: [1,15; 1,65] nas pescadoras com idade superior a 38 em comparação com as mais jovens. Desta forma denotando a degradação da saúde com a carga exaustiva de trabalho.

Introduction: musculoskeletal disorders are characterized by inflammatory and/or degenerative impairments in several body segments and reach different groups of workers; however, there is still little scientific evidence to verify the possible relationships between MSD and daily working hours of artisanal fishermen. Objective: to analyze the daily hours dedicated to work as a fisherwoman and prevalence of musculoskeletal disorders in regions of upper limbs (shoulder) and neck. Methodology: a cross-sectional study was carried out involving a probabilistic sample of the population of artisanal/shellfish fisherwomen in the municipality of Saubara, for a total of 209 individuals. Validated instruments were used for the Brazilian population, such as: the Nordic Musculoskeletal Questionnaire, the Job Content Questionnaire and the Physical Demands adapted to this work. Results: the prevalence of musculoskeletal disorders in the neck or shoulder region was found in 71.2% (n = 146) of shell fisherwomen. It should come to attention that there was no interaction between the variables worked hours/day and age, with p-value = 0.1807. There were positive associations among the shellfish workers that worked more than 11h with the prevalence ratio of 1.23 and 95% confidence interval: [1.04; 1.45] than those who worked less than 11 hours, as well as the prevalence ratio of 1.38 and 95% confidence interval: [1.15; 1.65] in fisherwoman aged over 38 compared to younger ones. Thus denoting health degradation with an exhaustive workload.

Perfiles asociados al consumo de alcohol en adolescentes colombianos / Perfis associados ao consumo de álcool em adolescentes colombianos / Profiles associated with alcohol consumption in Colombian adolescents

Resumen El consumo de alcohol en adolescentes tiene una serie de consecuencias negativas desde el punto de vista de salud, comportamiento y riesgo de consumo problemático a edades tempranas. En este estudio, se aplicó un instrumento de 24 preguntas a 9348 estudiantes de ambos sexos en nueve ciudades de Colombia, de los cuales 7625 fueron incluidos en este análisis por haber consumido alcohol. Específicamente, se exploraron temas como la edad de inicio de consumo, el tipo de alcohol y las cantidades ingeridas, así como los sitios y la facilidad de adquisición, la presencia de adultos, el consumo en el colegio y las actitudes frente a las restricciones legales, entre otros. Se hizo un análisis de correspondencias múltiples que determinó inicialmente tres factores que fueron después clasificados en dos grupos y, por último, en cuatro subgrupos en función de cuatro categorías de consumo: experimental, selectivo, regular y alto, que representan dos grandes grupos: bajo y alto consumo. De este análisis surgieron perfiles bastante claros que muestran diferencias importantes, especialmente entre dos grupos: los de bajo consumo, que son los más jóvenes, no toman solos, no han estado en fiestas con alcohol, nunca toman en el colegio ni durante varios días seguidos; y los de alto consumo, que son un poco mayores, cuando toman se emborrachan, tienden a tomar todas las semanas, han tomado en el colegio y antes de entrar por las mañanas, se han metido en problemas por tomar y rechazan las restricciones a los menores de edad o que se sancione a quienes les venden.

Resumo O consumo de álcool em adolescentes tem uma série de consequências negativas desde o ponto de vista da saúde, do comportamento e do risco de consumo problemático em idades precoces. Neste estudo, aplicou-se um instrumento de 24 perguntas e 9348 estudantes de ambos os sexos em nove cidades da Colômbia, dos quais 7625 foram incluídos nesta análise por terem consumido álcool. Especificamente, foram explorados temas como a idade inicial de consumo, o tipo de álcool e as quantidades ingeridas, assim como os lugares e a facilidade de aquisição, a presença de adultos, o consumo no colégio e as atitudes frente às restrições legais, entre outros. Foi realizada uma análise de correspondências múltiplas que determinou inicialmente três fatores que depois foram desclassificados em dois grupos e, por último, em quatro subgrupos em função de quatro categorias de consumo: experimental, seletivo, regular e alto, que representam dois grandes grupos: baixo e alto consumo. A partir dessa análise, surgiram perfis bastante claros que mostram diferenças importantes, especialmente entre dois grupos: os de baixo consumo, que são os mais jovens, não bebem sozinhos, não estiveram em festas com bebidas alcoólicas, nunca bebem no colégio nem durante vários dias consecutivos; e os de alto consumo, que são um pouco mais velhos, embriagam-se quando bebem, tendem a beber semanalmente, já beberam no colégio e antes de ir para a aula de manhã, já se meteram em problemas por beber e se opõem às restrições aos menores de idade ou às sanções àqueles que vendem para menores.

Abstract Alcohol abuse in adolescents has several negative consequences on health, behavior and risk of becoming involved in problematic consumption at early ages. In this study a 24-item questionnaire was answered by 9,348 school adolescents of both sexes in nine Colombian cities. 7,625 students were included in this analysis due to their consumption of alcohol. The questions inquired about age of first intake, kind and amounts of alcohol consumed on each occasion, places and availability, presence of adults, alcohol use at school and attitudes toward legal restrictions, among others. A multiple correspondence analysis was carried out, generating four factors which were condensed later into two groups, and finally in four sub-groups based on categories of alcohol use: experimental, selective, regular and high, representing two categories: low and high use. The analysis produced identifiable profiles, quite different especially for two categories: the 'low consumption' group, that is younger, never drinks alone, does not attend parties where alcohol is offered to minors, has never drunk at school or during several days. In the 'high consumption' group are those over 16 years of age, who generally get drunk when they drink, have taken alcohol while at school and before arriving to school, have been in trouble because of alcohol and consider as inappropriate the legal restrictions to minors and the sanctions imposed to adults who sell or offer alcohol to minors.

Factores asociados con dispepsia funcional en trabajadores de establecimientos de comida rápida en un centro comercial de Huancayo, Perú / Factors associated with functional dyspepsia among fast food workers at a shopping center in Huancayo, Peru

Resumen Introducción: La dispepsia funcional (DF) comprende trastornos crónicos y recurrentes del tracto digestivo superior y no tiene origen orgánico. Objetivos: Determinar los factores asociados con DF en trabajadores de establecimientos de comida rápida en un centro comercial de Huancayo, Perú. Metodología: Estudio transversal analítico, se encuestó a 128 trabajadores de establecimientos de comida rápida en una ciudad de la serranía peruana. Se usó la prueba "A new questionnaire for the diagnosis of dyspepsia" para el diagnóstico de DF, esto se cruzó con variables sociales, de consumo y de hábitos alimenticios; se obtuvieron estadísticas de asociación. Resultados: El 40 % tuvo DF. Estuvo asociado con una menor frecuencia de DF el sexo femenino (razones de prevalencias ajustadas [RPa]: 0,64; intervalo de confianza [IC] 95 %: 0,41-0,99; valor p = 0,044); en cambio, los que tenían dificultad para conciliar el sueño o padecían de despertares nocturnos (RPa: 1,89; IC 95 %: 1,37-2,61; valor p <0,001) y los que tomaban alcohol regularmente tenían mayor frecuencia de DF (RPa: 3,28; IC 95 %: 1,02-10,6; valor p = 0,047); ajustadas por 5 variables. Según los hábitos de alimentación, se encontró que estuvo asociado con una mayor frecuencia de dispepsia quien omitiera comer el almuerzo (RPa: 1,88; IC 95 %: 1,22-2,90; valor p = 0,004), quien omitiera la cena (RPa: 3,44; IC 95 %: 2,72-4,35; valor p <0,001) y quien se alimentase regularmente en otros restaurantes (RPa: 1,87; IC 95 %: 1,22-2,88; valor p = 0,004); ajustadas por 3 variables. Conclusiones: se encontraron algunas características asociadas con la DF en esta población que comparte características con otras similares, lo que puede ser útil para generar estrategias de detección y diagnóstico oportunos.

Abstract Introduction: Functional dyspepsia includes chronic and recurrent disorders of the upper digestive tract and which have no organic origin. Objectives: The objectives of this study were to determine factors associated with functional dyspepsia among the workers of fast food establishments at a mall in Huancayo, Perú. Methodology: This is an analytical cross-sectional study of 128 fast food workers in a city in the Peruvian highlands. "A new questionnaire for the diagnosis of dyspepsia" was used to diagnose functional dyspepsia and record social variables, consumption and eating habits. From this information statistical measures of association were obtained. Results: Forty percent of those surveyed had functional dyspepsia. There was a lower frequency of functional dyspepsia among women than men (Prevalence ratio: 0.64, 95% CI: 0.41-0.99, p-value = 0.044). Those who had difficulty falling asleep and/or suffered from nighttime awakening (Prevalence ratio: 1.89, 95% CI: 1.37-2.61, p value <0.001) and those who drank alcohol regularly (Prevalence ratio: 3.28, 95% CI: 1, 02-10.6, p value = 0.047) had a higher frequency of functional dyspepsia. This was adjusted by five variables. According to eating habits, it was found that a higher frequency of dyspepsia was associated with skipping lunch (Prevalence ratio: 1.88, 95% CI: 1.22-2.90, p-value = 0.004), skipping dinner (Prevalence ratio: 3.44, 95% CI: 2.72-4.35, p value <0.001) and eating regularly in other restaurants (Prevalence ratio: 1.87, 95% CI: 1.22-2.88; p = 0.004). This was adjusted by three variables. Conclusions: We found some characteristics associated with functional dyspepsia in this population shares characteristics with similar populations which could be useful for developing strategies for detection and timely diagnosis.

Prevalencia e incidencia de hiperpotasemia en población española con insuficiencia cardiaca con fracción de eyección deprimida: revisión sistemática y relevancia poblacional / Prevalence and incidence of hyperkalaemia in the Spanish population with heart failure with reduced ejection fraction: a systematic review and populational relevance

Antecedentes y objetivo: La hiperpotasemia (K+≥5,5mmol/l) es un desequilibrio iónico grave cuando aparece en pacientes que padecen insuficiencia cardiaca con fracción de eyección deprimida (ICFED), ya que incrementa el riesgo de fibrilación ventricular. No existen estimaciones del número de pacientes que sufren esta complicación. El objetivo de este estudio fue estimar la prevalencia e incidencia de hiperpotasemia en pacientes con ICFED en España. Materiales y métodos: A partir de una búsqueda bibliográfica sistemática se calculó mediante un metaanálisis la prevalencia de ICFED<40% en población europea y norteamericana. A partir de otra búsqueda bibliográfica sistemática se calculó la prevalencia de hiperpotasemia en individuos con insuficiencia cardiaca, así como su incidencia anual. Considerando los anteriores valores y la pirámide de población española en 2016 se estimó el número de individuos con ICFED que presentan actualmente y que desarrollan cada año hiperpotasemia en España. Resultados: Alrededor de 17.100 individuos (10.000 hombres y 7.100 mujeres) de los 508.000 pacientes con ICFED presentan hiperpotasemia en España. Asimismo, unos 14.900 pacientes con ICFED (9.500 hombres y 5.400 mujeres) la desarrollan cada año. Conclusiones: Aproximadamente uno de cada 30 pacientes con ICFED presenta valores plasmáticos de potasio por encima de 5,5mmol/l

Background and objectives: Hyperkalaemia (K+ levels≥5.5mmol/L) is a severe ion imbalance that occurs in patients who have heart failure (HF) with reduced ejection fraction (HFrEF) and increases the risk of ventricular fibrillation. Given that there are no estimates on the number of patients with this complication, the aim of this study was to estimate the prevalence and incidence of hyperkalaemia in patients with HFrEF in Spain. Material and methods: Based on a systematic literature search and through a meta-analysis, we calculated an HFrEF prevalence of ≤40% in the European and U.S. population. Based on another systematic literature search, we calculated the prevalence of hyperkalaemia in patients with HF and its annual incidence rate. Considering the previous values and the Spanish population pyramid in 2016, we estimated the number of individuals with HFrEF who currently have hyperkalaemia and those who develop it each year in Spain. Results: Approximately 17,100 (10,000 men and 7100 women) of the 508,000 patients with HFrEF in Spain have hyperkalaemia. Furthermore, approximately 14,900 patients with HFrEF (9500 men and 5400 women) develop hyperkalaemia each year. Conclusions: Approximately 1 of every 30 patients with HFrEF has plasma potassium values >5.5 mmol/L

Sobre la importancia de los grupos normativos en estudios de prevalencia / About the importance of the normative groups in prevalence studies

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Violência na gestação: prevalência e perfil do agressor / Violence during pregnancy: prevalence and profile of the agressor

Objetivo: O objetivo deste trabalho foi estabelecer a prevalência de violência na gestação e caracterizar o perfil do agressor. Métodos: Estudo transversal, com entrevista a 195 puérperas internadas por meio de questionário adaptado e validado para investigar a violência doméstica. A análise foi realizada com o programa SPSS 16.0 de forma descritiva e bivariada, com o teste qui-quadrado e a razão de prevalência (IC95%). Resultados: A prevalência geral de violência na gestação foi de 49,2%, sendo que 95,8% foram perpetradas pelo parceiro íntimo. Caracterizaram-se três tipos de violência: psicológica (85%), física (13%) e sexual (2%). Quanto ao período, 41,7% dos casos ocorreram no 1o trimestre da gestação. Os fatores das participantes relacionados com a violência na gestação foram: não morar com sua família (p=0,001) e ter sofrido violência antes de engravidar (p=0,003). Os dados do companheiro relacionados com a violência na gestação foram: baixa escolaridade (p=0,018), uso de drogas (p=0,003), brigas contra terceiros (p<0,001) e entre o casal (p<0,001). Conclusão: O estudo estima uma prevalência de 49,2% de violência na gestação. Baixa escolaridade, uso de drogas, brigas contra terceiros e entre o casal são características do companheiro agressor.(AU)

Objective: The aim of this study was to establish the prevalence of violence during pregnancy and characterize the profile of the aggressor. Methods: Cross-sectional study, with interviews of 195 women interned, through an adapted and validated questionnaire to investigate domestic violence. The analysis was performed with SPSS 16.0 for descriptive and bivariate, with the chi-square test and the prevalence ratio (CI95%). Results: The overall prevalence of violence during pregnancy was 49.2%, being 95.8% perpetrated by an intimate partner. It was characterized three types of violence: psychological (85%), physical (13%) and sexual (2%). As for the period, 41.7% of cases occurred in the first trimester of pregnancy. The factors of the participants related to violence during pregnancy were: not living with their family (p=0.001) and have suffered violence before pregnancy (p=0.003). Data from the partner related to violence during pregnancy were: low education (p=0.018), drug use (p=0.003), fights with other people (p<0.001) and between the couple (p<0.001). Conclusion: The study estimates a 49.2% prevalence of violence during pregnancy. Low education, drug use, fights against other people and between the couple are characteristics of the partner offender.(AU)

Influencia de los hábitos en la depresión del estudiante de medicina peruano: estudio en siete departamentos / Influence of Habits on Depression in the Peruvian Medical Student: Study in Seven Administrative Regions

RESUMEN Objetivo: Determinar la influencia de los hábitos en la depresión del estudiante de medicina de 7 departamentos de Perú. Métodos: Estudio transversal analítico de un análisis secundario de datos. El diagnóstico de depresión se obtuvo según el resultado del test de Zung, considerado positivo ante cualquier grado de esta condición. Además, se comparó esto con otras variables socioeducativas importantes según publicaciones previas. Resultados: De los 1.922 encuestados, el 54,5% (n = 1.047) eran mujeres; la mediana de edad era de 20 [intervalo intercuartílico, 18-22] arios. El 13,5% (n = 259) tenía algún grado de depresión según la escala de Zung. En el análisis multivariable, incrementaron la frecuencia de depresión la mayor cantidad de horas de estudio por día (razón de prevalencias ajustada [RPa] = 1,03; intervalo de confianza del 95% [IC95%], 1,01-1,04; p < 0,001) y que el estudiante trabaje (RPa = 1,98; IC95%, 1,21-3,23; p = 0,006); en cambio, disminuyeron la frecuencia de depresión tener horarios similares para comer (RPa = 0,59; IC95%, 0,38-0,93; p = 0,022) y un lugar fijo donde conseguir sus alimentos (RPa = 0,66; IC95%, 0,46-0,96; p = 0,030), ajustado por el año de ingreso a la universidad. Conclusiones: Se encontró que algunos factores estresantes predisponen a la depresión (trabajar y estudiar más horas por día); en cambio, tener un orden en su rutina diaria disminuye esta condición (tener un lugar y horarios fijos para comer.

ABSTRACT Objective: To determine the influence of habits on depression in medical students from 7 Peruvian Regions. Methods: Analytical cross-sectional study of a secondary data analysis. The diagnosis of depression was obtained according to the Zung test result, with any level of this condition being considered positive. This was also compared with other social and educational variables that were important according to previous literature. Results: Of the 1922 respondents, 54.5% (1047) were female. The median age was 20 [interquartile range, 18-22] years, and 13.5% (259) had some degree of depression according to the Zung scale. In the multivariate analysis, the frequency of depression increased with the hours of study per day (RPA= 1.03; 95%CI; 1.01-1.04; P<.001) and the student work (RPA = 1.98; 95%CI; 1.21-3.23; P=.006). On the other hand, decreased the frequency of depression decreased on having similar meal schedules (RPA = 0.59; 95%CI; 0.38-0.93; P=.022), and having a fixed place in which to get food (RPA = 0.66; 95%CI; 0.46-0.96; P=.030), adjusted for the year of college entrance. Conclusions: Some stressors predisposed to depression were found (the work and studying more hours a day). On the other hand, to have order in their daily routine decreased this condition (having a set place and times for meals).

Prevalência do uso de antipsicóticos em idosos de instituições de longa permanência para idosos (ILPI) na cidade do Natal/RN / Prevalence of the use of antipsychotics in elderly people from long-stay institutions for the elderly (ILPI) in the city of Natal/RN

Objetivo: Identificar a prevalência de uso dos antipsicóticos em idosos nas Instituições de Longa Permanência para Idosos (ILPI) na cidade do Natal-RN. Metodologia: Estudo transversal realizado por meio de dados provenientes do projeto "Envelhecimento Humano e Saúde: a realidade dos idosos institucionalizados na cidade do Natal/RN", ocorrido no período de 2013 a 2015 em 10 ILPI da cidade de Natal. A amostra foi composta por 320 residentes das ILPI com 60 anos ou mais. Para a identificação de fatores associados a prescrição de antipsicóticos, foi utilizada a análise bivariada através do teste do qui-quadrado e a regressão de Poisson em que a variável dependente foi o número de antipsicóticos prescritos; e as variáveis independentes incluíram informações sociodemográficas, assim como variáveis relacionadas à própria instituição e às condições de saúde. Resultados: A prevalência de uso de antipsicóticos entre os idosos foi de 50% (n=160). Nas instituições com fins lucrativos 65,5% (n=76) dos idosos utilizavam pelo menos 1 antipsicótico, enquanto nas ILPI sem fins lucrativos a prevalência foi de 40,9% (n=83). A análise múltipla demonstrou que a idade de 60 a 79 anos (RP=1,39), ter comprometimento cognitivo moderado a grave (RP=1,78), ser portador de transtorno mental (RP= 2,07), utilizar polifarmácia (RP=1,30), estar em Instituições com fins lucrativos (RP=1,51), apresentaram associação estatística (p<0,05), ao maior uso de antipsicóticos nos idosos em ILPI de Natal. Conclusão: Foi constatada elevada prevalência do uso de antipsicóticos em ILPI na cidade do Natal (AU).

Objective: The aim of this study was to examine the prevalence of antipsychotic use and associated factors in Nursing Home (NH) residents in the city of Natal-RN. Methodology: This is a cross-sectional study, part of the research project entitled "Human Aging and Health: the reality of institutionalized older adults in the city of Natal", conducted from 2013 to 2015 in 10 NH (05 for-profit institutions and 05 notfor-profit institutions) in the city of Natal. Individuals over the age of 60 who reside in the institutions were included (n=320 residents). Bivariate analysis was used through the chi-square test and Poisson regression for the identification of factors associated with antipsychotic prescription. The dependent variable was the number of prescribed antipsychotics, and independent variables included sociodemographic information, as well as variables related to the institution itself and to health conditions. Results: The prevalence of antipsychotic use among the older adults was 50% (n = 160). In the forprofit institutions, 65.5% (n = 76) of the older adults used at least 1 antipsychotic, whereas the prevalence was 40.9% (n = 83) in not-for-profit NH. After multivariate analysis, older adults between the ages of 60 to 79 years (PR = 1.39) had moderate to severe cognitive impairment (PR = 1.78), mental disorder (PR = 2.07), polypharmacy use (PR = 1.30), with for-profit institutions (PR = 1.51) being positively and independently associated to the greater use of antipsychotics in older adults of NH (p <0.05). Conclusion: A high prevalence of antipsychotic use was observed in NH in Natal (AU).