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1.
Rev Saude Publica ; 53: 72, 2019 Sep 02.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31483008

RESUMO

OBJECTIVE: To evaluate the adherence of pregnant women to personal protective measures against mosquito bites, recommended by the Ministry of Health, and to investigate the factors associated with the non-adoption of these measures. METHODS: We interviewed 177 pregnant women between November 2016 and February 2017 in the 10 basic health units of the municipality of Propriá, state of Sergipe, two located in the rural area and eight in the urban area, during prenatal appointments, to raise information about the use of preventive measures against the vector transmission of Zika virus. Data were analyzed using descriptive statistical methods, chi-square test or Fisher's exact test, and the odds ratio was calculated. The independent variables were grouped by the analysis of principal components, and the dependents (the use of repellent, mosquito nets, garments, screens and insecticides) were analyzed using the logistic regression method. RESULTS: Among the measures recommended by the Ministry of Health, mosquito nets were the most used by pregnant women living in rural areas and with low education level, while the repellents were more used by women in the urban area and with higher education level. Women in a vulnerable socio-economic situation presented a risk 2.4 times higher for not using screens in their homes, 1.9 times higher for not changing clothes and 2.5 times higher for not using repellent than pregnant women in better economic conditions. CONCLUSIONS: The socioeconomic status of pregnant women, especially among the less privileged, influenced the use of protective measures against Zika virus, from the purchase of repellent, clothing, insecticides to other resources in the municipality of Propriá, SE.


Assuntos
Controle de Mosquitos/métodos , Complicações Infecciosas na Gravidez/prevenção & controle , Infecção por Zika virus/prevenção & controle , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Repelentes de Insetos/administração & dosagem , Inseticidas/administração & dosagem , Pessoa de Meia-Idade , Mosquiteiros/estatística & dados numéricos , Gravidez , Gestantes , Fatores Socioeconômicos , Adulto Jovem , Infecção por Zika virus/epidemiologia
2.
Stud Health Technol Inform ; 264: 1855-1856, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438377

RESUMO

Vaccination against influenza is important in pregnancy for the health of both mother and unborn baby. Influenza introduces risks to pregnancy and to the baby who relies on maternal antibodies for protection. Because the data associated with pregnancy is fragmented across multiple providers of health care, it is challenging to conduct pregnancy-related public health surveillance using a single data source. We report the integration of a novel ontological approach to identifying pregnancies in routine data with a web-based dashboard that feeds back information to general practices in a sentinel network. As a result, practices receive information about how well they are performing influenza vaccination in pregnancy in near-real-time.


Assuntos
Armazenamento e Recuperação da Informação , Feminino , Humanos , Vacinas contra Influenza , Influenza Humana , Gravidez , Complicações Infecciosas na Gravidez , Gestantes , Atenção Primária à Saúde , Vacinação
3.
J Natl Black Nurses Assoc ; 30(1): 7-13, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31465679

RESUMO

Fetal alcohol spectrum disorders (FASD) affect all nations harshly, however, very little is known about the scope of FASD in Swaziland. Alcohol exposure in utero is one of the leading preventable causes of poor fetal birth outcomes. This study assessed the knowledge and practices of pregnant Swazi women, revealing that most participants had knowledge deficit on the effects of consuming alcohol on both the woman (63.3%, n = 19) and her fetus (83.3%, n = 25). The majority (83.0%, n = 25) of the participants reported that they did not drink alcohol, while 16.7% (n = 5) reported that they did consume alcohol. In health facilities, there is a need to intensify health education concerning the effects of alcohol consumption to both the fetus and the pregnant woman. A policy that enforces screening of pregnant women at risk for giving birth to infants with FASD is essential.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Conhecimentos, Atitudes e Prática em Saúde , Gestantes/psicologia , Feminino , Transtornos do Espectro Alcoólico Fetal/etiologia , Transtornos do Espectro Alcoólico Fetal/prevenção & controle , Humanos , Gravidez , Suazilândia
4.
Stud Health Technol Inform ; 264: 749-752, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438024

RESUMO

This study aimed to explore the use and expectation of smartphone applications about pregnancy among pregnant women using a survey method. A total of five hundreds pregnant women from 3 hospitals in the city of Chengde in hebei province in China were randomly selected to conduct a questionnaire survey. The study found that 61.48% of pregnant women used at least one pregnancy apps, mainly for fetal development information (83.3%) and maternal changes information (65.3%); only 8% of pregnant women worried about the security of personal information very much. The main expected functions of pregnancy apps are prenatal examination reminder (65%) and fetal monitoring (54.7%). Also, 77.3% of pregnant women hoped that information provided pregnancy apps should be recognized by relevant authorities. It indicated that pregnancy apps in the market in China was not able to meet the needs of pregnant women and needed further improvement in future.


Assuntos
Motivação , China , Feminino , Humanos , Gravidez , Gestantes , Smartphone , Inquéritos e Questionários
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46660

RESUMO

Microcefalia é uma malformação congênita em que o cérebro não se desenvolve de maneira adequada. Essa malformação pode ser efeito de uma série de fatores de diferentes origens, como substâncias químicas e infecciosas, além de bactérias, vírus e radiação. Em relação ao aleitamento materno, como não há evidência científica que demonstre a transmissão do vírus Zika pelo leite, o Ministério da Saúde recomenda que seja mantida a amamentação contínua até os dois anos ou mais, sendo ele exclusivo até os seis primeiros meses de vida da criança.


Assuntos
Zika virus , Leite Humano , Infecção por Zika virus , Microcefalia , Recém-Nascido , Gestantes , Sistema Único de Saúde , Saúde da Criança
6.
BMC Public Health ; 19(1): 895, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286930

RESUMO

BACKGROUND: It is recommended that Antenatal Care (ANC) be initiated within the first trimester of pregnancy for essential interventions, such folic acid supplementation, to be effective. In Tanzania, only 24% of mothers attend their first ANC appointment during their first trimester. Studies have shown that women who have had contact with a health worker are more likely to attend their first antenatal care appointment earlier in pregnancy. Community health workers (CHWs) are in an opportune position to be this contact. This study explored CHW experiences with identifying women early in gestation to refer them to facility-based antenatal care services in Morogoro, Tanzania. METHODS: This qualitative study employed 10 semi-structured focus group discussions, 5 with 34 CHWs and 5 with 34 recently delivered women in three districts in Morogoro, Tanzania. A thematic analytical approach was used to identify emerging themes among the CHW and RDW responses. RESULTS: Study findings show CHWs play a major role in identifying pregnant women in their communities and linking them with health facilities. Lack of trust and other factors, however, affect early pregnancy identification by the CHWs. They utilize several methods to identify pregnant women, including: asking direct questions to households when collecting information on the national census, conducting frequent household visits and getting information about pregnant women from health facilities. CONCLUSIONS: We present a framework for the interaction of factors that affect CHWs' ability to identify pregnant women early in gestation. Further studies need to be conducted investigating optimal workload for CHWs, as well as reasons pregnant women might conceal their pregnancies.


Assuntos
Agentes Comunitários de Saúde/psicologia , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/psicologia , Adulto , Agendamento de Consultas , Feminino , Grupos Focais , Instalações de Saúde/estatística & dados numéricos , Humanos , Gravidez , Primeiro Trimestre da Gravidez/psicologia , Pesquisa Qualitativa , Medição de Risco , Tanzânia
7.
JAMA ; 322(4): 349-354, 2019 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-31334800

RESUMO

Importance: Screening for hepatitis B virus (HBV) infection during pregnancy identifies women whose infants are at risk of perinatal transmission. Data from a nationally representative sample showed a prevalence of maternal HBV infection of 85.8 cases per 100 000 deliveries from 1998 to 2011 (0.09% of live-born singleton deliveries in the United States). Although there are guidelines for universal infant HBV vaccination, rates of maternal HBV infection have increased annually by 5.5% since 1998. Children infected with HBV during infancy or childhood are more likely to develop chronic infection. Chronic HBV infection increases long-term morbidity and mortality by predisposing infected persons to cirrhosis of the liver and liver cancer. Objective: To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for HBV infection in pregnant women. Evidence Review: The USPSTF commissioned a reaffirmation evidence update to identify substantial new evidence sufficient enough to change the prior recommendation. The USPSTF targeted its evidence review on the effectiveness and potential harms of screening and the effectiveness and harms of case management to prevent perinatal transmission. Findings: The USPSTF previously found adequate evidence that serologic testing for hepatitis B surface antigen accurately identifies HBV infection. Interventions are effective for preventing perinatal transmission, based on foundational evidence and observational studies of US case management programs. In addition, there is evidence that over time, perinatal transmission has decreased among women and infants enrolled in case management, providing an overall substantial health benefit. Therefore, the USPSTF reaffirms its previous conclusion that there is convincing evidence that screening for HBV infection in pregnant women provides substantial benefit. Conclusions and Recommendation: The USPSTF recommends screening for HBV infection in pregnant women at their first prenatal visit. (A recommendation).


Assuntos
Vírus da Hepatite B , Hepatite B , Criança , Feminino , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa , Programas de Rastreamento , Gravidez , Gestantes , Estados Unidos
8.
Rev Bras Enferm ; 72(3): 692-699, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269134

RESUMO

OBJECTIVE: to discuss the benefits of using high-risk prenatal case management. METHOD: a qualitative, convergent care study with six high-risk pregnant women, performed in a municipality in the south of Brazil. Data were produced by case management from April to August of 2017 through observation-participant. Analysis followed the processes of Convergent Care Research: apprehension, synthesis, theorization and transfer. RESULTS: case management identified important elements in the care of pregnant women, which denoted a greater complexity to the cases; was shown as a relevant space for nurses to act, because it is an intervention that requires knowledge and specific skills. FINAL CONSIDERATIONS: case management provides differentiated management in complex cases, facilitates the flow between health services, concretizing the comprehensiveness and equity of the care. It was found, in the convergence between research and care, that participants were benefited by case management.


Assuntos
Administração de Caso/tendências , Gestantes/psicologia , Cuidado Pré-Natal/métodos , Adulto , Brasil , Feminino , Humanos , Gravidez , Gravidez de Alto Risco , Pesquisa Qualitativa
9.
Zhonghua Er Ke Za Zhi ; 57(8): 608-613, 2019 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-31352746

RESUMO

Objective: To investigate the association between maternal nocturnal sleep during pregnancy and their infants' nocturnal sleep patterns in early infancy by establishing a birth cohort. Methods: In this prospective study,healthy pregnant women and their infants were recruited in Chongqing Health Center for Women and Children from September 2013 to January 2014. A total of 40 healthy pregnant women and their infants were enrolled, and 34 pairs (85%) completed the whole survey. Actiwatch, wearing on the mother's wrist or infant's ankle,was used to monitor nighttime sleep at home for 7 times in total,with 7 consecutive days for each monitoring course. Pregnant women were monitored at 16, 24, 32 weeks gestational age, and were required to finish Pittsburgh Sleep Quality Index (PSQI) scale at the end of each monitoring. Their infants were initially monitored at 14 days after birth, followed by 1(st), 2(nd), and 3(rd) month after birth,with sleep diary recorded by parents. Pearson correlation analysis and multivariate linear regression were used to investigate the potential correlation between these two sleep patterns. Results: The average nocturnal sleep time was (465±53) min throughout pregnancy, with increased trend in the latency of maternal nighttime sleep onset ((30±15), (34±29), (38±30) min) while decreasing of average sleep efficiency ((85±5)%, (84±8)%, (83±8)%). The longest night sleep duration decreased from (382±74) min in the first trimester to (330±83) min in the third trimester (F=4.932, P<0.05), while awakening time after sleep onset (WASO) correspondingly increased from (27±22) min to (53±25) min (F=12.605, P<0.05). In terms of infants, the latency of nighttime sleep onset decreased from (43±33) min on the 14th day to (20±29) min at 3-month of age (t=3.281, P=0.002), while the longest nighttime sleep duration increased from (20±62) min to (265±140) min (t=3.867, P<0.01); meanwhile, the total nocturnal sleep time and the sleep efficiency increased from (373±126) min and (63±28)% to (431±103) min and (75±16)%, respectively (t=2.362, P=0.024; t=2.418, P=0.039, respectively). After adjusting for maternal age and body mass index (BMI), parental educational level and family income, maternal mood, exposure to tobacco and alcohol during pregnancy, method of delivery, as well as infants' gender, feeding patterns and gestational weeks, the regression analysis showed that the total nocturnal sleep time and the longest nighttime sleep duration during pregnancy were positively correlated with the corresponding parameters of their infants at the age of 3 months (B=0.541, 95%CI 0.168-0.914, t=2.882, P=0.005; B=0.310, 95%CI 0.035-0.586, t=2.240, P=0.027, respectively). Conclusions: The total nocturnal sleep time and the longest nighttime sleep duration during pregnancy are positively correlated with the corresponding parameters of their infants in early infancy. Paying more attention to improve maternal sleep quality may facilitate their infants to establish sleep-wake patterns early.


Assuntos
Gestantes , Sono , Criança , Feminino , Humanos , Lactente , Monitorização Fisiológica , Gravidez , Estudos Prospectivos , Inquéritos e Questionários
12.
BJOG ; 126 Suppl 4: 50-57, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257691

RESUMO

OBJECTIVE: To assess the effectiveness of a counselling intervention in antenatal care settings for pregnant women who report domestic violence. DESIGN: Pre-experimental study with pretest-posttest design. SETTINGS: Two public hospitals in Mumbai, India. SAMPLE: In all, 2778 pregnant women accessing antenatal care (ANC) in the hospitals from February to November 2016 were approached for study participation; 2515 women consented. These women were screened by trained counsellors for domestic violence during pregnancy (domestic violence during pregnancy). Domestic violence during pregnancy was reported by 16.2% (408) of women. Of these, 155 women sought counselling services. Post-intervention analyses were carried out with 142 women at 6 weeks post-delivery; 13 women were not contactable. METHODS: The 442 women who reported domestic violence during pregnancy were provided a minimum of two counselling sessions by trained counsellors during their ANC visits. A counselling intake form was used to collect pre- and post-intervention data. MAIN OUTCOME MEASURES: Prevalence of domestic violence during pregnancy, change in women's ability to cope, safety, and health. RESULTS: Prevalence of domestic violence during pregnancy (16.1%) was comparable to those of common obstetric complications routinely screened for during ANC. In all, 60-65% women reported cognitive changes such as recognising impact of violence and need to speak out against it. In all, 50.7% women took action at the individual level to address domestic violence during pregnancy. This change was not statistically significant (P-value 0.193). Of the women studied, 35.9% adopted at least one safety measure, and 84% of the women reported better health status post-intervention. CONCLUSIONS: Routine enquiry and counselling for domestic violence during pregnancy are effective in improving women's ability to cope, safety, and health. FUNDING: This study was funded by The John D. and Catherine T. MacArthur Foundation. TWEETABLE ABSTRACT: Improving coping strategies, safety and health of pregnant women who reported domestic violence by providing counselling in antenatal care setting.


Assuntos
Aconselhamento , Violência Doméstica/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/psicologia , Adulto , Terapia Cognitivo-Comportamental/métodos , Violência Doméstica/prevenção & controle , Violência Doméstica/estatística & dados numéricos , Família/psicologia , Feminino , Humanos , Índia/epidemiologia , Projetos Piloto , Período Pós-Parto/psicologia , Gravidez , Complicações na Gravidez/psicologia , Adulto Jovem
13.
Washington, D.C.; OPS; 2019-07-12.
em Inglês | PAHO-IRIS | ID: phr-51355

RESUMO

[Objetivos del protocol]. Este documento ha sido concebido para proporcionar un marco que respalde los estudios de prevalencia de las ITS en los niveles local y nacional. El propósito de estos estudios es conocer la carga de las infecciones por NG y CT, dos ITS prioritarias que dan lugar a resultados obstétricos y perinatales adversos. Para ello, el objetivo es describir epidemiológicamente la prevalencia de estas dos infecciones en las embarazadas y, por extensión, en la población general del país. Dada la naturaleza frecuentemente asintomática de estas infecciones, es difícil conocer la auténtica carga de enfermedad sin llevar a cabo evaluaciones de la prevalencia. Existe una carencia general de datos sobre las infecciones por NG y CT en los niveles local y nacional; a menudo no se conoce la carga en la población general. En muchos casos se utiliza al grupo de las embarazadas como sustituto de la población general. En las embarazadas, las infecciones por clamidias y por gonococos pueden dar lugar, si no se tratan, a resultados obstétricos y perinatales adversos graves, como la prematuridad y el peso bajo al nacer. Por otra parte, dado que la mayor incidencia de estas infecciones se registra en los adolescentes y adultos jóvenes, las actividades de tamizaje se han centrado en ese grupo etario. En este protocolo se describe una metodología normalizada para realizar encuestas y se usa un diseño de estudio sencillo, fiable y reproducible que puede replicarse ampliamente y aplicarse en el nivel local.


Assuntos
Cuidado Pré-Natal , Gonorreia , Gestantes , Controle de Infecções , Testes Laboratoriais , Doenças Sexualmente Transmissíveis , Chlamydia trachomatis , Neisseria gonorrhoeae
14.
BMC Public Health ; 19(1): 890, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277611

RESUMO

BACKGROUND: Pregnant women are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as highest priority. However, achieving high influenza vaccine coverage among pregnant women remains challenging. We conducted a cross-sectional survey to estimate the coverage and determinants of influenza vaccination among pregnant women in Singapore. METHODS: Between September and November 2017, pregnant women aged ≥21 years were recruited at two public hospitals in Singapore. Participants completed an anonymous, self-administered online questionnaire assessing participants' influenza vaccination uptake, knowledge of and attitudes towards influenza and the influenza vaccine, vaccination history, willingness to pay for the influenza vaccine, and external cues to vaccination. We estimated vaccine coverage and used multivariable Poisson models to identify factors associated with vaccine uptake. RESULTS: Response rate was 61% (500/814). Only 49 women (9.8, 95% Confidence Interval (CI): 7.3-12.7%) reported receiving the vaccine during their current pregnancy. A few misconceptions were identified among participants, such as the belief that influenza can be treated with antibiotics. The most frequent reason for not being vaccinated was lack of recommendation. Women who were personally advised to get vaccinated against influenza during pregnancy were 7 times more likely to be vaccinated (prevalence ratio (PR) = 7.11; 95% CI: 3.92-12.90). However, only 12% of women were personally advised to get vaccinated. Other factors associated with vaccine uptake were vaccination during a previous pregnancy (PR = 2.51; 95% CI: 1.54-4.11), having insurance to cover the cost of the vaccine (PR = 2.32; 95% CI: 1.43-3.76), and higher vaccine confidence (PR = 1.62; 95% CI: 1.30-2.01). CONCLUSIONS: Influenza vaccination uptake among pregnant women in Singapore is low. There is considerable scope for improving vaccination coverage in this high-risk population through vaccination recommendations from healthcare professionals, and public communication targeting common misconceptions about influenza and influenza vaccines.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Cobertura Vacinal/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos , Humanos , Pessoa de Meia-Idade , Gravidez , Medição de Risco , Singapura , Inquéritos e Questionários , Adulto Jovem
15.
BMC Public Health ; 19(1): 889, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277638

RESUMO

BACKGROUND: Many low- and middle-income countries recommend micronutrient supplements for pregnant women to improve their nutritional status, prevent possible deficiencies and avoid fetal healgth consequences. This study evaluated the influence of socioeconomic status on the use of folic acid, iron salts and other vitamins and minerals among pregnant women in the 2015 Pelotas Birth Cohort. METHODS: This population-based birth cohort study was carried out with 4270 women. Participants were interviewed during pregnancy and at the maternity hospital about the antenatal period; including the use of iron salts, vitamins and other minerals. Descriptive analyses were performed to characterize the sample. The analyses were adjusted according to socioeconomic variables (maternal education, ethnicity, household income). RESULTS: The overall prevalence of the use of folic acid, iron salts or other vitamins and minerals was 91.0% (95% CI: 90.1-91.8). Specifically, 70.9% (95% CI: 69.5-72.3) used folic acid, 72.9% (95% CI: 71.5-74.3) used iron compounds, and 31.8% (95% CI: 30.3-33.2) used other vitamins or minerals. In the adjusted analysis, the use of iron salts was associated with nonwhite mothers, with ≤4 years of education and whose family income was less than or equal to the monthly minimum wage. The use of folic acid and other vitamins and minerals was associated with white mothers who were more highly educated and had a higher family income. CONCLUSION: Although folic acid and other vitamins and minerals were more frequently used in white, richer and more educated mothers, which indicates inequality, iron supplements were more frequently used in the poorer, less educated nonwhite mothers, suggesting the opposite association for this supplement.


Assuntos
Ácido Fólico/administração & dosagem , Ferro na Dieta/administração & dosagem , Gestantes , Vitaminas/administração & dosagem , Adolescente , Adulto , Brasil , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Fatores Socioeconômicos , Adulto Jovem
16.
Hu Li Za Zhi ; 66(4): 79-86, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342504

RESUMO

Influenza vaccinations may decrease the risk of contracting influenza and its complications significantly in pregnant women and effectively help infants less than six months of age avoid hospitalization. Based on scientific evidence supporting the safety and benefits of the influenza vaccination for pregnant women and fetuses, the epidemic prevention policy of both the World Health Organization and Taiwan's Ministry of Health and Welfare recommend that pregnant women receive the influenza vaccination. However, low acceptance of the influenza vaccine among pregnant women is an ongoing concern in Taiwan. Nursing staffs play a key role in implementing the influenza vaccination program for pregnant women. Therefore, strengthening the professional competency and service effectiveness of nursing staffs may be expected to significantly improve the vaccination coverage rate. This article offers practical methods for achieving this, including promoting nursing staffs' professional knowledge and positive attitudes regarding influenza vaccinations for pregnant women, improving nursing staffs' related education and skills in communication with pregnant women and their families, and improving the implementation of the notification mechanism for disseminating accurate information regarding the vaccine and vaccine adverse events. Our ultimate goal is to enhance the confidence and willingness of pregnant women with regard to receiving influenza vaccinations in order to promote the health of mothers and their fetuses.


Assuntos
Adaptação Psicológica , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Recursos Humanos de Enfermagem/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Feminino , Humanos , Lactente , Pesquisa em Avaliação de Enfermagem , Gravidez , Taiwan
17.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 937-943, jul.-set. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005767

RESUMO

Objetivo: identificar a partir da história de vida das gestantes/puérperas usuárias de crack, as necessidades prioritárias que poderiam ajudá-las a reconstruir um viver sem drogas. Metodologia: Trata-se de uma pesquisa qualitativa do tipo estudo de caso, com três participantes, sendo uma gestante e duas puérperas usuárias de crack, cujos dados foram coletados por meio de entrevistas semiestruturadas, realizadas entre outubro e dezembro/2015. Resultados: Apontaram como prioritárias as necessidades de proteger o filho; necessidade de apoio familiar; necessidade de uma relação de confiança com profissionais; e a necessidade espiritual. Conclusão: Reconstruir um viver sem drogas é um empreendimento coletivo que envolve a família, não apenas como um recurso, mas, também, como objeto de cuidado; os profissionais que precisam rever seus próprios valores e preconceitos; e o poder público, pois a não adesão dessa clientela aos serviços de saúde é uma forma de negligência também com as próximas gerações


Objective: to identify, from the life history of pregnant / puerperal users of crack, the priority needs that could help them rebuild a drugfree life. Methodology: This is a qualitative study of the case study, with three participants being a pregnant woman and two puerperal users of crack, whose data were collected through semi-structured interviews, carried out between October and December / 2015. Results: They identified as priorities the need to protect the child; Need for family support; Need for a relationship of trust with professionals; And spiritual need. Conclusion: Rebuilding a drug-free life is a collective enterprise that involves the family, not only as a resource, but also as an object of care; Professionals who need to review their own values and prejudices; And of the public power, since the non-adhesion of this clientele to the health services is a form of neglect also with the next generations


Objetivo: identificar a partir de la historia de vida de las gestantes / puérperas usuarias de crack, las necesidades prioritarias que podrían ayudarlas a reconstruir un vivir sin drogas. Metodología: Se trata de una investigación cualitativa del tipo estudio de caso, con tres participantes siendo una gestante y dos puérperas usuarias de crack, cuyos datos fueron recolectados a través de entrevistas semiestructuradas, realizadas entre octubre y diciembre / 2015. Resultados: señalaron como prioritarias las necesidades de proteger al hijo; Necesidad de apoyo familiar; Necesidad de una relación de confianza con los profesionales; Y la necesidad espiritual. Conclusión: Reconstruir un vivir sin drogas es un emprendimiento colectivo que involucra a la familia, no sólo como un recurso, sino también como objeto de cuidado; Los profesionales que necesitan revisar sus propios valores y preconceptos; Y del poder público, pues la no adhesión de esta clientela a los servicios de salud es una forma de negligencia también con las próximas generaciones


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Cocaína Crack , Cocaína , Gestantes , Usuários de Drogas , Cuidados de Enfermagem , Relações Familiares , Cooperação e Adesão ao Tratamento
18.
Ann Agric Environ Med ; 26(2): 266-272, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31232058

RESUMO

INTRODUCTION: In animal models, gestational exposure to inorganic arsenic has been associated with higher corticosterone concentration and consequent impairment of stress control in offspring. An equivalent association relating cortisol, a glucocorticoid hormone, in humans has not been previously studied. OBJECTIVE: The aim of the study was to explore the association between prenatal inorganic arsenic exposure and salivary cortisol in infants from Arica, Chile. MATERIAL AND METHODS: A cohort study of 168 mother-child dyads was recruited. In the 2nd trimester of pregnancy, urinary inorganic arsenic was assessed; 18-24 months after delivery, salivary cortisol was measured in the children. Maternal cortisol, maternal depression, stress, and socio-economic status were also evaluated. RESULTS: The adjusted association was estimated with multiple linear regression after evaluating confounding through a directed acyclic graph. Median urinary inorganic arsenic in pregnant women was 14.1 µg/L (IQR: 10.4-21.7) while salivary cortisol in the children was 0.17 µg/L (IQR: 0.11-0.38). Among children from the highest income families (> 614 USD/month), arsenic exposure was associated with salivary cortisol. Children in the third quartile of arsenic exposure had -0.769 units of the logarithm of salivary cortiso, compared with those in the first quartile (p = 0.045). CONCLUSIONS: In this sample, prenatal exposure to arsenic was associated with salivary cortisol (third quartile of inorganic arsenic), only in infants belonging the highest income strata (> 614 USD). More studies are needed to confirm these preliminary results.


Assuntos
Arsênico/análise , Hidrocortisona/análise , Exposição Materna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Saliva/química , Adulto , Arsênico/urina , Criança , Pré-Escolar , Chile , Feminino , Humanos , Hidrocortisona/metabolismo , Lactente , Masculino , Gravidez , Gestantes , Estudos Prospectivos , Saliva/metabolismo , Adulto Jovem
19.
Stud Health Technol Inform ; 261: 223-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156120

RESUMO

INTRODUCTION: Patient Decision Aids (PtDA) facilitates Shared Medical Decision-Making (SDM). This study aims to facilitate the childbirth decision-making process by a decision aid mobile application. METHOD: The model development process for decision aids was used and a master group supervised it. The assessment of study was made by a face-to-face interview and prototype was also developed for it. Then Alpha test was performed with 10 pregnant women and 10 experts. 60 pregnant women and 9 clinical professionals participated in a beta test. RESULT: The modules of our PtDA consisted of health record, decision aid, educational content, frequently asked questions and help. The result of alpha test revealed that this system had high usability. After increasing intervention, the intervention group had more knowledge of women in comparison with the control group. Moreover, the reduction of decisional conflict in the intervention group was statistically significant compared with the control group. In addition, the preference for women was changed from cesarean section (CS) to vaginal delivery in the intervention group. In the beta test, the result of the ultimate usability evaluation showed that this system was usable and easy. CONCLUSION: According to the results, it seems that PtDAs can be effective for empowering women in order to choose the mode of delivery.


Assuntos
Cesárea , Técnicas de Apoio para a Decisão , Participação do Paciente , Tomada de Decisões , Feminino , Humanos , Parto , Gravidez , Gestantes
20.
Ann Agric Environ Med ; 26(2): 369-374, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31232073

RESUMO

INTRODUCTION: Low birth weight (LBW) is an important indicator of the healthy of the population and reflects the living conditions, health and health behaviours of pregnant women. OBJECTIVE: To assess the relationship between Gross Enrollment Rate at the Tertiary Education Level, average salary, Gross Domestic Product per capita, unemployment, housing area, urbanization and low birth weight in Polish sub-regions. MATERIAL AND METHODS: An ecological study was undertaken using data on socio-economic and demographic features and LBW in 2005-2014. The units of observation were 66 Polish sub-regions according to the NUTS-3 classification. Two models were used to assess the influence of SES variables on LBW incidence rate in a 10-year study period. The first was the Poisson regression model adjusted for density of population, which was followed by the multivariable model using the GEE method of model parameters estimation. RESULTS: In Poland, significant slow changes in the LBW incidence rate were observed in 2005-2014 (AAPC = -0.44%/year). In model 1, the increase in LBW was associated with an increase in unemployment (1.005) and decrease of average salary (0.987), GERTEL (0.990) and housing area (0.991). In model 2, an unfavorable association was detected between the density of population (1.068) and a still existing relationship with unemployment (1.004), average salary (0.990) and GERTEL (0.991). CONCLUSIONS: Protective factors for newborns' health were a higher level of education and income. The results indicate the need to take actions to reduce the risk factors of LBW among pregnant women living in densely populated areas.


Assuntos
Recém-Nascido de Baixo Peso , Resultado da Gravidez/economia , Adulto , Feminino , Produto Interno Bruto , Humanos , Renda , Recém-Nascido , Masculino , Polônia , Gravidez , Gestantes , Classe Social , Fatores Socioeconômicos , Desemprego , Adulto Jovem
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