Monitoring the feeding and parental care behavior of a pair of free-living owls (Tyto furcata) in the nest during the reproductive period in Rio de Janeiro, Brazil / Monitoramento do comportamento alimentar e cuidado parental de um casal de corujas de vida livre (Tyto furcata) no ninho durante o período reprodutivo no Rio de Janeiro, Brasil

Abstract The American Barn Owl (Tyto furcata) lives in urban, periurban and wild environments and feeds mainly on small rodents, meaning it has great importance in the biological control of pests. The aim of this work was to describe the reproductive, parental and eating habits of a pair of American barn owls naturally living outside a residence in the urban area of the municipality of Campos dos Goytacazes, Rio de Janeiro state, Brazil. A wood box was installed on an outside wall of the home, monitored by a video camera. A spreadsheet was created to keep track of the observations recorded. The female laid four eggs, and after an incubation period of 30-32 days all the eggs hatched, but only two chicks survived after cannibalism among the chicks. Initially, the male provided the food to the chicks and the female remained in the nest caring for the brood. After approximately a month, the female also began to leave the nest and return with prey, which was offered to the chicks, with the male also continuing this behavior. The chicks left the nest in September, 2017. The data obtained show the existence of cooperation and division of tasks between male and female owls during the reproductive period.

Resumo A coruja-das-torres americana (Tyto furcata) vive em ambientes urbanos e se alimenta principalmente de pequenos roedores, sendo de grande importância no controle biológico de pragas. O objetivo deste trabalho foi descrever os hábitos alimentares, parentais e reprodutivos de um casal de corujas-das-torres americanas, naturalmente vivendo fora de uma residência na zona urbana do município de Campos dos Goytacazes, estado do Rio de Janeiro, Brasil. Uma caixa de madeira foi instalada em uma parede externa da casa, monitorada por uma câmera de vídeo. Uma planilha foi criada para manter o controle das observações registradas. A fêmea pôs quatro ovos, e após período de incubação de 30-32 dias todos os ovos eclodiram, mas apenas dois filhotes sobreviveram após o canibalismo entre os filhotes. Inicialmente, o macho fornecia a comida aos filhotes e a fêmea permanecia no ninho cuidando da ninhada. Depois de cerca de um mês, a fêmea também começou a sair do ninho e voltar com a presa, que era oferecida aos filhotes, com o macho também continuando com esse comportamento. Os filhotes deixaram o ninho em setembro de 2017. Os dados obtidos mostram a existência de cooperação e divisão de tarefas entre corujas machos e fêmeas durante o período reprodutivo.

Estudo epidemiológico descritivo dos casos notificados de Leishmaniose visceral no estado de Goiás no período de 2011 a 2020 / Descriptive epidemiological study of notified cases of visceral Leishmaniasis in the state of Goiás in the period from 2011 to 2020 / Estudio epidemiológico descriptivo de los casos notificados de Leishmaniasis visceral en el estado de Goiás en el período de 2011 a 2020

A leishmaniose visceral, conhecida também como calazar, trata-se da forma mais grave das leishmanioses por ser uma enfermidade sistêmica e com um grande espectro clínico e um caráter irregular. Desse modo, objetivou-se avaliar a situação epidemiológica da leishmaniose visceral no Estado de Goiás, bem como o caráter dessa doença e o perfil mais atingido. Para isso, foi realizada uma pesquisa retrospectiva compreendendo o período de 2012 a 2021, com os casos notificados de leishmaniose visceral no Estado de Goiás. A busca pelos dados ocorreu por meio dos SINAN/DATASUS do Ministério da Saúde. Os dados encontrados foram tabulados e analisados por meio do programa Excel da Microsoft®. No período avaliado, foram notificados 388 casos de LV em Goiás, distribuídos em 47 municípios goianos. 66,23% das ocorrências pertenciam ao sexo masculino; 25,51% eram adultos com idade entre 20- 39 anos; 74,48% eram moradores da zona urbana; além disso, 9,27% do total de casos notificados em Goiás evoluíram para óbito. Há ainda uma a taxa de coinfecção LV/HIV de 12,11% do total de casos notificados. Constatou-se, portanto, que algumas localidades possuem registros consequentes de LV, levando a existência de áreas endêmicas no estado. Existe um perfil de acometimento em Goiás, no período de análise, direcionado para o sexo masculino, de cor parda, jovens adultos, com baixa escolaridade, vivendo nas cidades e grandes centros urbanos. Destaca-se o elevado quantitativo de dados identificados como ignorado/branco, que podem interferir significativmente em análises epidemiológicas.

Visceral leishmaniasis, also known as kala-azar, is the most serious form of leishmaniasis because it is a systemic disease with a wide clinical spectrum and an irregular character. Thus, the objective was to evaluate the epidemiological situation of visceral leishmaniasis in the State of Goiás, as well as the character of this disease and the most affected profile. For this, a retrospective survey was carried out covering the period from 2012 to 2021, with reported cases of visceral leishmaniasis in the State of Goiás. The search for data took place through the SINAN/DATASUS of the Ministry of Health. The data found were tabulated and analyzed using the Microsoft® Excel program. In the period evaluated, 388 cases of VL were reported in Goiás, distributed in 47 munic- ipalities in Goiás. 66.23% of the occurrences were male; 25.51% were adults aged be- tween 20-39 years; 74.48% were residents of the urban area; in addition, 9.27% of the total cases reported in Goiás evolved to death. There is also a LV/HIV co-infection rate of 12.11% of the total reported cases. It was found, therefore, that some localities have consequent records of VL, leading to the existence of endemic areas in the state. There is a profile of involvement directed towards males, of mixed race, young adults, with low education, living in cities and large urban centers. The high quantity of data identified as ignored/white stands out, which can significantly interfere in epidemiological analyses. KEYWORDS: Epidemiology; Leishmania; Notification.

La leishmaniasis visceral, también conocida como kala-azar, es la forma más grave de leishmaniasis por tratarse de una enfermedad sistémica de amplio espectro clínico y carácter irregular. Así, el objetivo fue evaluar la situación epidemiológica de la leishmaniasis visceral en el Estado de Goiás, así como el carácter de esta enfermedad y el perfil más afectado. Para ello, se realizó una encuesta retrospectiva que abarcó el período de 2012 a 2021, con los casos notificados de leishmaniasis visceral en el Estado de Goiás. La búsqueda de datos se realizó a través del SINAN/DATASUS del Ministerio de Salud. Los datos encontrados fueron tabulados y analizados utilizando el programa Microsoft® Excel. En el período evaluado, fueron notificados 388 casos de LV en Goiás, distribuidos en 47 municipios de Goiás. 66,23% de las ocurrencias fueron del sexo masculino; 25,51% eran adultos con edad entre 20-39 años; 74,48% eran residentes del área urbana; además, 9,27% del total de casos notificados en Goiás evolucionaron a muerte. Existe también una tasa de coinfección LV/VIH de 12,11% del total de casos notificados. Se constató, por lo tanto, que algunas localidades tienen registros consecuentes de LV, llevando a la existencia de áreas endémicas en el estado. Existe un perfil de envolvimiento dirigido a hombres, mestizos, adultos jóvenes, con baja escolaridad, residentes en ciudades y grandes centros urbanos. Se destaca la elevada cantidad de datos identificados como ignorados/blancos, lo que puede interferir significativamente en los análisis epidemiológicos.

Envejecimiento saludable: un primer acercamiento a la revisión de indicadores subjetivos de salud en zonas urbanas y rurales en Costa Rica / Healthy aging: An initial review of subjective health indicators in urban and rural areas in Costa Rica

Resumen En este artículo se presentan los resultados de una primera aproximación al análisis del efecto moderador del contexto social, cultural y geográfico en indicadores subjetivos del envejecimiento saludable en personas mayores de 46 años residentes en territorios con características diferenciadas en Costa Rica. Se trabajó con una muestra de 305 personas residentes en tres áreas geográficas: una urbana, una semiurbana y una tercera principalmente rural. La diferenciación de las tres zonas se basó en criterios de densidad poblacional, infraestructura y acceso a bienes y servicios. Los indicadores subjetivos del envejecimiento saludable analizados fueron: participación social, apoyo social, salud percibida, espiritualidad, autoeficacia, comportamientos de autocuidado, bienestar subjetivo (satisfacción con la vida y bienestar psicológico) y estado de ánimo; todas las variables fueron condicionadas por zona de residencia, edad y sexo. Para analizar los indicadores subjetivos se estimó un análisis de covarianza (ANCOVA) o un análisis multivariado de covarianza (MANCOVA), dependiendo del número de variables dependientes analizadas. En general, se identificaron indicadores subjetivos de envejecimiento saludable altos en las personas participantes del estudio, quienes reportaron altos niveles de participación social, satisfacción con la vida y estados de salud y ánimo positivos. Se encontraron diferencias por edad entre los grupos. Sin embargo, no se evidenciaron diferencias estadísticamente significativas en los indicadores subjetivos analizados según la zona de residencia o el sexo. En síntesis, este estudio encontró que los indicadores subjetivos de envejecimiento saludable analizados eran muy similares en residentes de tres zonas geográficas con características distintas. Estos hallazgos iniciales se discuten desde una perspectiva cultural y geográfica y en relación con los modelos de envejecimiento saludable.

Abstract This review exposes the results of a first approximation to the analysis of the moderator effect of the geographical, social, and cultural context on subjective indicators of healthy aging in the Costa Rican context. Costa Rica is a middle-income democratic country that is in an advanced demographic changing process; this phenomenon makes it one of the aged countries in the Latin American region. Therefore, studying healthy aging becomes relevant in the context of population demographic change in the present and future aging societies. The study compared several subjective indicators of healthy aging among people older than 46 who resided in three different geographical areas in the country. Participants were 305 healthy people from three locations: one urban (Heredia Central City), one semi-urban (Santa Ana Central City), and one mainly rural (Nicoya). Participants completed standardized assessment scales to evaluate social participation, social support, perceived health, spirituality, self-efficacy, self-care behaviors, and subjective well-being (life satisfaction and psychological well-being). All variables were conditioned by geographical zone (urban, semi-urban, and mainly rural), age, and gender. Either Analysis of Covariance (ANCOVA) or Multivariate Analysis of Covariance (MANCOVA) were estimated depending on the number of dependent variables analyzed to test the effect of the zone of residence, gender, and age, over the subjective indicator of healthy aging studied. In general, participants evidenced high scores on subjective indicators such as self-care, social support, spirituality, life satisfaction, and psychological well-being, which have been associated with health and well-being during the aging process. Participants reported high levels of social participation and perceived that they received adequate support for their daily life needs. Likewise, participants evidenced a general state of well-being, a positive state of health, high levels of self-efficacy, and positive moods. Differences were found among the groups by comparing age. However, no significant differences were found in the variables studied related to geographical areas of residence and sex, suggesting invariant comparison evidence by zone of residence and sex. Nevertheless, the results indicate that the subjective indicators of healthy aging studied are key to promoting healthy aging at the national level. It is considered necessary to improve opportunities for social participation aimed at older adults, to strengthen community and family social networks, to promote socio-economic support such as financial and instrumental support for activities of daily living, and finally emotional support such as listening, empathy and advice. Although the differences among geographical areas of residence of the people studied were not statistically significant in this study, the evidence suggested a trend of high well-being indicators mainly in the rural areas studied, and particularly more in males than in females. As this study only reached preliminary data, further research must obtain conclusive evidence, as previous research had suggested older people living in rural areas with high longevity indicators in Costa Rica might enjoy unusual environmental characteristics and personal protective factors that could be absent in most of the urban areas in the country. On the other hand, it will be necessary to include the historical and socio-cultural determinants focusing on context-specific review analyses in the mainstream research on healthy aging, even more in aged countries like Costa Rica. The findings are discussed within the inter-cultural emphasis and healthy aging models in order to contribute to a better understanding of how the context (physical-constructed and social/cultural) influences the differences, although subtle, in the study´s variables and participants, and how the process of aging might be different according to the multiple contextual conditions in which people live and adapt their capacities and abilities for coping with daily life demands.

Shantala na atenção primária à saúde: relato de experiência / Shantala in primary health care: experience report / Shantala en la atención primaria de salud: informe de experiencia

A Shantala consiste em uma prática integrativa complementar que apresenta benefícios para a saúde da criança e para o fortalecimento do vínculo cuidador-bebê; no entanto, ainda é desconhecida por grande parte da população. Este estudo teve como objetivo promover o conhecimento sobre a prática integrativa complementar da Shantala para gestantes e profissionais da atenção primária. Trata-se de um relato de experiência de cinco oficinas de Shantala com gestantes realizadas nos postos de saúde da zona urbana do município de Una (BA), e de uma capacitação sobre o tema voltada para enfermeiros e agentes comunitários de saúde. Ao todo, participaram das oficinas 27 gestantes e três mães de bebês com idades entre 2 e 8 meses. A atividade de educação permanente contou com 11 profissionais. Todas as mães relataram ter recorrido à técnica em algum momento, mas nem todas conseguiram inseri-la em suas rotinas. Os benefícios observados incluem: alívio de gases, bebê mais calmo, sono tranquilo, genitores mais calmos e satisfeitos por observar o bem-estar do(a) filho(a). Pela experiência relatada, é possível observar que mais iniciativas com terapias complementares devem ser implementadas na atenção primária com o intuito de ultrapassar o modelo biomédico e aproximar a comunidade dos serviços de saúde para fins de promoção e prevenção.

Shantala consists of a complementary integrative practice which benefits the child's health and the strengthening of the caregiver-baby bond; however, it is still unknown by a large part of the population. This study aimed to promote the knowledge about the Shantala complementary integrative practice for pregnant women and primary health care professionals. This is an experience report of five Shantala workshops with pregnant women held at health centers in the urban area of the municipality of Una (BA), and of one training on the subject aimed at nurses and community health agents. In all, 27 pregnant women and three mothers of babies aged between 2 and 8 months participated in the workshops. The permanent education activity involved 11 professionals. All mothers reported having resorted to the technique at some point, but not all managed to insert it in their routines. The observed benefits include: gas relief, calmer babies, peaceful sleep, and calmer and more satisfied parents for observing their child's well-being. From the reported experience, more initiatives with complementary therapies should be implemented in primary care aiming to go beyond the biomedical model and bring the community closer to health services for promotion and prevention.

La Shantala es una de las prácticas integradoras complementarias que proporciona beneficios para la salud del niño y el fortalecimiento del vínculo cuidador-bebé, sin embargo, aún es una práctica desconocida por gran parte de la población. Este estudio tuvo como objetivo difundir la práctica integradora complementaria Shantala para mujeres embarazadas y para profesionales de atención primaria. Se trata de un informe de experiencia de cinco talleres de Shantala con embarazadas realizados en centros de salud del área urbano del municipio de Una (Bahia, Brasil), y de una capacitación sobre el tema dirigida a enfermeros y a agentes comunitarios de salud. En total, participaron 27 mujeres embarazadas y tres madres de bebés de entre 2 y 8 meses de edad. La actividad de educación permanente involucró a 11 profesionales. Todas las madres reportaron haber realizado la técnica en algún momento, pero no todas lograron incluirla en su rutina diaria. Los beneficios observados incluyen: alivio de gases, bebé más tranquilo, sueño tranquilo, padres más tranquilos y satisfechos al observar el bienestar de su hijo/a. A partir de la experiencia, es posible observar que se deben implementar más iniciativas con terapias complementarias en la atención primaria, con el objetivo de superar el modelo biomédico y acercar a la comunidad a los servicios de salud con fines de promoción y prevención.

Abordagem epidemiológica e considerações bioéticas sobre a infecção pelo vírus da hepatite b em crianças e adolescentes no estado do acre, Brasil / Enfoque epidemiológico y consideraciones bioéticas sobre la infección por el virus de la hepatitis b en niños y adolescentes en el estado de Acre, Brasil / Epidemiological approach and bioethical considerations on hepatitis b virus infection in children and adolescents in the state of Acre, Brazi

O estudo investiga os aspectos epidemiológicos da hepatite B em crianças e adolescentes, discutindo os resultados encontrados à luz dos princípios da bioética. Trata-se de um estudo transversal, retrospectivo, com base em uma série temporal de casos, cujos dados de notificação foram extraídos do Sistema de Informação de Agravos de Notificação (SINAN) e dados de vacinação do Sistema de Informação do Programa Nacional de Imunizações - SIPNI, no período de 2011 a 2020. Foram notificados 889 casos de hepatite B na população de estudo. A maioria dos participantes encontravam-se na faixa etária de 15 a 19 anos 738 (83%), do sexo feminino 549 (62%), cor da pele parda 637 (72%) residentes na zona urbana 490 (55%) e com ensino fundamental incompleto 279 (31%). A provável fonte de infecção foi por via sexual 450 (51%). A forma clínica mais comum foi a Hepatite Crônica 496 (56%). A maioria dos contaminados com Hepatite B foram indivíduos não vacinados 298 (34%). A luz da bioética os resultados demostram que a prática da vacinação pode contemplar os princípios bioéticos, já que o grau de autonomia depende de um tipo de intervenção planejada e quanto maior a relação entre benefício e ônus, tendo em conta os princípios de beneficência e não maleficência, menos decisiva é essa autonomia.

El estudio investiga los aspectos epidemiológicos de la hepatitis B en niños y adolescentes, discutiendo los resultados encontrados a la luz de los principios bioéticos. Se trata de un estudio transversal, retrospectivo, basado en una serie temporal de casos, cuyos datos de notificación fueron extraídos del Sistema de Información de Enfermedades de Declaración Obligatoria (SINAN) y datos de vacunación del Sistema de Información del Programa Nacional de Inmunizaciones SIPNI, desde 2011 hasta 2020. Se informaron 889 casos de hepatitis B en la población de estudio. La mayoría de los participantes tenían entre 15 y 19 años 738 (83 %), sexo femenino 549 (62 %), color de piel morena 637 (72 %), residentes en zona urbana 490 (55 ) y con educación primaria incompleta 279 (31 %). La fuente probable de infección fue a través de relaciones sexuales 450 (51%). La forma clínica más frecuente fue la Hepatitis Crónica 496 (56%). La mayoría de los infectados con Hepatitis B eran individuos no vacunados 298 (34%). A la luz de la bioética, los resultados muestran que la práctica de la vacunación puede contemplar principios bioéticos, ya que el grado de autonomía depende de un tipo de intervención planificada y mayor la relación entre beneficio y carga, teniendo en cuenta los principios de beneficencia y no maleficencia, menos decisiva es esta autonomía.

The study investigates the epidemiological aspects of hepatitis B in children and adolescents, discussing the results found in the light of bioethical principles. This is a cross-sectional, retrospective study, based on a time series of cases, whose notification data were extracted from the Notifiable Diseases Information System (SINAN) and vaccination data from the National Immunization Program Information System SIPNI, from 2011 to 2020. 889 cases of hepatitis B were reported in the study population. Most participants were aged between 15 and 19 years old 738 (83%), female 549 (62%), brown skin color 637 (72%) living in the urban area 490 (55%) and with incomplete elementary education 279 (31%). The probable source of infection was through sexual intercourse 450 (51%). The most common clinical form was Chronic Hepatitis 496 (56%). Most of those infected with Hepatitis B were unvaccinated individuals 298 (34%). In the light of bioethics, the results show that the practice of vaccination can contemplate bioethical principles, since the degree of autonomy depends on a type of planned intervention and the greater the relationship between benefit and burden, taking into account the principles of beneficence and not maleficence, the less decisive is this autonomy.

Factores sociodemográficos de las gestantes de un policlínico de Guantánamo, que interrumpieron voluntariamente el embarazo

Introducción: la interrupción voluntaria del embarazo -aborto inducido o provocado-, a pesar de ser una temática antigua, continúa siendo un problema social que afecta no solo a la mujer, sino también a la familia y la comunidad, en aspectos políticos, socioeconómicos, culturales y religiosos. Objetivo: caracterizar las interrupciones voluntarias del embarazo, según variables sociodemográficas en el Policlínico Universitario Hermanos Martínez Tamayo. Materiales y métodos: se realizó un estudio observacional, descriptivo, transversal en el Policlínico Universitario Hermanos Martínez Tamayo, del municipio Baracoa, provincia de Guantánamo, durante el año 2021. La muestra obtenida de 111 pacientes fue seleccionada por muestreo no probabilístico intencionado. El dato primario se obtuvo de la historia clínica individual y de encuestas realizadas a las pacientes. Resultados: se observó un predominio del grupo de edad de 20 a 24 años, con 36 pacientes (32,4 %). Las mujeres de zona urbana fueron la mayoría, con 79 (71,2 %). Respecto al estado civil, predominaron las solteras (56,7 %) y las divorciadas (19,8 %). El 36,9 % estaban en la universidad o contaban con nivel universitario y el 45,9 % eran de ocupación estudiante. Conclusiones: el tratamiento de algunos determinantes sociodemográficos en las características de las interrupciones voluntarias del embarazo, permite entender su variabilidad y su constitución como problema de salud en el Policlínico Universitario Hermanos Martínez Tamayo.

Introduction: the voluntary interruption of pregnancy -induced or provoked abortion- despite being an old issue, continues to be a social problem that affects not only women, but also family and community in political, socio-economic, cultural and religious aspects. Objective: to characterize the voluntary interruptions of pregnancy, according to socio-demographic variables in the University Polyclinic Hermanos Martinez Tamayo. Materials and methods: an observational, descriptive, cross-sectional study was carried out in the University Polyclinic Hermanos Martinez Tamayo, from the municipality of Baracoa, province of Guantanamo, during 2021. The sample obtained from 111 patients was selected by intentioned, non-probabilistic sampling. The primary data were obtained from the individual clinical records and from surveys carried out on the patients. Results: the age group between 20 and 24 years predominated with 36 patients (32.4%). Urban women were the majority 79 (71.2%). Regarding marital status single (56.7%) and divorced (19.8%) women predominated. 36.9% studied in the university or finished university studies, and 45.9% were students. Conclusions: the treatment of some socio-demographic determinants in the characteristics of pregnancy voluntary interruptions, allows us to understand its variability and its constitution as a health problem in the University Polyclinic Hermanos Martinez Tamayo.

Alterações do sono e os fatores associados em gestantes atendidas pela atenção primária em saúde / Sleep alterations and associated factors in pregnant women attended by primary health care / Alteraciones del sueño y factores asociados en gestantes atendidas en atención primaria de salud

Resumo Contexto: A gestação ocasiona diversas mudanças fisiológicas, anatômicas, hormonais e psicológicas na mulher. As modificações gravídicas podem repercutir no sono da gestante, diminuindo sua qualidade e duração. Objetivo: Este estudo tem como objetivo verificar a prevalência de alteração do sono em gestantes e os fatores associados. Métodos: Estudo epidemiológico, transversal e analítico realizado com gestantes cadastradas nas Equipes da Estratégia de Saúde Da Família da zona urbana do município de Montes Claros no ano de 2018. A amostra, probabilística, foi calculada em 1.180 gestantes. Os dados foram coletados a partir de um questionário contendo as informações de interesse com posterior análise das variáveis. Resultados: Verificou-se que 87,5% das participantes apresentavam alterações do sono durante a gestação. O aumento do sono foi relatado por 50,5%, a diminuição por 21,8% e 15,1% ambos. O apoio social (p= 0,032), a qualidade de vida (p< 0,001), o estresse (p= 0,009) e os sintomas de depressão (p= 0,005) associaram-se individualmente com a alteração de sono e a qualidade de vida se manteve associada após ajuste (RP ajustada: 0,482, IC95% 0,482; p=<0,001). Conclusão: É elevada a alteração de sono entre as gestantes, sendo associada ao apoio social, à qualidade de vida, ao estresse e à depressão.

Abstract Background: Pregnancy causes several physiological, anatomical, hormonal and psychological changes in women. Pregnancy changes can affect the pregnant woman's sleep, reducing its quality and duration. Objective: This study aims to verify the prevalence of sleep alterations and associated factors in pregnant women. Methods: Epidemiological, cross-sectional and analytical study carried out with pregnant women registered in the Family Health Strategy Teams of the urban area of the municipality of Montes Claros in 2018. The probabilistic sample was calculated in 1,180 pregnant women. Data were collected from a questionnaire containing the information of interest with subsequent analysis of the variables. Results: It was verified that 87.5% of the participants had sleep alterations during pregnancy. The increase in sleep was reported by 50.5%, the decrease by 21.8% and 15.1% both. Social support (p=0.032), quality of life (p<0.001), stress (p=0.009) and symptoms of depression (p=0.005) were individually associated with sleep disturbance and quality of life was remained associated after adjustment (adjusted PR: 0.482, 95% CI 0.482; p=<0.001). Conclusion: There is a high sleep disturbance among pregnant woman, being associated with social support, quality of life, stress and depression.

Resumen Contexto: El embarazo provoca diversos cambios fisiológicos, anatómicos, hormonales y psicológicos en la mujer. Los cambios del embarazo pueden afectar el sueño de la mujer embarazada, reduciendo su calidad y duración. Objetivo: Este estudio tiene como objetivo verificar la prevalencia de trastornos del sueño en mujeres embarazadas y los factores asociados. Métodos: Estudio epidemiológico, transversal y analítico realizado con gestantes registradas en los Equipos de Estrategia de Salud de la Familia del casco urbano del municipio de Montes Claros en el año 2018. La muestra probabilística se calculó en 1.180 gestantes. Los datos se recogieron a partir de un cuestionario que contenía la información de interés con el posterior análisis de las variables. Resultados: Se encontró que 87,5% de las participantes presentaron trastornos del sueño durante el embarazo. El aumento del sueño fue reportado en un 50,5%, la disminución en un 21,8% y en un 15,1% ambos. El apoyo social (p=0,032), la calidad de vida (p<0,001), el estrés (p=0,009) y los síntomas de depresión (p=0,005) se asociaron individualmente con la alteración del sueño y la calidad de vida se mantuvo asociada después del ajuste (RP ajustado: 0,482, IC 95% 0,482, p=<0,001). Conclusión: Existe una alta alteración del sueño entre las gestantes, siendo asociado al apoyo social, calidad de vida, estrés y depresión.

[A study on knowledge, attitude, and vaccination behavior of herpes zoster vaccine among urban residents in selected areas of China].

Objective: To understand the knowledge, attitude, and current status of vaccination of herpes zoster vaccination among urban residents aged 25 years and above in China. Methods: In August to October 2022, a convenience sampling method was used to survey residents aged 25 years and above at 36 community centers in 9 cities across China. Questionnaires were used to collect basic information, knowledge, and attitude toward herpes zoster and its vaccination, as well as vaccination status and reasons for non-vaccination among residents. Results: A total of 2 864 urban residents were included in the study. The total score of residents' cognition of herpes zoster and its vaccine was 3.01±2.08, and the total score of their attitude was 18.25±2.76. Factors such as being male (ß=-0.45, P<0.001), older than 40-59 years (ß=-0.34, P=0.023) or ≥60 years (ß=-0.68, P<0.001), married (ß=-0.69, P=0.002) were negatively associated with knowledge score. The educational level of high school or secondary school (ß=0.44, P=0.036), college (ß=0.65, P=0.006), bachelor's degree and above (ß=1.20, P<0.001), annual net household income ≥120 000 Yuan in 2021 (ß=0.42, P=0.020), having urban employee medical insurance (ß=0.62, P=0.030), having public or commercial medical insurance (ß=0.65, P=0.033), and having a history of chickenpox (ß=0.29, P=0.025) were positively associated with knowledge scores. Being male (ß=-0.38, P=0.008) and not remembering a history of chickenpox (ß=-0.49, P=0.012) were negatively associated with attitude scores. Annual net household income in 2021 was between 40 000-80 000 Yuan (ß=0.44, P=0.032) or between 80 000-120 000 Yuan (ß=0.62, P=0.002) or ≥120 000 Yuan (ß=0.93, P<0.001), and a history of herpes zoster (ß=0.59, P=0.004) were positively associated with attitude scores. Of the 2 864 residents surveyed, only 29 (1.01%) had received the herpes zoster vaccine, with a vaccination rate of 1.70% for those aged 50 years and above, with the main reason for non-vaccination being lack of knowledge about the herpes zoster vaccine, followed by the high price. 42.67% of the population said they would consider getting the herpes zoster vaccine in the future. Conclusion: Low knowledge of herpes zoster and its vaccine, positive attitudes towards the preventive effects of herpes zoster and its vaccine, and extremely low vaccination rates among the urban population in China call for multiple measures to strengthen health education and vaccination recommendations for residents, especially for the elderly, low-education and low-income populations.

Técnicas de Intervención educativa nutricional en el consumo de alimentos fuentes de hierro en preescolares / Nutritional intervention techniques in the consumption of foods that are sources of iron in preschoolers

Introducción: La ingesta deficiente de alimentos fuentesde hierro, es un factor de riesgo para el desarrollo de anemiaferropénica infantil, es necesario identificar la estrategia deintervención educativa nutricional más efectiva en un entornocomunitario urbano y dinámico. Objetivo: Comparar el efecto de la intervención educativanutricional a través de dos técnicas, en el consumo de alimentos fuentes de hierro en preescolares residentes en unazona urbana.Materiales y Métodos: Se realizó un estudio de enfoquecuantitativo, aplicada, diseño experimental de tipo ensayo nocontrolado, realizado en 80 preescolares de 3 a 5 años edad.Se seleccionaron dos grupos de 40 (madre e hijo) para unaintervención educativa nutricional sincrónica y presencial respectivamente: antes y después de la intervención educativanutricional; se evaluó a ambos grupos el consumo de hierrode los preescolares, a través de un cuestionario de frecuenciade consumo de alimentos fuentes de hierro. Para el análisisestadístico, se aplicó la prueba estadística T de Student.Resultados: El consumo de hierro promedio de la dietafue de1,25 ± 0,29 mg/día y después de la intervención nutrición sincrónica fue de 1,35 + 0,19 mg/día. En el grupo deintervención presencial, antes fue de 1,17 ± 0,27 mg/día ydespués de la intervención fue de 2,63 ± 0,35 mg/día. Existediferencia del consumo de hierro antes y después de la intervención educativa nutricional en ambas técnicas de intervención nutricional, sincrónica y presencial (p<0,001).Conclusión: La técnica de intervención nutricional, bajo lamodalidad presencial fue la más efectiva en aumentar el consumo de alimentos fuentes de hierro en preescolares residentes en una zona urbana.(AU)

Introduction: Deficient intake of food sources of iron is arisk factor for the development of iron deficiency anemia inchildren, it is necessary to identify the most effective nutritional educational intervention strategy in an urban and dynamic community environment. Objective: To compare the effect of the nutritional educational intervention through two techniques, on the consumption of foods that are sources of iron in preschoolers residingin an urban area.Materials and Methods: A study with a quantitative approach, applied, experimental design of the uncontrolled trialtype, carried out in 80 preschoolers from 3 to 5 years of age, was carried out. Two groups of 40 (mother and son) were selected for a synchronous and face-to-face nutritional educational intervention respectively. Before and after the nutritional educational intervention, the iron consumption of thepreschoolers was evaluated in both groups, through a questionnaire on the frequency of consumption of foods that aresources of iron. For the statistical analysis, the Student’s Tstatistical test was applied.Results: Before the intervention, the average dietary ironintake was 1,25 ± 0,29 mg (synchronous nutritional intervention) and 1,17 ± 0,27 mg (face-to-face nutritional intervention). After the intervention it was 1,35 ± 0,19 mg (synchronous nutritional intervention) and 2,63 ± 0,35 mg(synchronous nutritional intervention). There is a differencein iron consumption before and after the nutritional educational intervention of the synchronous and face-to-facetechnique (p<0,001).Conclusion: The nutritional intervention technique, underthe face-to-face modality, was the most effective in increasing the consumption of foods that are sources of iron inpreschoolers residing in an urban área.(AU)

SOCIAL HEALTH DETERMINANTS OF CONGENITAL SYPHILIS IN AN INSURANCE COMPANY IN VALLE DEL CAUCA 2015-2020 / DETERMINANTES SOCIALES EN SALUD DE LA SÍFILIS CONGÉNITA EN UNA ASEGURADORA EN EL VALLE DEL CAUCA 2015-2020

Introducción: CS (congenital syphilis) is a serious disorder that, if it does not cause death at an early age, can cause permanent disorders. This can be almost completely prevented, as long as the mother receives adequate and timely treatment. Objective: To establish the structural and intermediate determinants that best explain the outcome of congenital syphilis. Methodology: Descriptive observational study with analytical intention and focus on social determinants of health, carried out in a cohort of pregnant women confirmed with gestational syphilis, active members of an insured person in Valle del Cauca between 2015 and 2020, exploratory analysis was carried out by absolute frequencies. and related bivariate analyzes with contingency tables using the chi square test and multivariate logistic regression analysis. Results: A higher volume of cases of gestational syphilis was found in women living in urban areas, in the subsidized regime, in socioeconomic status one or two, and in vulnerable population groups such as displaced persons, in prison, and residents of the municipalities of Cali and the district of Bonaventure. Conclusions: The structural and intermediate determinants that increase the probability of congenital syphilis outcome were pregnant women in the subsidized regime, rural area, indigenous and ROM (gypsy) ethnic groups, socioeconomic stratum 2, with late diagnosis, absent prenatal check-ups, without screening tests, without their own treatment or contacts, residents in municipalities far from the capital and with a higher infant mortality rate.

Introducción: La SC (sífilis congénita) es un trastorno grave que, si no provoca la muerte a edad temprana, puede causar trastornos permanentes. Esto puede prevenirse casi por completo, siempre y cuando la madre reciba un tratamiento adecuado y oportuno. Objetivo: Establecer los determinantes estructurales e intermedios que mejor explican el desenlace de sífilis congénita. Metodología:Estudio observacional descriptivo con intención analítica y enfoque en determinantes sociales de la salud, realizado en una cohorte de gestantes confirmadas con sífilis gestacional, afiliadas activas a una asegurada en el Valle del Cauca entre 2015 y 2020, se realizó análisis exploratorios por frecuencias absolutas y relacionadas , análisis bivariados con tablas de contingencia utilizando la prueba de chi cuadrado y análisis multivariado de regresión logística. Results: Se encontró mayor volumen de casos de SG en mujeres residentes de la zona urbana, del régimen subsidiado, de estrato socioeconómico uno o dos y de grupos poblacionales vulnerables como desplazadas, en condición carcelaria y residente en los municipios de Cali y el distrito de Buenaventura. Conclusiones:los determinantes estructurales e intermedios que incrementaron la probabilidad de desenlace de SC fueron las gestantes del régimen subsidiado, área rural, de etnias indígenas y ROM (gitanos), de estrato socioeconómico 2, con diagnóstico tardío, que no asistieron a los controles prenatales, sin pruebas de tamizaje, sin tratamiento propio ni de contactos, residentes en municipios alejados de la capital y con mayor tasa de mortalidad infantil.

Análisis de la demanda asistencial desde atención primaria a traumatología: propuestas para la mejora del continuo asistencial / Analysis of the demand of care from Primary Care to Traumatology: Proposals for the improvement of the continuous care

Objetivo: Analizar las derivaciones dirigidas desde Atención Primaria a Cirugía Ortopédica y Traumatología. Como objetivo secundario, establecer 2escenarios de derivación, con el fin de conocer el impacto de la variabilidad en la derivación. Material y métodos: Estudio observacional de carácter transversal de análisis de las derivaciones de Atención Primaria a Cirugía Ortopédica y Traumatología durante el primer semestre de los años 2018, 2019 y 2021. Se ha examinado el número de derivaciones que emite cada facultativo y cada centro de salud de Atención Primaria, atendiendo a la clasificación de las distintas zonas básicas de salud. Resultados: Existe una gran variabilidad en el número de derivaciones, tanto según el tipo de zona básica de salud (p < 0,001) como por cada facultativo (p < 0,001). Las ratios de derivación se comportan de forma uniforme en el tiempo (p < 0,001). Debido al alto número de derivaciones, se han construido dosescenarios: en el primero de ellos la ratio de derivación se situaría en la zona media del espectro de la tasa de derivación. En el segundo escenario, se han tomado como referencia las menores ratios de derivación registradas. La reducción de la variabilidad en los 2escenarios supuestos proporciona una disminución importante de la demanda asistencial. Conclusiones: La reducción de la variabilidad tendría un efecto beneficioso sobre la capacidad asistencial del servicio de Cirugía Ortopédica y Traumatología.

Objective: To analyze referrals from Primary Care consultation to Orthopaedic Surgery reference department. As a secondary objective, to establish 2referral scenarios in order to determine the impact of variability on referral. Material and methods: Cross-sectional observational study, analyzing referrals from Primary Care to Orthopaedic Surgery during the first half of the years 2018, 2019, and 2021. The number of referrals issued by each doctor and each Primary Care Healthcare Center was examined, according to the classification of the different Basic Healthcare Zones. Results: There is great variability in the number of referrals, both according to the type of Basic Healthcare Zone and by each Primary Care facultative. The referral ratios behaved uniformly over time (P<0.001). Due to a large number of referrals, 2scenarios have been constructed: In the first scenario, the referral ratio would be in the middle of the referral rate spectrum. In the second scenario, the lowest referral ratios recorded have been taken as a reference. The reduction of variability in the 2scenarios assumed provides a significant reduction in the demand for care. Conclusion: Reducing variability would have a beneficial effect on the capacity of the Orthopaedic Surgery service to provide care.(AU)

[Translated article] Analysis of the demand of care from Primary Care to Traumatology: Proposals for the improvement of the continuous care / Análisis de la demanda asistencial desde atención primaria a traumatología: propuestas para la mejora del continuo asistencial

Objetivo: Analizar las derivaciones dirigidas desde Atención Primaria a Cirugía Ortopédica y Traumatología. Como objetivo secundario, establecer 2escenarios de derivación, con el fin de conocer el impacto de la variabilidad en la derivación. Material y métodos: Estudio observacional de carácter transversal de análisis de las derivaciones de Atención Primaria a Cirugía Ortopédica y Traumatología durante el primer semestre de los años 2018, 2019 y 2021. Se ha examinado el número de derivaciones que emite cada facultativo y cada centro de salud de Atención Primaria, atendiendo a la clasificación de las distintas zonas básicas de salud. Resultados: Existe una gran variabilidad en el número de derivaciones, tanto según el tipo de zona básica de salud (p < 0,001) como por cada facultativo (p < 0,001). Las ratios de derivación se comportan de forma uniforme en el tiempo (p < 0,001). Debido al alto número de derivaciones, se han construido dosescenarios: en el primero de ellos la ratio de derivación se situaría en la zona media del espectro de la tasa de derivación. En el segundo escenario, se han tomado como referencia las menores ratios de derivación registradas. La reducción de la variabilidad en los 2escenarios supuestos proporciona una disminución importante de la demanda asistencial. Conclusiones: La reducción de la variabilidad tendría un efecto beneficioso sobre la capacidad asistencial del servicio de Cirugía Ortopédica y Traumatología.

Objective: To analyze referrals from Primary Care consultation to Orthopaedic Surgery reference department. As a secondary objective, to establish 2referral scenarios in order to determine the impact of variability on referral. Material and methods: Cross-sectional observational study, analyzing referrals from Primary Care to Orthopaedic Surgery during the first half of the years 2018, 2019, and 2021. The number of referrals issued by each doctor and each Primary Care Healthcare Center was examined, according to the classification of the different Basic Healthcare Zones. Results: There is great variability in the number of referrals, both according to the type of Basic Healthcare Zone and by each Primary Care facultative. The referral ratios behaved uniformly over time (P<0.001). Due to a large number of referrals, 2scenarios have been constructed: In the first scenario, the referral ratio would be in the middle of the referral rate spectrum. In the second scenario, the lowest referral ratios recorded have been taken as a reference. The reduction of variability in the 2scenarios assumed provides a significant reduction in the demand for care. Conclusion: Reducing variability would have a beneficial effect on the capacity of the Orthopaedic Surgery service to provide care.(AU)

Species and biotypes of Streptococcus bovis causing infective endocarditis / Especies y biotipos de Streptococcus bovis causantes de endocarditis infecciosa

Introduction: Streptococcus bovis/equinus complex (SBEC) is a major cause of infective endocarditis (IE), although its incidence varies greatly depending on the geographical area. The characteristics of IE caused by Streptococcus gallolyticus susp. gallolyticus are well known; there are hardly any descriptions of IE caused by other species or biotypes. Methods: Retrospective cohort study, from 1990 to 2019, of all SBEC IE in adults in three Spanish hospitals, Lugo (LH), Barcelona (BH) and Ferrol (FH) where the population is mainly rural, urban and mixed, respectively. The incidence of IE was analyzed in 3 areas. Clinical characteristics of IE (277 cases, 258 biotyped) were compared according to SBEC species and biotypes. Results: There are significant differences between the incidence of SBEC IE in HL (27.9/106) vs. HF and HB (8.8 and 7,1, respectively, p<0.001). We found significant differences (SbI vs. SbII) in mean age (68.5 vs. 73 years; p<0.01), duration of symptoms before diagnosis (46.9±46.5 vs. 30.4±40.9 days; p<0.01), presence of comorbidities: 39.1% (78) vs. 54.2% (32; p<0.04), predisposing heart illness:62.3% (124) vs. 81.3% (48; p<0.006), particularly, prosthetic or intravascular devices IE: 24.6% (49) vs. 52.4% (31; p<0.001), bi-valve involvement:23.6% (47) vs. 11.8% (7; p<0.05) and heart failure: 24.6% (49) vs. 38.9% (23; p<0.03). There were no significant differences in embolic events, need for surgery or mortality. The association with CRC was high in both groups: 77.7% vs. 66.6%. Conclusions: IE due to SBEC has geographical variations in incidence and different clinical characteristics among biotypes. The association with CRC was high.(AU)

Introducción: El complejo Streptococcus bovis/equinus (SBEC) es una de las principales causas de endocarditis infecciosa (EI), aunque su incidencia es muy variable según la zona geográfica. Las características de EI causada por Streptococcus gallolyticus subsp. gallolyticus son bien conocidas; apenas hay descripciones de EI causada por otras especies o biotipos. Métodos: Estudio de cohorte retrospectivo, desde 1990 hasta 2019, de todas las EI por SBEC en adultos en 3 hospitales españoles, Lugo (LH), Barcelona (BH) y Ferrol (FH) donde la población es mayoritariamente rural, urbana y mixta, respectivamente. Se analizó la incidencia de EI en 3 áreas. Se compararon las características clínicas de EI (277 casos, 258 biotipados) según las especies y biotipos de SBEC. Resultados: Existen diferencias significativas entre la incidencia de EI por SBEC en HL (27,9/106) vs. HF y HB (8,8 y 7,1, respectivamente, p<0,001). Encontramos diferencias significativas (SbI vs. SbII) en edad media (68,5 vs. 73 años; p<0,01), duración de los síntomas antes del diagnóstico (46,9±46,5 vs. 30,4±40,9 días; p<0,01); comorbilidades: 39,1 (78) vs. 54,2% (32; p<0,04); enfermedad cardíaca predisponente: 62,3 (124) vs. 81,3% (48; p<0,006), en particular, EI protésica o sobre dispositivos intravasculares: 24,6 (49) vs. 52,4% (31; p<0,001); afectación bivalva: 23,6 (47) vs. 11,8% (7; p<0,05) e insuficiencia cardiaca: 24,6 (49) vs. 38,9% (23; p<0,03). No hubo diferencias significativas en cuanto a eventos embólicos, necesidad de cirugía o mortalidad. La asociación con el CCR fue alta en ambos grupos: 77,7 vs. 66,6%. Conclusiones: La EI por SBEC tiene variaciones geográficas en la incidencia y diferentes características clínicas entre los biotipos. La asociación con el CCR fue elevada.(AU)

Perfil clínico e epidemiológico dos acidentes por Lepidópteros, do gênero Lonomia, atendidos no CIATox/PR, 2015-2019 / Clinical and epidemiological profile of accidents caused by Lepidoptera, of the Lonomia genus, assisted at CIATox/PR

Introdução: Os acidentes por lepidópteros são agravos de interesse à saúde pública e a avaliação de suas características pode contribuir para melhorar sua assistência e prevenção. Este estudo analisou o perfil epidemiológico dos acidentes por lagartas do gênero Lonomia no Paraná. Métodos: Trata-se de estudo retrospectivo de base secundária realizado no Centro de Informação e Assistência Toxicológica do Paraná (CIATox/PR), em Curitiba, no período de 2015 a 2019. A análise foi realizada por estatística descritiva e Teste do qui-quadrado (p<0,05). Resultados: A amostra foi composta de 84 acidentes por Lonomia sp. com predomínio em adultos (45,2%), do sexo masculino (59,5%), e de lesões em membros superiores (84,5%). O contato com as lagartas ocorreram na área peridomiciliar da residência habitual do paciente (72,6%), na zona rural (64,27%) da macrorregião oeste paranaense (38,1%). O verão concentrou 71,4% dos casos, seguido por primavera e outono com 14,3% dos casos, respectivamente, sem registros no inverno. As manifestações clínicas mais frequentes foram dor local (62,4%), equimose (34,1%), eritema (34,1%), edema e queimação (17,6% cada). A classificação leve mostrou uma redução entre a fase inicial e a final do processo, ao contrário da moderada e grave, que tiveram aumento significativo de casos (p=0,006). O RNI (Relação Normatizada Internacional) foi incoagulável em 16,7% dos pacientes. Dois casos apresentaram piora do quadro clínico, sendo uma evolução para acidente vascular cerebral hemorrágico e um óbito. Discussão: Maior número de casos registrados na zona rural, tanto na residência habitual ou ambiente laboral, se dá pelo maior contato com o habitat das lagartas como árvores frutíferas e grandes monoculturas, o que também explica o fato de a macrorregião oeste ter o maior número de casos registrados. O aumento do desmatamento, incentivos à construção de parques públicos e plantio de árvores frutíferas na zona urbana são hipóteses para o aumento de casos nessa área. Percebeu-se que manifestações clínicas discretas podem ter uma evolução desfavorável, quando comparado estadiamento inicial e final. A realização do RNI se mostrou de grande importância na mudança de estadiamento, conduta terapêutica e diagnóstico. Conclusão: O perfil encontrado foi de acidentes por Lonomia sp. com sazonalidade no verão, em homens adultos da zona rural com gravidade moderada. Esses achados revelam a importância do diagnóstico e tratamento precoce frente às diferentes possibilidades de evolução clínica desses acidentes. É fundamental estimular estratégias para identificação da lagarta, notificação dos casos e medidas preventivas permanentes para reduzir riscos e agravos (AU).

Introduction: Lonomic accidents are of public health interest and the evaluation of their characteristics can contribute to the improvement of their attention and prevention. This study analyzed the epidemiological profile of Lonomic accidents in Paraná. Methods: This study is a retrospective secondary-based study carried out at the Center of Toxicologic Information and Assistance of Paraná (CIATox/PR), in Curitiba, from 2015 to 2019. Descriptive statistical analyses were performed using the Chi-square test (p<0.05). Results: The sample consisted of 84 accidents with Lonomia sp., showing greater occurrences among adults (45.2%) of the male gender (59.5%) and injuries on the upper limbs (84.5%). Contact with the worm occurred mainly in the patient's usual residence (72.6%), in the rural area (64.27%), and in Paraná's West macro-region (38.1%). Most cases were registered in the summer (71.4%), followed by spring and autumn (14.3%), and no accidents were registered in winter. The most frequent clinical manifestations were local pain (62.3%), ecchymosis (34.1%), erythema (34.1%), swelling and burning (17.6% each). The mild classification showed a reduction between the initial and the final phase of the process, as opposed to moderate and severe classifications, which showed a significant increase in the percentage (p=0,006). The INR was incoagulable in 16.7% of patients. Two cases showed progressive worsening, one of them evolved into a hemorrhagic stroke and one death. Discussion: The greater number of incidents registered in the rural area, both in the patients' usual residence and work environment, can be due to the greater contact with the caterpillar's natural habits, such as fruit trees and large monocultures. This also explains the larger number of registered incidents in the western macro-region. The increased deforestation, the construction of public parks, and the planting of fruit trees in the urban area are hypotheses for the increase of reported cases in this area. When comparing initial and final staging, it was noticed that discrete clinical manifestations could have an unfavorable evolution. The INR request proved to be of great importance in the management, diagnosis and change of staging of the patient. Conclusion:The epidemiological profile was of Lonomia sp. accidents happening in summer in adult males in the rural area with moderate severity. These findings reveal the importance of early diagnosis and treatment in view of these accidents' different possibilities of clinical evolution. It is essential to encourage strategies for identifying the caterpillar, reporting cases, and implementing permanent preventive measures to reduce risks and complications (AU).

O uso dos serviços odontológicos no último ano na população brasileira: revisão sistemática com metanálise / The use of dental services in the past year in the brazilian population: a systematic review with meta-analysis

Resumo O objetivo foi analisar os fatores associados ao uso dos serviços odontológicos no Brasil. A estratégia de revisão incluiu as bases PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS e Google Scholar, além de repositórios e bancos de dissertações e teses. Os estudos foram selecionados ​​usando a estratégia PEO (população/exposição/desfechos). O desfecho deste estudo foi o uso dos serviços odontológicos no último ano pela população brasileira, tratado como variáveis dicotômicas para as análises: ≤ 1 ano e > 1 ano. Foi realizada uma metanálise de efeito randômico de Mantel-Haenszel, estimando-se razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Foram selecionados 94 estudos. A maioria (98%) tinha delineamento transversal, sendo 63% oriundos de dados primários. Para a metanálise, 25 estudos foram incluídos. O uso dos serviços odontológicos no último ano esteve associado com maior escolaridade (≥ 8 anos de estudo) (RP = 0,49, (IC95%: 0,39-0,60)); maior renda familiar (≥ 2 salários-mínimos) (RP = 0,79, (IC95%: 0,74-0,84)); e residir na zona urbana (RP = 0,79, (IC95%: 0,64-0,97)). A oferta de serviços odontológicos no Sistema Único de Saúde precisa ser ampliada entre pessoas com menor renda, menor escolaridade e moradores da zona rural.

Abstract The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.

Influencia de los hábitos y los conocimientos sobre alimentación en la sobrecarga ponderal según el ámbito de residencia: estudio transversal.

OBJETIVO: comprobar la influencia de los conocimientos y los hábitos alimenticios en la sobrecarga ponderal según el ámbito de residencia (urbano o rural). MÉTODO: se administró un cuestionario a 451 personas, residentes en la zona básica de salud de Villaviciosa (Asturias, España), entre 35 y 65 años, distribuidas en zona rural y urbana, formulario compuesto por preguntas sobre datos sociodemográficos, hábitos y conocimientos nutricionales. Se calcularon frecuencias relativas (%) para las variables cualitativas, y medias aritméticas (desviaciones estándar) para las cuantitativas. Se empleó la correlación de Pearson para comprobar o descartar la relación entre la puntuación en el cuestionario de conocimientos sobre nutrición y el índice de masa corporal (IMC). Para estudiar la relación entre cada pregunta del cuestionario de hábitos y el ámbito de residencia se empleó la prueba chi-cuadrado. Para comparar las medias del IMC por ámbito se aplicó la prueba t para muestras independientes. Se realizaron regresiones logísticas para calcular las odds ratio (OR) entre la variable dependiente (sobrecarga ponderal) y las variables sociodemográficas. RESULTADOS: la edad media de los encuestados fue de 49.96 años y el IMC promedio de 26.87 kg/m2, presentando sobrecarga ponderal el 57.6 % total. No leer las etiquetas nutricionales aumenta el riesgo de tener sobrecarga ponderal (OR = 2.2; p = 0.001); quienes consideran que comen en exceso muchas veces presentan mayor probabilidad de sobrecarga ponderal (OR = 8.6; p < 0.001); comer fuera de casa varias veces por semana (OR = 11.6; p = 0.019), así como el consumo de refrescos o zumos procesados (OR = 3.3; p = 0.013) y alcohol de baja graduación (OR = 2.8; p = 0.003) durante las comidas aumentan la probabilidad de sobrecarga ponderal. CONCLUSIONES: los hábitos alimenticios y los patrones de actividad física son los principales responsables de sobrecarga ponderal. El adecuado conocimiento en la población puede ayudar a la elaboración de un plan preventivo que permita frenar el crecimiento del sobrepeso y la obesidad.

Perfil bioquímico de pessoas com diabetes mellituse hipertensão na atenção primária à saúde / Biochemical profile of people with diabetes mellitusand hypertension in primary health care

Introdução: O diabete mellitus (DM) e a hipertensão arterial sistêmica (HAS) são doenças crônicas não-transmissíveis que se associam a alto risco de mortalidade. Objetivo: Analisar o perfil laboratorial de pessoas com DM e HAS acompanhados na atenção primária à saúde. Método: Estudo descritivo e transversal, com a amostra de 345 pessoas em acompanhamento pelas estratégias de saúde da família pertencentes a duas Unidades Básicas de Saúde da zona urbana do município de Santarém, Pará, Brasil. Os participantes foram divididos em quatro grupos conforme diagnóstico: HAS; DM; ambas (DM-HAS); ou nenhuma (SEM). Foram coletadas informações socioeconômicas e clínicas dos participantes, com posterior coleta de sangue para as variáveis bioquímicas. Para a análise de dados foi realizada a estatística descritiva e inferencial, adotando-se significância de p<0,05. Resultados: Em todos os grupos predominaram participantes do sexo feminino, casados, pardos, com renda até dois salários, com 4-7 anos de estudo, não tabagistas e não estilistas. Em relação ao SEM, o DM se associou com valores alterados para glicose (p<0,0001), HDL-c (p=0,0481), ureia (p=0,0252), creatinina (p=0,0006) e hemoglobina (p=0,0024). Já o DM-HAS se associou com a presença de alteração para glicose (p<0,0001), ureia (p=0,0009), creatinina (p=0,0059) e taxa de filtração glomerular (p=0,0048). Conclusão: Conclui-se, conforme o método proposto, que a presença da DM e/ou HAS são capazes de modificar o perfil bioquímico de maneira negativa, bem como se ressalta a importância do acompanhamento desta pessoa pela atenção primária à saúde, visto que algumas pessoas apresentaram alterações bioquímicas que chamam atenção e não estão em acompanhamento (AU).

Introduction:Diabetes mellitus (DM) and systemic arterial hypertension (SAH) are chronic non-communicable diseases that are associated with a high risk of mortality. Objective: To analyze the laboratory profile of people with DM and SAH followed up in primary health care. Methods: Descriptive and cross-sectional study, with a sample of 345 people being monitored by family health strategies belonging to two Basic Health Units in the urban area of the city of Santarém, Pará, Brazil. Participants were divided into four groups according to their diagnosis: SAH; DM; both (DM-SAH); or neither (NO). Socioeconomic and clinical information was collected from the participants, with subsequent blood collection for biochemical variables. Descriptive and inferential statistics were used for data analysis, adopting a significance of p<0.05. Results: In all groups, female participants, married, brown, with an income of up to two salaries, 4-7 years of schooling, non-smokers, and non-alcoholics predominated. Compared to NO, DM was associated with altered values for glucose (p<0.001), HDL-c (p=0.048), urea (p=0.025), creatinine (p<0.001), and hemoglobin (p=0.002). DM-SAH was associated with the presence of alterations in glucose (p<0.001), urea (p<0.001), creatinine (p=0.005), and glomerular filtration rate (p=0.004). Conclusion: In conclusion, the results using the proposed method indicate that the presence of DM and/or SAH is able to negatively modify the biochemical profile. In addition, the importance of monitoring this population in primary health care was demonstrated, since some people presented potentially worrying biochemical alterations that are not being followed up (AU).

Anamnesis ambiental como parte de la consulta pediátrica: estudio piloto / Environmental history-taking as part of pediatric consultations: a pilot study

Introducción. La salud ambiental infantil es la rama de la pediatría que estudia la influencia del medioambiente en la salud y la enfermedad de los niños. Las exposiciones ambientales globales representan una seria amenaza para la salud, lo que justifica una mayor investigación y acción. Objetivo. Evaluar la salud ambiental de una muestra de niños que viven en áreas urbanas y rurales de la ciudad de Uruguaiana, Brasil. Población y métodos. Se incluyeron padres/tutores (n = 714) de niños atendidos en el Policlínico Infantil de la Ciudad de Uruguaiana de enero a octubre de 2021, que respondieron la anamnesis ambiental en pediatría (Sociedad Brasileña de Pediatría). Los datos obtenidos se analizaron según la residencia en zona urbana o rural, o el ingreso familiar. Resultados. Al comparar los habitantes de la zona urbana (n = 660) con los de la zona rural (n = 54), verificamos que entre los de la zona rural fue significativamente mayor la actividad con productos químicos (15 % vs. 32,7 %; p = 0,004), vivir cerca de plantación (7,5 % vs. 74,5 %; p <0,001) o con fuente de contaminación (4,8 % vs. 32,7 %; p <0,001), tener perro (62 % vs. 87,3 %; p <0,001), usar plaguicidas (0,6 % vs. 32,7 %; p <0,001) y exposición a contaminación química (2,6 % vs. 18,2 %; p <0,001). En el área urbana predominó la exposición al tránsito de vehículos cerca de la vivienda (85 % vs. 48,1 %; p <0,001), renta media inferior a 3 salarios mínimos (90 %) y baja escolaridad. Conclusión. Realizar la anamnesis ambiental es fundamental para la detección de amenazas ambientales presentes en los lugares donde los niños y adolescentes viven, aprenden, juegan y estudian.

Introduction. Children's environmental health studies the influence of the environment on health and disease in children. Global environmental exposures pose a serious threat to health, warranting further research and action. Objective. To assess the environmental health of a sample of children living in urban and rural areas in Uruguaiana, Brazil. Population and methods. We included parents/legal guardians (n = 714) of children seen at Policlinica Infantil de Uruguaiana between January and October 2021, who completed the environmental history- taking in pediatrics (Brazilian Society of Pediatrics). Collected data were analyzed based on place of residence (urban or rural) or household income. Results. The comparison between inhabitants of the urban area (n = 660) and the rural area (n = 54) established that, among those living in the rural area, activity with chemical substances (15% versus 32.7%; p = 0.004), living near a plantation (7.5% versus 74.5%; p < 0.001) or near a source of contamination (4.8% versus 32.7%; p < 0.001), having a dog (62% versus 87.3%; p < 0.001), using pesticides (0.6% versus 32.7%; p < 0.001), and exposure to chemical contamination (2.6% versus 18.2%; p < 0.001) were significantly higher. In the urban area, exposure to vehicle traffic near the house (85% versus 48.1%; p < 0.001), an average income below 3 minimum wages (90%), and a low level of education predominated. Conclusion. Environmental history-taking is critical for the detection of environmental threats present in the areas where children and adolescents live, learn, play, and study

[The use of dental services in the past year in the brazilian population: a systematic review with meta-analysis]. / O uso dos serviços odontológicos no último ano na população brasileira: revisão sistemática com metanálise.

The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.

O objetivo foi analisar os fatores associados ao uso dos serviços odontológicos no Brasil. A estratégia de revisão incluiu as bases PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS e Google Scholar, além de repositórios e bancos de dissertações e teses. Os estudos foram selecionados ​​usando a estratégia PEO (população/exposição/desfechos). O desfecho deste estudo foi o uso dos serviços odontológicos no último ano pela população brasileira, tratado como variáveis dicotômicas para as análises: ≤ 1 ano e > 1 ano. Foi realizada uma metanálise de efeito randômico de Mantel-Haenszel, estimando-se razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Foram selecionados 94 estudos. A maioria (98%) tinha delineamento transversal, sendo 63% oriundos de dados primários. Para a metanálise, 25 estudos foram incluídos. O uso dos serviços odontológicos no último ano esteve associado com maior escolaridade (≥ 8 anos de estudo) (RP = 0,49, (IC95%: 0,39-0,60)); maior renda familiar (≥ 2 salários-mínimos) (RP = 0,79, (IC95%: 0,74-0,84)); e residir na zona urbana (RP = 0,79, (IC95%: 0,64-0,97)). A oferta de serviços odontológicos no Sistema Único de Saúde precisa ser ampliada entre pessoas com menor renda, menor escolaridade e moradores da zona rural.

Actividad física en las áreas verdes urbanas: estudio de caso / Physical activity in urban green areas: a case study

Outdoor physical activity has become one of the main trends in Europe, specially the practice in informal places such as parks, streets or natural surrounds. The purpose of this study is to go in depth the knowledge of sports practice in urban green areas, their meanings and motivations in the environment of a medium-sized Spanish city.Considering the object of study nature, a case study design in the city of Zaragoza was chosen. This work shows a qualitative research, where three focus group with 28 participants were carried out.Results point to sports practice increase in urban green areas could be due to city expansion, green areas promotion, economic situation, sport and health links, sports culture evolution, and trends and fashions. (AU)

La actividad física al aire libre se ha convertido en una de las principales tendencias en Europa, especialmente la practicada en espacios informales tales como parques, calles o entornos naturales. Este estudio tiene como finalidad profundizar en el conocimiento de la práctica físico-deportiva en áreas verdes urbanas, sus significados y motivaciones, en el entorno de una ciudad española de tamaño medio. Dada la naturaleza del objeto de estudio, se optó por un diseño de estudio de caso en la ciudad de Zaragoza. En este trabajo se presenta una investigación de tipo cualitativo donde se realizaron tres focus group con 28 participantes. Los resultados indican que el aumento de la práctica físico-deportiva en espacios verdes urbanos podría deberse a la expansión de la ciudad, la promoción de zonas verdes, la situación económica, los vínculos entre deporte y salud, la evolución de la cultura deportiva, y las tendencias y modas. (AU)