Adverse health events associated with domestic violence during pregnancy among Brazilian women

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Background: domestic violence during pregnancy remains an unsolved and neglected social problem despite the recognised adverse physical and mental health consequences. Objective: to examine the association between domestic violence (psychological violence and physical or sexual violence) and health problems self-reported by pregnant women. Methods: a cross-sectional analysis from a cohort study of 1,379 pregnant women attending prenatal care in public primary care units in Campinas, Sao Paulo, Brazil. Data were collected by interviewing women when they enroled for prenatal care. Domestic violence and alcohol abuse were ascertained by validated questionnaires. Referred morbidities, undesirable behaviours and sociodemographic characteristics were also recorded. Univariate analyses were used to estimate prevalence and unadjusted odd ratios. Multivariate logistic regression was used to identify the independent association between psychological violence and physical or sexual violence during pregnancy and women's health outcomes. Findings: psychological violence and physical or sexual violence were reported by 19.1% (n=263) and 6.5% (n=89) of the pregnant women, respectively. Psychological violence was significantly associated with obstetric problems [odds ratio (OR) 1.95; 95% confidence interval (CI) 1.39-2.73], premature rupture of membranes (OR 1.64, 95% CI 1.01-2.68), urinary tract infection (OR 1.71, 95% CI 1.19-2.42), headache (OR 1.75, 95% CI 125-2.40) and sexual risk behaviours (OR 228, 95% CI 1.18-4.41). Physical or sexual violence was significantly associated with: obstetric problems (OR 1.72, 95% CI 1.08-2.75), premature rupture of membranes (OR 2.11, 95% CI 1.14-3.88), urinary tract infection (OR 2.05, 95% CI 126-3.34), vaginal bleeding (OR 1.95, 95% CI 1.10-3.43) and lack of sexual desire (OR 3.67, 95% CI 2.23-6.09). Conclusion: domestic violence during pregnancy was associated with adverse clinical and psychological outcomes for women. These results suggest that a well-organised health-care system and trained health professionals, as well as multisectorial social support, are necessary to prevent or address the negative influence of domestic violence on women's health in Brazil. (C) 2011 Elsevier Ltd. All rights reserved.284416421Brazilian Department of Science and Technology (DECIT)/Ministry of HealthConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CNPq [505273/2004-7

Gender of respondent does not affect the psychometric properties of the Brazilian Household Food Security Scale

Background Food insecurity is a major public concern that occurs when nutritional needs are not met, incorporates psychological and physiological coping mechanisms, and can range from basic concern over obtaining food to severe malnutrition. This study was performed to explore differences in female and male respondent psychometric characteristics of a locally adapted Brazilian Household Food Security Scale (Escala Brasileira de Medida da Insegurana Alimentar-EBIA). Methods The 16-item EBIA was incorporated into the 2004 Brazilian National Household Sample Survey 2004 (Pesquisa Nacional por Amostra de Domiclios-PNAD; n = 108 606). Rasch Modelling was used to evaluate survey one-dimensionality, construct and independence through analysis of infit and relative item severities of adult and children items by gender. Differences in estimated item severities between male and female respondents were assessed using Differential Item Functioning (DIF) models. Results The scale presented good fitness and most item infit values were within adequate range (0.8-1.2), being practically identical when comparing female and male responses. Both female and male respondents presented similar relative item severities for adult and children items and followed the same pattern of increasing relative item severities with each item in the questionnaire. None of the items presented substantial DIF. Conclusions This research demonstrates that the psychometric properties of the EBIA are not affected by respondent gender in Brazil. The results of this study support the validity of the proposed scale, suggesting that the scale will provide accurate information regardless of respondent gender for governments, researchers and agencies concerned with reducing epidemic levels of food insecurity and the resulting health disparities.37476677

Food insecurity as an indicator of inequity: analysis of a population survey

This study aimed to analyze the association between food insecurity and certain socioeconomic and demographic variables that measure social inequality: income, schooling, race, family structure, household characteristics, and sewage conditions. A sample of 456 families in Campinas, Sao Paulo State, was interviewed using the Brazilian Food Insecurity Scale (EBIA). Family food insecurity was associated with: more children < 18 years; precarious housing; overcrowding; lack of sewage system; low income (< 2 times the minimum wage); head-of-household with no schooling; no university graduate in the family; and race (black). Directly measuring food insecurity is important for monitoring inequality, and can be used either with other socioeconomic and demographic indicators or alone to identify social vulnerability in population groups.24102376238

Estado nutricional de população adulta beneficiária do Programa Bolsa Família no município de Curitiba, PR Nutritional Status of the adult population in the Bolsa Família Program in Curitiba, State of Paraná, Brazil

INTRODUÇÃO: O Programa Bolsa Família é o maior programa de transferência condicionada de renda do Brasil, e tem como um dos principais objetivos reverter o quadro atual de insegurança alimentar, porém ainda são escassos os estudos que mostram o estado nutricional de população dessa população. OBJETIVO: O presente trabalho teve como objetivo descrever o estado nutricional da população adulta inscrita no Programa Bolsa Família, no Município de Curitiba, PR. MÉTODOS: Trata-se de um estudo transversal, de base populacional, aplicado nos distritos sanitários do município de Curitiba, Paraná, no período de julho de 2006 a julho de 2007. Foram entrevistados 747 adultos a partir dos 18 anos de idade, de ambos os sexos, residentes nas áreas de abrangência das unidades básicas de saúde do município. Para avaliação do estado nutricional dessa população foram aferidos peso (kg), altura (cm) e circunferência da cintura (cc), e calculado o índice de massa corpórea; foram questionados ainda quanto à idade, estado civil, ocupação, número de moradores no domicílio, procedência, escolaridade do entrevistado e do chefe da família. A associação entre excesso de peso, circunferência da cintura e as co-variáveis sociodemográficas foi avaliada por meio da técnica de regressão logística. RESULTADOS: Cerca de 40% da população foi considerada eutrófica e 27,1% obesa, segundo padrões de IMC. Avaliando-se os dados de circunferência da cintura, 48,2% da população possuem medidas que denotam risco muito aumentado para o desenvolvimento de doenças cardiovasculares. Houve uma associação estatisticamente significativa entre o aumento do IMC e a idade (OR = 2,16; IC 95%: 1,57-2,96), sexo (OR = 0,57; IC 95%: 0,33-0,97) e estado marital(OR = 1,40; IC 95% : 1,03-1,88). Para a circunferência da cintura observou-se uma associação significativa apenas com a idade (OR = 2,93; IC 95%: 2,13-4,02) e o sexo. CONCLUSÃO: Grande parte dos beneficiários apresentou excesso de peso e gordura abdominal que denota risco. Os resultados ora apresentados mostram-se como subsídio para construção e implantação de políticas públicas regionais ligadas à alimentação.<br>INTRODUCTION: The Bolsa Família Program is the largest program of conditional cash transfer in Brazil, and its major goal is to reverse the current food insecurity. In spite of that, there are few studies that show the development of nutritional status for this population. OBJECTIVE: This study aimed to describe the nutritional status of the adult population enrolled in the Bolsa Família program, in the municipality of Curitiba, PR. METHODS: This is a cross-sectional, population-based study, performed in the health districts of the city of Curitiba, Parana, in the period from July 2006 to July 2007. We interviewed 747 adults, 18 years of age and over, of both sexes, living in the catchment area of the basic healthcare units in the city. To assess the nutritional status of this population, we measured weight (kg), height (cm), and waist circumference (WC) and calculated the body mass index. They were asked about age, marital status, occupation, number of household members, origin, and years of schooling. The association between excessive weight, waist circumference and sociodemographic co-variables was assessed by unconditional logistic regression. RESULTS: About 40% of the population was considered of normal weight and 27.1% obese, according to BMI standards. Analyzing waist circumference data, 48.2% have measures that show a much greater risk for developing cardiovascular disease. Significant statistical association occurred between BMI increase and age (OR = 2.16; CI 95%: 1.57-2.96), sex (OR = 0.57; CI 95%: 0.33-0.97) and marital status (OR = 1.40; CI 95%: 1.03-1.88). A significant association was observed between waist circumference and age (OR = 2.93; IC 95%: 2.13-4.02) and sex. CONCLUSION: Most of the population presented excessive weight and abdominal fat, risks for cardiovascular diseases. The results point towards the need to build and implement regional diet public policies