Exposición a la violencia y el consumo de sustancias entre estudiantes en el sur de Brasil

Abstract: Cross-sectional study with probabilistic sample of 3,547 adolescents aged from 12 to 17 years old, 54.2% girls, from southern Brazilian schools that analysed the association between exposure to violence and substance use. Gender and age distribution in general population were controlled and sample proportions were assured. A self report measure was used to evaluate sociodemographic conditions, violence, substance use, psychiatric disorders, school performance, parental practices and relationship with parents and teachers. Descriptive analysis were hold, prevalence ratio for substance use were estimated by Poisson Regression, preceded by control for design effect by school variable. The analysis were adjusted by gender, alcohol and tobacco use by the parents and psychiatric disorders. Association between violence exposure and use in the year of all drugs investigated was found: tobacco [PR=2.49 (CI95%: 1.92-3.25) p&lt;.001], alcohol [PR=1.46 (CI95%: 1.35-1.59) p&lt;.001] and illicit drugs [PR=1.60 (CI95%: 1.27-2.01) p&lt;.001]. When adjusting also for the use of other substances (for example: cocaine, crack), the association remained only for tobacco and alcohol. Prevalence substance use found are similar to national levels and there are evidences of significant and strong association of substance use and exposure to violence at school, mainly for alcohol and tobacco. It is recommended that public policies to improve school climate and school context should focus on school staff skills and competencies to prevent school violence and licit or illicit substance use by Brazilian adolescents.Exposición a la violencia y el consumo de sustancias entre estudiantes en el sur de BrasilResumen: Este estudio transversal con muestra probabilística de 3.547 adolescentes, 54.2% niñas, media de edad 14 años (SD=1.66), realizado en escuelas brasileñas del sur de Brasil, analizó la asociación entre la exposición a la violencia y el consumo de sustancias. El género y la edad fueron controlados y la proporción de la muestra fue asegurada. Una medida de autoinforme ha evaluado datos sociodemográficos, la violencia, el consumo de sustancias, trastornos psiquiátricos, rendimiento escolar, prácticas parentales y la relación de los jóvenes con padres y profesores. Se realizó análisis descriptivo y la razón de prevalencia para el consumo de sustancias fue estimada por regresión de Poisson, precedida por el control para efecto de la variable escuela. El análisis fue ajustada por sexo y el consumo de alcohol y tabaco por los padres, así como por los trastornos psiquiátricos. Asociaciones entre la exposición a la violencia y el uso en el año de todos las sustancias investigadas fueron encontradas: tabaco [PR=2.49 (IC 95%: 1.92 - 3.25) p&lt;.001], alcohol [PR=1.46 (IC95%: 1.35-1.59) p&lt;.001] y drogas ilícitas [PR=1.60 (IC95%: 1.27 - 2.1) p&lt;.001]. Al ajustar para el uso de cualquier sustancia de otros grupos, la asociación sólo quedó para el consumo de tabaco y de alcohol. La prevalencia del consumo de sustancias encontrada fue similar a los niveles nacionales. Se recomienda que las políticas públicas para mejorar el clima de las escuelas brasileñas se centren en las competencias del equipo escolar para prevenir la violencia y el consumo de sustancias por adolescentes</jats:p

Maternal complications and cesarean section without indication: systematic review and meta-analysis

OBJECTIVE: The objective of this study was to determine the risks of severe acute maternal complications associated with cesarean section without medical indication. METHODS: A systematic review was carried out with meta-analysis. The literature search was performed systematically, in multiple stages, in the PubMed, Lilacs, and Web of Science databases using the following descriptors: (postpartum period) and (cesarean section or natural childbirth) and ((morbidity or mortality) or (postpartum hemorrhage) or (puerperal infection) or (surgical infection) or (puerperal disorders)). The protocol of the study was registered at PROSPERO as CRD42016032933. A total of 1,328 articles were found; after selection, eight publications that met the study objective and inclusion criteria were selected, with information on 1,051,543 individuals. RESULTS: The results obtained in the meta-analyses indicate that women with cesarean section have a higher chance of maternal death (OR = 3.10, 95%CI 1.92–5.00) and postpartum infection (OR = 2.83, 95%CI, 1.585.06), but they have a lower chance of hemorrhage (OR = 0.52, 95%CI 0.48–0.57). For the blood transfusion outcome, the group effect was not associated with the type of delivery (95%CI 0.88–2.81). CONCLUSIONS: The quality of evidence was considered low for hemorrhage and blood transfusion and moderate for postpartum infection and maternal death. Thus, cesarean sections should be performed with caution and safety, especially when its benefits outweigh the risks of a surgical procedure.OBJETIVO: Determinar os riscos de complicações maternas agudas graves associadas ao parto cesárea sem indicação médica. MÉTODOS: Foi conduzida uma revisão sistemática com meta-análise. A busca na literatura ocorreu de forma sistemática, em múltiplas etapas, nas bases de dados PubMed, Lilacs e Web of Science, utilizando os descritores: (postpartum period) and (cesarean section or natural childbirth) and ((morbidity or mortality) or (postpartum hemorrhage) or (puerperal infection) or (surgical infection) or (puerperal disorders)). O protocolo de estudo foi registrado na PROSPERO sob o número CRD42016032933. Foram encontrados 1.328 artigos, permanecendo, após seleção, oito publicações que atendiam ao objetivo do estudo e critérios de inclusão, com informações de 1.051.543 indivíduos. RESULTADOS: Os resultados obtidos nas meta-análises indicam que mulheres de parto cesárea tem maior chance de morte materna (OR = 3,10; IC95% 1,92–5,00) e infecção pós-parto (OR = 2,83; IC95% 1,58–5,06), mas possuem menor chance de hemorragia (OR = 0,52; IC95% 0,48–0,57). Para o desfecho transfusão de sangue, o efeito agrupado não foi associado à via de parto (IC95% 0,88–2,81). CONCLUSÕES: A qualidade da evidência foi considerada baixa para os desfechos hemorragia e transfusão de sangue e moderada para infecção pós-parto e morte materna. Assim, as cesáreas devem ser realizadas com prudência e segurança, principalmente quando seus benefícios superam os riscos de um procedimento cirúrgico

Prevenção do carcinoma do colo uterino uma Unidade Sanitária da UFPel

Este estudo avaliou a adesão das pacientes de uma Unidade Sanitária da Universidade Federal de Pelotas ao Programa de Prevenção do Carcinoma do Colo Uterino. Foram entrevistadas 224 mulheres com idade entre 15 e 55 anos que consultavam nesta US, com um questionário padronizado. O questionário continha perguntas sobre o uso de métodos anti-concepcionais, hábito de fumar, atividade sexual, realização do exame de Papanieolaou (se ela já havia a ele se submetido, há quanto tempo e qual seu resultado). Do total de entrevistados, 81,2% delas haviam feito pré-câncer; das com vida sexual ativa, aproximadamente 80% tinham feito o exame de Papanieolaou pelo menos uma vez. Estes resultados demonstram uma alta cobertura do programa

Factors associated with smoking in pregnancy

The aim of this cross-sectional study was to identify factors related to smoking during pregnancy. The sample included 267 puerperae hospitalized in the maternity unit of a university hospital in Porto Alegre/RS. The data were collected through a self-applied instrument and statistically analyzed. The majority of the puerperae (51.3%) were between 18 and 25 years old, 55.4% were nonsmokers, 25.5% were smokers, 19.1% had recently ceased smoking (in abstinence). The nonsmokers had more consultations than the smokers and the abstinent smokers (p=0.025). The number of women who had more than one child was higher among smokers than among nonsmokers and abstinent smokers (p=0.002). Women were more likely to stop smoking before pregnancy when they had a partner who was a nonsmoker (p=0.007). Several factors influence smoking and smoking cessation and these are important in prenatal interventions aimed at pregnant women and their partners

Violence exposure and substance use among southern Brazilian schoolchildren

Cross-sectional study with probabilistic sample of 3,547 adolescents aged from 12 to 17 years old, 54.2% girls, from southern Brazilian schools that analysed the association between exposure to violence and substance use. Gender and age distribution in general population were controlled and sample proportions were assured. A self report measure was used to evaluate sociodemographic conditions, violence, substance use, psychiatric disorders, school performance, parental practices and relationship with parents and teachers. Descriptive analysis were hold, prevalence ratio for substance use were estimated by Poisson Regression, preceded by control for design effect by school variable. The analysis were adjusted by gender, alcohol and tobacco use by the parents and psychiatric disorders. Association between violence exposure and use in the year of all drugs investigated was found: tobacco [PR=2.49 (CI95%: 1.92-3.25) p<.001], alcohol [PR=1.46 (CI95%: 1.35-1.59) p<.001] and illicit drugs [PR=1.60 (CI95%: 1.27-2.01) p<.001]. When adjusting also for the use of other substances (for example: cocaine, crack), the association remained only for tobacco and alcohol. Prevalence substance use found are similar to national levels and there are evidences of significant and strong association of substance use and exposure to violence at school, mainly for alcohol and tobacco. It is recommended that public policies to improve school climate and school context should focus on school staff skills and competencies to prevent school violence and licit or illicit substance use by Brazilian adolescents.Este estudio transversal con muestra probabilística de 3.547 adolescentes, 54.2% niñas, media de edad 14 años (SD=1.66), realizado en escuelas brasileñas del sur de Brasil, analizó la asociación entre la exposición a la violencia y el consumo de sustancias. El género y la edad fueron controlados y la proporción de la muestra fue asegurada. Una medida de autoinforme ha evaluado datos sociodemográficos, la violencia, el consumo de sustancias, trastornos psiquiátricos, rendimiento escolar, prácticas parentales y la relación de los jóvenes con padres y profesores. Se realizó análisis descriptivo y la razón de prevalencia para el consumo de sustancias fue estimada por regresión de Poisson, precedida por el control para efecto de la variable escuela. El análisis fue ajustada por sexo y el consumo de alcohol y tabaco por los padres, así como por los trastornos psiquiátricos. Asociaciones entre la exposición a la violencia y el uso en el año de todos las sustancias investigadas fueron encontradas: tabaco [PR=2.49 (IC 95%: 1.92 - 3.25) p<.001], alcohol [PR=1.46 (IC95%: 1.35-1.59) p<.001] y drogas ilícitas [PR=1.60 (IC95%: 1.27 - 2.1) p<.001]. Al ajustar para el uso de cualquier sustancia de otros grupos, la asociación sólo quedó para el consumo de tabaco y de alcohol. La prevalencia del consumo de sustancias encontrada fue similar a los niveles nacionales. Se recomienda que las políticas públicas para mejorar el clima de las escuelas brasileñas se centren en las competencias del equipo escolar para prevenir la violencia y el consumo de sustancias por adolescentes

Maternal complications and cesarean section without indication: systematic review and meta-analysis

ABSTRACT OBJECTIVE The objective of this study was to determine the risks of severe acute maternal complications associated with cesarean section without medical indication. METHODS A systematic review was carried out with meta-analysis. The literature search was performed systematically, in multiple stages, in the PubMed, Lilacs, and Web of Science databases using the following descriptors: (postpartum period) and (cesarean section or natural childbirth) and ((morbidity or mortality) or (postpartum hemorrhage) or (puerperal infection) or (surgical infection) or (puerperal disorders)). The protocol of the study was registered at PROSPERO as CRD42016032933. A total of 1,328 articles were found; after selection, eight publications that met the study objective and inclusion criteria were selected, with information on 1,051,543 individuals. RESULTS The results obtained in the meta-analyses indicate that women with cesarean section have a higher chance of maternal death (OR = 3.10, 95%CI 1.92–5.00) and postpartum infection (OR = 2.83, 95%CI, 1.585.06), but they have a lower chance of hemorrhage (OR = 0.52, 95%CI 0.48–0.57). For the blood transfusion outcome, the group effect was not associated with the type of delivery (95%CI 0.88–2.81). CONCLUSIONS The quality of evidence was considered low for hemorrhage and blood transfusion and moderate for postpartum infection and maternal death. Thus, cesarean sections should be performed with caution and safety, especially when its benefits outweigh the risks of a surgical procedure

Maternal complications and cesarean section without indication: systematic review and meta-analysis

ABSTRACT OBJECTIVE The objective of this study was to determine the risks of severe acute maternal complications associated with cesarean section without medical indication. METHODS A systematic review was carried out with meta-analysis. The literature search was performed systematically, in multiple stages, in the PubMed, Lilacs, and Web of Science databases using the following descriptors: (postpartum period) and (cesarean section or natural childbirth) and ((morbidity or mortality) or (postpartum hemorrhage) or (puerperal infection) or (surgical infection) or (puerperal disorders)). The protocol of the study was registered at PROSPERO as CRD42016032933. A total of 1,328 articles were found; after selection, eight publications that met the study objective and inclusion criteria were selected, with information on 1,051,543 individuals. RESULTS The results obtained in the meta-analyses indicate that women with cesarean section have a higher chance of maternal death (OR = 3.10, 95%CI 1.92–5.00) and postpartum infection (OR = 2.83, 95%CI, 1.585.06), but they have a lower chance of hemorrhage (OR = 0.52, 95%CI 0.48–0.57). For the blood transfusion outcome, the group effect was not associated with the type of delivery (95%CI 0.88–2.81). CONCLUSIONS The quality of evidence was considered low for hemorrhage and blood transfusion and moderate for postpartum infection and maternal death. Thus, cesarean sections should be performed with caution and safety, especially when its benefits outweigh the risks of a surgical procedure