O nível socioeconômico pode influenciar as características de um grupo de hipertensos?

Estudou-se 440 hipertensos (57±12 anos, 66% mulheres, 51% brancas, 57% casadas, 52% com ensino fundamental e 44% com renda de 1 a 3 salários mínimos) para caracterizar variáveis biossociais, crenças, atitudes e conhecimento, falta à consulta e interrupção do tratamento, e associar o nível socioeconômico com as variáveis estudadas. Para a avaliação da condição econômica, elaborou-se índice de bens acumulados a partir da posse de eletrodomésticos convertidos em valor de salários mínimos/mês. Os hipertensos que não concordaram com "não há nada que se possa fazer para evitar a pressão alta" apresentaram índice de bens acumulados significativamente mais elevados; os que afirmaram nunca chegar atrasado às suas consultas apresentaram índice de bens acumulados mais baixos e, na avaliação de bem-estar subjetivo, a tristeza se associou com índice de bens acumulados mais baixo (pSe han estudiado 440 hipertensos (57±12 años, 66% mujeres, 51 % blancas, 57% casadas con educación primaria y 44% con renta de 1 a 3 sueldos mínimos) para caracterizar las variables biosociales, creencias, actitudes y conocimientos, faltas a las consultas e interrupción del tratamiento y asociar el nivel socioeconómico con las variables estudiadas. Para evaluar la condición económica, se elaboró un índice de bienes acumulados, a partir de la posesión de electrodomésticos convertidos en valores de sueldo mínimo/mes. Los hipertensos que discordaron con "no hay nada que hacer para evitar la tensión alta" presentaron un índice mayor de bienes acumulados y los que dijeron nunca haber llegado atrasados a sus consultas presentaron un menor índice de bienes acumulados (pA total of 440 hypertensive patients participated in the study (57 years old ±12, 66% women, 51% white, 57% married, 52% with primary school and 44% with income from 1 to 3 minimum salaries) to characterize biosocial, beliefs, attitudes and knowledge variables, absence to consultation and treatment interruption, and to associate the socioeconomic level to the variables studied. An index of accumulated goods, from the possession of household appliances converted in minimum salaries/mo., was elaborated in order to evaluate the economic status. The hypertensive people who disagreed with "there is nothing you can do to prevent high blood pressure" presented significantly higher levels of accumulated goods; those who affirmed never getting late to their consultations presented lower levels of accumulated goods; in the subjective well-being evaluation, sadness was associated to a lower accumulated goods index (

Aleitamento materno na perspectiva de mães adolescentes: contribuições para atenção primária à saúde

Objetivo: Compreender, a partir dos relatos das mães adolescentes, os sentimentos, o apoio recebido e suas dificuldades na prática do Aleitamento Materno. Método: Estudo qualitativo de abordagem interpretativa, desenvolvido através de entrevistas semiestruturadas. As participantes do estudo foram 12 mães adolescentes com filhos em idade de 2 a 12 meses. Resultados: As entrevistadas discorrem que, em meio a reações (de responsabilização, preconceito, autoestima melhorada, restrição social e vínculo mãe-bebê), receberam algum apoio na amamentação e reconhecem sua importância. Porém, relataram ainda muitas dificuldades. Isso demonstra que, na verdade, o apoio ofertado ainda é muito incipiente. Os discursos decorrem, não apenas, das dificuldades inerentes das mães adolescentes, mas também do reflexo da falta de apoio e acompanhamento adequados, principalmente dos profissionais de saúde, no processo de amamentação, destacando sua condição de mãe adolescente. Conclusão: Percebe-se a necessidade de orientação e apoio adequados dos profissionais de saúde e da família da adolescente. Portanto, é necessário um acompanhamento que deve ser iniciado no pré-natal e desenvolvido ao longo do tempo de forma contínua, dinâmica, processual e interativa, favorecendo também a autonomia e corresponsabilização dos envolvidos, principalmente dos profissionais da atenção primária à saúde no que diz respeito à adolescência e ao aleitamento materno

Hypertension control and related factors at primary care located in the west side of the city of São Paulo, Brazil

Realizou-se estudo para caracterizar o controle de hipertensos atendidos na atenção primária com amostra de 440 hipertensos. Os hipertensos foram entrevistados e a medida da pressão foi realizada com aparelho automático validado. A relação entre as variáveis classificatórias foi avaliada com o teste qui-quadrado e posterior análise multivariada. Os resultados mostraram que o controle da hipertensão arterial foi de 45,5% e se associou (p<0,05) a mulheres, idade menos elevada, menos tempo de doença, já ter feito tratamento para hipertensão, menos interrupção do tratamento, conhecimento sobre a importância dos exercícios físicos, raramente deixar de tomar remédio na hora certa, menor número de drogas anti-hipertensivas prescritas, antecedentes para doenças cardíacas, prática de exercícios físicos e menos tristeza. A análise de regressão logística mostrou que a falta de controle da hipertensão foi dependente de tratamento anterior para hipertensão (OR = 2,26; IC 95%, 1,4 - 3,6), falta de conhecimento sobre prática de atividade física (OR = 3,5; IC 95%, 1,1 - 10,8) e ausência de antecedente familiar para problemas cardíacos (OR = 2,2; IC 95%, 1,3 - 3,5). Menos da metade dos hipertensos estava controlada e o controle se associou a variáveis biológicas, tratamento, atitudes e conhecimento sobre a hipertensão e seu tratamento.The objective of this study was to characterize blood pressure control of 440 hypertensive patients. The subjects were interviewed and had their blood pressure measurement by means of an automatic device. The results showed that 45.5% had an adequate blood pressure control. People under control were different (p<0.05) from those without control: the ones under blood pressure control were mainly women, younger, with a shorter time of disease, with previous treatment for hypertension, less interruptions in treatment and more conscious about the importance of physical activities. They also rarely forgot to take the medicines in the right time, generally using less than, 3 or more antihypertensive drugs, with family history of cardiovascular diseases, reporting physical activity more frequently and less sadness. The multivariate analysis revealed a statistically significant association of uncontrolled hypertension with previous treatment (OR = 2.26; IC 95%, 1.4 - 3.6), no family history of cardiovascular diseases (OR = 2.2; IC 95%, 1.3 3.5) and unaware of the importance of physical activities for blood pressure control (OR = 3.5; IC 95%, 1.1 10.8). Blood pressure control was associated with biological variables, behavior and information about hypertension as a risk factor and its treatment

Perfil das adolescentes grávidas do município de São Gonçalo do Pará/MG

Este estudo tem como objetivo conhecer o perfil das adolescentes grvidas assistidas pela ateno primria sade do municpio de So Gonalo do Par MG. Trata-se de um estudo descritivo-exploratrio de abordagem quantitativa. Foram analisados idade da adolescente, grau de escolaridade, estado civil, nmero de consultas de pr-natal, idade gestacional, paridade e tipo de parto. Estes aspectos foram obtidos atravs de dados secundrios disponibilizados pelo Departamento de Informtica do SUS (DATASUS) no perodo de 2000 a 2011. O ndice de adolescentes grvidas ficou em torno de 16%. 70,9% estavam solteiras em sua primeira gravidez. 38,2% dessas adolescentes grvidas no realizaram o nmero adequado de consultas de pr-natal e o percentual de prematuridade nos dois ltimos anos preocupante. A caracterizao do perfil das adolescentes grvidas permite identificar as necessidades destas e assim direcionar as atividades educativas em sade e a assistncia pr e ps-parto para esta populao. Descritores: Gravidez na adolescncia; Cuidado pr-natal; Comportamento do adolescente; Ateno bsica sade

Perfil das adolescentes grávidas do município de São Gonçalo do Pará/MG

Este estudo tem como objetivo conhecer o perfil das adolescentes gr&aacute;vidas assistidas pela aten&ccedil;&atilde;o prim&aacute;ria &agrave; sa&uacute;de do munic&iacute;pio de S&atilde;o Gon&ccedil;alo do Par&aacute; &ndash; MG. Trata-se de um estudo descritivo-explorat&oacute;rio de abordagem quantitativa. Foram analisados idade da adolescente, grau de escolaridade, estado civil, n&uacute;mero de consultas de pr&eacute;-natal, idade gestacional, paridade e tipo de parto. Estes aspectos foram obtidos atrav&eacute;s de dados secund&aacute;rios disponibilizados pelo Departamento de Inform&aacute;tica do SUS (DATASUS) no per&iacute;odo de 2000 a 2011. O &iacute;ndice de adolescentes gr&aacute;vidas ficou em torno de 16%. 70,9% estavam solteiras em sua primeira gravidez. 38,2% dessas adolescentes gr&aacute;vidas n&atilde;o realizaram o n&uacute;mero adequado de consultas de pr&eacute;-natal e o percentual de prematuridade nos dois &uacute;ltimos anos &eacute; preocupante. A caracteriza&ccedil;&atilde;o do perfil das adolescentes gr&aacute;vidas permite identificar as necessidades destas e assim direcionar as atividades educativas em sa&uacute;de e a assist&ecirc;ncia pr&eacute; e p&oacute;s-parto para esta popula&ccedil;&atilde;o. Descritores: Gravidez na adolesc&ecirc;ncia; Cuidado pr&eacute;-natal; Comportamento do adolescente; Aten&ccedil;&atilde;o b&aacute;sica &agrave; sa&uacute;de

Prevalence of Hepatitis B and C virus infection among alcoholic individuals: importance of screening and vaccination

Drug users have been reported to have an increased risk for acquisition of viral hepatitis. This study aims to evaluate the prevalence of HBV and HCV infection and usefulness of saliva for HBsAg and anti-HCV detection in alcoholic patients.A total of 90 alcoholic patients were recruited in 2013. HBsAg and anti-HCV were tested in serum and saliva, anti-HBc and anti-HBs were tested in serum using commercial enzyme immunoassays (EIA).Using serum samples, anti-HCV, HBsAg, anti-HBc and anti-HBs prevalences were 5.6%, 0%, 15.7%, and 29.2%. HBsAg detection in saliva showed 100% of specificity and anti-HCV detection demonstrated 100% of sensitivity and 94.7% of specificity. Low prevalence of HBV and high prevalence of anti-HCV were found and reinforced the recommendation of HBV vaccination to avoid the acute and chronic cases and HCV screening in this group to identify cases for antiviral therapy. Saliva samples could be used for anti-HCV detection in this population, what could increase the diagnosis access

Questões bioéticas e adolescência: revisão integrativa da literatura brasileira

Este estudo objetivou sintetizar o conhecimento produzido sobre as questes bioticas envolvendo adolescentes. Tratou-se de uma reviso integrativa da literatura em que foram buscados artigos das bases de dados LILACS, PubMed e Scielo com os descritores Biotica e adolescentes, publicados entre janeiro de 2009 e janeiro de 2014, a partir das quais foram selecionados 16 artigos em consonncia com o estudo proposto. Para sua efetivao, foi elaborado um protocolo a fim de operacionalizar sua realizao e o percurso de busca. Aps a leitura na ntegra emergiram trs categorias: Biotica e autonomia dos adolescentes; Violncia sexual e direitos dos adolescentes e Adolescncia e multidisciplinaridade em Biotica. Embora tenha sido realizada a procura de artigos em bases com divulgao mundial foi encontrado um nmero escasso de publicaes, o que remete necessidade de serem desenvolvidos mais trabalhos voltados para as questes bioticas envolvendo adolescentes

Telephone-based psychological crisis intervention: the Portuguese experience with COVID-19

Published online: 07 Jun 2020Portugal is one of the European countries that implemented early protective measures in the context of the COVID-19 pandemic. Portugal declared a state of emergency on 18 March, and a set of regional and national preventive public health measures was progressively implemented. Studies on the psychological impact of pandemics show evidence of the negative impact on mental health. Of particular concern are individuals with previous fragility (e.g. personal, family or occupational) and those undergoing life transitions. In this paper, we present a telephone-based psychological crisis intervention that was implemented to provide brief, appropriate, and timely psychological help. This intervention follows standard models of crisis intervention and is structured in five phases and five different intervention modules to take into account the impact of the pandemic on the mental health of specific risk groups. With these support services, we hope to help our community better cope with the immediate impact of the pandemic and to contribute to preventing serious mental health problems in the medium and long term.This study was partially conducted at the Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (UID/PSI/01662/2019), through the national funds (PIDDAC). We acknowledge Associação de Psicologia da Universidade do Minho (APsi-UMinho) and APsiUMinho collaborators for supporting the telephone-based psychological crisis intervention: Ana Daniela Silva, Ana Isabel Gonçalves, Ana Rita Pereira, Andreia Milhazes, Ângela Ferreira, Alexandra Vieira, Célia Sampaio, Carina Magalhães, Cátia Braga, Delfina Fernandes, Dulce Lopes, Dulce Pinto, Inês Castro, Inês Marques, Gabriela Santana, Joana Andrade, Joana Coutinho, Joana Guimarães, Joana Soares, Joana Teixeira, Joana Torres, João Batista, João Tiago Oliveira, Mariana Leite, Marta Sousa, Patrícia Mendes, Sara Lima, Soraia Mesquita, Teresa Castanho. We would like to thanks P5 and affiliated Psychologists: Liliana Amorim, and Inês Fernandes. We gratefully acknowledge OutSystems for the financial support through OutSystems COVID-19 Community Response Program

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens