Night eating syndrome among university students: are aspects of academic life associated with eating disorders? / Síndrome do comer noturno entre estudantes universitários: aspectos da vida acadêmica estariam associados ao distúrbio alimentar?

Introduction: the critical period in the lives of college adults implies lifestyle changes such as reducing physical activity and adopting unhealthy eating habits that can result in increased body fat. Thus, college students may represent a population at increased risk for Night Eating Syndrome. Objective: to analyze aspects of university students' academic life, work and housing that could be associated with Night Eating Syndrome. Methods: cross-sectional study carried out with 900 students from Architecture, Engineering, Medicine and Psychology courses at a higher education institution located in Cajazeiras, Paraíba, Brazil. Self-administered questionnaires were used for data collection: the Night Eating instrument Questionnaire (NEQ) to quantify Night Eating Syndrome (NCS) behaviors and a form for variables on demographic, health, academic life, work and housing aspects. Results: the prevalence of NES determined by the NEQ≥25 score was 16.8%. In the Engineering course, the prevalence of SCN was higher in women than in men, and in the Psychology course, it was higher in men than in women. Among students with a job and who lived at home, the prevalence of the syndrome was higher for those who worked in the afternoon and lower for those who worked at night. Conclusion: the prevalence of NES found among Brazilian university students was high (16.8%), particularly in two situations: (1) being enrolled in an undergraduate course with a predominance of students of the other sex; and (2) live with parents and work in the afternoon. These observations may be helpful in identifying subpopulations of students at increased risk for eating disorders.

Introdução: o período crítico da vida de adultos universitários implica mudanças do estilo de vida como a diminuição da atividade física e a adoção de hábitos alimentares pouco saudáveis que podem resultar em aumento da gordura corporal. Assim, estudantes universitários podem representar uma população com risco aumentado para a Síndrome do Comer Noturno. Objetivo: analisar aspectos da vida acadêmica, do trabalho e da moradia de estudantes universitários que poderiam se associar à Síndrome do Comer Noturno. Método: estudo transversal realizado com 900 estudantes dos cursos de Arquitetura, Engenharia, Medicina e Psicologia de uma instituição de ensino superior localizada em Cajazeiras, Paraíba, Brasil. Para a coleta de dados foram usados questionários autoaplicados: o instrumento Night Eating Questionnaire (NEQ) para quantificar comportamentos da Síndrome do Comer Noturno (SCN) e um formulário para variáveis sobre aspectos demográficos, de saúde, vida acadêmica, trabalho e moradia. Resultados: a prevalência da SCN determinada pelo escore NEQ≥25 foi 16,8%. No curso de Engenharia a prevalência da SCN foi maior nas mulheres em relação aos homens, e no curso de Psicologia, foi maior nos homens em relação as mulheres. Entre os estudantes com emprego e que moravam na casa dos pais, a prevalência da síndrome foi maior para aqueles que trabalham no período da tarde e menor para aqueles que trabalham à noite. Conclusão: a prevalência da SCN encontrada entre os estudantes universitários brasileiros foi alta (16,8%), particularmente em duas situações: (1) estar matriculado um curso de graduação com predominância de estudantes do outro sexo; e (2) morar com os pais e trabalhar no período da tarde. Estas observações podem ser úteis na identificação de subpopulações de estudantes com risco aumentado de distúrbios de alimentação

Epidemiological study on the lip and oral cavity cancer in Brazil: connecting science and clinical applicability

SUMMARY OBJECTIVE: The aim of this study was to describe and discuss the epidemiological indicators of lip and oral cavity cancer in Brazil, in 2017, according to data from the Global Burden of Disease data. METHODS: This is a descriptive study reported according to STROBE guidelines. We identified epidemiological indicators using the Global Burden of Disease results tool. Mortality/incidence rates were described per 100,000 population. Global Burden of Disease 2017 reviews were completed using Python version 2.7, Stata version 13.1, and R version 3.3. RESULTS: In 2017, there were 5,237 deaths from the lip or oral cavity cancer in Brazil, most of them were males aged between 50 and 69 years (2,730 cases, which was equivalent to 52% of the universe of deaths resulting from this cause). Regarding the burden of lip and oral cavity cancer, per 100,000 Brazilians, we observed an incidence of 3.99, prevalence of 15.46, and mortality of 2.29 (with higher indicators in the South and Southeast regions of the country). CONCLUSIONS: Epidemiological indicators of lip and oral cavity cancer were higher in men, with higher mortality indicators in individuals aged 50-69 years, and higher rates (incidence, prevalence, and mortality) in the South and Southeast regions of Brazil. From 2002-2015, there was a reduction in mortality; however, in the period from 2015-2017, there was a resumption in the growth of this indicator.

Autonomic cardiac modulation in postmenopausal women with dry eye syndrome: a cross-sectional analytical study

SUMMARY OBJECTIVE The aim of this study was to assess cardiac autonomic modulation in postmenopausal women with and without dry eye syndrome (DES) and to identify associations between clinical and socioeconomic factors. METHODS A cross-sectional study was carried out at the Institute of Ocular Surgery of the Northeast (ICONE), Brazil. Convenience sample of postmenopausal women, over 40 years old, who were divided into two groups: with and without DES. Clinical, sociodemographic, and ophthalmological characteristics of these women were assessed. Capture of RR intervals was performed using a cardio frequency meter. Differences between the groups were analyzed using the Chi-square test, the Student's t test, and the Mann-Whitney test. RESULTS Women with DES were present in 60.4% (n=58), highest median age (63.5 years, 95%CI 62.0-67.9; p<0.001), median length of time menopause (19 years old, 95%CI 10.4-24.0; p<0.001). There was a difference in the standard deviation of all normal-to-normal index between the groups. However, when the differences were adjusted to the clinical model, no association was found between DES and heart rate variability (HRV). CONCLUSIONS The analysis of cardiac autonomic modulation in postmenopausal women is similar in the presence or absence of DES. Clinical factors, time of menopause, and intensity of symptoms were not associated with HRV indices.

Profile of pharmaceutical care in primary health centers in São Bernardo do Campo, Southeastern Brazil

The effective insertion of the pharmacist into primary care is an important goal for health policies. The objective of this study was to describe and analyze pharmacists and Pharmaceutical Care in the primary health centers (UBS) of São Bernardo do Campo. Data were obtained through an interview applied to pharmacists. The instrument has three sections: (1) Pharmacist identification; (2) Pharmacist work; and (3) Pharmaceutical activities. Items in section 3 correspond to the guidelines of agencies that promote Pharmaceutical Care in the primary health system. All 24 pharmacists working in UBS in São Bernardo do Campo were interviewed. Every center dispensing medicines has a responsible pharmacist. These pharmacists are predominantly women and postgraduates. Activities of Pharmaceutical Care reported were: daily prescription analysis (75% of interviewees); monthly participation in patient groups (70.8%); monthly follow-up of pharmacotherapy adherence (58.3%); monthly participation in multiprofessional team meetings (54.2%); monthly home visits (12.5%); health education to the community (83.3%); and pharmacist consultation (37.5%). Frequency of prescription analysis and home visits was weakly associated with aspects of the pharmacist and the facility. This study showed that Pharmaceutical Services are structured in primary care in São Bernardo do Campo and many Pharmaceutical Care activities are offered in its UBS

Diagnosis and referral flow in the single health system for climacteric women

SUMMARY OBJECTIVE The association between gynecological diagnoses and their distribution across healthcare sectors benefits health promotion and the identification of topics for continued education of gynecological care. This study aimed to identify healthcare diagnoses and referral flow in climacteric women. METHODS This is a cross-sectional study conducted at the Women's Health Clinic of the University Hospital, University of São Paulo, with a reference to gynecology and training for Residents of Family and Community Medicine, between 2017 and 2018. The medical records of 242 women whose sociodemographic and clinical information, gynecological diagnoses, and distribution of healthcare services (primary, secondary, and tertiary) had been processed were collected. Statistical analysis included the chi-square test and odds ratio. RESULTS Smoking (OR = 2.27, 95% CI 1.05-4.89; p = 0.035) was associated with the referral of climacteric women to higher complexity services. Considering the distribution of non-oncological diagnoses in climacteric patients, the chance of women being referred to medium- and high-complexity health services presented a 2-fold increase in cases of breast diseases, a 2.35-fold increase in cases of noninflammatory disorders of the female genital tract, and a 3-fold increase in cases of inflammatory diseases of the pelvic organs. CONCLUSION Climacteric women aged over 55 years, postmenopausal women, and smoking women were most frequently referred to medium- and high-complexity outpatient surgery.

RESUMO INTRODUÇÃO A associação entre diagnósticos ginecológicos e sua distribuição nos setores de saúde proporciona benefícios no campo da promoção de saúde e na identificação de temas para educação continuada na assistência. OBJETIVO Identificar os diagnósticos em saúde e o fluxo de encaminhamento de mulheres no climatério. MÉTODO Trata-se de estudo transversal realizado no Ambulatório de Saúde da Mulher do Hospital Universitário da Universidade de São Paulo, de referência em ginecologia e de treinamento para residentes de Medicina de Família e Comunidade, entre 2017-2018. A casuística foi realizada a partir de 274 prontuários de mulheres atendidas e foram processados informações sociodemográficas e clínicas, diagnósticos ginecológicos e distribuição dos serviços de saúde (primário, secundário e terciário). O teste qui-quadrado e razão de chance foram utilizados para estatística. RESULTADOS O tabagismo (OR=2,27, IC95% 1,05;4,89, p=0,035) foi associado ao encaminhamento de mulheres no climatério para a maior complexidade. Em relação aos tipos de diagnóstico, a chance de serem encaminhadas para a média e alta complexidade foi de 135% (OR=1,69, IC95% 0,93;3,08) nos transtornos não inflamatórios do trato genital feminino, 200% (OR=0,98, IC95% 0,23;4,02) nas doenças da mama, 300% (OR=1,51, IC95% 0,47;4,83) nos transtornos inflamatórios do trato genital feminino, sem predomínio entre os diagnósticos. CONCLUSÃO As mulheres climatéricas e na pós-menopausa acima de 50 anos e tabagistas com diagnósticos de transtornos não inflamatórios do trato genital feminino e inflamatórios, bem como doenças da mama, foram as mais direcionadas para ambulatório cirúrgico na média e alta complexidade.

Prevalence and associated factor with frailty syndrome in the brazilian elderly attended in primary care facilities: a cross-sectional study / Prevalência e fator associado à fragilidade em idosos brasileiros atendidos nas unidades básicas de saúde: um estudo transversal

INTRODUCTION: Frailty is a multidimensional syndrome that increases the vulnerability in the elderly, decreasing physiological reserves, intensifying the functional decline, being associated with numerous physical changes, determining greater risks to the elderly's health. OBJECTIVE: To analyze the association between frailty and sociodemographic conditions of the elderly met in primary care facilities in the city of Cajazeiras, northeastern Brazil. METHODS: A cross-sectional study, conducted in July 2015, with 823 elderly people through semi-structured questionnaire containing the proposed frailty criteria by Linda Fried and colleagues, and analyzed using SPSS version 21. The Chi-Square test was used to assess the association between variables, considering p<0.05 as statistically significant. The sociodemographic data were collected using an instrument created by the authors. RESULTS: The prevalence of frailty was 23.8% and is associated with older age groups (70-90 years) and older people who did not attend school (25.5%), and the main criterion of frailty found among the elderly was "slow walk" (71.7%). CONCLUSION: The frailty in elderly from Northeastern Brazil is associated with higher age and illiteracy.

INTRODUÇÃO: A fragilidade é uma síndrome multidimensional que aumenta a vulnerabilidade em idosos, causando diminuição das reservas fisiológicas, aumento do declínio funcional e está associada a inúmeras alterações físicas, determinando maiores riscos à saúde do idoso. OBJETIVO: Analisar a associação entre fragilidade e condições sociodemográficas de idosos atendidos em Unidades Básicas de Saúde da cidade de Cajazeiras, nordeste do Brasil. MÉTODOS: Estudo transversal, realizado em julho de 2015, com 823 idosos, por meio de questionário semiestruturado contendo os critérios de fragilidade propostos por Linda Fried e analisado pelo SPSS versão 21. Utilizou-se o teste qui-quadrado para verificar a associação entre as variáveis, considerando-se estatisticamente significativo p<0,05. Coletaram-se os dados sociodemográficos por meio de instrumento elaborado pelos autores. RESULTADOS: A prevalência de fragilidade foi de 23,8% e está associada a faixa etária mais velha (70-90 anos), idosos que não frequentaram a escola (25,5%), e a principal característica de fragilidade encontrada entre os idosos era "lenta" (71,7%). CONCLUSÃO: A fragilidade em idosos do Nordeste Brasileiro está associada à idade e ao analfabetismo.

The sensitivity, specificity, and agreement of a point of care method: an assessment of the diagnostic accuracy / Sensibilidade, especificidade e concordância do método point of care: um estudo de precisão diagnóstica

Abstract The use of new technologies can improve screening in communities with difficult access to health. This article aims to evaluate the sensitivity, specificity, and agreement of a point of care test in comparison to laboratory methods for the determination of glucose (GLI), triglyceride (TG), and total cholesterol (TC) concentrations. This prospective study used data from the remaining adult population of quilombolas in Brazil. Laboratory tests using conventional methods for the analysis of venipuncture samples were used as a standard method to measure the concentrations of GLI (mg/dL), TG (mg/dL), and TC (mg/dL) and compared to the metered dose from the collection of fingertip capillary blood (point of care). Contingency tables (2x2) were used to estimate the sensitivity and specificity of the methods. Lin and Bland & Altman coefficients were used to statistically assess agreement, the level of significance was 5%. There was substantial agreement between the methods for measuring TG and poor agreement for of TC and GLI. Analysis of the Bland & Altman coefficients revealed that the fingertip method did not produce good measures. The point of care method did not offer a good ability to measure compared to that of the reference laboratory method.

Resumo O uso de novas tecnologias pode melhorar o screening em comunidades de difícil acesso à saúde. O objetivo deste artigo é avaliar a sensibilidade, especificidade e concordância do teste de point of care em comparação com método laboratorial para dosagem de Glicose (GLI), Triglicerídeo (TG) e Colesterol total (CT). Estudo prospectivo com dados de população de adultos remanescentes de quilombolas no Brasil. Exames laboratoriais convencionais para análise foram obtidos por venopunção, utilizados como método padrão para mensuração das concentrações de GLI (mg/dL), TG (mg/dL) e CT (mg/dL) e comparados a mensuração por meio de técnica de ponta de dedo (point of care). Tabelas de contingência (2x2) foram utilizadas para estimar sensibilidade e especificidade dos métodos e o coeficiente de Lin e análises de Bland & Altman foram métodos de concordância com nível de significância de 5%. Houve concordância substancial entre os métodos para mensuração de TG e fraca concordância para mensuração de CT e GLI. Os coeficientes de Bland & Altman indicam que o método de ponta de dedo não apresentou boa mensuração. O método point of care não apresentou boa capacidade de mensuração de Glicose, Triglicerídeo e Colesterol total tendo como referência o método laboratorial.

Neonatal mortality in Luanda, Angola: what can be done to reduce it? / Mortalidade neonatal em Luanda, Angola: o que pode ser feito para sua redução?

INTRODUCTION: One of the main health indicators is infant mortality rate, which is a metric of living conditions and population development. The goal of reducing neonatal mortality requires an adequate knowledge of the real factors at each level of health care so that maternal and human resources are efficiently channeled to the constraint. Countries that have paid special attention to improving health services for the entire pregnancy-puerperal cycle have attained the reduction of infant mortality, especially early neonatal mortality. OBJECTIVE: The present study aims to describe the profile and analyze the risk factors associated with neonatal mortality in the Angolan context at a tertiary level public maternity hospital, located in Luanda. METHODS: This is a retrospective cross-sectional study with a quantitative approach, using secondary data, of provincial base in hospital and ministerial registry instruments from January to December 2012. RESULTS: The results show that the neonatal deaths are not mere occurrences, since they indicate failures of the political powers, professionals of the health system and of the families. CONCLUSIONS: This study suggests that the major risk factor for birth mortality in Luanda is the type of delivery (c-section) and that this data is not related to the age of the mother or to premature birth. We also found that there was higher mortality between May and July, during the period of lower rainfall index in the region. However, further studies are needed that may provide a logical framework and arguments for realistic policies to mitigate neonatal mortality.

INTRODUÇÃO: Um dos principais indicadores de saúde é a taxa de mortalidade infantil, que é uma métrica de condições de vida e desenvolvimento populacional. A redução da mortalidade neonatal requer um conhecimento adequado dos fatores reais em cada nível de atenção à saúde, de modo que os recursos maternos e humanos sejam eficientemente avaliados. Os países que deram atenção especial à melhoria dos serviços de saúde para todo o ciclo gravídico-puerperal atingiram a redução da mortalidade infantil, especialmente a mortalidade neonatal precoce. OBJETIVO: O presente estudo tem como objetivo descrever o perfil e analisar os fatores de risco associados à mortalidade neonatal em uma maternidade pública de nível terciário localizada em Luanda, Angola. MÉTODO: Trata-se de um estudo retrospectivo de corte transversal com abordagem quantitativa, utilizando dados secundários de base provincial em instrumentos de registro hospitalar e ministerial de janeiro a dezembro de 2012. RESULTADOS: Os resultados mostram que os óbitos neonatais não são meras ocorrências, pois indicam falhas dos poderes políticos, de profissionais do sistema de saúde e das famílias. CONSLUSÃO: Este estudo sugere que o maior fator de risco para mortalidade ao nascimento em Luanda é o tipo de parto (c-section) e que este dado não está relacionado com a idade da mãe ou com o nascimento prematuro. Identificamos também que houve maior mortalidade entre os meses de maio a julho, durante o período de menor índice de chuvas na região. No entanto, são necessários mais estudos que possam fornecer um quadro lógico e argumentos para políticas realistas para mitigar a mortalidade neonatal.

Knowledge and acceptability of the human papillomavirus vaccine among health professionals in Acre state, western Amazon

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.

Associaton between violence and drug consumption with suicide in lesbians, gays, bisexuals, transvestites, and transsexuals: cross-sectional study / Violencia y consumo de drogas está asociado con el suicidio en lesbianas, gays, bisexuales, transvestitas y transexuales: Estudio transversal

Abstract: Introduction: Lesbian, gay, bisexual, transvestite, and transgender (LGBT) people are affected by prejudice and psychological, physical, and/or sexual violence due to their sexual orientation. Objective: To analyze the association between violence, drug use, and suicide in LGBT people. Method: We interviewed 316 LGBT people from two cities of the Brazilian Northeast by means of a structured instrument. This included questions about sociodemographic data, sexual orientation, type of violence, type and quantity of drugs consumed, and suicide. Results: There was a positive association between physical violence and anabolic consumption (p = .001) and tranquilizers (p = .012). In relation to psychological and verbal violence, there was a positive association with the use of tranquilizers (p = .021) and negative with the use of amphetamines (p = .027). Suicide attempts were associated with having experienced physical (p = .03) and sexual (p = .037) violence. Drug use, especially ecstasy, cocaine, marijuana, and tranquilizers, was also associated with suicide attempts (p = .002, p = .031, p < .001, p < .001, respectively). The participants who had already attempted suicide were more vulnerable to experience violence and consume drugs within 30 days prior to the interview (p < .001). Discussion and conclusion: Psychological/verbal violence showed to be associated with the use of amphetamines, while physical violence was associated with a higher consumption of tranquilizers and anabolic steroids. Suicide attempts were more common among participants who had suffered physical violence and who were users of substances such as ecstasy, cocaine, marijuana, and tranquilizers.

Resumen: Introducción: Las personas lesbianas, gays, bisexuales, travestis y transexuales (LGBT) se ven afectadas por juicios y violencia psicológica, física y/o sexual debido a su orientación sexual. Objetivo: Analizar la asociación entre violencia, uso de drogas y suicidio en personas LGBT. Método: Entrevistamos a 316 personas LGBT de dos ciudades del Noreste brasileño por medio de un instrumento estructurado. Esto incluyó preguntas sobre datos sociodemográficos, orientación sexual, tipo de violencia, tipo y cantidad de drogas consumidas y suicidio. Resultados: Se encontró una asociación positiva entre la violencia física y el consumo de anabólicos (p = .001) y tranquilizantes (p = .012). En relación con la violencia psicológica y verbal, hubo una asociación positiva con el uso de tranquilizantes (p = .021) y negativa con el uso de anfetaminas (p = .027). Los intentos de suicidio se asociaron con la violencia física (p = .03) y sexual (p = .037). El consumo de drogas, especialmente éxtasis, cocaína, marihuana y tranquilizantes, se asoció también con intentos de suicidio (p = .002, p = .031, p < .001, p < .001, respectivamente). Los participantes que ya habían intentado suicidarse eran más vulnerables a experimentar violencia y consumir drogas dentro de los 30 días previos a la entrevista (p < .001). Discusión y conclusión: La violencia psicológica/verbal se asoció con el uso de anfetaminas, mientras que la violencia física se asoció con un mayor consumo de tranquilizantes y esteroides anabólicos. Los intentos de suicidio fueron más comunes entre los participantes que habían sufrido violencia física y que consumían sustancias como el éxtasis, la cocaína, la marihuana y los tranquilizantes.

Evolução do Programa de Triagem Neonatal em hospital de referência no Ceará: 11 anos de observação / Evolution of Neonatal Screening Program in a reference hospital in Ceará: 11 years of observation

INTRODUÇÃO: O Programa Nacional de Triagem Neonatal (PNTN) tem como objetivo a detecção de doenças congênitas em fase pré-sintomática. Esse teste é realizado em todos os Estados do Brasil, porém com diferentes realidades quanto à incidência das doenças diagnosticadas devido à diversa origem étnica observada nacionalmente. O registro dos casos permite a elaboração de políticas públicas de prevenção e tratamento. OBJETIVO: Analisar a eficácia de um programa de triagem neonatal em um hospital de referência do Estado do Ceará ao longo dos últimos 11 anos. MÉTODOS: Estudo transversal realizado a partir de prontuários de crianças nascidas entre os anos de 2002 e 2012 no referido hospital. RESULTADOS: Dos 5.000 testes realizados, 2.893 prontuários completos foram incluídos no estudo (57,8%). Desses casos, dois apresentaram fenilcetonúria e três, hipotireoidismo. Uma vez que quase a metade dos resultados dos testes não estava devidamente registrada no prontuário clínico dos pacientes, tornou-se inviável o cálculo de frequência da doença na população. CONCLUSÃO: A falha no registro dos dados do teste de triagem pode fazer com que falte aos gestores municipais e hospitalares o conhecimento sobre o número de casos da região, acarretando, consequentemente, falha nas estratégias de tratamento. Verifica-se a necessidade de organização de um banco de dados informatizado e de capacitação dos profissionais de saúde para o preenchimento dos dados do teste, para viabilizar o diagnóstico e o tratamento precoces, bem como permitir o delineamento do cenário real sobre a incidência das doenças diagnosticadas pelo "Teste do Pezinho" no Brasil.

INTRODUCTION: The National Neonatal Screening Program (PNTN) aims to detect pre-symptomatic congenital diseases. This test is performed across all States of Brazil with different realities concerning the incidence of diagnosed diseases due to the diverse national ethnicity observed. Accurate knowledge about diseases' incidence allows the elaboration of public policies for prevention and treatment. OBJECTIVE: To evaluate the efficacy of neonatal screening program from a reference hospital in the State of Ceará for 11 years. METHODS: Cross-sectional study based on medical records of children born between 2002 and 2012 in the referred hospital. RESULTS: Of the 5,000 exams performed, 2,893 complete medical records (57.8%) were included in the sample. Of these, two cases of phenylketonuria and three cases of hypothyroidism were observed. As almost half of the results had not been properly registered in patients' clinical records, the calculation of diseases frequency in this population was not reliable. CONCLUSION: Failure to register data of the screening test may impair knowledge acquisition of municipal and hospital managers when it comes to the number of cases in each region, consequently leading to a failure in treatment strategies. It is necessary to organize a digital database and to train health professionals to fill test result forms in order to enable early diagnosis and treatment, as well as to properly delineate a credible scenario of diseases' prevalence in Brazil.

Etapas para decisão baseada na análise estatística / Steps for the decision making based on the statistical analyses

Researchers and students in training are uncertain when they need to conclude their research based on results. However, for many reasons, they address their research questions based mainly on p-values. In this article, we present a framework for decision-making, based on statistical analyses, and describe fundamental aspects of rational decisions. Additionally, we discuss several aspects of the obtainment of scientific evidence, for example, how statistical analyses and research questions are related. Finally, we developed a step-by-step framework for decision-making based on statistical analyses. With this article, we intend to contribute to the development of research, and guide researchers and students regarding this important and neglected subject.

Pesquisadores e estudantes em formação ficam inseguros quando precisam concluir suas pesquisas com base nos resultados encontrados. Entretanto, por vários fatores, acabam respondendo suas perguntas de pesquisas baseados principalmente nos valores de "p". Neste artigo, apresentamos um quadro para decisão baseada na análise estatística e descrevemos aspectos fundamentais para a decisão adequada. Além disso, também discutimos aspectos relacionados a construção da evidência científica, como por exemplo, como a pergunta de pesquisa e a análise estatística estão relacionadas. Por fim, desenvolvemos um quadro com o passo a passo para tomada de decisão baseada na análise estatística. Com esse artigo, pretendemos contribuir para o desenvolvimento das pesquisas e orientar os pesquisadores e estudantes no que diz respeito a esse tema tão importante e negligenciado.

Características do abuso sexual em Santo André, São Paulo, Brasil: das vítimas ao agressor, do diagnóstico ao tratamento / Sexual abuse characteristics in Santo André, São Paulo, Brazil: from victims to aggressors, from diagnosis to treatment

INTRODUCTION: Sexual violence against children and adolescents in Brazil is an underreported public health problem. Knowing the profile of the victims and the factors related to each case is a strategy for the development of more effective public policies. OBJECTIVE: To describe the profile of children and adolescent victims of libidinous act, characteristics of aggression and aggressors, consequences for victims, and legal actions related to sexual abuse METHODS: This is a descriptive study. Sociodemographic characteristics of the victims, characteristics of the aggressors and aggression, and clinical, psychological, and legal aspects of 61 sexually abused patients admitted to the specialized outpatient clinic of the Network of Health for Violence and Sexual Abuse located in Santo André, São Paulo State, Brazil, were analyzed. RESULTS: Victims had a mean age of 10.4 years, female (60.7%, n= 37), white (70.5%, n= 43), and admitted to the care network after of 72 hours of having been a victim of abuse (68.3%, n = 40). Most of the aggressions were by a libidinous act (65.6%, n = 40) and by an individual known by the victim (72.1%, n= 44). As a result of libidinous act, the children had a change in family composition (42.6%, n = 26), cognitive disturbances (34.4%, n= 21), emotional disturbances (83.6%, n= 51), and behavioral disorders (54.1%, n= 33). Two-thirds of the cases resulted in a police investigation, only 20% of the offenders were convicted. CONCLUSION: Girls suffer sexual abuse where the perpetrator is known and close to the family; they delay seeking health services and can present mental disorders related to those abuses, but the perpetrators remain unpunished in most cases.

INTRODUÇÃO: Violência sexual contra crianças e adolescentes no Brasil é um problema de saúde pública subnotificado. Conhecer o perfil dos casos e dos fatores relacionados a estes casos é uma estratégia para o desenvolvimento de políticas públicas mais efetivas. OBJETIVO: Descrever o perfil de crianças e adolescentes vítimas de abuso sexual, as características das agressões e dos agressores, as consequências para as vítimas e ações jurídicas relacionadas ao abuso sexual. MÉTODO: Foram analisadas características sociodemográficas das vítimas, características dos agressores e agressão, bem como aspectos clínicos, psicológicos e legais, de 61 pacientes que sofreram abuso sexual admitidos no ambulatório especializado da Rede de Atenção à Saúde por Violência e Abuso Sexual, em Santo André, Brasil. RESULTADOS: As vítimas tinham média de idade de 10,4 anos, do sexo feminino (60,7%, n=37), de cor branca (70,5%, n=43) e que foram admitidas na rede de atendimento depois de 72 horas de ter sofrido o abuso (68,3%, n=40). A maior parte das agressões foi por ato sexual (65,6%, n=40) e por indivíduo conhecido (72,1%, n=44). Em consequência de ter sofrido abuso sexual, as crianças tiveram alteração da composição familiar (42,6%, n=26), apresentaram distúrbios cognitivos (34,4%, n=21), distúrbios emocionais (83,6%, n=51) e distúrbios comportamentais (54,1%, n=33). Dois terços dos casos resultaram em investigação policial, apenas 20% dos criminosos foram condenados. CONCLUSÃO: Meninas sofrem atos sexuais onde o agressor é conhecido e próximo, demoram a procurar os serviços de saúde e apresentam distúrbios mentais relacionados a esses abusos, mas os agressores continuam impunes na maior parte dos casos.

Álcool, drogas e violência: implicações para a saúde de minorias sexuais / Alcohol, drugs and violence: implications for the health of sexual minorities

OBJETIVO: Identificar o perfil de violência e consumo de drogas em minorias sexuais e suas implicações para a saúde. Método: Estudo transversal e quantitativo com 316 indivíduos lésbicas, gays, bissexuais, travestis e transexuais durante as Paradas Gays em Juazeiro do Norte e Crato, Ceará, Brasil. Usou como instrumento de coleta de dados formulário estruturado com questões voltadas para violência, consumo de álcool/drogas e implicações para a saúde. Para análise dos dados usou‐se o teste de qui‐quadrado para associação entre variáveis nominais. O valor de significância adotado foi de p ≤ 0,05. O estudo teve aprovação de Comitê de Ética em Pesquisa. Resultados: A violência psicológica/verbal foi a mais prevalente na amostra (78,8%) e o álcool foi a droga de escolha para consumo (70,9%). O álcool, quando associado à violência, implicou consequências para a saúde e resultou em sofrimento, por meio da manifestação de sintomas de abstinência (p=0,04) e problemas para resistir ao consumo (p=0,01). Conclusões: Minorias sexuais são vítimas de violência e consomem drogas. O consumo dessas substâncias resultou em agravos a saúde do grupo.

OBJECTIVE: To identify the profile of violence and drug use on sexual minorities and their implications for health. Method: Cross‐sectional study, quantitative conducted with 316 individuals lesbian, gay, bisexual, and transgender during realization of Gays stops in the cities of Juazeiro and Crato, Ceará, Brazil. Used as form data collection instrument structured with questions related to violence, alcohol/drugs and health implications. For data analysis we used chi‐square test to associations between nominal variables. The significance value was p ≤ 0.05. The study was approved by the Ethics Committee. Results: The psychological/verbal was the most prevalent in the sample (78.8%) and alcohol was the drug of choice for consumption (70.9%). Alcohol, when associated with violence, implied health consequences, resulting in suffering, through the manifestation of withdrawal symptoms (p = 0.04) and problems to resist consumption (p = 0.01). Conclusions: Sexual minorities are victims of violence and consume drugs. The use of these substances resulted in injuries to Group Health.