Casamiento infantil y salud perinatal en Ecuador, 2015-2020 / Child marriage and perinatal health in Ecuador, 2015-2020

RESUMEN Este estudio buscó estimar la prevalencia y distribución de nacidos vivos de madres menores de 18 años en Ecuador y la asociación entre indicadores perinatales y estado marital materno. A partir de los registros de nacidos vivos obtenidos del Instituto Nacional de Estadísticas y Censos de Ecuador para el período 2015-2020, se estimó la asociación conjunta entre grupos de edad (10-15, 16-17, 18-19 y 20-24 años) y la situación conyugal materna (casada, unión estable y soltera), con bajo peso al nacer, parto pretérmino e inadecuada atención prenatal. La prevalencia de partos de madres menores de 18 años fue del 9,3% y declinó en el periodo de estudio, drásticamente entre las mujeres casadas. La asociación entre estado marital y las variables explicativas dependió de la edad materna. Los resultados más favorables de salud observados entre las madres casadas de 20-24 años, en comparación con las madres solteras, se debilitan o desaparecen entre las menores de edad. Las madres en uniones de hecho experimentaron resultados intermedios entre las mujeres casadas y las solteras.

ABSTRACT This study sought to estimate the prevalence and distribution of newborns to mothers under age 18 in Ecuador and the association between perinatal indicators and maternal marital status. Newborn records obtained from Ecuador's Instituto Nacional de Estadísticas y Censos (INEC) between 2015 and 2020 were used to assess the joint association between maternal age groups (10-15, 16-17, 18-19, and 20-24 years) and marital status (married, common-law, and single) with low birthweight, preterm birth, and inadequate prenatal care. The prevalence of newborns to mothers under age 18 was 9.3% overall, but declined over the study period, drastically among married mothers. The association between marital status and perinatal indicators depended on maternal age. The more favorable outcomes observed among married mothers aged 20-24 years (compared to their single counterparts) weaken or disappear among mothers under age 18. Mothers in stable unions exhibited outcomes in between those of married and single mothers.

Comportamiento del alcoholismo en el Consultorio Médico de Familia 25. Policlínico Bayamo Oeste. 2018- 2019 / Behavior of alcoholism in the Family Medical Office 25. Bayamo Oeste Polyclinic. 2018 - 2019 / Comportamento do alcoolismo no Serviço Médico da Família 25. Policlínica Bayamo Oeste. 2018-2019

RESUMEN Se realizó un estudio epidemiológico, observacional, descriptivo, de corte transversal, con la participación de 72 pacientes que tienen problemas con el alcohol pertenecientes al Consultorio Médico de Familia (CMF) No 25 del Reparto Camilo Cienfuegos, perteneciente al área de salud del Policlínico "Bayamo Oeste" del municipio de Bayamo, provincia Granma. En este se recopilaron datos de las historias clínicas de los pacientes y encuestas para la obtención de variables demográficas tales como: edad, sexo; así como las variables sociales: escolaridad, estado civil, vínculo laboral. Se computan los datos por procedimientos estadísticos convencionales y se expresan mediante tablas. Al finalizar el estudio y analizar los resultados se pudo apreciar que la edad comprendida entre 39 y 48 años resultó ser la de mayor incidencia, predominando la afección del sexo masculino y en personas de menor nivel escolar, solteras, desempleadas.

ABSTRACT An epidemiological, observational, descriptive, cross-sectional study was carried out, with the participation of 72 patients who have problems with alcohol belonging to the Family Medical Office (CMF) No. 25 of the Camilo Cienfuegos Department, belonging to the Polyclinic health area "Bayamo Oeste" in the municipality of Bayamo, Granma province. This collected data from the patient's medical records and surveys to obtain demographic variables such as: age, sex; as well as social variables: schooling, marital status, employment relationship. Data are computed by conventional statistical procedures and expressed by means of tables. At the end of the study and analyzing the results, it was observed that the age between 39 and 48 years turned out to be the one with the highest incidence, prevailing the affection of the male sex and in people of lower school level, single, unemployed.

RESUMO Foi realizado um estudo epidemiológico, observacional, descritivo e transversal, com a participação de 72 pacientes com problemas de álcool pertencentes ao Serviço Médico de Família (CMF) nº 25 do Departamento de Camilo Cienfuegos, pertencente à área de saúde policlínica " Bayamo Oeste"no município de Bayamo, província de Granma. Ele coletou dados dos prontuários e pesquisas médicas do paciente para obter variáveis ​​demográficas como: idade, sexo; bem como variáveis ​​sociais: escolaridade, estado civil, vínculo empregatício. Os dados são calculados por procedimentos estatísticos convencionais e expressos por meio de tabelas. Ao final do estudo e analisando os resultados, observou-se que a idade entre 39 e 48 anos foi a de maior incidência, prevalecendo o acometimento do sexo masculino e em pessoas de menor escolaridade, solteiras, desempregadas.

Percepción de la infidelidad de adultos en el Área Metropolitana de Buenos Aires / Infidelity Perceptions in the Buenos Aires Metropolitan Area

Resumen Se realizó un estudio exploratorio a 600 adultos del Área Metropolitana de Buenos Aires, vinculado con la infidelidad, tipificando la población por medio de una taxonomía de respuestas emocionales con un cuestionario online. Según estudios anteriores, y por el contrario que las mujeres, los hombres mostrarían reacciones celosas de tipo sexual y no emocional, ya que la infidelidad femenina podría conducir a la posibilidad de que tuvieran que mantener descendientes que no fueran genéticamente suyos. Las conductas se organizaron de acuerdo con la Perceptions of Dating Infidelity Scale, distinguiendo tres clases de respuestas: ambiguas, explícitas y las engañosas. Utilizando Chi cuadrado, se discuten las diferencias respecto a estas variables: la edad, el estado civil, el género, nivel educativo y creencias religiosas.

Abstract An exploratory study was conducted on 600 adults from the Metropolitan Area of ​​Buenos Aires regarded infidelity, typifying the population through a taxonomy of emotional responses with an online questionnaire. According to previous research, and opposite to women, men would show sexual and non-emotional jealousies responses, since female infidelity could lead to the possibility of having offspring that were not genetically theirs. Behaviors were organized according to the Perceptions of Dating Infidelity Scale, distinguishing three kinds of responses: ambiguous, explicit and misleading ones. Using Chi square, we discuss the differences regarding these variables: age, marital status, gender, educational level and religious practices.

Variables asociadas con el sentimiento de soledad en adultos que asisten a programas de la tercera edad del municipio de Medellín / Variables associated to the feeling of loneliness in adults attending senior citizen programs in Medellín / Variáveis associadas com o sentimento de solidão em adultos que participam a programas da terceira idade do município de Medellín

Objetivo: el sentimiento de soledad es inherente a la condición humana, y es considerada como un problema de salud pública que se relaciona directamente con el bienestar. El objetivo de este trabajo es identificar la predictibilidad de las variables sociodemográficas en el sentimiento de soledad de los adultos mayores. Metodología: estudio de corte. La muestra estuvo conformada por 869 adultos de 55 y más años de edad que asistieron a grupos abiertos de la tercera edad del municipio de Medellín, en 2010. Resultados: el modelo explica el 21.6% de la varianza en el puntaje de la escala de soledad. En la soledad familiar, la principal variable predictiva es el número de personas con quienes conviven; en la soledad conyugal y social, el estado civil y en la crisis de adaptación, el estrato socioeconómico. Conclusiones: la variable sociodemográfica que tiene mayor peso para la predictibilidad de la soledad es el estado civil, que aparece en los diferentes tipos de soledad y para el total de soledad.

Objective: The feeling of loneliness is inherent in the human condition, and is considered a public health issue that is directly related to welfare. The aim of this study was to identify the sociodemographic predictor variables of loneliness in the elderly. Methodology: Cross-sectional study. The sample consisted of 869 adults aged 55 and older who attended senior citizen groups in Medellin in 2010. Results: The model explained the 21.6% of variance in the scale scores for loneliness. The main predictor variables for family loneliness was the number of people whom they live with; for marital and social loneliness was marital status; and for crisis of adaptation was socioeconomic status. Conclusions: The demographic variable that best predicts loneliness is marital status, appearing in different types of loneliness and global loneliness.

Objetivo: o sentimento de solidão é inerente à condição humana, e é considerada como um problema de saúde pública que se relaciona diretamente com o bem-estar. O objetivo deste trabalho é identificar a previsibilidade das variáveis sócio-demográficas no sentimento de solidão dos adultos maiores. Metodologia: estudo de corte. A amostra esteve conformada por 869 adultos de 55 e mais anos de idade que participam a grupos abertos da terceira idade do município de Medellín, em 2010. Resultados: o modelo explica 21.6% da variância na pontuação da escala de solidão. Na solidão familiar, a principal variável preditiva é o número de pessoas com quem convivem; na solidão conjugal e social, o estado civil e na crise de adaptação, o estrato socioeconômico. Conclusões: a variável sócio-demográfica que tem maior peso para a previsibilidade da solidão é o estado civil, que aparece nos diferentes tipos de solidão e para o total de solidão.

Edad y estado civil de las gestantes, ontogenia familiar y conocimientos sobre la lactancia materna / Age and Marital Status of Pregnant Women, Family Ontogeny and Breastfeeding Knowledge

Introducción: debido a sus conocidas y múltiples virtudes, la OMS y la UNICEF recomiendan la lactancia materna como alimento insustituible en los primeros seis meses de vida. No obstante, los resultados en cuanto a su utilización no son siempre los esperados. Objetivos: evaluar la relación entre la edad de las gestantes, el estado civil, la ontogenia de las familias, los conocimientos que manifestaban poseer sobre lactancia materna y los que realmente poseían. Métodos: se realizó un estudio analítico y transversal de 192 gestantes en su tercer trimestre, entre marzo de 2010 y marzo de 2011 en los Policlínicos "Turcios Lima" y "Mártires del 9 de Abril" del Municipio San José de las Lajas. Se aplicaron 22 preguntas mediante entrevista y se estableció un sistema de puntaje para evaluar el nivel de conocimientos. Resultados: predominaron las gestantes de 19 a 35 años que mantenían una unión consensuada, pertenecían a familias extensas, deseaban lactar y se consideraban con los conocimientos necesarios para lograrlo, aunque realmente dichos conocimientos eran insuficientes para ese proceder. Las pacientes con mayores deficiencias fueron las adolescentes y las solteras, que estaban enmarcadas en familias extensas y que a priori habían reconocido que no poseían los conocimientos adecuados sobre lactancia materna. Conclusiones: aunque la mayoría de las gestantes consideró que tenía los conocimientos necesarios para la lactancia materna, no demostró tener los indispensables para asumirla exitosamente(AU)

Introduction: Due to its known and many virtues, breastfeeding is recommended by WHO and UNICEF as irreplaceable food in the first six months of life. However, the results in terms of use are not always as expected. Objectives: Evaluate the relationship between ages of pregnant women, marital status, ontogeny of families, and their knowledge about breastfeeding. Methods: A cross-sectional study of 192 pregnant women in their third trimester was conducted from March 2010 to March 2011 at the polyclinics "Turcios Lima" and "Martyrs of the April 9" in San Jose de las Lajas the municipalities. A 22 question- interview was applied and a point system was established to assess the level of knowledge. Results: Pregnant women aging 19-35 years prevailed. They had a consensual union and lived in extended families. They wished to breastfeed and considered themselves to have the knowledge to do it, although that knowledge was not sufficient to proceed. Patients with major deficiencies were adolescents and unmarried, which lived in extended families and who had previously acknowledged that they did not have the proper knowledge about breastfeeding. Conclusions: Although most pregnant women saw the skills needed for breastfeeding, they did not demonstrate the necessary to successfully do it(AU)

Síndrome de burnout en personal sanitario del Hospital Santiago de Jinotepe, Carazp. Nicaragua. enero 2014

Se realizó un estudio analítico de factores de riesgo, en personal médico y de enfermería del Hospital Santiago de Jinotepe, Carazo, Nicaragua, en el mes de Enero 2014. Se planteó identificar dichos factores en una población de 233trabajadores sanitarios. Los datos fueron obtenidos a través de una encuesta anónima y auto administrada y dividida en dos cuestionarios, uno sobre características sociodemográficas y el otro el Maslach Burnout Inventory, cuestionario mundialmente utilizado y validado para estudiar el síndrome de burnout.Se identificaron como factores de riesgo asociados al síndrome de burnoutel sexo femenino (OR= 2.19, Chí cuadrado = 5.61, p= 0.01), el estado civil soltero,separado y divorciado (OR= 0.22, Chí cuadrado= 50.67, p= 0.00), mayor número de horas diarias de trabajo (OR= 4.73, Chí cuadrado= 27.52, p= 0.00), el horario de trabajo mixto (OR= 4.24, Chí cuadrado= 19.46, p= 0.00001), una mayor carga de trabajo semanal (OR= 14.06 Chí cuadrado = 67.44, p= 0.00), el trabajar en otrainstitución (OR= 2.85, Chí cuadrado = 7.42, p= 0.006), y trabajar mayor número dehoras en otra institución (OR= 9.11, Chí cuadrado = 9.53, p= 0.002).Se determinó una prevalencia del síndrome de 0.7 (71 %), afectando mayoritariamente a enfermeras y en menor proporción a médicos y auxiliares de enfermería. La esfera más afectada fue la de Realización personal con 40 %, seguidade cansancio emocional (25 %) y des personalización (20 %).El síndrome de burnout moderado apareció en el 62 % y el síndrome deburnout alto en el 9 % de los estudiados.

El sentimiento de soledad en adultos / Loneliness in Older Adults

Objetivo: caracterizar los tipos de soledad en las personas mayores que asisten a los grupos de la tercera edad del municipio de Medellín (Colombia) y su asociación con algunas variables sociodemográficas. Metodología: estudio de corte transversal realizado en personas de 55 y más años que asisten a los grupos de la tercera edad del municipio de Medellín para un total de 1.169 encuestados en 2011. Para la recolección de la información se aplicó el instrumento escala ESTE de medición de la soledad, validado para Colombia. Resultados: se halló una mayor soledad familiar y crisis de adaptación en el hombre y soledad conyugal en la mujer; las personas que no tienen pareja manifiestan más soledad y, a medida que se incrementa el estrato socioeconómico y el grado de escolaridad, disminuyen los niveles en los distintos tipos de soledad. Las personas adultas que viven solas tienen mayor sentimiento de soledad. Conclusiones: las variables de edad, estado civil, grado de escolaridad, estrato y número de personas con las que se convive, están asociadas con la soledad en el adulto mayor.

Objective: To characterize the types of loneliness in older adults attending senior citizen groups in the municipality of Medellin (Colombia) and its association with sociodemographic variables. Methods: Cross sectional study performed in people 55 years old and over who attend senior citizen groups in the municipality of Medellin for a total of 1,169 respondents in 2011. The "ESTE" loneliness scale, validated for Colombia, was used as the data collection instrument. Results: Greater family loneliness and adaptation crisis were found in men, and greater marital loneliness in women. People without partners expressed more loneliness; as socioeconomic status and academic level increased, the levels of various types of loneliness decreased; adults living alone had a greater level of loneliness. Conclusions: The variables of age, marital status, education level, socioeconomic status, and number of people with whom they live are associated with loneliness in the elderly

Objetivo: caracterizar os tipos de solidão nas pessoas maiores que assistem aos grupos da terceira idade do município de Medellín (Colômbia) e sua associação com algumas variáveis sócio-demográficas. Metodologia: estudo de corte transversal (cross seccion) realizado em pessoas com 55 ou mais anos, que assistem aos grupos da terceira idade do município de Medellín para um total de 1.169 interrogados em 2011. Para o recolhimento da informação se aplicou o instrumento a escala "ESTE" de medição da solidão, validado para Colômbia. Resultados: achou-se uma maior solidão familiar e crise de adaptação no homem e solidão conjugal na mulher, as pessoas que não têm casal manifestam mais solidão, à medida que se incrementa o nível socioeconômico e o grau de escolaridade, diminuem os níveis nos diferentes tipos de solidão. As pessoas adultas que vivem sós têm maior sentimento de solidão. Conclusões: as variáveis: idade, estado civil, grau de escolaridade, nível socioeconômico e número de pessoas com as que se convive, estão associadas com a solidão no adulto maior

Associação entre mortalidade e estado marital: uma análise para idosos residentes no Município de São Paulo, Brasil, Estudo SABE, 2000 e 2006 / Association between marital status and mortality among elderly residents in São Paulo City, Brazil, SABE Study, 2000 and 2006 / Asociación entre el estado civil y la mortalidad: un análisis de los ancianos residentes en São Paulo, Brasil, el Estudio SABE, 2000 y 2006

Este trabalho tem como objetivo analisar, para a população com 60 anos e mais, residente no Município de São Paulo, Brasil, a associação entre mortalidade e estado marital. Para atingir o objetivo proposto, foram utilizados os dados do Estudo SABE: Saúde, Bem-estar e Envelhecimento (SABE), realizado nos anos 2000 e 2006, e modelos de Regressão de Poisson foram estimados, levando-se, em consideração, a variação do tempo de risco de morte. No geral, os resultados indicam que, entre os idosos paulistanos do sexo masculino, a taxa de mortalidade dos solteiros é 61% maior que a taxa de mortalidade observada para os casados. Por sua vez, a separação/divórcio ou a viuvez parece elevar a chance de morte das mulheres idosas analisadas. No geral, idosas separadas e viúvas apresentaram taxas de mortalidade 82% e 35% maiores que a observada para as casadas. Espera-se que este trabalho possa contribuir para um melhor entendimento dos fatores associados à sobrevivência dos idosos, além de subsidiar políticas de saúde voltadas para esse contingente populacional.

This study aimed to analyze the association between mortality and marital status in the elderly population (60 years and older) in São Paulo, Brazil. The authors used data from the SABE Study (Health, Well-Being, and Aging) from 2000 and 2006. Statistical analysis used Poisson regression, considering variation in time of mortality risk. The mortality rate among single elderly males was 61% higher than among married men. Separation or divorce and widowhood increased the odds of death in elderly women (separated/divorced women and widows showed mortality rates 82% and 35% higher, respectively, than married women). It is hoped that the current study will improve our understanding of factors associated with survival in the elderly, in addition to supporting health policies for this population group.

Este trabajo tiene como objetivo analizar la asociación entre el estado civil y la mortalidad, entre la población de 60 años o más que vive en São Paulo, Brasil. Para alcanzar ese objetivo, se utilizaron los datos del Estudio SABE (Salud, Bienestar y Envejecimiento), realizado en 2000 y 2006, y los modelos de regresión de Poisson se estimaron teniendo en cuenta la variación tiempo en el riesgo de muerte. En general, los resultados indican que, entre los ancianos de sexo masculino en São Paulo, la tasa de mortalidad de solteros es un 61% más alta que la tasa de mortalidad observada para los casados. A su vez, la separación/divorcio o viudez parece aumentar el riesgo de muerte de las mujeres ancianas. En general, las ancianas separadas y viudas presentaron tasas de mortalidad un 82% y un 35% mayores que la observada para las casadas. Se espera que este trabajo contribuya a una mejor comprensión de los factores asociados con la supervivencia de los ancianos, además de apoyar las políticas de salud dirigidas a este contingente de población.

O perfil de casais que vivenciam divórcios consensuais e litigiosos: uma análise das demandas judiciais / The profile of couples who experience consensual divorces and litigation: an analysis of lawsuits / El perfil de las parejas que experimentan divorcios consensuales y litigiosos: un análisis de los litigios

Este estudo objetivou identificar os motivos, circunstâncias e desdobramentos das separações conjugais com base em registros em processos judiciais. Realizou-se uma análise documental de 152 separações conjugais arquivadas de 1992 a 2006, no Fórum de uma cidade do interior do RS. Fez-se uma análise descritiva e discriminante dos dados. Os motivos mais citados referem-se ao conflito conjugal em seus diferentes matizes e intensidades. Quanto ao desfecho, constatou-se que 46,7% dos processos foram consensuais, 30,9% litigiosos e em 22,4% houve abandono da ação ou reconciliação. O perfil dos casais discrimina-se prioritariamente pelo nível socioeconômico no que diz respeito aos processos consensuais ou litigiosos. Separações consensuais são mais comuns em níveis socioeconómicos baixos e litigiosas em altos. Os dados indicam que o divórcio pode ser considerado uma crise vital contemporânea e demanda dos profissionais maior complexidade nas suas intervenções tanto de ordem jurídica como psicológica no fenômeno.

This study aimed to identify the reasons, circumstances and consequences of marital dissolution from records in legal proceedings. A documentary analysis of 152 marital dissolutions archived from 1992 to 2006 in the Forum of a city in RS was performed. There was a descriptive and discriminant analysis of the data. The most cited reasons relate to marital conflict in its different hues and intensities. As for the outcome, it was found that 46.7% of cases were consensual, 30.9 % litigation, 22.4% abandoned the lawsuit or have reconciled. The profile of the couples is mainly discriminated by socioeconomic level in relation to consensual processes or litigation. Consensual separations are more common in low socioeconomic levels and litigation in high. Data indicate that divorce may be considered a contemporary life crisis that demands more complexity of professionals in their interventions both legal and psychological phenomenon.

Este estudio tuvo como objetivo identificar las razones, circunstancias y consecuencias de las separaciones matrimoniales por medio de registros en procesos judiciales. Se realizó un análisis documental de 152 separaciones conyugales archivadas desde 1992 hasta 2006, en el Foro de una ciudad de RS-Brasil. Se hizo un análisis descriptivo y discriminante de datos. Los motivos más citados se refieren a conflictos de pareja en sus diferentes matices e intensidades. En cuanto a los resultados, se encontró que el 46,7% de los casos fueron consensuales, el 30,9% litigiosos, y en el 22,4% de ellos hubo abandono de la acción o reconciliación. El perfil de las parejas es discriminado principalmente por el nivel socioeconómico en relación a los procesos consensuales o litigiosos. Separaciones consensuales son más frecuentes en niveles socioeconómicos más bajos y litigiosas en las altas. Los datos indican que el divorcio puede ser considerado como una crisis vital contemporánea y demanda de los profesionales una mayor complejidad en sus intervenciones tanto de orden jurídico como psicológico en el fenómeno.

Aborto induzido: uma comparação entre mulheres casadas e solteiras residentes na cidade de São Paulo em 2008 / Induced abortion: a comparison between married and single women residing in the city of São Paulo in 2008

O objetivo deste estudo foi verificar a associação entre ter realizado algum aborto provocado e estado civil (ser solteira ou legalmente casada) em mulheres residentes no município de São Paulo. A presente análise é derivada de um inquérito populacional maior sobre aborto realizado em 2008. Aqui enfocamos o subgrupo de 389 mulheres entre 15 e 49 anos, solteiras ou casadas legalmente. Recorreu-se à análise de regressão logística para avaliar a associação entre ter realizado aborto ou não e estado conjugal, controlando-se por idade, escolaridade, renda, número de nascidos vivos, uso de métodos contraceptivos e aceitação da prática do aborto. Ser solteira foi a única característica associada à recorrência ao aborto provocado; isto é, diante de uma gravidez as solteiras têm quatro vezes mais chances de aborto do que as casadas (OR=3,9; p=0,009).

The scope of this study was to evaluate the association between having had an induced abortion and marital status (being single or legally married) in women residing in the city of São Paulo. This analysis is derived from a broader population survey on abortion conducted in 2008. In this study we focus on the subset of 389 single and legally married women between 15 and 49 years of age. Logistic regression models were used to evaluate the association between induced abortion and being single or married, monitoring age, education, income, number of live births, contraceptive use and acceptance of the practice of abortion. Being single was the only characteristic associated with having had an induced abortion, in other words, when faced with a pregnancy single women were four times more likely to have an abortion than married women (OR=3.9; p=0.009).

El papel de los estresores y las condiciones de estado civil para explicar la depresión y el estrés en adolescentes gestantes / The role of stressors and conditions of marital status to explain the stress and depression in pregnant teenagers

Este estudio identicó la relación entre depresión, estrés y número de estresores enfrentados por adolescentes primigestas bajo distintas condiciones de estado civil. Correspondió a un estudio no experimental, transversal y exploratorio; la muestra estuvo compuesta por 82 adolescentes primigestas entre 15 y 19 años, a quienes se les aplicaron el Inventario de Depresión de Beck, la Escala de Estrés Percibido y el Cuestionario de Sucesos Vitales. Los resultados del análisis de ecuaciones estructurales indicaron que la condición de estado civil, el tipo de embarazo y los estresores relacionados a nanzas, hijos y situaciones sociales, son factores que explican el 64% de la varianza de estrés, así como el 71% de la depresión en las adolescentes primigestas.

This study aimed to identify the relationship between depression, stress and the number of stressors faced by pregnant teenagers under different conditions of marital status. This was a non-experimental, cross-sectional and exploratory study. The sample consisted of 82 rst-time pregnant teenagers, who responded to the assessment instruments: Beck Depression Inventory, Perceived Stress Scale and Life Events Questionnaire. Using structural equation models we found that the condition of marital status, pregnancy type, and stressors related to nances, children and social situations are factors that explain 64% of the variance in stress and 71% for depression in rst-time pregnant teenagers.

A longevidade na metrópole de São Paulo pelas notas de falecimento no Jornal da Tarde (2004-2005) / Longevity in the city of São Paulo, Brazil, through the analysis of obtuaries in the newspaper Jornal da Tarde (2004-2005)

Trata-se de estudo da longevidade na metrópole de São Paulo, Brasil, através da análise das notas de falecimento no Jornal da Tarde, um jornal local. Foram analisadas 665 notas de falecimento nos períodos de junho, julho e agosto de 2004 e 2005. Objetivou-se verificar a longevidade dos idosos moradores da metrópole de São Paulo e aspectos contidos nas notas de falecimento, como: faixa etária dos idosos, estado civil, prevalência de sexo (feminino ou masculino), se o idoso deixou familiares e os familiares deixados por ele. Utilizou-se o SPSS (versão 11.0) para tratamento estatístico dos dados, pois se trabalhou com perguntas fechadas, por meio de um questionário, elaboradas a partir dos próprios recortes de notas de falecimento. Os resultados obtidos mostram uma média de idade maior para o sexo feminino, de 87,4 anos com desvio padrão de 8,6 anos; para o sexo masculino, de 82,1 anos com desvio padrão de 9 anos. Em relação ao estado civil a grande maioria das idosas se enquadrava na categoria de viúvas e os homens na categoria de casados / vive junto. No estado marital sem companheiro (solteiro, viúvo, separado / divorciado), a maior freqüência foi verificada no sexo feminino e com companheiro (casado / vive junto), no sexo masculino. Houve ainda resultado significante em relação ao estado marital, sendo que o falecimento de idosos sem companheiros se concentrou em faixas etárias maiores e, com companheiros, em faixas etárias menores. Não foi encontrada associação significativa com relação aos familiares deixados e tipo de familiar deixado. O processo do aumento da longevidade no Brasil pode ser evidenciado pelas notas de falecimento de idosos. A longevidade é um fenômeno atual no país e é determinada pelo tempo de vida maior alcançado pelos idosos. Esse processo tem maior predominância no sexo feminino, sendo chamado de feminização da velhice.

Study on longevity carried out in the city of São Paulo, Brazil, through the analysis of obituaries in Jornal da Tarde, a local newspaper. The 665 obituaries were analyzed throughout the periods of June, July and August of 2004 and 2005. The aim was to verify longevity of elderly residents in São Paulo metropolitan area and the aspects contained in the obituaries, such as: elderly?s age group, marital status, gender prevalence (feminine or masculine), if the elderly left their families and families left by the elderly. The SPSS (version11.0) was used to deal with statisticcal data, because of the multiple choice questions, through a questionnaire elaborated after obituary clippings. Results showed a greater range of age for females, of 87,4 years of age with the deviation standard of 8,6 years and, for males, 82.1 years with deviation standard of 9 years. In relation to marital status, most part of the elderly were widows and men were in the category of being married/living together. For marital status without a partner (single, widow, separated/divorced), a higher frequency of females was observed and with a partner (married/living together), a higher frequency for males was noticed. Another significant association was encountered in relation to marital status, given that obituaries of the elderly without partners concentrated in the highest age ranges and with partners in the lower ones. The research did not find significant association concerning relatives left and type of relative left. The process longevity increasing in Brazil can be evinced by obituaries of elderly people. Longevity is a current phenomenon in the country and is determined by the highest age reached by the elderly. This process is more predominant among the female gender, and is known as feminization of old age.

Fatores associados à ocorrência de cesárea e aborto em mulheres selecionadas em um centro de saúde no município do Rio de Janeiro, Brasil / Factors associated to cesarean sections and abortions in women selected from a health clinic in the city of Rio de Janeiro, Brazil

OBJETIVOS: investigar fatores potencialmente associados à ocorrência de cesárea e aborto. MÉTODOS: foram analisados dados de uma coorte no pós-parto com 352 mulheres entre 15-45 anos. Os seguintes desfechos foram estudados: ocorrência de cesárea no último parto e ocorrência de aborto anterior à última gravidez. A análise estatística foi feita por meio de modelos de regressão logística multivariados e hierarquizados. RESULTADOS: as prevalências de cesárea e aborto foram de 36,3 por cento e 34,0 por cento, respectivamente. O modelo final revelou que as seguintes variáveis permaneceram estatisticamente associadas à ocorrência de cesárea: nível 1: cor de pele branca (OR=2,02; IC95 por cento: 1,29-3,16); nível 2: ligadura (OR=19,68; IC95 por cento: 5,77-67,15). As seguintes variáveis permane-ceram associadas à ocorrência de aborto: nível 1: idade >29 anos (OR=6,11; IC95 por cento: 2,94-12,72), estado marital: vive em união (OR=4,22; IC95 por cento: 2,03-8,78); solteira: (OR=3,70; IC95 por cento: 1,59-8,61). CONCLUSÕES: a cor de pele branca e a prática de ligadura foram co-variáveis potencialmente associadas à ocorrência de cesárea, enquanto o estado marital em união ou solteira e a idade materna estiveram associadas à ocorrência de aborto, sendo maior a probabilidade para mulheres acima de 29 anos.

OBJECTIVES: to investigate factors potentially associated to cesarean sections and abortions. METHODS: data from a cohort study during postpartum were analyzed for 352 women aged 15-45 years old. The following outcomes were studied: cesarean sections and abortions prior to current pregnancy. Statistical analysis included multivariate logistic regression models with hierarchical approach. RESULTS: c-sections and abortions prevalence were 36.3 percent and 34.0 percent, respectively. The final model indicated that the following variables remained associated to cesarean sections: level 1: Caucasian white (OR=2.02; 95 percentCI: 1.29-3.16); level 2: tubal ligation (OR=19.68; 95 percentCI: 5.77-67.15). The following variables remained associated to abortion occurrence: level 1: age >29 years (OR=6.11; 95 percentCI: 2.94-12.72); marital status: married (OR=4.22; 95 percentCI: 2.03-8.78), single (OR=3.70; 95 percentCI: 1.59-8.61). CONCLUSIONS: white Caucasian women and tubal ligation were potentially associated co-variables for cesarean sections performance while marital status and maternal age were associated to abortions, prevalent in women over 29 years old.

Variables demográficas asociadas con la depresión: diferencias entre hombres y mujeres que habitan en zonas urbanas de bajos ingresos

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Summary This paper is aimed at exploring the relationship of some socio-demographic variables with the presence of depressive disorders among a low-income urban sample. Different variables have consistently been associated with such disorders, for instance, marital status, sex, and socio-economic status. As to marital status, some studies show that married people have better health conditions and feel more satisfied with their lives than their unmarried counterparts. Similarly, it has been found that widowed or divorced people present a number of psychological problems. Low-income population is also at high risk of suffering depressive symptoms, in this sense, some researchers have stated that the lack of resources is associated with sadness, high stress levels, isolation, uncertainty, and low access to health care and/or other sources of support. According to the Mexican National Survey on Mental Health conducted with urban population over 18, the prevalence of depressive disorders is higher among widowers and divorced individuals -both males and females- than among their married counterparts. In addition, an association was found between depression, low schooling and unemployment. A survey undertaken in Mexico City yielded similar results though gender differences were not explored; higher prevalences of depression were found for those who reported having lost their couple or marital break up than for those who were married or single. Other groups that had high depression prevalence were lower income individuals, and those with less schooling. Couple relationships and other socio-demographic variables play a key role in the presence of depressive disorders. Thus, the present study is aimed at: a) analysing how marital status affects the presence of depressive disorders in men and women; b) exploring the role of low socio-economic level in the presence of depressive symptoms; c) exploring which combination of socio-demographic variables better predict the presence of depressive disorder in males and females Method: This research was carried out in four low-income communities located in southern Mexico City. The selected communities include Topilejo, Isidro Fabela and San Pedro Mártir within the Tlalpan district, and the fourth community was constituted by the neighbourhoods of San Marcos and San Juan, in the Xochimilco district. The research design was multistage; blocks were selected at the first stage, dwelling segments, at second stage, and finally, in the third stage the interviewed individual was selected. After this procedure, the final sample consisted of 1156 interviewees, 49% were males and 51% females. The information was gathered through a household questionnaire that explores the general characteristics of the people living in the same dwelling listed on the questionnaire, such as relationship to the family head, age, sex, schooling and income. Some other aspects related to the dwelling characteristics were also explored. Diagnosis of depressive disorder was obtained through the diagnostic interview CIDI version 1.1, which assesses the presence of mental disorders according to the criteria of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. The selected interviewees participated voluntarily after the research objectives were explained; in addition, the terms of confidentiality were particularly emphasized. Each interview lasted 90 minutes on average. Data analysis were performed with the statistical program SPSS v. 10 for Windows. Results: The findings showed higher prevalence of depressive disorders among females, among people that experienced loss or family rupture and among those with lower economic resources. Similarly, prevalence of depression was higher for men (6.1%) and women (18.3%) who had lost their spouse than for their married counterpart. As to differences between married and single people, the prevalence of depressive disorders in the group of men that had ever married was lower (4.9%) than the prevalence found in the group of married men (5.8%). The opposite was observed among females, since single women present more depressive problems (13.2%) than married women (5.3%). Results also showed how economic difficulties have an effect on the presence of depressive disorders. However, differencesbetween married and single men with the lowest income were minimal. Two logistic regression models show that, particularly among women, the presence of depressive disorder is related to the lack of a couple, economic disadvantages; for instance, low family income, belonging to a large extended family, and playing the social role of family head, which implies responsibility to a large extent. Discussion: The findings of the present study are consistent with previous research that report higher prevalence of depression among females, people without a couple and those with less economic resources. Different authors have confirmed that problems of economic nature are consistently associated with depression problems. Lack of resources leads to high stress levels, sadness, isolation, among other troubles. This situation is more severe for females. Women play a number of social roles that put them at higher risk of suffering mental disorders. Nowadays, women still bear the responsibility of being wives, mothers, educators and care providers for many people, and have become an important part of the work force at the same time. The deficiencies that female family heads must face in different areas not only increase the risk of suffering disorders such as depression and poor quality of life, but also jeopardize their children's opportunities in the future. Dejarlais and colleagues suggest that in order to improve these women's mental health it is necessary to take actions in two ways. On the one hand, it is essential to deal with the factors related to the presence of female distress; on the other, it is crucial to provide attention to reduce the negative consequences. In this way, any prevention or intervention program must include, among other elements, tools to expand women's capabilities to have an income, reinforce social support networks, and to stimulate social and community participation in order to improve their cognitive and relational resources as well as self-esteem. In addition, women must have information about the pathological process they undergo and attention options at their disposal, but to make these programs effective it is above all necessary to tailor them according to women's concerns and needs. This can only be possible if women act as active collaborators. Finally, to work on intervention and prevention programs for female family heads encloses the possibility of breaking the cycle that reproduces distress among their children.