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1.
Article in English | WPRIM | ID: wpr-880364

ABSTRACT

BACKGROUND@#Physical activity is reported to prevent metabolic syndrome. However, it is unclear whether exercise or daily physical activity is more beneficial for residents of semi-mountainous areas. This study aimed to identify whether daily physical activity is more beneficial than exercise for the prevention of metabolic syndrome among middle-aged and older residents in semi-mountainous areas.@*METHODS@#We analyzed secondary data of 636 people who underwent a specific health checkup in a semi-mountainous area of Japan. Physical activity was classified into four types: inactivity (I-type; without exercise and without daily physical activity), only exercise (E-type; with exercise and without daily physical activity), only daily physical activity (D-type; without exercise and with daily physical activity), and full physical activity type (F-type; with exercise and with daily physical activity). We compared the means of risk factors for metabolic syndrome by these four types, followed by logistic regression analysis, to identify whether and to what extent the D-type was less likely to have metabolic syndrome than the E-type.@*RESULTS@#The prevalence of metabolic syndrome was 28.5% (men 45.7%, women 15.8%). The proportions of men with exercise and daily physical activity were 38.7% and 52.8%, respectively. For women, the proportions were 33.0% and 47.1%, respectively. In women, the D-type had the significantly lowest BMI, smallest waist circumference, highest HDL-C, and lowest prevalence of metabolic syndrome of the four types; the same was not observed in men. Additionally, D-type activity was more strongly associated with a reduced risk of metabolic syndrome than E-type activity in women (adjusted odds ratio 0.24; 95% confidence interval 0.06-0.85, P = 0.028).@*CONCLUSIONS@#Compared to middle-aged and older women residents with exercise in a semi-mountainous area of Japan, those with daily physical activity may effectively prevent metabolic syndrome.


Subject(s)
Adult , Aged , Altitude , Exercise , Female , Humans , Japan/epidemiology , Male , Metabolic Syndrome/prevention & control , Middle Aged , Rural Population/statistics & numerical data
2.
Psicol. reflex. crit ; 34: 01, 2021. tab, graf
Article in English | LILACS, INDEXPSI | ID: biblio-1155188

ABSTRACT

Abstract Most studies equate children's mental health to a state of flourishing, which is a positive feeling and functions in their lives. Identity exploration and the satisfaction of three basic psychological needs are universal and crucial indicators of children's flourishing. First, according to identity crisis theory, children in the pre-adolescence period begin to explore their own identities, a process which significantly affects their development and flourishing. Meanwhile, self-determination theory points out that the basic psychological needs, namely the needs for autonomy, competence, and relatedness, are essential for children's development and flourishing in the worldwide. Accordingly, this study examined how identity exploration affects the flourishing of rural children in China, one kind of collectivism cultural contexts, with the interaction effect of identity exploration and basic psychological needs satisfaction. To understand the interaction effect of identity exploration and basic psychological needs satisfaction on rural children's flourishing, we form a theoretical framework combining identity crisis theory and self-determination theory. Both these two theories emphasize the importance of self in facilitating mental health and the development of functioning. Specifically, identity crisis theory focuses on intrapsychic process, while self-determination theory stresses the influence of the surrounding environment on the individual, which provides a solid foundation for integrating these two theories to explore rural children's flourishing in China. Accordingly, this study collected 520 left-behind children and 475 other rural children in Liaoning Province in Mainland of China, and used regression analysis to measure the associations among variables. This study found that identity exploration and basic psychological needs satisfaction positively affect rural children's flourishing respectively, while their interaction effects negatively affect on their flourishing.


Subject(s)
Humans , Male , Female , Child , Adolescent , Rural Population/statistics & numerical data , Child Development , Child Health/ethnology , Personal Autonomy , Ego , China , Culture
3.
Gac. méd. Méx ; 156(6): 509-518, nov.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1249960

ABSTRACT

Resumen Introducción: La desnutrición infantil en México alcanza prevalencias de 27.5 % en zonas rurales. Objetivo: Evaluar la efectividad de un suplemento alimenticio listo para consumir (SALC) para corregir desnutrición aguda leve y prevenir desnutrición aguda moderada en preescolares de comunidades rurales. Método: Ensayo clínico aleatorizado por grupos: con y sin SALC (g-SALC y g-S/SALC); se incluyeron niños de dos a cinco años, con puntuaciones-Z de peso para la talla (pZ-P/T) mayor de −2 y menor de −1 y nivel socioeconómico bajo. Todos recibieron educación sobre nutrición, salud e higiene dos veces al mes; los niños del g-SALC debieron consumir diariamente una porción del suplemento. Se evaluó pZ-P/T al inicio y a los cuatro, seis y 12 meses. La comparación entre grupos se realizó con el modelo de riesgos proporcionales de Cox. Resultados: Respecto a la recuperación de desnutrición aguda leve, en g-SALC se observó 68.7 versus 52.1% en el grupo control en el análisis de intención para tratar, con una razón de riesgo (HR) = 1.25; en el análisis por protocolo del primer semestre se observó una HR = 1.48 y en el segundo semestre, HR = 1.56. Un paciente progresó a desnutrición aguda moderada. Conclusiones: El g-SALC mostró resolución significativamente mayor de desnutrición aguda leve.


Abstract Introduction: Child malnutrition in Mexico reaches a prevalence as high as 27.5 % in rural areas. Objective: To assess the effectiveness of a ready-to-use supplementary food (RUSF) to correct mild acute malnutrition and prevent moderate acute malnutrition in preschool children from rural communities. Method: Randomized clinical trial, with assignment to two groups: group with RUSF (RUSF-g) or group without it (non-RUSF-g); children aged from two to five years, with weight-for-height Z-scores (WHZ) between -2 and -1 and low socioeconomic status were included. All received education on nutrition, health and hygiene twice monthly; the RUSF-g children had to consume four biscuits of the supplement every day. WHZ was assessed at baseline and at four, six, and 12 months. The comparison between groups was carried out with Cox proportional hazards model. Results: With regard to mild acute malnutrition correction in the RUSF-g, 68.7 versus 52.1 % in the control group was observed in the intent-to-treat analysis, with a hazard ratio (HR) = 1.25; in the per-protocol analysis of first semester, a HR = 1.48 was observed, and in the second semester, HR = 1.56. One patient progressed to moderate acute malnutrition. Conclusions: The RUSF-g showed a significantly higher resolution of mild acute malnutrition.


Subject(s)
Humans , Male , Female , Child, Preschool , Rural Population/statistics & numerical data , Child Nutrition Disorders/prevention & control , Dietary Supplements , Fast Foods , Social Class , Time Factors , Child Nutrition Disorders/epidemiology , Proportional Hazards Models , Acute Disease , Prevalence , Intention to Treat Analysis , Mexico/epidemiology
4.
Rev. habanera cienc. méd ; 19(1): 112-124, ene.-feb. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1099150

ABSTRACT

Introducción: La citología cervical constituye la principal herramienta para la detección y tratamiento del cáncer de cérvix. Algunos estudios llevados a cabo en población urbana han relacionado la realización y adherencia con los conocimientos, las actitudes y las prácticas favorables de las mujeres con respecto a esta prueba. Objetivo: evaluar los conocimientos, actitudes y prácticas con respecto a la citología cervical en mujeres pertenecientes a un grupo poblacional del ámbito rural. Material y Métodos: estudio de corte transversal-analítico en una población de aproximadamente 3148 mujeres en edad fértil, de ellas se obtuvo una muestra representativa. Se utilizó una encuesta anónima, validada, dirigida, y aplicada por personal de salud capacitado que labora en centros de salud del primer nivel de atención de los distritos de la provincia de Bolívar, La Libertad. Resultados: El 80 por ciento de las mujeres encuestadas tuvo un nivel de conocimiento alto e intermedio, el 70 por ciento una actitud favorable, mientras que el 44 por ciento reportó prácticas correctas en relación con la prueba de citología cervical. El nivel de conocimiento alto e intermedio estuvo asociado a la edad mayor de 30 años (p:0.02), estado civil casada (p:0.05), el mayor grado de instrucción (p:0.00) y el uso de métodos anticonceptivos (p:0.01); no se encontró relación con la edad de inicio de relaciones sexuales (p:0.98). Conclusiones: Existe un alto nivel de conocimientos, actitudes y prácticas correctas hacia la citología cervical en la población rural de la provincia de Bolívar, pero una baja adherencia hacia la misma(AU)


Introduction: Cervical cytology is the main tool for the detection and treatment of cervical cancer. Some studies carried out in the urban population have associated the realization and adherence with knowledge, attitudes and favorable practices of women with respect to this test. Objective: The aim of this study was to determine the level of knowledge, attitudes and practices towards cervical cytology in women of childbearing age in a rural Peruvian province. Material and Methods: A cross-sectional analytical study was conducted in a population of approximately 3148 women of childbearing age, a representative sample was obtained. An anonymous, validated, directed survey was used; it was applied by trained health personnel working in health centers of the primary care level in the districts of the province of Bolívar, La Libertad. Results: A total of 400 surveys were carried out. The results showed that 80 percent of the women surveyed had high and intermediate levels of knowledge, 70 percent had a favorable attitude, while 44 percent reported correct practices related to the cervical cytology test. The high and intermediate levels of knowledge were associated with age over 30 years (p: 0.02), married marital status (p: 0.05), the highest level of instruction (p: 0.00) and the use of contraceptive methods (p: 0.01); no relationship was found with the age of onset of sexual intercourse (p: 0.98). Conclusions: There is a high level of knowledge, attitudes and correct practices towards cervical cytology in the rural population of the province of Bolívar, but a low adherence to it(AU)


Subject(s)
Humans , Female , Adult , Cervix Uteri/cytology , Health Knowledge, Attitudes, Practice/ethnology , Rural Health/education , Peru , Rural Population/statistics & numerical data , Cross-Sectional Studies , Women's Health
5.
Ciênc. Saúde Colet ; 25(2): 613-621, Feb. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1055829

ABSTRACT

Resumo Compreender mudanças no consumo de frutas e verduras por adolescentes é importante para criação de ações de saúde pública. O objetivo deste artigo é investigar mudanças, em dez anos, no consumo diário de frutas e verduras por adolescentes, de acordo com sexo, idade e área de moradia. Estudo de painel (análise secundária) da pesquisa "Estilo de vida e comportamentos de risco de jovens catarinenses". Adolescentes (15-19 anos) de escolas estaduais, em 2001 (n = 5.028) e 2011 (n = 6.529), responderam questionário sobre consumo de frutas e verduras e aspectos sociodemográficos. Estatística descritiva e regressão logística (2001 vs 2011), estratificada para sexo, idade e área de moradia. Houve diminuição no consumo diário de frutas (39,1% e 16,6%) e de verduras (40,1% e 20,6%). Diferentes prevalências são observadas de acordo com subgrupos, principalmente entre moças. A chance para consumo diário de verduras entre rapazes e adolescentes de área rural continuou a mesma. A diminuição na prevalência do consumo diário de frutas e verduras por adolescentes catarinenses de 15 a 19 anos aponta necessidade de criação de estratégias para reversão deste cenário.


Abstract Understanding the changes in the trends of fruit and vegetable consumption among adolescents is important in order to implement public health actions. The scope of this article is to investigate the changes over a ten-year period in the daily fruit and vegetable consumption among adolescents from Santa Catarina, according to sex, age and housing area. It is a secondary analysis of a panel survey entitled "Lifestyle and Risk Behavior of Adolescents in the State of Santa Catarina, Brazil (ComPAC)." Adolescents (15-19 years of age) of state schools in 2001 (n=5.028) and 2011 (n=6.529) answered a questionnaire about fruit and vegetable consumption as well as about sociodemographic aspects. Descriptive statistics and logistic regression were applied, according to sex, age and housing area. There was a decrease in daily fruit (39.1% and 16.6%) and vegetable (40.1% and 20.6%) consumption. Different prevalence levels were observed when analyzing subgroups, mainly among girls. From 2001 to 2011, daily vegetable consumption among boys and adolescents in rural areas remained the same. The decrease in daily consumption of fruit and vegetables among adolescents aged 15 to 19 in Santa Catarina highlights the need for the development of strategies to reverse this scenario.


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Vegetables , Adolescent Behavior , Feeding Behavior , Fruit , Rural Population/statistics & numerical data , Urban Population/statistics & numerical data , Brazil , Sex Factors , Cross-Sectional Studies , Surveys and Questionnaires , Diet/statistics & numerical data
6.
Rev. saúde pública (Online) ; 54: 149, 2020. tab
Article in English | SES-SP, LILACS, BBO, SES-SP | ID: biblio-1145060

ABSTRACT

ABSTRACT OBJECTIVE To characterize the access and use of health services considered reference among the older rural population from a municipality in southern Brazil, whose rural area has full coverage of the Family Health Strategy (FHS), investigating factors associated with the choice of the Basic Family Health Unit (BFHU) as reference. METHODS This is a cross-sectional study conducted in 2017 with systematic sampling of rural households in the municipality of Rio Grande (RS) using a standardized in-house questionnaire. We performed descriptive analyses of sociodemographic profile, type of reference service chosen, and reasons for choosing/using the prime-choice service and the nearest BFHU. Poisson regression was used to investigate factors associated with the type of reference service chosen. RESULTS Among the 1,030 older adults who participated in the study, 61.4% considered the BFHU a prime choice/reference service mostly due to its proximity (82.6%); the others sought other places due to a greater ease (34.6%) and resoluteness (52.6%). Almost ⅔ of the respondents sought care at the BFHU during the last year, and the reasons differed among those who considered the unit as reference (chronic disease) and those who sought another place (procedures). We also found that the lower the age, income, education, and household-unit distance, the greater the likelihood of the older adult considering the nearest BFHU as reference service. CONCLUSIONS The FHS has reached the vulnerable older rural population, approaching an equitable public health system. However, further evaluations are necessary to verify the quality and adequacy of care, given that social structure, enabling factors (such as economic condition), and possible beliefs regarding health still establish the standards for choosing a service.


RESUMO OBJETIVO Caracterizar o acesso e utilização de serviços de saúde considerados como referência pela população rural idosa de um município do sul do Brasil, com cobertura de 100% da área rural pela Estratégia Saúde da Família (ESF), investigando os fatores associados à escolha da Unidade Básica de Saúde da Família (UBSF) como serviço de referência. MÉTODOS Estudo transversal com amostragem sistemática dos domicílios da área rural do município de Rio Grande (RS), realizado em 2017, através de questionário padronizado, aplicado em domicílio. Foram realizadas análises descritivas referentes a perfil sociodemográfico; tipo de serviço de referência escolhido; e motivos de escolha/utilização do serviço de primeira opção e da UBSF mais próxima. Realizou-se regressão de Poisson para investigar fatores associados ao tipo de serviço de referência escolhido. RESULTADOS Participaram do estudo 1.030 idosos, dos quais 61,4% indicaram a unidade básica como serviço de primeira opção/referência. Enquanto aqueles que escolheram ser atendidos na UBSF o faziam principalmente em razão da proximidade (82,6%), os demais procuraram outros locais pela percepção de maior facilidade (34,6%) e resolutividade (52,6%). Quase ⅔ dos entrevistados buscaram atendimento na UBSF no último ano, e os motivos foram diferentes entre aqueles que consideravam a unidade como referência (doença crônica) e aqueles que procuravam outro local (procedimentos). Além disso, quanto menor a idade, renda, escolaridade e distância residência-unidade, maior a probabilidade do idoso considerar a UBSF mais próxima como serviço de referência. CONCLUSÃO A ESF tem conseguido atingir a parcela rural idosa em situação de vulnerabilidade, indo ao encontro de um sistema de saúde público equitativo. Todavia, novas avaliações para averiguar adequação e qualidade do atendimento se fazem necessárias, visto que estrutura social, fatores capacitantes (como condição econômica) e possíveis crenças sobre saúde ainda definem o padrão de escolha do serviço.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Primary Health Care/statistics & numerical data , Rural Population/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Brazil , Serial Cross-Sectional Studies , Middle Aged
7.
Rev. bras. epidemiol ; 23: e200008, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1092613

ABSTRACT

RESUMO: Introdução: O comportamento sedentário tem sido associado a diversos indicadores de saúde. O objetivo deste estudo é descrever esse desfecho em idosos residentes de zona rural. Metodologia: Realizou-se um estudo transversal com idosos da zona rural de Rio Grande/RS, em 2017. A coleta de dados foi realizada por meio de questionário eletrônico. O comportamento sedentário foi avaliado pelo somatório de oito aspectos: assistir a televisão/vídeos/DVD, usar computador/internet, ler, socializar com amigos e/ou família, dirigir ou andar de carro/moto/transporte público, praticar algum hobby, trabalhar e outras atividades. A análise deu-se pela descrição dos aspectos e pela análise multivariável (regressão linear), para testar associações com características socioeconômicas, demográficas e atividade física. Também foi verificada associação do excesso de comportamento sedentário e tempo assistindo à televisão com as variáveis independentes. Resultados: A média de comportamento sedentário foi de 274,9 minutos/dia (n = 1.030), e assistir televisão representou quase a metade (130,5 minutos/dia). Idade mostrou-se inversamente associada com o comportamento sedentário, enquanto renda e escolaridade apresentaram uma relação direta. Renda apresentou associação positiva com excesso de comportamento sedentário e tempo assistindo televisão. Conclusão: A média de comportamento sedentário foi menor quando comparada com a literatura em idosos. Sugere-se que ações para incentivar hábitos saudáveis visem especialmente diminuir o tempo assistindo televisão.


ABSTRACT: Introduction: Sedentary behavior has been associated with several health indicators. This study aims to describe this outcome in elderly people living in rural areas. Methodology: A cross-sectional study was carried out with elderly people from the rural area in the city of Rio Grande/RS, in 2017. Data were collected using an electronic questionnaire. Sedentary behavior was evaluated by eight aspects: watching television/videos/DVDs, using computer/internet, reading, socializing with friends and/or family, driving or riding a car/bike/taking public transport, practicing a hobby, working, and other activities. The analysis was composed by the description of aspects and multivariable (linear regression) analysis to test associations between the outcome and socioeconomic, demographic and physical activity characteristics. Association of the excess of sedentary behavior and time watching television within the independent variables was also verified. Results: The mean of sedentary behavior was 274.9 minutes/day (n = 1,030), but watching television represented almost half (130.5 minutes/ day). Age was inversely associated with sedentary behavior, while income and schooling presented a direct relation. Income had a positive association with excessive sedentary behavior and time watching television. Conclusion: The mean sedentary behavior was lower when compared with the literature for the elderly. We suggest that actions to encourage healthy habits aim especially at reducing the time spent watching television.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Rural Population/statistics & numerical data , Sedentary Behavior , Socioeconomic Factors , Television , Time Factors , Exercise , Linear Models , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Leisure Activities , Middle Aged
8.
Epidemiol. serv. saúde ; 29(3): e2019285, 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1101135

ABSTRACT

Objetivo: avaliar a associação entre trabalho e comportamentos de risco à saúde entre escolares de zona rural. Métodos: estudo transversal com escolares do 5° ao 8° ano do ensino fundamental das escolas municipais de Barão do Triunfo, RS, Brasil, em 2010; utilizou-se questionário autoaplicável; caracterizou-se o perfil de trabalho como 'trabalhadores atuais', 'trabalhadores prévios' e 'não trabalhadores'; revelaram-se comportamentos de risco à saúde o tabagismo, o consumo de álcool, o excesso de peso e a inatividade física (≤300 minutos semanais). Resultados: dos 339 participantes menores de 16 anos (89,9%), 82,3% eram trabalhadores atuais; entre os trabalhadores, predominaram serviços domésticos (39,8%) e agricultura (29,9%); 24,8% estavam com excesso de peso, 51,2% inativos no lazer, 6,6% fumavam; e 27,0% haviam consumido álcool nos últimos 30 dias, principalmente trabalhadores, comparados a não trabalhadores (p=0,02). Conclusão: oito em cada dez escolares trabalhava, e a maioria destes estava em trabalho infanto-juvenil; consumo de álcool foi o comportamento de risco à saúde mais frequente.


Objetivo: evaluar la asociación entre el trabajo y los comportamientos de riesgo a la salud entre los escolares de zona rural. Métodos: estudio transversal con estudiantes de quinto a octavo grado de primaria en las escuelas municipales de Barão do Triunfo, RS, Brasil, en 2010; en cuestionario autoaplicable, se caracterizó el perfil de trabajo como 'trabajadores actuales', 'trabajadores previos' y 'no trabajadores'; los comportamientos de riesgo a la salud fueron el tabaquismo (sí; no) y el consumo de alcohol (sí; no) en el último mes, exceso de peso e inactividad física. Resultados: entre los 339 participantes menores de 16 años (89,9%), el 82,3% eran trabajadores; entre los trabajadores, predominaron los servicios domésticos (39,8%) y la agricultura (29,9%); 24,8% de los estudiantes tenía sobrepeso, 51,2% estaba inactivo en el tiempo libre, 6,6% fumaba y 27,0% consumió alcohol en los últimos 30 días; este consumo fue mayor entre los trabajadores que entre los no trabajadores (p=0,02). Conclusión: ocho de cada diez escolares trabajaba, y la mayoría fue de niños y adolescentes; el comportamiento de mayor riesgo entre ellos fue el alcohol.


Objective: to evaluate association between work and health risk behaviors among rural schoolchildren. Methods: this was a cross-sectional study with 5th to 8th grade elementary and middle school students attending municipal schools in Barão do Triunfo, RS, Brazil in 2010; a self-administered questionnaire was used; their work profile was characterized as 'current workers', 'former workers', and 'non-workers'; health risk behaviors examined were smoking, alcohol consumption, overweight, and physical inactivity (≤300 minutes per week). Results: of the 339 participants under 16 years old (89.9%), 82.3% were current workers; their predominant work was domestic services (39.8%), and farming (29.9%); 24.8% of students were overweight, 51.2% were inactive during leisure, 6.6% smoked, and 27.0% had consumed alcohol in the last 30 days; alcohol consumption was higher among workers than non-workers (p=0.02). Conclusion: eight out of ten schoolchildren worked, most of them as child labor; the most frequent health risk behavior was alcohol consumption.


Subject(s)
Humans , Male , Female , Child , Adolescent , Rural Population/statistics & numerical data , Tobacco Use Disorder/epidemiology , Child Labor/statistics & numerical data , Adolescent Behavior/psychology , Alcoholism/epidemiology , Health Risk Behaviors , Brazil/epidemiology , Student Health , Cross-Sectional Studies , Social Vulnerability , Sedentary Behavior
9.
Medwave ; 20(1): e7766, 2020.
Article in English, Spanish | LILACS | ID: biblio-1053124

ABSTRACT

INTRODUCCIÓN El cáncer de mama es la neoplasia maligna más común en las mujeres en todo el mundo y en Chile, siendo la primera causa de muerte oncológica femenina. Se ha reportado amplia variación en la mortalidad, con focos geográficos de mayor riesgo. OBJETIVO Analizar espacialmente la mortalidad por cáncer de mama en mujeres de la Región Metropolitana en 2015. MÉTODOS Estudio ecológico. Se utilizaron los datos de los registros de defunciones del año 2015 (C50 según CIE10), y las proyecciones poblacionales del Instituto Nacional de Estadísticas. Se calcularon tasas de mortalidad por cáncer de mama brutas y razones de mortalidad estandarizadas. Se realizó un análisis epidemiológico espacial estimando el índice I de Moran Global y Local para evaluar autocorrelación espacial. Los resultados se presentan en mapas (cartografía precenso 2016). RESULTADOS Se registraron 622 defunciones por cáncer de mama en la Región Metropolitana en 2015. La edad promedio de las mujeres fallecidas fue de 66 años (desviación estándar: 15,5). El 92,4% de las muertes se registró en zonas centrales o urbanas. Sin embargo, las mayores tasas de mortalidad se observaron en comunas periféricas. No se observó autocorrelación espacial global en la región (I de Moran de 0,007; p = 0,134). A nivel local, cuatro comunas se diferencian de forma significativa de sus vecinas. CONCLUSIONES El riesgo de morir por cáncer de mama en la Región Metropolitana de Chile se concentra en comunas periféricas. Cuatro comunas de la región presentan riesgos diferentes de sus comunas vecinas, por lo que es necesario explorar factores que explican la desigual distribución de las muertes.


INTRODUCTION Breast cancer is the most common malignancy in women worldwide and Chile, being the leading cause of female cancer death. A wide variation in mortality has been reported, with geographic clusters of higher risk. OBJECTIVE To spatially analyze mortality from breast cancer in women in the Metropolitan Region in 2015. METHODS Ecological study of location. We used death records in 2015 (C50 according to ICD10) and population projections of the Statistics Institute to estimate mortality rates. We calculated crude breast cancer mortality rates and standardized mortality ratios and performed a spatial epidemiological analysis of breast cancer mortality in women, estimating the global and local Moran I index to assess spatial autocorrelation. We present the results in maps according to the 2016 pre-census cartography. RESULTS There were 622 deaths from breast cancer in the Metropolitan Region in 2015. The mean age was 66 years (SD: 15.5). 92.4% of deaths were registered in urban or central areas. However, the highest mortality rates were observed in peripherical districts. No global spatial autocorrelation was observed in the region (Moran's I 0.007 p = 0.134). However, at the local level, four districts differ significantly from their neighbors. CONCLUSIONS The risk of dying from breast cancer in the Metropolitan Region of Chile is concentrated in women from peripherical communes. Four districts in the region present different risks from their neighboring districts. It is necessary to investigate local realities to prevent deaths from this pathology.


Subject(s)
Humans , Female , Aged , Breast Neoplasms/mortality , Rural Population/statistics & numerical data , Suburban Population/statistics & numerical data , Urban Population/statistics & numerical data , Chile/epidemiology , Death Certificates , Risk Factors
10.
Rev. saúde pública (Online) ; 54: 90, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1127246

ABSTRACT

ABSTRACT OBJECTIVE: To analyze factors associated with diarrheal disease in the rural Caribbean region of Colombia. METHOD: A cross-sectional study conducted in the rural area of the Cesar Department, Colombia, between November 2017 and June 2018. Self-reported cases of diarrheal disease were surveyed, and water samples from 42 households were collected and analyzed. Descriptive statistics were employed in the analysis of socioeconomic status, environmental and sanitary conditions, and we evaluated their association with the diarrheal disease using the Poisson regression models. Each model was adjusted with variables suggested by specific directed acyclic graphs. RESULTS: Poor water supply conditions, hygiene and basic sanitation were reported in the study area. All water samples were classified either as high risk for health problems or unfit for human consumption. The diarrheal disease had a prevalence of 7.5% across all ages and of 23.5% in children under five years old. The variables rainy season (PR = 0.24; 95%CI 0.07-0.85), children under five years old (PR = 4.05; 95%CI 1.70-9.68), water from deep wells (PR = 16.90; 95%CI 2.45-116.67), water from artificial ponds (PR = 11.47; 95%CI 1.27-103.29), toilets availability (PRA = 0.23; 95%CI 0.06-0.96), and swine presence (PR = 0.20; 95%CI 0.05-0.74) were significantly associated with the occurrence of diarrheal disease. CONCLUSION: Water supply, hygiene and basic sanitation conditions have been associated with the diarrheal disease, affecting almost a quarter of the population under five years old. There is an urge for the design of effective policies that improve environmental and sanitation conditions in rural areas.


RESUMEN OBJETIVO: Analizar factores asociados con enfermedad diarreica en área rural del Caribe colombiano. MÉTODO: Estudio transversal en área rural dispersa del departamento del Cesar, Colombia, entre noviembre de 2017 y junio de 2018. Se indagó sobre morbilidad auto-reportada de enfermedad diarreica y se recolectaron y analizaron muestras de agua en 42 domicilios. Fue realizado un análisis descriptivo de condiciones socioeconómicas, ambientales y sanitarias y evaluamos su asociación con enfermedad diarreica mediante modelo robusto de regresión de Poisson. Cada modelo fue ajustado con variables sugeridas por diagramas causales específicos. RESULTADOS: Se evidenciaron condiciones precarias de abastecimiento de agua, higiene y saneamiento básico en la zona de estudio. Todas las muestras de agua se clasificaron entre los niveles de riesgo alto e inviable sanitariamente. La prevalencia de enfermedad diarreica fue 7,5% en todas las edades y 23,5% en niños menores de cinco años. Las variables estación lluviosa (RP = 0,24; IC95% 0,07-0,85), niños menores de cinco años (RP = 4,05; IC95% 1,70-9,68), abastecimiento de agua desde pozo profundo (RP = 16,90; IC95% 2,45-116,67), abastecimiento de agua desde estanco (RP = 11,47; IC95% 1,27-103,29), tenencia de baño (RPA = 0,23; IC95% 0,06-0,96) y presencia de cerdos (RP = 0,20; IC95% 0,05-0,74) mostraron asociaciones estadísticamente significativas con la ocurrencia de enfermedad diarreica. CONCLUSIÓN: Condiciones de abastecimiento de agua, higiene y saneamiento básico estuvieron asociadas con la ocurrencia de enfermedad diarreica, afectando alrededor de un cuarto de la población menor de cinco años. Urge un diseño efectivo de políticas que contribuyan al mejoramiento de condiciones ambientales y saneamiento en áreas rurales.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Rural Population/statistics & numerical data , Diarrhea/epidemiology , Cross-Sectional Studies , Risk Factors , Health Surveys , Colombia/epidemiology , Middle Aged
11.
Rev. bras. epidemiol ; 23: e200027, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1101593

ABSTRACT

RESUMO: Objetivo: Estimar a prevalência de exposição a agrotóxicos e fatores associados entre moradores de zona rural. Métodos: Estudo transversal de base populacional realizado com 1.518 indivíduos, em 2016. Foram aleatoriamente selecionados 24 setores censitários de oito distritos rurais de Pelotas, RS. Indivíduos ≥ 18 anos residentes nos domicílios aleatoriamente selecionados eram elegíveis. Foi realizada análise descritiva e apresentada prevalência de contato com os agrotóxicos. A associação entre desfecho e variáveis independentes deu-se por regressão de Poisson, conforme modelo hierárquico. As variáveis foram ajustadas para todas do mesmo nível, além daquelas que foram mantidas no modelo do nível anterior e das com valor p < 0,20. Resultados: A prevalência de contato com agrotóxicos no último ano foi de 23,7%, e, entre esses participantes, 5,9% relataram intoxicação por agrotóxicos alguma vez na vida. A probabilidade de contato com agrotóxicos no último ano foi maior entre os homens (razão de prevalência - RP = 2,00; intervalo de confiança de 95% - IC95% 1,56 - 2,56); entre aqueles com idades entre 40 e 49 anos (RP = 1,44; IC95% 1,12 - 1,80); entre os menos escolarizados (RP = 2,06; IC95% 1,39 - 3,10); os que exerciam trabalho rural (RP = 2,87; IC95% 2,05 - 4,01); e aqueles que moraram na zona rural a vida inteira (RP = 1,28; IC95% 1,00 - 1,66). Conclusões: Aproximadamente um em cada quatro adultos da zona rural de Pelotas entrou em contato com agrotóxicos no ano anterior ao estudo. Os achados evidenciam a existência de desigualdades sociais relacionadas à exposição aos agrotóxicos e fornecem informações para ações visando à redução da exposição e intoxicação por esses produtos.


ABSTRACT: Objective: To estimate the prevalence of pesticide exposure and associated factors among rural residents. Methods: A population-based, cross-sectional study conducted with 1,518 individuals in 2016. We randomly selected 24 census tracts from the eight rural districts of the city of Pelotas, RS. All individuals aged 18 years or older, living in the randomly selected households were eligible. A descriptive analysis was performed and the prevalence of contact with pesticides was presented. The association between outcome and independent variables was analyzed using Poisson regression according to the hierarchical model. The variables were all adjusted to the same level, including those at the previous level and those with p<0.20 were kept in the model. Results: The prevalence of contact with pesticides in the past year was 23.7% and among the participants, 5.9% reported having pesticide poisoning at some time in their lives. The probability of contact with pesticides in the past year was higher among men (PR=2,00; 95%CI 1.56 - 2.56), among those aged 40-49 years (PR = 2.00; 95%CI 1.12 - 1.80), among individuals with lower levels of education (PR = 2.06; 95%CI 1.39 - 3.10), in those who performed rural work (PR = 2.87; 95%CI 1.39 - 3.10) and in those who had lived in rural areas all their lives (PR = 1.28 95%CI 1.00 - 1.66). Conclusions: Approximately one in four adults in rural Pelotas had come into contact with pesticides in the year before the study. The findings show the existence of social inequalities related to exposure to pesticides and provide information for action aimed at reducing exposure and poisoning from these products.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Pesticides/poisoning , Rural Population/statistics & numerical data , Environmental Exposure/statistics & numerical data , Socioeconomic Factors , Brazil/epidemiology , Poisson Distribution , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Sex Distribution , Age Distribution , Farmers/statistics & numerical data , Middle Aged
12.
Rev. saúde pública (Online) ; 54: 20, 2020. tab, graf
Article in English | LILACS | ID: biblio-1094413

ABSTRACT

ABSTRACT OBJECTIVE To compare the access to and effective use of health services available among international migrants and Chileans. METHODS Secondary analysis of the National Socioeconomic Characterization Survey (CASEN - Caracterización Socioeconómica Nacional ), version 2017. Indicators of access to the health system (having health insurance) and effective use of health services (perceived need, appointment or coverage, barriers and need satisfaction) were described in immigrants and local population, self-reported. Gaps by immigrant status were estimated using logistic regressions, with complex samples. RESULTS Immigrants were 7.5 times more likely to have no health insurance than local residents. Immigrants presented less perceived need than local residents, together with a greater lack of appointments (OR: 1.7 95%CI: 1.2-2.5), coverage (OR: 2.7 95%CI: 2.0-3.7) and unsatisfied need. The difference between immigrants and locals was not statistically significant in barriers to health care access (α = 0.005). CONCLUSIONS Disadvantages persist regarding the access to and use of health services by immigrants as opposed to Chileans compared with information from previous years. It is necessary to reduce the gaps between immigrants and people born in Chile, especially in terms of health system access. This is the first barrier to effective use of services. The generation of concrete strategies and health policies that consider an approach of social participation of the immigrant community is suggested to bring the health system closer to this population.


RESUMEN OBJETIVO Comparar el acceso y uso efectivo de servicios de salud disponibles entre migrantes internacionales y chilenos. MÉTODOS Análisis secundario de la encuesta poblacional de Caracterización Socioeconómica Nacional (CASEN), versión 2017. Se describieron indicadores de acceso al sistema de salud (tener previsión de salud) y uso efectivo de servicios de salud (necesidad sentida, consulta o cobertura, barreras y satisfacción de la necesidad) en inmigrantes y locales, autorreportados. Las brechas por condición de inmigrante se estimaron utilizando regresiones logísticas, con muestras complejas. RESULTADOS Los inmigrantes presentaron 7,5 veces más chances de no tener previsión de salud que los locales. Los inmigrantes presentaron una menor necesidad sentida que los locales, en conjunto con una mayor falta de consulta (OR: 1,7 IC95%: 1,2-2,5), cobertura (OR: 2,7 IC95%: 2,0-3,7) e insatisfacción de necesidades. La diferencia entre inmigrantes y locales no fue estadísticamente significativa en barreras de acceso a atención en salud (α = 0,005). CONCLUSIONES Persisten las desventajas en acceso y uso a servicios de salud en inmigrantes en comparación con los nacidos en Chile en contraste con información de años anteriores. Es necesario reducir las brechas entre inmigrantes y nacidos en Chile, sobre todo en cuanto a pertenencia a un sistema de salud. Esta es la primera barrera para un uso efectivo de servicios. Se sugiere generar estrategias concretas y políticas en salud que consideren un enfoque de participación social de la comunidad inmigrante y, adicionalmente, acerquen al sistema de salud a esta población.


Subject(s)
Humans , Male , Female , Public Policy , Needs Assessment/statistics & numerical data , Emigrants and Immigrants/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Insurance, Health/statistics & numerical data , Rural Population/statistics & numerical data , Socioeconomic Factors , Transients and Migrants/statistics & numerical data , Urban Population/statistics & numerical data , Chile , Residence Characteristics , Cross-Sectional Studies , Health Surveys , Health Status Disparities , Self Report
13.
Ciênc. Saúde Colet ; 24(7): 2531-2542, jul. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1011835

ABSTRACT

Resumo O artigo analisa o efeito da violência contra a mulher na autopercepção da saúde, a partir de uma população de mulheres brasileiras com idades entre 20 e 49 anos, considerando as informações da Pesquisa Nacional de Saúde de 2013. Os resultados indicam que mais de 80% das mulheres que sofreram violência por indivíduo nos últimos doze meses anteriores a pesquisa, relataram como mais grave a agressão psicológica e/ou física. O pior reporte de saúde foi maior entre mulheres que relataram violência sofrida por pessoa conhecida, em caso de residentes em áreas rurais; já dentre as residentes de localidades urbanas, houve relatos de violência perpetrada por agressor desconhecido. Em função desses resultados, pode-se inferir que as mulheres vítimas de violência possuem pior percepção de saúde vis-à-vis as que não foram vítimas de violência.


Abstract This article analyzes the effect of violence against women on their self-perception of health, based on the population of Brazilian women aged between 20 and 49 years of age, using data from the 2013 National Health Survey. The results indicate that more than 80% of women who suffered violence caused by an individual in the last 12 months prior to the survey, reported the most severe being psychological and/or physical aggression. The worst health reports were higher among women who reported violence suffered at the hands of a person known to them, in the case of residents in rural areas. With respect to residents of urban locations, there were reports of violence perpetrated by an unknown aggressor. Based on these results, it can be inferred that women who are victims of violence have a worse self-perception of health vis-à-vis those who were not victims of violence.


Subject(s)
Humans , Female , Adult , Young Adult , Self Concept , Health Status , Gender-Based Violence/psychology , Rural Population/statistics & numerical data , Urban Population/statistics & numerical data , Brazil/epidemiology , Health Surveys , Middle Aged
14.
An. bras. dermatol ; 94(2): 157-163, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001134

ABSTRACT

Abstract BACKGROUND: Skin cancer is common in Brazil and is related to sun exposure, among other risk factors. There are no data on the incidence of malignant skin neoplasm in rural workers in western Paraná. OBJECTIVE: To analyze the incidence and profile of rural workers who were diagnosed with skin cancer at a reference service in Cascavel, western Paraná, in the last five years (2011-2016). METHODS: This retrospective cross-sectional study was carried out through a review of the anatomopathological reports of rural workers diagnosed with skin cancer at Cascavel Oncology Center (CEONC), in Cascavel. The following variables were collected: year of diagnosis, age, gender, injury location and histological subtype. RESULTS: A total of 681 cases of malignant epithelial neoplasia were identified, with a higher frequency in the 61-70 age group. Data analysis showed an increase of about 210% in the occurrence of skin cancers in the last 5 years. The cephalic region was the most affected, and the most common histological subtype was nodular basal cell carcinoma. There was no association between gender and location. STUDY LIMITATIONS: This is a retrospective study and analysis of a secondary data bank. CONCLUSION: This study is a regional estimation of the incidence of cutaneous neoplasms and provides evidence of a considerable increase in the number of diagnoses in rural workers from western Paraná, Brazil. Moreover, it is possible to conclude that the sample group studied is at risk of developing skin cancer.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Melanoma/epidemiology , Rural Population/statistics & numerical data , Skin Neoplasms/etiology , Sunlight/adverse effects , Brazil/ethnology , Brazil/epidemiology , Carcinoma, Basal Cell/etiology , Carcinoma, Squamous Cell/etiology , Incidence , Cross-Sectional Studies , Retrospective Studies , Age Distribution , Face , Melanoma/etiology
15.
Ciênc. Saúde Colet ; 24(3): 865-874, mar. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-989600

ABSTRACT

Resumo Esta revisão objetivou analisar a insegurança alimentar e nutricional no meio rural brasileiro, bem como os instrumentos de mensuração utilizados na avaliação dessa situação. Realizou-se revisão sistemática nas bases de dados SciELO, Pubmed e o portal de periódicos da CAPES, usando os termos de busca: 'segurança alimentar' e 'rural'. Posteriormente foi realizada busca reversa dentro dos artigos selecionados. Os critérios de inclusão foram: artigos originais, relacionados à (in) segurança alimentar e nutricional na população rural brasileira. Foram incluídos 12 estudos. A maioria utilizou a Escala Brasileira de Insegurança Alimentar-EBIA e questionários socioeconômicos para avaliar a insegurança alimentar (IA), sendo encontrada associação entre eles. Cinco estudos abordaram o aspecto nutricional pela antropometria, porém não encontraram associação com a IA. O consumo alimentar foi avaliado por quatro estudos e foi observada associação. Os resultados mostram alta prevalência de IA no meio rural em relação à população analisada na Pesquisa Nacional por Amostra de Domicílio-PNAD nos anos de 2009 e 2013, assim como alta prevalência de IA grave. Conclui-se que o meio rural se apresenta em vulnerabilidade, principalmente quanto à questão alimentar e nutricional e aos determinantes socioeconômicos atrelados.


Abstract This review sought to analyze food and nutritional insecurity in the Brazilian rural environment, and the measurement instruments used to assess this situation. A systematic review was conducted in the SciELO, PubMed and CAPES databases, using the search terms: 'food security' and 'rural,' Subsequently, a reverse search was performed in the 12 articles selected. The inclusion criteria were: original articles related to food and nutritional (in)security in the Brazilian rural population. Twelve studies were included. Most of them used the Escala Brasileira de Insegurança Alimentar - EBIA (Brazilian Scale for Food Insecurity) and socioeconomic questionnaires to assess food insecurity (FI), an association being found between them. Five studies addressed the nutritional aspect by anthropometry but found no association with FI. Food consumption was assessed by four studies and an association was detected. The results show a high prevalence of FI in rural areas in relation to the population analyzed in the Pesquisa Nacional por Amostra de Domicílio - PNAD (National Household Sample Survey) in the years 2009 and 2013, as well as a high prevalence of severe FI. The conclusion reached is that the rural environment is vulnerable, mainly regarding food and nutritional issues and the associated socioeconomic determinants.


Subject(s)
Humans , Rural Population/statistics & numerical data , Surveys and Questionnaires , Food Supply/statistics & numerical data , Socioeconomic Factors , Brazil , Feeding Behavior
16.
Ciênc. Saúde Colet ; 24(2): 419-430, Feb. 2019. tab
Article in Portuguese | LILACS | ID: biblio-984212

ABSTRACT

Resumo O objetivo deste artigo é descrever o consumo e o comportamento alimentar de adolescentes quilombolas e não quilombolas da zona rural do sudoeste baiano. Estudo transversal com 390 adolescentes de 10 a 19 anos em 2015, utilizando questionário adaptado da PeNSE e PNS. O consumo alimentar foi avaliado pela frequência nos últimos 7 dias de alimentos marcadores de alimentação saudável e não saudável. Realizar o desjejum foi marcador de comportamento saudável e, realizar refeição enquanto assistia TV, de não saudável. Foi realizada distribuição de frequências e as diferenças entre os grupos quilombola e não quilombola foram testadas com qui-quadrado. A razão de prevalência (RP) estimou a associação do consumo e comportamento alimentar e as variáveis de interesse. Observou-se baixo consumo de frutas (30,8%), hortaliças (44,3%) e leite (24,4%). Quando comparados, os quilombolas tiveram consumo de feijão maior (RP = 1,11), entretanto, o consumo de hortaliças (RP = 0,73), frutas (RP = 0,67) e leite (RP = 0,68) foi inferior ao dos não quilombolas. Recomendam-se políticas públicas voltadas à assistência nutricional, específicas aos adolescentes rurais, uma vez que os maus hábitos alimentares podem permanecer ao longo da vida e levar a condições precárias de saúde.


Abstract The scope of this article is to describe the food consumption and eating behavior of quilombola and non-quilombola adolescents from the rural area of Southwest Bahia. A cross-sectional study with 390 adolescents aged 10 to 19 years was conducted in 2015, using an adapted PeNSE and PNS questionnaire. Food consumption was assessed by the frequency of healthy and unhealthy food markers in the previous 7 days. Eating breakfast was used as a marker of healthy eating behavior and having meals while watching TV as being unhealthy. Frequency distribution was carried out and the differences between quilombola and non-quilombola groups were assessed using the chi-square test. The prevalence ratio (PR) estimated the association of food consumption and eating behavior and the variables of interest. Low fruit consumption (30.8%), vegetables (44.3%) and milk (24.4%) was observed. Comparison between the groups revealed lower consumption of vegetables (PR = 0.73), fruit (PR = 0.67) and milk (PR = 0.68) among quilombola than among non-quilombola adolescents. Public policies targeted at nutritional assistance specific to rural adolescents are recommended, since bad eating habits can prevail throughout life and lead to poor health conditions.


Subject(s)
Humans , Animals , Male , Female , Child , Adolescent , Young Adult , Rural Population/statistics & numerical data , Ethnic Groups/statistics & numerical data , Eating/ethnology , Feeding Behavior/ethnology , Public Policy , Vegetables , Brazil , Prevalence , Cross-Sectional Studies , Milk , Fruit
17.
Ciênc. Saúde Colet ; 24(2): 509-522, Feb. 2019. tab
Article in Portuguese | LILACS | ID: biblio-984207

ABSTRACT

Resumo O objetivo desta pesquisa é analisar as implicações da violência entre pares no contexto escolar, do clima escolar e da percepção dos contextos de desenvolvimento no bem-estar subjetivo de crianças e adolescentes. A amostra é composta por 910 estudantes do 6º e 7º ano do ensino fundamental, de 27 escolas, públicas e privadas, urbanas e rurais do Ceará. Trata-se de um estudo transversal quantitativo que utilizou os instrumentos escala de vitimização e agressão entre pares e de clima escolar; três índices de percepção dos contextos de desenvolvimento (casa, escola, bairro); três escalas de bem-estar (satisfação com a vida para estudantes, índice de bem-estar pessoal e item único de satisfação com a vida) para coleta de dados. Os dados passaram por análise de variância multivariada com nível de significância não superior a 0,01. Os resultados indicam que a tipologia bullying, isoladamente ou em interação com as variáveis analisadas, é a que mais impacto exerce sobre o bem-estar da população estudada, sendo os envolvidos os que apresentam as menores médias de bem-estar. Níveis baixos de percepção dos contextos casa, escola, bairro, e do clima escolar, bem como estudar em escola pública e/ou morar em zona rural, estão igualmente associados a bem-estar subjetivo baixo.


Abstract The scope of this study is to analyze the implications of peer violence in the school context, the school environment and the perceived developmental contexts on the subjective well-being of children and adolescents. The sample is comprised of 910 students in Years 6 and 7 of primary school in 27 urban and rural public and private schools in Ceará. It is a quantitative cross-sectional study and the following tools were used: scales measuring victimization and aggression among peers and the school environment; three indices on perceptions of developmental contexts (home, school, neighborhood); and three well-being scales (Students' Life Satisfaction Scale, Personal Well-being Index and Single item on Overall Life Satisfaction). Data were analyzed using multivariate variance analysis, with a significance level below 0, 01. Results indicate that bullying, alone or in interaction with the variables analyzed, is the variable that has the greatest impact on the well-being of the population studied, whereby those involved in bullying have the lowest well-being averages. Low levels of perception regarding the contexts of home, school and neighborhood and the school environment, as well as attending a public school and/or living in rural areas, are all also associated with low subjective well-being.


Subject(s)
Humans , Male , Female , Child , Adolescent , Peer Group , Violence/statistics & numerical data , Crime Victims/statistics & numerical data , Bullying/statistics & numerical data , Personal Satisfaction , Rural Population/statistics & numerical data , Schools/statistics & numerical data , Students/psychology , Students/statistics & numerical data , Urban Population/statistics & numerical data , Residence Characteristics , Cross-Sectional Studies , Aggression , Interpersonal Relations
18.
Ciênc. Saúde Colet ; 24(2): 431-441, Feb. 2019. tab
Article in Portuguese | LILACS | ID: biblio-984188

ABSTRACT

Resumo O objetivo deste artigo é descrever a experimentação do tabaco e fatores associados em adolescentes da zona rural do sudoeste da Bahia. Este foi um recorte da pesquisa Adolescer, do tipo seccional, em 2015, com 390 adolescentes. Os dados foram analisados através de medidas de frequência e qui-quadrado; e regressão de Poisson, com variância robusta, para estimar as razões de prevalências (RP) para a experimentação do tabaco em relação às variáveis explicativas. Dos adolescentes, 5,1% experimentaram cigarro alguma vez na vida e 0,3% faziam uso regular. Mostraram-se associados à experimentação: sexo masculino (RP = 6,46); ter tido relação sexual alguma vez na vida (RP = 20,55); ter pais que raramente ou nunca entenderem os seus problemas (RP = 7,89); ter 3 ou mais amigos (RP = 0,10). Apesar das baixas prevalências de experimentação do tabaco e do seu uso regular, que indicam a adoção de um estilo de vida mais saudável ou ainda uma maior autonomia e capacidade de decisão para o não consumo, sabe-se que não existe nível seguro de exposição ao tabaco. Sugere-se o estabelecimento de parceria intersetorial educação-saúde para fortalecer ações de promoção da saúde e prevenção de doenças, com ênfase no tabagismo.


Abstract The aim of this study is to describe incipient tobacco use and associated factors among adolescents from the rural zone of southwestern Bahia. It was based on data from the cross-sectional Adolescer research project among 390 adolescents conducted in 2015. Data were analyzed using frequency and chi-square measurements and Poisson regression with robust variance to estimate the prevalence ratios (PR) for incipient tobacco use in relation to the explanatory variables. Among the adolescents, 5.1% had smoked at some stage and 0.3% smoked regularly. The following variables were associated with incipient smoking: male gender (PR = 6.46); having had sexual intercourse at some stage in life (PR = 20.55); having parents who rarely or never understood their problems (PR=7.89); having 3 or more friends (PR = 0.10). Despite low incipient smoking or the prevalence of regular smoking, which indicate the adoption of a healthier lifestyle or greater autonomy and decision-making ability for non-smoking, it is acknowledged that there is no safe level of exposure to tobacco. The recommendation is that an intersectoral partnership between education and health be created to foster health promotion and disease prevention, with an emphasis on curtailing smoking habits.


Subject(s)
Humans , Male , Female , Adolescent , Parent-Child Relations , Rural Population/statistics & numerical data , Friends , Tobacco Use/epidemiology , Sexual Behavior , Brazil/epidemiology , Poisson Distribution , Sex Factors , Prevalence , Cross-Sectional Studies , Risk Factors
19.
Cad. Saúde Pública (Online) ; 35(9): e00174818, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019636

ABSTRACT

Intimate partner violence (IPV) is a worldwide public health problem. Many proposals aiming to eliminate its occurrence include the empowerment of women through their socio-economic development. In this context, some studies suggested that microcredit programs (MP) and cash transfer programs (CTP) are initiatives that can also reduce the risk of IPV. Others pointed to an opposite effect. The objective of this study was to investigate the influence of women's economic empowerment in MP and CTP on the risk of physical, psychological and sexual violence through a systematic review. Papers/documents selection was conducted by two researchers according to the following criteria: published in English, Portuguese or Spanish; primary data; assessing the effect of MP or CTP on IPV; in heterosexual couples; on women beneficiaries of the intervention; using a comparator group eligible for an MP or CTP; and focusing on risk IPV as the outcomes. Our results showed that the impact of MP are mixed when it comes to physical and physical/sexual violence. Even so, the review suggests that the effect of MP on sexual violence is trivial or nonexistent. Regarding the impact of CTPs, the present study showed that the effects on physical, physical/sexual, psychological, and sexual violence were also heterogeneous. Women more empowered and with some autonomy could be at risk. Despite that, participation in the empowerment program should be encouraged for poor women and families. However, parallel interventions to lead with IPV should be addressed to the main actions to reduce the risk of increasing IPV prevalence in certain scenarios.


A violência entre parceiros íntimos (VPI) é um problema de saúde pública de alcance global. Muitas propostas para eliminar a VPI incluem o empoderamento das mulheres através do desenvolvimento socioeconômico individual. Nesse contexto, alguns estudos sugerem que programas de microcrédito (PMC) e de transferência de renda (PTR) também podem reduzir o risco de VPI, enquanto outros apontam para um efeito oposto. Através de uma revisão sistemática, este estudo teve como objetivo investigar a influência do empoderamento econômico das mulheres através de PMCs e PTRs sobre o risco de violência física, psicológica e sexual. A seleção de artigos e documentos foi realizada por dois pesquisadores, com base nos seguintes critérios: publicação em inglês, português ou espanhol; dados primários; avaliação do efeito de PMC ou PTR sobre VPI; casais heterossexuais; mulheres beneficiárias da intervenção; uso de um grupo de comparação elegível para um PMC ou PTR e foco sobre o risco de VPI como o desfecho. Nossos resultados mostraram que o impacto dos PMCs é misto no que diz respeito à violência física e física/sexual. Contanto, a revisão sugere que o efeito dos PMCs sobre a violência sexual é trivial ou inexistente. Quanto ao impacto dos PTRs, o estudo mostrou que os efeitos sobre a violência física, física/sexual, psicológica e sexual também foram heterogêneos. As mulheres mais empoderadas e com alguma autonomia poderiam estar em risco maior. Entretanto, a participação no programa de empoderamento deve ser incentivada para as mulheres e famílias pobres. Intervenções paralelas para líder com a VPI devem focar nas principais medidas para reduzir o risco de aumento de prevalência de VPI em determinados cenários.


La violencia doméstica (VPI por sus siglas en portugués) es un problema de salud pública en todo el mundo. Las propuestas para eliminarla incluyen el empoderamiento de las mujeres a través de su desarrollo socioeconómico. Algunos estudios sugieren que los programas de microcrédito (PMCs) y de transferencia de renta (PTRs) son iniciativas capaces de reducir el riesgo de VPI. Otros estudios indican un efecto contrario. Basándonos en una revisión sistemática, el estudio procuró investigar la influencia del empoderamiento económico de las mujeres, a través de PMCs y PTRs, sobre el riesgo de violencia física, psicológica y sexual. Los artículos y documentos fueron seleccionados por dos investigadores, de acuerdo con los siguientes criterios: estudios publicados en inglés, portugués o español; datos primarios; evaluación del efecto del PMC o PTR sobre la VPI; parejas heterosexuales; mujeres beneficiarias de la intervención; un grupo de comparación elegible para un PMC o PTR y centrados en el riesgo de VPI como desenlace. De acuerdo con nuestros resultados, el impacto de los PMCs es mixto en lo que se refiere a la violencia física y física/sexual. No obstante, la revisión sugiere que el efecto de los PMCs sobre la violencia sexual es trivial o inexistente. En relación con el impacto de los PTRs, el estudio mostró que los efectos sobre la violencia física, física/sexual, psicológica y sexual también son heterogéneos. Las mujeres más empoderadas y con alguna autonomía podrían estar en riesgo. Sin embargo, la participación en el programa de empoderamiento debe incentivarse en el caso de las mujeres y familias pobres. Las intervenciones paralelas para combatir VPI deben dar prioridad a medidas para reducir el riesgo de aumento de la prevalencia de esta violencia en determinados contextos.


Subject(s)
Humans , Female , Women/psychology , Financial Support , Employment/psychology , Intimate Partner Violence/economics , Empowerment , Rural Population/statistics & numerical data , Socioeconomic Factors , Urban Population/statistics & numerical data , Prevalence , Surveys and Questionnaires , Risk Factors , Financial Management , Intimate Partner Violence/psychology , Intimate Partner Violence/statistics & numerical data , Latin America/epidemiology
20.
Cad. Saúde Pública (Online) ; 35(supl.3): e00006119, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1019646

ABSTRACT

Resumo: As investigações sobre os sistemas de classificação racial no Brasil evidenciam as influências de aspectos socioeconômicos na expressão das categorias de cor/raça, com destaque para brancos e negros. O objetivo deste trabalho foi analisar arranjos específicos formados entre pais, mães e filhos em que, pelo menos, um deles era indígena. Com base na amostra do Censo Demográfico de 2010, foram selecionados domicílios com pelo menos três moradores (pai, mãe e filhos), sendo, pelo menos, um indígena. Os filhos foram caracterizados segundo cor/raça (branca, parda e indígena), sexo, idade, renda domiciliar per capita, escolaridade das mães e número de moradores nos domicílios urbanos e rurais. Foram realizadas análises descritivas e regressão logística multinomial. Estimou-se um total de 290.247 filhos (77,1% indígenas, 13,8% pardos e 9,1% brancos), dos quais 74,3% residiam em domicílios rurais e 41,3% na Região Norte; filhos brancos e pardos estavam localizados majoritariamente em áreas urbanas. As chances de os filhos de pais ou mães indígenas terem sido classificados como brancos foram mais expressivas nas regiões Sudeste e Sul. Os filhos apresentaram maiores chances de serem classificados como brancos e pardos com o aumento do rendimento mensal e da escolaridade materna. Os achados demonstram como a posição socioeconômica está associada de forma significativa com os processos de classificação de cor/raça no Brasil, também nos segmentos indígenas da população.


Abstract: Studies on racial classification systems in Brazil reveal the influence of socioeconomic factors in the expression of color/race categories, especially for whites and blacks. The aim of this study was to analyze specific family arrangements between fathers, mothers, and children, at least one of whom was indigenous. Based on the sample from the 2010 Population Census, we selected households with at least three residents (father, mother, and children), at least one of whom was indigenous. Children were characterized according to color/race (white, brown, and indigenous), sex, age, per capita household income, maternal schooling, and number of urban and rural household residents. Descriptive and multinomial logistic regression analyses were performed. We estimated a total of 290.247 children (of whom 77.1% were classified as indigenous, 13.8% brown, and 9.1% white), 74.3% living in rural households and 41.3% in the North region of Brazil; children classified as white and brown were located mostly in urban areas. The odds of children of indigenous fathers or mothers being classified as white were higher in the Southeast and South. The odds of children being classified as white or brown increased proportionally with monthly income and maternal schooling. The findings show that socioeconomic status is significantly associated with color/race classification in Brazil, including in indigenous households.


Resumen: Las investigaciones sobre los sistemas de clasificación racial en Brasil evidencian las influencias de aspectos socioeconómicos en la expresión de las categorías de color/raza, destacando blancos y negros. El objetivo de este trabajo fue analizar núcleos específicos familiares formados por padres, madres e hijos donde, por lo menos, uno de ellos era indígena. A partir de la muestra del Censo Demográfico 2010, se seleccionaron domicilios con por lo menos tres residentes (padre, madre e hijos), siendo, por lo menos, uno indígena. Todos ellos fueron caracterizados según color/raza (blanca, mestiza e indígena), sexo, edad, renta domiciliaria per cápita, escolaridad de las madres y número de residentes en los domicilios urbanos y rurales. Se realizaron análisis descriptivos y una regresión logística multinomial. Se estimó un total de 290.247 hijos (77,1% indígenas, 13,8% mestizos y 9,1% blancos), de los cuales un 74,3% residían en domicilios rurales y 41,3% en la región norte; los hijos blancos y mestizos estaban localizados mayoritariamente en áreas urbanas. Las oportunidades de que los hijos de padres o madres indígenas hayan sido clasificados como blancos fueron más expresivas en las regiones del sudeste y sur. Los hijos presentaron mayores oportunidades de ser clasificados como blancos y mestizos con el aumento de la renta mensual, así como de la escolaridad materna. Los hallazgos demuestran como la posición socioeconómica se asocia de forma significativa con los procesos de clasificación de color/raza en Brasil, también en los segmentos indígenas de la población.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Indians, South American/statistics & numerical data , Family Characteristics/ethnology , Censuses , Rural Population/statistics & numerical data , Socioeconomic Factors , Urban Population/statistics & numerical data , Brazil , Skin Pigmentation , Educational Status , Fathers/classification , Fathers/statistics & numerical data , Race Factors/classification , Race Factors/statistics & numerical data , Mothers/statistics & numerical data
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