A pandemia de COVID-19 e casos de violência doméstica: percepções de profissionais da atenção primária à saúde no contexto de isolamento social / The COVID-19 pandemic and cases of domestic violence: perceptions of primary healthcare professionals in the context of social isolation / La pandemia de COVID-19 y la violencia doméstica: percepción de los profesionales de atención primaria de salud en el contexto del aislamiento social

Objetivo: analisar as percepções de profissionais da atenção primária à saúde de Paranaguá/PR sobre as relações entre a pandemia de COVID-19 e casos de violência doméstica em seus territórios adscritos, identificando desafios na abordagem, impactos nas famílias e manejo dos casos. Metodologia: pesquisa qualitativa com entrevistas semiestruturadas e grupos focais com 36 profissionais de duas unidades básicas de saúde de Paranaguá, litoral paranaense. Resultados: profissionais da atenção primária à saúde foram unânimes em relatar o aumento no número de casos de violência doméstica naquelas comunidades, com impactos tanto para mulheres, quanto para crianças e adolescentes, sendo o fechamento das escolas um fator agravante. Como principais desafios, foram reportados: a desestruturação da atenção primária à saúde durante o auge da pandemia com deslocamento de profissionais e recursos; desinformação sobre fluxos de encaminhamento nos casos de violência doméstica na rede intersetorial; medo dos profissionais, tanto da pandemia, quanto de denunciar casos de violência doméstica; e rotatividade de profissionais. Conclusão: o período de isolamento social causado pela pandemia intensificou os casos de violência doméstica segundo as percepções de profissionais da atenção primária à saúde de Paranaguá. O desmonte da rede intersetorial prejudicou ainda mais o cuidado de pessoas em situação de vulnerabilidade e/ou violência. A ausência de diretrizes nacionais do governo federal deixou municípios e profissionais da atenção primária à saúde à própria sorte para lidar com o problema.

Objective: to analyze the perceptions of primary health care professionals in Paranaguá/PR about the relationship between the COVID-19 pandemic and cases of domestic violence in their assigned territories, identifying challenges in the approach, impacts on families and case management. Methodology: qualitative research was conducted using semi-structured interviews and focus groups with 36 professionals from two primary health care units in Paranaguá, on the Paraná coast. Results: primary health care professionals unanimously reported an increase in the number of domestic violence cases in those communities, affecting women, children, and adolescents, with the closure of schools identified as an aggravating factor. The main challenges highlighted were the disruption of primary health care services during the peak of the pandemic due to the reallocation of professionals and resources; misinformation about referral processes for domestic violence cases within the intersectoral network; fear among professionals regarding the pandemic and reporting domestic violence cases; and high staff turnover. Conclusion: the period of social isolation caused by the pandemic intensified domestic violence cases, according to the perceptions of primary health care professionals in Paranaguá. The dismantling of the intersectoral network further compromised the care of individuals in situations of vulnerability and/or violence. The absence of national guidelines from the federal government left municipalities and primary health care professionals on their own to deal with the issue.

Objetivo: analizar las percepciones de los profesionales de la atención primaria de salud de Paranaguá/PR sobre las relaciones entre la pandemia de COVID-19 y los casos de violencia doméstica en sus territorios asignados, identificando desafíos en el abordaje, impactos en las familias y gestión de casos. Metodología: investigación cualitativa con entrevistas semiestructuradas y grupos focales con 36 profesionales de dos unidades básicas de salud de Paranaguá, en la costa de Paraná. Resultados: los profesionales de la atención primaria de salud fueron unánimes al reportar el aumento del número de casos de violencia doméstica en esas comunidades, con afectaciones tanto a mujeres, niños y adolescentes, siendo el cierre de escuelas un agravante. Se informaron los principales desafíos: la interrupción de la atención primaria de salud durante el apogeo de la pandemia con el desplazamiento de profesionales y recursos; desinformación sobre los flujos de derivación de casos de violencia doméstica en la red intersectorial; miedo entre los profesionales, tanto a la pandemia como a denunciar casos de violencia doméstica; y rotación profesional. Conclusión: el período de aislamiento social provocado por la pandemia intensificó los casos de violencia doméstica según la percepción de los profesionales de la atención primaria de salud en Paranaguá. El desmantelamiento de la red intersectorial perjudicó aún más la atención a personas en situación de vulnerabilidad y/o violencia. La ausencia de directrices nacionales por parte del gobierno federal dejó a los municipios y a los profesionales de atención primaria de salud a su suerte a la hora de abordar el problema.

Incontinencia urinaria en trabajadoras de la salud como factor predisponente de presentismo en Chile: estudio exploratorio de método mixto / Urinary incontinence in health workers as a predisposing factor for presenteeism in Chile: A mixed-methods exploratory study

Introducción La incontinencia urinaria impacta de forma negativa la calidad de vida de quienes la padecen y puede perjudicar las actividades laborales, siendo causante de presentismo en las profesionales de salud. Esto puede implicar la disminución en la calidad de la atención y seguridad de la/el paciente. El objetivo del presente estudio es explorar la autopercepción de las trabajadoras de salud que padecen incontinencia urinaria como factor predisponente de presentismo. Métodos Estudio mixto de carácter exploratorio-descriptivo. La muestra fue seleccionada de forma no probabilística e intencionada por criterio y conveniencia con un tamaño de 14 voluntarias, considerando la saturación de la información. Para el proceso y análisis de datos temáticos se consideraron los criterios de confiabilidad definidos por Guba. Resultados Muestra con edad media de 38,9 + 7,1 años y un puntaje de SPS-6 medio de 15,8 + 3,5 puntos, mostrando mayor alteración en la dimensión de evitar la desconcentración. Las narrativas presentes en el caso estudiado aportaron información relevante de cómo la incontinencia urinaria afecta el desempeño laboral de las trabajadoras de salud a través de la interrupción en su jornada, disminución en la calidad de la atención clínica, como también el aumento de su ansiedad respecto a su entorno. Conclusiones Dado que la incontinencia urinaria y el presentismo son experiencias subjetivas y multidimensionales, al igual que el efecto negativo en el desempeño laboral, se recomienda un estudio que permita identificar variables predictoras y las pérdidas económicas asociadas a esta condición. Con ello se buscaría establecer mejoras en el ambiente laboral, así como en el autocuidado de funcionarias, procurando mayores beneficios y mejores niveles de eficiencia en la organización.

Introduction Urinary incontinence negatively impacts the quality of life and can harm work activities, causing presenteeism in health professionals and decreasing the quality of care and patient safety. The objective of this study is to explore the self-perception of health workers who suffer from urinary incontinence as a predisposing factor for presenteeism. Methods Mixed study of an exploratory-descriptive nature. The sample was selected in a non-probabilistic and intentional way by criterion and convenience with a size of 14 volunteers, considering the saturation of the information. Reliability criteria defined by Guba for the process and analysis of thematic data were considered. Results The sample had a mean age of 38.9 + 7.1 years and a mean SPS-6 score of 15.8 + 3.5 points, showing alteration in the dimension of avoiding deconcentration. The narratives in the case study provide relevant information on how urinary incontinence affects the work performance of health workers through the interruption in their day, decreases the quality of clinical care, and increases their anxiety regarding their environment. Conclusions Urinary incontinence and presenteeism are subjective, and multidimensional experiences affect work performance. Therefore, further studies are recommended to identify predictor variables and the economic losses associated with this condition to establish improvements in the work environment and the self-care of female employees seeking greater benefits and better levels of efficiency in the organization

Laura E. Rodriguez Dulanto: El primer experimento clínico realizado por una médica graduada en el Perú / Laura E. Rodríguez Dulanto: The first clinical trial performed by a female physician in Peru

RESUMEN Laura Rodriguez Dulanto ha sido destacada por su calidad de primera mujer graduada en Medicina en el Perú, se ha señalado desde diversas perspectivas sus elevadas cualidades intelectuales, así como el esfuerzo y tesón para vencer las dificultades para seguir estudios universitarios, en particular en disciplinas científicas, entonces reservadas exclusivamente a varones. Se ha señalado sin embargo que por las limitaciones impuestas a las mujeres en la época tuvo una disminuida actividad profesional, y una escasa producción científica, lo cual no ha sido revisado por la historiografía existente. En el presente artículo se analiza, su producción científica especialmente el estudio "empleo de ictiol en la inflamación pélvica" mostrando sus ideas sobre la ciencia y la medicina e identificando un pensamiento claro, moderno e innovador, no exento de sensibilidad social, además de mostrarse como una aguda y minuciosa observadora de problemas clínico-quirúrgicos.

ABSTRACT Laura Rodriguez Dulanto has been highlighted for her status as the first woman to graduate in Medicine in Peru. Her high intellectual qualities have been noted from various perspectives, as well as her effort and tenacity to overcome the difficulties of pursuing university studies, particularly in scientific disciplines, then reserved exclusively for men. It has been pointed out, however, that due to the limitations imposed on women at the time, she had a diminished professional activity and little scientific production, which has not been reviewed by existing historiography. This article analyzes his scientific production, especially a clinical study developed in a women's hospital in Lima, Peru, showing his ideas about science and medicine and identifying a clear, modern and innovative thought, not exempt from social sensitivity, in addition. to show herself as a keen and thorough observer of clinical-surgical problems.

Changes and significance of serum 25(OH)D3,blood calcium and bone metabolism in menopausal women with BPPV / 中国现代医生

Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D3[25(OH)D3],blood calcium and bone metabolism indexes in menopausal women with benign paroxysmal positional vertigo(BPPV).Methods A total of 103 menopausal BPPV patients from Hangzhou Ninth People's Hospital from August 2020 to August 2021 were enrolled into BPPV group.According to the one-year recurrence situation,they were divided into recurrence group(n=18)and non-recurrence group(n=85).A total of 50 healthy menopausal women during the same period were enrolled as control group.The clinical data,serum 25(OH)D3,calcium and bone metabolism indexes[procollagen typeⅠN-terminal propeptide(PINP),N-terminal midfragment of osteocalcin(N-MID),β-isomerised C-terminal telopeptide of collagen typeⅠ(β-CTX),bone alkaline phosphatase(BALP)]were collected.Logistic regression model was constructed to analyze the risk factors of BPPV in menopausal women.The predictive value of related indexes for BPPV recurrence was analyzed by receiver operating characteristic curves.Results The serum 25(OH)D3 level in BPPV group was significantly lower than that in control group(P<0.05),and the proportion of long-term irregular diet,PINP,N-MID and BALP levels were significantly higher than those in control group(P<0.05).Multivariate Logistic regression analysis showed that low 25(OH)D3,high PINP,high N-MID and high BALP were all risk factors for BPPV in menopausal women(P<0.05).The 25(OH)D3 level in recurrence group was significantly lower than that in non-recurrence group(P<0.05),and the PINP,N-MID and BALP levels were significantly higher than those in non-recurrence group(P<0.05).The area under the curve(AUC)of 25(OH)D3,PINP,N-MID,BALP and the four combined predictions for BPPV recurrence were 0.833,0.654,0.697,0.782 and 0.910,respectively,and the AUC of the four combined predictions was the largest.The sensitivity and specificity were 98.97%and 70.62%,respectively.Conclusion There is no significant change in level of serum calcium in menopausal women with BPPV.Decreased serum 25(OH)D3 and increased PINP,N-MID and BALP are risk factors of BPPV,which can be applied to predict BPPV recurrence.

Passive smoking among pregnant women in Jinshan District / 预防医学

Objective@#To investigate the status of passive smoking among pregnant women in Jinshan District, Shanghai Municipality, so as to provide insights into developing targeted smoking control measures and promoting maternal and infant health.@*Methods@#Pregnant women who had early pregnancy registration at Jinshan District Community Health Service Center from April 2021 to December 2023 were selected as subjects. The basic information, passive smoking and awareness of passive smoking hazards among pregnant women were collected through questionnaire surveys, and passive smoking rate and awareness rate of passive smoking hazards were analyzed.@*Results@#Totally 8 273 questionnaires were allocated, and 8 216 valid questionnaires were recovered, with an effective rate of 99.31%. The mean age of participants was (29.52±4.60) years. There were 4 991 participants with an education of college degree or above, accounting for 60.75%; 3 565 participants with the first pregnancy, accounting for 43.39%; 3 990 primiparas, accounting for 48.56%; 3 193 participants living with smokers, accounting for 38.86%. A total of 3 710 participants passively smoked, with a passive smoking rate of 45.16%. There were 2 817 participants passively smoked in public places, accounting for 75.93%; 2 253 participants passively smoked in workplaces, accounting for 60.73%; 1 563 participants that passively smoked at home, accounting for 42.13%. The awareness rates regarding the hazards of passive smoking to health, causing lung cancer in adults, causing lung diseases in children, causing preterm birth and low birth weight infants, and causing heart diseases in adults were 92.13%, 88.85%, 87.99%, 82.05% and 62.56%, respectively.@*Conclusion@#The rate of passive smoking among pregnant women in Jinshan District is comparatively high, while their awareness regarding non-respiratory diseases emanating from passive smoking is comparatively low.

Meta-analysis of efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures / 中国组织工程研究

OBJECTIVE:To compare the efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures through a Meta-analysis. METHODS:By searching PubMed,Cochrane Library,EMbase,CNKI,WanFang and VIP databases,18 randomized controlled studies on terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures were included according to inclusion and exclusion criteria.Endnote X9 software was used to manage the literature and Revman 5.3 software was used to perform a Meta-analysis on the extracted data.The incidences of vertebral fracture,non-vertebral fracture and adverse reaction in postmenopausal osteoporosis patients treated with terlipatide and bisphosphate were analyzed. RESULTS:A total of 18 randomized controlled studies were included,of which 10 were of medium and high quality and 8 were of low quality.Meta-analysis results showed that the fracture incidence in the teriparatide group[risk ratio(RR)=0.56,95%confidence interval(CI):0.48-0.66,P＜0.000 01]was lower than that in the bisphosphonate group,and teriparatide was superior to alendronate in preventing fractures in postmenopausal women with osteoporosis(RR=0.50,95%CI:0.35-0.69,P＜0.000 1)and other bisphosphonates(RR=0.58,95%CI:0.49-0.70,P＜0.000 01).During the follow-up over 18 months,teriparatide was superior to bisphosphonates in preventing fractures in postmenopausal women with osteoporosis(RR=0.56,95%CI:0.48-0.69,P＜0.000 01).In addition,we found that teriparatide was superior to bisphosphonates in preventing vertebral fractures(RR=0.48,95%CI:0.37-0.62,P＜0.000 01)and non-vertebral fractures(RR=0.63,95%CI:0.51-0.78,P＜0.000 1)in postmenopausal women with osteoporosis.Teriparatide was superior to bisphosphonates in increasing lumbar bone density[odds ratio=4.16,95%CI:2.96-5.36,P＜0.000 1)and femoral neck bone density(odds ratio=1.02,95%CI:0.04-2.01,P=0.04).There was no significant difference in adverse reactions between teriparatide and bisphosphonates(RR=0.95,95%CI:0.85,1.06,P=0.37). CONCLUSION:Teriparatide is superior to bisphosphonates in preventing vertebral and non-vertebral fractures in postmenopausal women with osteoporosis,but the safety and adverse drug reactions of teriparatide and bisphosphonates are basically similar.Teriparatide is superior to bisphosphonate in preventing fracture and improving lumbar and femoral neck bone density regardless of short-term(＜18 months)or long-term(≥18 months)use.

Risk factors for adjacent vertebral compression fractures after percutaneous vertebroplasty / 中国组织工程研究

BACKGROUND:Percutaneous vertebroplasty is the most widely used method for the treatment of osteoporotic vertebral compression fractures,and most studies have concluded that percutaneous vertebroplasty increases the probability of adjacent vertebral secondary compression fractures in patients with osteoporotic vertebral compression fractures.However,controversy remains regarding the risk factors associated with adjacent vertebral re-fracture caused after percutaneous vertebroplasty. OBJECTIVE:To summarize the influencing factors of adjacent vertebral compression fractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures,in order to provide a certain reference for reducing the risk of its occurrence as well as formulating the corresponding treatment plan. METHODS:Using"osteoporosis,fracture,percutaneous vertebroplasty,adjacent vertebral compression fractures,risk factors"as the Chinese search terms,"osteoporosis,osteoporotic vertebral compression fractures,percutaneous vertebroplasty,adjacent vertebral compression fractures,risk factors"as English search terms,computerized searches were conducted on CNKI,Wanfang Medical Network,VIP,PubMed,Springer,ScienceDirect,and Elsevier databases.The search timeframe focuses on January 2018 through September 2023,with the inclusion of a few classic forward literature.The literature was screened by reading the titles and abstracts,and 83 papers were finally included in the review. RESULTS AND CONCLUSION:(1)Osteoporotic vertebral compression fractures are one of the most common complications of osteoporosis,placing elderly patients at a significant risk of disability and death.Percutaneous vertebroplasty is a practical and effective treatment for osteoporotic vertebral compression fractures.(2)With the popularity of percutaneous vertebroplasty,its secondary vertebral compression fractures have gradually increased,with adjacent vertebral compression fractures being the most common.(3)Previous studies have only discussed the effects of factors such as bone mineral density,multiple vertebral fractures,body mass index,age,sex,amount of bone cement,cement leakage,and anti-osteoporosis treatment on secondary compression fractures of adjacent vertebrae after percutaneous vertebroplasty,and summarized the number of vertebral fractures,timing of the operation,surgical approach,cement material,diffuse distribution of bone cement,recovery height of the injured vertebrae,and wearing of a support after surgery,which is not yet comprehensive.The analysis of the specific mechanisms of risk factor-induced adjacent vertebral fractures is relatively rare.(4)The results of the article showed that low bone mineral density,advanced age,perimenopausal women,multiple vertebral fractures,excessive recovery of the height of the injured vertebrae,cement leakage,comorbid underlying diseases,and poor lifestyle habits were the risk factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty,and that maintaining a normal body mass index,early surgery,bilateral percutaneous vertebroplasty,use of a new type of cement material,an appropriate volume of bone cement injection and uniform cement dispersion,regular anti-osteoporosis treatment,and postoperative brace wearing are protective factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty.

The effects of group B streptococcus colonization during late pregnancy on vaginal microbiota and neonatal outcomes / 中国新生儿科杂志

Objective:To study the effects of group B streptococcus (GBS) colonization during late pregnancy on vaginal microbiota and neonatal outcomes.Methods:From September 2020 to September 2021, pregnant women receiving prenatal care and delivered in our hospital were prospectively enrolled. They were assigned into GBS(+) group and GBS(-) group based on the results of GBS culture and/or PCR tests of vaginal secretions. The mothers were also assigned into early-onset infection(EO) group and non-early-onset infection(non-EO) group based on the presence or absence of early-onset infection of their neonates. The vaginal microbiota and neonatal outcomes were compared between these groups.Results:A total of 125 cases were enrolled, including 65(52.0%) in GBS(+) group and 60(48.0%) in GBS(-) group. 24 cases (19.2%) were in EO group and 101 cases (80.8%) in non-EO group. The incidences of premature rupture of membranes (PROM), amniotic fluid contamination, chorioamnionitis and early-onset neonatal infection in GBS(+) group were significantly higher than GBS(-) group(all P<0.05).The abundances of Streptococcus and Ureaplasma in vaginal flora of GBS(+) group were higher than GBS(-) group ( P<0.01), whereas Rhodococcus, Phyllobacterium and Bifidobacterium were lower than GBS(-) group ( P<0.05).The EO group had significantly higher abundance of enterococcus than the non-EO group ( P<0.05). Mothers with GBS colonization and neonates with early-onset infection had the highest abundance of Escherichia/Shigella ( P=0.04). Mothers with GBS colonization and neonates without early-onset infection showed the highest abundance of Gardnerella ( P=0.04). Conclusions:GBS colonization during late pregnancy increases the incidences of PROM, amniotic fluid contamination, chorioamnionitis and early-onset neonatal infection. GBS colonization causes abnormal vaginal flora in pregnant women. The increases of Ureaplasma, Streptococcus, Escherichia/Shigella and Enterococcus in vaginal microbiota maybe associated with early-onset neonatal infection.

Investigation on iodine nutrition and thyroid function of pregnant women in Hubei Province in 2020 / 中华地方病学杂志

Objective:To investigate the iodine nutrition level and thyroid function status of pregnant women in Hubei Province.Methods:According to the requirements of "the National Iodine Deficiency Disorders Monitoring Program (2016 Edition)", in 2020, using a cross-sectional survey method, two mountainous counties and two plain areas in Hubei Province were divided into five districts: east, west, south, north, and central. One township (street) was selected from each district, and 20 pregnant women were selected from each township (street) as survey subjects. Urine iodine content and thyroid function indicators [serum free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb)] were tested. Abnormal thyroid function rate and antibody positive rate were analyzed, and correlation analysis of thyroid function indicators was conducted (Spearman method). Results:A total of 321 pregnant women were included, including 43, 114, and 164 in early, middle, and late pregnancy, respectively; The median urinary iodine was 164.80 μg/L. The median serum FT 3, FT 4, TSH, TPOAb, TgAb levels were 4.10, 12.83 pmol/L, 1.85 mU/L, 15.84 and 13.35 U/ml, respectively. There were statistically significant differences in FT 3, FT 4, and TSH levels among different trimesters ( P < 0.05). According to Spearman's correlation analysis, FT 3 in early stage of pregnancy was negatively correlated with TSH and TPOAb levels ( r = - 0.46, - 0.33, P < 0.05), while TSH was positively correlated with TPOAb level ( r = 0.33, P = 0.032); there was a positive correlation between FT 4 and TgAb levels in middle stage of pregnancy ( r = 0.21, P = 0.032); there was a negative correlation between FT 3 and TPOAb levels in late stage of pregnancy ( r = - 0.19, P = 0.017); FT 3 and FT 4, TPOAb and TgAb levels were positively correlated throughout pregnancy ( P < 0.05). There was no correlation between urinary iodine content and thyroid function indicators ( P > 0.05). The total abnormal rate of thyroid function was 7.79% (25/321), with 16.28% (7/43), 5.26% (6/114), and 7.32% (12/164) in early, middle, and late pregnancy, respectively. There was no statistically significant difference in the abnormal rate of thyroid function among different pregnancy periods (χ 2 = 4.83, P = 0.097). The detection rates of hypothyroxinemia, hypothyroidism, subclinical hypothyroidism, hyperthyroidism, and subclinical hyperthyroidism were 4.36% (14/321), 0.31% (1/321), 2.49% (8/321), 0.31% (1/321), and 0.31% (1/321), respectively. The positive detection rate of autospecific antibodies was 10.28% (33/321), with a TPOAb positive detection rate of 9.97% (32/321) and a TgAb positive detection rate of 5.30% (17/321). Conclusions:The iodine nutrition level of pregnant women in Hubei Province is at a suitable level, and the rates of abnormal thyroid function and thyroid autospecific antibody positive are relatively low. It is necessary to continuously monitor the iodine nutrition and thyroid function indexes of pregnant women, strengthen health education on the hazards of iodine deficiency during pregnancy, and minimize the harm to maternal and infant health caused by iodine deficiency.

A cross-sectional study of contraceptive use and healthcare status among women at different times in the postpartum period / 上海预防医学

ObjectiveTo investigate the use of contraceptive methods， and to evaluate maternal healthcare services utilization among women within 2 years in Pudong New Area of Shanghai. MethodsA cross-sectional survey was conducted using a questionnaire for women at different postpartum periods who visited a community health clinic with their children from June to November 2021. Data were analyzed using χ2 test and binary logistic regression. ResultsAmong the 1 946 postpartum women surveyed， 1 934 were either married or cohabiting， and1 430 had resumed their sexual life. Among women at 4， 6， 12， 18 and 24 months postpartum， the contraceptive prevalence rates （CPR） were 92.34% （193/209）， 92.16% （235/255）， 87.31% （282/323）， 91.95% （297/323） and 90.00% （288/320）， respectively. The modern contraceptive prevalence rates （mCPR） were 87.08% （182/209）， 87.06% （222/255）， 82.04% （265/323）， 83.09% （271/323） and 85.31% （273/320）， respectively， while the unmet contraceptive needs （UMNs） were 7.66% （16/209）， 7.84% （20/255）， 11.46% （37/323）， 6.81% （22/323） and 10.00% （32/320）， respectively. The use rates of long-acting reversible contraceptive （LARC） methods among women at 6， 12， 18 and 24 months postpartum period were 0.39% （1/255）， 2.17% （7/323）， 0.31% （1/323）， and 2.81% （9/320）， respectively. Among all surveyed subjects， 32.17% （626/1 946） had received postpartum contraceptive services only once， while 27.85% （542/1 946） had not received any postpartum contraceptive services. Binary logistic regression analysis indicated that the use of contraceptive methods among postpartum women was associated with whether relevant educational services were received after childbirth and during postpartum home visits （all P<0.05）. ConclusionPostpartum women have unmet needs for contraception. Contraceptive guidance at the 42-day postnatal healthcare visit needs to be further strengthened and postpartum contraceptive education could be integrated into the pregnancy care. The quality and effectiveness of contraceptive education during delivery and postpartum home visits， and even at the 42-day postnatal healthcare visit need to be further explored.

Associations between lifestyle and comorbid anxiety and depression in pregnant women / 环境与职业医学

Background Anxiety and depression are common perinatal mental health issues that often occur together and can have serious negative effects on both maternal and infant health. Objective To examine the relationships between lifestyle factors and comorbid anxiety and depression (CAD) among pregnant women in Shanghai. Methods The study estimated the prevalence of CAD during the first, second, and third trimesters of pregnancy using the Self-rating Anxiety Scale (SAS) and Center for Epidemiological Studies-Depression (CES-D) based on data from the China National Birth Cohort (CNBC) embryonic-derived diseases with assisted reproductive technology (ART) sub-cohort. Information on demographics, sleep status, nutritional intake, and exercise during each trimester was collected through self-made questionnaires, the Pittsburgh Sleep Quality Index (PSQI), and the Food Frequency Questionnaire (FFQ). Lifestyle factors (such as sleep status, nutritional intake, and exercise during each trimester) were analyzed using logistic regression and generalized linear mixed models (GLMM) to determine their impacts on the prevalence of CAD (yes or no) among pregnant women. Results A total of 2876 pregnant women were included in this study. The prevalence of CAD was 10.6% (305), 3.6% (103), and 5.5% (159) in the first, second, and third trimesters of pregnancy, respectively. The logistic regression analysis revealed that poor sleep quality throughout the entire pregnancy were statistically associated with an increased prevalence of CAD, and the odds ratios (OR) with 95% confidence intervals (CI) were 2.817 (1.845, 4.301), 2.840 (1.855, 4.347), and 9.316 (5.835, 14.876) for the first, second, and third trimesters, respectively, when compared to good sleep quality. Additionally, compared to an intake frequency of 7 times per week, the frequency of egg intake ≤3 times per week in the first trimester (OR=2.025, 95%CI: 1.197, 3.425) and the frequency of egg intake of 4–6 times per week (OR=1.896, 95%CI: 1.117, 3.216) or ≤3 times per week (OR=1.906, 95%CI: 1.082, 3.357) in the third trimester were associated with an increased risk of CAD (P<0.05). Moreover, when compared to a frequency of exercise >3 times per week, never or almost never exercising in the second trimester (OR=2.218, 95%CI: 1.220, 4.035) was associated with an increased risk of CAD (P<0.05). The GLMM analysis also demonstrated a significant association between poor sleep quality, lower exercise frequency, or lower intake frequency of vegetables, eggs, or milk and an increased risk of CAD (P<0.05). Conclusion The prevalence of CAD among pregnant women in Shanghai follows a U-shaped distribution, with the highest rate occurring in early pregnancy and the lowest rate in mid-pregnancy. Factors such as poor sleep quality, inadequate intake of vegetables, eggs, or milk, and lack of exercise during pregnancy may increase the risk of CAD. Implementing lifestyle interventions during pregnancy could potentially reduce the risk of mental health problems and improve the overall health of both mothers and babies.

Connaissances, attitudes et perceptions de la césarienne chez les gestantes suivies en CPN dans 6 maternités de Kinshasa / NA

Objectifs: Evaluer le niveau de connaissances, décrire les attitudes ainsi que les perceptions des gestantes sur la césarienne. MéthodesIl s'agissait d'une étude descriptive transversale qui s'est déroulée durant la période allant du 01 Février au 30Avril 2023 (soit 3mois) dans les services des consultations prénatales (CPN) des 6 6 structures de la Ville Province de Kinshasa ; les Cliniques Universitaires de Kinshasa (CUK), le Centre Hospitalier Roi Baudoin 1, l'Hôpital Saint Joseph(HSJ), les Maternités de Kintambo, de Binza et de Kingasani. Un total de 481 gestantes était interrogé dans l'ensemble des formations sanitaires sélectionnées. Les données sociodémographiques et celles relatives à la connaissance, attitude et perception sur la césarienne ont été récoltées par interview et analysées à l'aide des statistiques descriptives. L'évaluation de connaissances était faite selon la cotation suivante; moins de 50% de bonnes réponses (MAUVAISES) ;entre 50% et 70% de bonnes réponses (MOYENNES) et plus de 70% de bonnes réponses ( BONNES ). L'échelle de Likert a servi à l'évaluation des attitudes et perceptions sur la césarienne. Résultats Sur les 481 gestantes interviewées, seulement 16,1% avaient un antécédent personnel de Césarienne, l'âge de moyen de gestantes était de 29 ans, mariées pour la plupart (87,9%), employée (56,4%) avec un niveau d'étude secondaire (49,3%) et un niveau socio-économique moyen (53,8%). La source d'information sur cette intervention était diversifiée chez 39,8% de gestantes et les CPN n'ont contribué que dans 22,4%. Le niveau de connaissance était satisfaisant chez 73, 3% de gestantes. L'attitude des gestantes était négative chez 70,1% la perception par contre était positive à 64,4 %. Conclusion: La majorité de gestantes avait un niveau suffisant de connaissances sur la césarienne et une perception positive alors qu'elle garde une attitude négative face à cette intervention.

Objectives: Evaluate the level of knowledge, describe the attitudes and perceptions of pregnant women about cesarean section. Methods This was a cross-sectional descriptive study which took place during the period from February 1 to April 30, 2023 (i.e. 3 months) in the prenatal consultation services (PCS) of the 6 health structures in the City Province of Kinshasa; the University Clinics of Kinshasa (UCK), Roi Baudoin 1 Hospital Center, Saint Joseph Hospital (SJH), Kintambo, Binza and Kingasani maternity wards. A total of 481 pregnant women were interviewed in all the selected health facilities.ResultsAmong the 481 pregnant women interviewed, only 16.1% had a personal history of Caesarean section, the average age of pregnant women was 29 years, most of them married (87.9%), employed (56.4%) with a secondary education level (49.3%) and a socio-economic level. average economic (53.8%). The source of information on this intervention was diversified among 39.8% of pregnant women and antenatal cares only contributed to 22.4%. The level of knowledge was satisfactory in 73.3% of pregnant women. The attitude of the pregnant women was negative at 70.1%, the perception on the other hand was positive at 64.4%.Conclusion:The majority of pregnant women had a sufficient level of knowledge about caesarean section and a positive perception while they maintain a negative attitude towards this intervention

Maladie thromboembolique veineuse chez la femme au service de cardiologie du CHU de Kati / Venous thromboembolic disease in women in the cardiology department of the Kati university hospital

Introduction : La maladie thromboembolique veineuse (MTEV) regroupe : la thrombose veineuse profonde(TVP) et l'embolie pulmonaire(EP).Ce travail a été initié pour identifier les particularités féminines si elles existent. Matériels et Méthode : il s'agissait d'étude rétrospective, descriptive réalisée dans le service de cardiologie du CHU de Kati sur une période allant du 01 janvier 2014 au 31 décembre 2021. Ont été inclues les patientes hospitalisées durant la dite période pour maladie thromboemboliqueveineuse. Les variables étudiées étaient les données sociales démographiques, les facteurs de risque, les paramètres cliniques et paracliniques, les aspects thérapeutiques et évolutifs. Résultats : Au total nous avons enregistré 68 cas de MTEV dont 40 (58,8%) femmes. Il s'agissait 12 (30%) cas de TVP, 25 (62,5%) d'EP et leur association dans 3 (7,5%) cas. La majorité (82,5%) des patientes était des femmes au foyer.Le post partum représentait 10% des cas. La probabilité clinique, selonle score de Wells était élevée chez 93% des TVP, intermédiaire pour les cas d'embolie pulmonaire avec 50%. L'angioscanner révélait que l'embolie pulmonaire était bilatérale dans 80% des cas. L'héparine et l'AVK ont été les plus utilisés. La mortalité était de 7,5%. Conclusion : les femmes sont plus victime des maladies thromboemboliques veineuses que les hommes. Le post partum est une situationparticulière chez la femme. Les récidives ne sont pas rares

Introduction: Venous thromboembolic disease (MTEV) includes: deep venous thrombosis (DVT) and pulmonary embolism (PE).This work was initiated to identify the female particularities if they exist.Materials and Method: This was a retrospective, descriptive study conductedin the cardiology department of the Kati university hospital over a period from January 01, 2014 to December 31, 2021.Patients hospitalized during the period for venousthromboembolic disease were included.The variables studied were demographic social data, risk factors, clinical and para-clinical parameters, therapeutic and evolutionary aspects. Results: In total we recorded 68 cases of MTEV of which 40 (58.8%) women. There were 12 (30%) cases of deep vein thrombosis, 25 (62.5%) cases of pulmonary embolism and their association in 3 (7.5%) cases.The majority (82.5%) of patients were housewives.Thepostpartum accounted for 10% of cases.The clinical probability according to the Wells score was high in 93% of deep vein thrombosis, intermediate for cases of pulmonary embolism with 50%.Angio-CT showed that pulmonary embolism was bilateral in 80% of cases. Heparin and anti-vitamin K were the most commonly used. Mortality was 7.5%. Conclusion: women are more victims of venous thromboembolic diseases than men. Postpartum is a special situation for women. Recurrences are not uncommon

Casais de mulheres lésbicas e bissexuais que vivenciam a dupla maternidade: (des)encontros na produção do cuidado em saúde / Lesbian and bisexual couples experiencing dual motherhood: (dis)encounters in the provision of healthcare

Resumo O vínculo com os serviços de saúde é uma dimensão crucial para viabilizar o projeto materno de casais de mulheres lésbicas e bissexuais. Este estudo teve como objetivo analisar os significados culturalmente construídos sobre o vínculo com os serviços e profissionais de saúde por mulheres lésbicas e bissexuais que vivenciaram a dupla maternidade. Investigação qualitativa fundamentada na antropologia interpretativa. O corpus de pesquisa foi construído com base em entrevista em profundidade com 10 mulheres de 30 a 39 anos. Os resultados mostram que o acesso à parentalidade implicou um itinerário permeado por satisfações e sofrimentos devido a tentativas frustradas e perdas gestacionais. Também foram relatados percalços vivenciados na produção do cuidado em saúde devido a preconceitos, falta de empatia e despreparo de profissionais para lidarem com acompanhamento de pré-natal aos casais de mulheres lésbicas/bissexuais. As manifestações de discriminação foram mais contundentes em relação às mães não gestantes. Os resultados oferecem subsídios para implementação de políticas de humanização e planejamento de programas e serviços de saúde baseados em cuidados culturalmente sensíveis à diversidade para casais de mulheres lésbicas/bissexuais que vivenciam a transição para a maternidade.

Abstract The bond with healthcare services is a crucial dimension in facilitating the maternal journey of lesbian and bisexual women couples. This study aimed to analyze the culturally constructed meanings regarding the bond with healthcare services and professionals by lesbian and bisexual women who experienced dual motherhood. It is a qualitative investigation grounded in interpretative anthropology. The research corpus was built based on in-depth interviews with 10 lesbian and bisexual women, aged 30 to 39 years. The results indicate that access to parenthood, until its realization, involved a journey permeated by satisfactions and sufferings triggered by failed attempts and gestational losses. Challenges experienced in healthcare provision were also reported due to prejudices, lack of empathy, and unpreparedness of professionals in dealing with prenatal care for lesbian and bisexual women couples. Manifestations of discrimination were more pronounced concerning non-gestational mothers. The findings offer insights into implementing policies that prioritize humanization and planning programs and healthcare services based on culturally sensitive care for lesbian and bisexual women couples as they transition into dual motherhood.

A construção do cuidado na assistência às mulheres em situação de violência doméstica: perspectivas de trabalhadores e trabalhadoras da Estratégia Saúde da Família / The construction of care in assisting women in situations of domestic violence: perspectives of workers in the Family Health Strategy

Resumo A violência doméstica contra a mulher é um problema do campo da saúde, que tem na Estratégia Saúde da Família (ESF) importante via de enfrentamento. Este estudo buscou compreender as práticas de cuidado com esse público, elaboradas por trabalhadores e trabalhadoras da ESF e do Núcleo Ampliado de Saúde da Família. A pesquisa foi marcada pelo advento da pandemia do coronavírus, que impossibilitou a presença no campo. Assim, foram utilizadas a entrevista semiestruturada on-line como principal fonte de dados, e a Análise Temática como estratégia de análise. Observa-se que a construção do cuidado se dá principalmente a partir da valorização das tecnologias leves e dos saberes práticos, que se manifestam principalmente por meio do que os participantes denominam "protocolos intuitivos". O estudo aponta ainda o medo de represálias, a desvinculação de julgamentos morais, a implicação da mulher, o desconhecimento da rede de assistência e a ausência de protocolos como principais desafios a serem superados. Também revela a importância do protagonismo dos saberes elaborados no trabalho vivo em ato para a formulação das estratégias de cuidado, articuladas com a Política Nacional de Atenção Integral à Saúde da Mulher, além da necessidade de novas produções com essa perspectiva.

Abstract Domestic violence against women is a problem in the field of health, which has the Family Health Strategy (ESF) as an important way of coping. This study sought to understand the care practices for this public, elaborated by workers of the ESF and the Expanded Family Health Center. The research was marked by the advent of the coronavirus pandemic, which made it impossible to be present in the field, thus, the online semi-structured interview was used as the main source of data, and the Thematic Analysis as an analysis strategy. It is observed that the construction of care takes place mainly from the appreciation of light technologies and practical knowledge, which are manifested mainly through what the participants call "intuitive protocols". The study also points out the fear of reprisals, the disengagement of moral judgments, the implication of the woman, the lack of knowledge about the assistance network and the absence of protocols as the main challenges to be overcome. It also reveals the importance of the protagonism of the knowledge elaborated in the live work in action for the formulation of care strategies, articulated with the National Policy of Integral Attention to Women's Health, in addition to the need for new productions with this perspective.

Concepções de mulheres negras sobre autocuidado em saúde reprodutiva / Conceptions of black women about self-care in reproductive health

Resumo Neste trabalho se buscou identificar as concepções de mulheres negras em vulnerabilidade socioeconômica de um bairro da Zona Noroeste do município de Santos sobre saúde e autocuidado em saúde reprodutiva. Trata-se de uma pesquisa qualitativa realizada por meio de entrevista semiestruturada com 19 mulheres autodeclaradas negras. Os dados qualitativos foram submetidos à Análise de Conteúdo. Os resultados revelaram concepções acerca da saúde e do autocuidado que envolvem não apenas o aspecto biomédico, mas também a percepção de saúde integral. Concluiu-se que as mulheres consideram a saúde e o autocuidado como algo de grande importância, entretanto, atribuem ao profissional de medicina papel relevante na manutenção desse autocuidado, desconsiderando as práticas diárias que realizam de forma autônoma.

Abstract This work sought to identify the conceptions of black women in socioeconomic vulnerability in a neighborhood in the Northwest Zone of the municipality of Santos about health and self-care in reproductive health. This is a qualitative research carried out via semi-structured interviews with 19 self-declared black women. Qualitative data were submitted to Content Analysis. The results revealed conceptions about health and self-care that involve the biomedical aspect and a perception of integral health. In conclusion, women consider health and self-care very important; however, they attribute to the medical professional a relevant role in maintaining this self-care, disregarding the daily practices carried out autonomously.

"E Eu Não Sou Uma Mulher?" Confluências Entre a Psicanálise e a Mulher Negra / "And Am I Not a Woman?" Confluences Between Psychoanalysis and the Black Woman / "¿Y Yo No Soy Una Mujer?" Confluencias Entre el Psicoanálisis y la Mujer Negra

Este trabalho é um recorte de nossa pesquisa de mestrado, que se propôs a investigar, a partir de narrativas de mulheres negras, as percepções e significados de suas experiências enquanto mulheres, como também identificar os marcadores da diferença de suas vivências em torno da feminilidade e o que faz uma mulher negra experimentar a feminilidade de uma forma própria. Apoiamo-nos na perspectiva metodológica da pesquisa psicanalítica dos fenômenos sociais e políticos, por compreender que nossa questão advém de um impasse político-social, que foi examinado a partir da relação transferencial e da indissociabilidade entre teoria, clínica e pesquisa. Utilizamos o recurso de entrevistas enquanto instrumento para a produção do material de análise. Assim, entrevistamos três mulheres negras, convidadas a compartilhar suas histórias e experiências enquanto mulheres. A partir do debate teórico e do material levantado nas entrevistas, foi possível identificar as complexidades do processo de tornar-se mulher e negra, a partir dos marcadores difundidos no laço social, por possuir especificidades subjetivas. Para além disso, pensar no significado dos símbolos utilizados por mulheres negras e contar com uma outra mulher negra para apresentar esses elementos são direções que podem impactar a experiência da feminilidade dessas mulheres.

This work is part of our master's research, which has proposed to investigate, from narratives of black women, the perceptions and meanings of their experiences as women, as well as to identify the markers of the difference in their experiences around femininity and what makes a black woman experience femininity in her own way. We rely on the methodological perspective of psychoanalytic research on social and political phenomena, understanding that our issue stems from a political-social impasse, which has been examined from the transferential relationship and the inseparability between theory, clinic and research. We have used the interview resource as an instrument for the production of analysis material. Thus, we have interviewed three black women, which were invited to share their stories and experiences as women. From the theoretical debate and from the material that have raised in the interviews, it was possible to identify the complexities of the process of becoming woman and black, from the markers scattered through the social bond, as it has subjective specificities. Furthermore, thinking about the meaning of the symbols used by black women and relying on another black woman to present these elements are directions that can impact these women's experience of femininity.

Este trabajo forma parte de nuestra investigación de maestría, que se propuso indagar, a partir de narrativas de mujeres negras, las percepciones y significados de sus experiencias como mujeres, así como identificar los marcadores de la diferencia en sus experiencias en torno a la feminidad y que le permita experimentar la feminidad a su manera. Nos apoyamos en la perspectiva metodológica de la investigación psicoanalítica sobre los fenómenos sociales y políticos, entendiendo que nuestro problema surge de un impasse político-social, que fue examinado desde la relación transferencial y la inseparabilidad entre teoría, clínica e investigación. Utilizamos el recurso de la entrevista como instrumento para la producción de material de análisis. Así, entrevistamos a tres mujeres negras, invitadas a compartir sus historias y experiencias como mujeres. A partir del debate teórico y del material levantado en las entrevistas, fue posible identificar las complejidades del proceso de hacerse mujer y negra, a partir de los marcadores difundidos en el vínculo social, ya que tiene especificidades subjetivas. Además, pensar en el significado de los símbolos utilizados por las mujeres negras y confiar en otra mujer negra para presentar estos elementos son direcciones que pueden impactar la experiencia de la feminidad de estas mujeres.

Percepciones sobre la aplicación de principios bioéticos en mujeres puérperas en un Hospital público del Ecuador

Fundamento: El puerperio es el periodo de tiempo que comienza en la finalización del parto hasta las seis semanas posparto; durante el cual, es necesario brindar atención conforme a los principios bioéticos inscritos en la normativa de salud vigente en el Ecuador. Objetivo: Analizar las percepciones que tienen las mujeres puérperas sobre la aplicación de los 4 principios bioéticos durante la atención en salud. Metodología: El estudio es de tipo descriptivo con enfoque cualitativo. Los datos corresponden a 10 mujeres puérperas mayores de edad, atendidas en el Hospital Gineco Obstétrico Pediátrico de Nueva Aurora "Luz Elena Arizmendi" de la ciudad de Quito, que respondieron a una entrevista sobre los principios bioéticos aplicados en la atención recibida. Se realizaron análisis de contenido a través del software ATLAS TI versión 23. Resultados: Se obtuvo una percepción positiva de las mujeres puérperas acerca de la aplicación del principio de justicia. Por otra parte, se evidencian dificultades en el de autonomía, sobre todo en la comprensión de la información brindada a la paciente acerca de los procedimientos durante el parto y puerperio, además de coacciones por parte del personal sanitario. Se percibe el consentimiento informado como un mero trámite administrativo. El principio de beneficencia se lo asume como parte de la vocación del personal y la no maleficencia genera malestar si no va acompañado de información clara y oportuna. Conclusiones: Los principios bioéticos son transversales en la normativa de salud vigente, pero sobresale el de justicia en la atención a mujeres puérperas.

Background: The puerperium is the period of time beginning at the end of labor until six postpartum weeks; during which it is necessary to provide attention in accordance with the bioethical principles included in the current health guidelines in Ecuador. Objective: To analyze the perceptions that postpartum women have about the 4 bioethical principles application during health care. Methodology: The study type is descriptive with a qualitative approach. The data correspond to 10 adult postpartum women assisted at the Nueva Aurora "Luz Elena Arizmendi" Pediatric Obstetric and Gynecological Pediatric Hospital in the Quito city, who responded to an interview about the bioethical principles applied in the received care. Content analysis was conducted through ATLAS TI version 23 software. Results: A positive perception was obtained from postpartum women concerning the application of the Justice principle. Furthermore, difficulties are evident in the Autonomy section, mainly in the comprehension of the information provided to the patient about the procedures during the labor and puerperium, as well as coercion by health personnel. Informed consent is perceived as a mere administrative formality. The Beneficence principle is assumed as part of the vocation of the personnel and Non-maleficence generates discomfort if it is not accompanied by clear and opportune information. Conclusions: Bioethical principles are transversal in current health guidelines, but that of Justice stands out in the care of postpartum women.

Encuesta sobre factores de riesgo de enfermedad cardiovascular en la mujer, su percepción, conocimiento y conducta de prevención / Survey on Women's Perception and Awareness of Cardiovascular Risk Factors and How They Are Managed

RESUMEN Introducción : La enfermedad cardiovascular (ECV) es la principal causa de muerte en la mujer. A pesar de esto, las mujeres reciben menos frecuentemente que los hombres asesoramiento y/o tratamiento preventivo con el objetivo de disminuir la ECV. Objetivo : Detectar la prevalencia de factores de riesgo cardiovascular (FRC) y pesquisar el nivel de percepción y conocimiento de la mujer sobre FRC y ECV. Material y métodos : Estudio observacional, de corte transversal realizado en julio 2021, mediante una encuesta en formato digital de participación anónima y voluntaria. Se recabó información sobre edad, FRC, ECV, percepción de riesgo, implemen tación de hábitos y conductas saludables. Resultados : Participaron 3338 mujeres. El 50,1% tenía entre 46 y 65 años. El 34,1% tenía sobrepeso, el 43,6% perímetro de cintura mayor que 80 cm, el 24,2% hipertensión (HTA), el 19,6% colesterol mayor que 200 mg/dL, el 5,4% diabetes (DBT); 44,3% eran sedentarias, 11,3% fumaban y 34,5% eran exfumadoras. El 82,1% tuvo al menos un embarazo y el 26,9% refirió alguna complicación. Entre las pacientes con antecedentes de complicaciones del embarazo fueron significativamente más frecuentes la HTA (34% vs 24%, p <0,01), la DBT (7% vs 5%, p = 0,04) y la ECV (14% vs 11%, p <0,01). Del total de encuestadas 10,9% refirió ECV, el antecedente de infarto de miocardio fue el más frecuente (51,1%). El 62% de las encuestadas consideró que la principal causa de muerte en la mujer es el cáncer, particularmente de mama (53,4%). Conclusiones : Se encontró una alta prevalencia de FRC modificables con baja percepción del riesgo cardiovascular. El antecedente de complicaciones del embarazo se asoció con mayor prevalencia de FRC.

ABSTRACT Background : Cardiovascular disease (CVD) is the leading cause of death in women. Nevertheless, women are less likely than men to receive guidance or preventive treatment to reduce it. Objective : The aim of this study was to detect the prevalence of cardiovascular risk factors (CRF) and detect the level of women's perception and awareness of CRF and CVD. Methods : We conducted an observational, cross-sectional study in July 2021 using a voluntary, anonymous, and online survey. The information collected included age range, CRF, CVD, risk perception and implementation of healthy habits and behaviors. Results : A total of 3888 women participated (with age range between 46 and 65 years in 50.1%); 34.1% had excess weight and 43.6% had a waist circumference > 80 cm. Hypertension (HTN) was reported by 24.2%; total cholesterol was > 200 mg/ dL in 19.6%; 5,4% were diabetics (DM); 44.3% had sedentary lifestyle; 11.3% were current smokers and 34.5% were former smokers; 82.1% had been pregnant at least once and 26.9% reported a complication during pregnancy. A bad obstetric history was more commonly associated with HTN (34% vs. 24%, p < 0.01), DM (7% vs. 5%, p = 0.04) and CVD (14% vs. 11%, p <0.01). Among the 10.9% who reported a history of CVD, myocardial infarction was the most common condition (51.1%). Sixty-two percent of survey respondents considered that cancer, and particularly breast cancer (53.4%), is the main cause of death in women (53.4%). Conclusions : We found a high prevalence of modifiable CRFs with low perception of cardiovascular risk. A bad obstetric history was associated with higher prevalence of CRF.

La salud en la mujer empresaria: derechos y desafíos

La crisis causada por la pandemia de la COVID-19 posibilitó una mayor incorporación de la mujer al trabajo por cuenta propia, lo que ha favorecido la economía familiar y de los países. La mujer emprendedora ha enfrentado las dificultades de la brecha de género y la ansiedad por mantener el equilibrio entre la vida familiar y la empresarial. Este trabajo se propone visibilizar los problemas de salud de las féminas empresarias -muy poco estudiados en Cuba-, ya que se necesitan entornos laborales seguros, que garanticen sus derechos al bienestar integral, y así lograr una mayor productividad.

The crisis caused by COVID-19 pandemics made it possible greater incorporation of women to self-employment, which has favored the family and countries' economies. Woman entrepreneur has faced difficulties of the gender gap and the anxiety of maintaining the balance between family and business life. This work aims to make visible the health problems of women entrepreneurs -very little studied in Cuba-, since safe work environments are needed, which guarantee their rights to comprehensive well-being, and thus achieve greater productivity.