Health indicators in Brazil and Spain: strategies for health promoting universities.

AIMS: The study aims to identify and compare health indicators collected by national research in Spain and in Brazil that can generate action strategies for health promoting universities. METHODS: This is an epidemiological, descriptive, cross-sectional study that uses the database of the Secretariat of Health Surveillance of the Brazilian Ministry of Health and the database of the National Statistics Institute of Spain. Based on the National Health Promotion Policy, the analyzer axis prioritizes defined themes; percentage of physical exercise, daily smokers, sedentary lifestyle, obesity and self-perception of health status were evaluated. The data were collected from 2014 to 2020. RESULTS: In Brazil, physical exercise is the highest percentage indicator, whereas in Spain, sedentary lifestyle is the highest. Regarding the age group, Brazil presented the lowest prevalence of daily smokers in the age group from 18 to 24, with little increase in older age groups; in Spain, older age groups presented the highest rates of sedentary lifestyle and obesity. In 2020, 4.5% of Brazilians reported a negative self-perception of health and in Spain 6.6%. CONCLUSION: The indicators 'physical exercise', 'daily smokers' and 'sedentary lifestyle' presented better results in Brazil than in Spain. Brazil presents a better perspective on health when compared with Spain, as the results showed that older ages present higher rates of sedentary lifestyle and obesity. Our study results also show that Brazilians report better self-perception in health, which can be interpreted by health promotion strategies.

Spatial distribution of Robson 10-group classification system and poverty in southern and southeastern Brazil.

OBJECTIVE: To assess the spatial distribution of the Robson 10-group classification system (TGCS) and poverty in southeastern and southern regions of Brazil in 2016. METHODS: An ecologic study based on public data from the Brazilian Information System on Live Births and the Brazilian Institute of Geography and Statistics, including 1 519 289 (53.2%) of all live-born neonates in Brazil between January and December 2016. Statistical analysis used Bayesian modelling with spatial distribution following an autoregressive conditional structure, and Moran index. RESULTS: In 2016, the percentage of live-born neonates delivered by cesarean was 58.8% and 60.7% in the southeastern and southern regions, respectively. Robson groups 1 and 3, involving spontaneous labor, were related to regions with higher poverty (Moran index, 0.36 and 0.44, respectively), whereas groups 2 and 5, involving cesarean delivery, were related to poorer regions (Moran index, 0.56 and 0.45, respectively). CONCLUSION: The frequencies of each group of the Robson TGCS were heterogeneously distributed in the geographic space owing to important associations with the proportion of poverty in the different regions. Actions are needed to develop the poorest regions in order to minimize existing disparities.

Response of oxygen saturation in preterm infants receiving rib cage stabilization with an elastic band in two body positions: a randomized clinical trial.

BACKGROUND: Preterm newborns have higher thoracic compliance, providing less stability to the different forces of distortion imposed on the rib cage, leading to instability of the chest. Adequate body position may reduce this instability and facilitate respiratory work. OBJECTIVE: To assess the oxygen saturation response of preterm newborns receiving rib cage stabilization with an elastic band in two body positions. METHOD: A clinical, prospective, randomized crossover study was conducted, including sixteen newborns with a gestational age of 31 to 35 weeks (mean 32.8 weeks) at a tertiary care facility, who did not receive supplemental oxygen. The infants were placed in a sequence of prone and supine positions with and without chest stabilization with an elastic band. Respiratory rate, heart rate, and oxygen saturation were measured at 10-minute intervals, corresponding to 7 samplings of 60 minutes. Data collection was interrupted when oxygen saturation was less than 90%. RESULTS: The mean gestational age of the infants was 32.8±1.5 weeks and the mean birth weight was 1,789±255 g. Better values for the variables studied were observed in the supine position with an elastic chest band compared to the supine position without the band. The positions using an elastic band resulted in lower mean respiratory rate and heart rate and higher oxygen saturation. CONCLUSION: The use of an elastic chest band improves respiratory indicators such as oxygen saturation.

Response of oxygen saturation in preterm infants receiving rib cage stabilization with an elastic band in two body positions: a randomized clinical trial / Resposta da saturação de oxigênio no recém-nascido pré-termo com estabilização do gradil costal por meio da faixa elástica em duas posições corporais: ensaio clínico randomizado

BACKGROUND: Preterm newborns have higher thoracic compliance, providing less stability to the different forces of distortion imposed on the rib cage, leading to instability of the chest. Adequate body position may reduce this instability and facilitate respiratory work. OBJECTIVE: To assess the oxygen saturation response of preterm newborns receiving rib cage stabilization with an elastic band in two body positions. METHOD: A clinical, prospective, randomized crossover study was conducted, including sixteen newborns with a gestational age of 31 to 35 weeks (mean 32.8 weeks) at a tertiary care facility, who did not receive supplemental oxygen. The infants were placed in a sequence of prone and supine positions with and without chest stabilization with an elastic band. Respiratory rate, heart rate, and oxygen saturation were measured at 10-minute intervals, corresponding to 7 samplings of 60 minutes. Data collection was interrupted when oxygen saturation was less than 90%. RESULTS: The mean gestational age of the infants was 32.8±1.5 weeks and the mean birth weight was 1,789±255g. Better values for the variables studied were observed in the supine position with an elastic chest band compared to the supine position without the band. The positions using an elastic band resulted in lower mean respiratory rate and heart rate and higher oxygen saturation. CONCLUSION: The use of an elastic chest band improves respiratory indicators such as oxygen saturation. .

CONTEXTUALIZAÇÃO: Os recém-nascidos pré-termos possuem maior complacência torácica, oferecendo menor estabilidade às diferentes forças de distorção impostas à parede torácica, o que leva à instabilidade da caixa torácica. A posição corporal adequada pode diminuir essa instabilidade, facilitando o trabalho respiratório. OBJETIVO: Verificar a resposta da saturação de oxigênio em recém-nascido pré-termo com estabilização do gradil costal com faixa elástica em dois posicionamentos corporais. MÉTODO: Estudo com delineamento de ensaio clínico prospectivo, randomizado e tipo crossover. Foram avaliados 16 recém-nascidos com idade gestacional de 31 a 35 semanas (média 32,8 semanas) e sem oxigênio suplementar, em instituição de nível terciário. O grupo foi submetido à sequência de decúbitos posturais ventral e dorsal, alterando-os com e sem estabilização do tórax por meio da faixa elástica. Os indicadores biológicos colhidos foram frequência respiratória, frequência cardíaca e saturação de oxigênio. Os dados foram coletados de 10 em 10 minutos, totalizando 60 minutos com sete coletas. O critério de interrupção da coleta se deu pela saturação menor que 90%. RESULTADOS: O grupo estudado apresentou média de idade gestacional de 32,8±1,5 semanas e peso ao nascimento de 1.789±255g. Encontramos melhores valores das variáveis na supinação com faixa quando comparada com supinação sem faixa. Os valores médios menores da frequência respiratória e da frequência cardíaca foram alcançados no decúbito com faixa, já a saturação ...

[Decrease of the occurrence of pneumothorax in newborns with respiratory distress syndrome through reduction of ventilatory parameters]. / Diminuição da ocorrência de pneumotórax em recém-nascidos com síndrome de desconforto respiratório através de estratégias de redução de parâmetros ventilatórios.

OBJECTIVE: To verify if the strategy of reduction of the ventilatory parameters decreases the occurrence of pneumothorax in preterm newborns with respiratory distress syndrome. PATIENTS AND METHODS: A longitudinal prospective study of preterm newborns with respiratory distress syndrome was carried out at the Pediatric Intensive Care Center of HOspital Santa Casa de Misericórdia of Franca, from July 1999 to June 2000. One hundred and twenty-seven female and male newborns between the 25th and the 37th week of gestation, with birthweight varying from 625 g to 2500 g were studied. The ventilatory parameters were analyzed during the assisted mechanical ventilation in two groups of patients: the controlled group and the other group, in which the parameters were reduced, by investigating and comparing the occurrence of penumothorax. The association of data was verified through chi-square test; level of significance alpha = 0.05 and 0.01, and the difference among the studied parameters was obtained throught he Student's t test. RESULTS: The results show lower parameters of inhalation flow and shorter period of inhalation, generating minor tidal volume, decrease of the occurrence of pneumothorax (8.1% compared to 24.5% of the controlled group), with statistical significance (chi(2) = 6.545; p < 0.05), and without significance related to mortality and hospital discharge (chi(2) = 0.736; p = 0.391). CONCLUSION: This study verified that lower inhalation flow and shorter period of inhalation in preterm newborns with respiratory distress syndrome were associated with the decrease of the occurrence of pneumothorax.