ABSTRACT
The objective of this study was to analyze the trend of the age standardized mortality rate (ASMR) for cervical cancer in Brazil between 2005 and 2019 and investigate its association with the Socio-demographic Index (SDI), an indicator of development status strongly correlated with health outcomes. We conducted an ecological time-series study using data from the Mortality Information System of the Ministry of Health. Trend analyses were performed using Prais-Winsten regression. The association between the SDI and ASMR was evaluated using simple linear regression. Between 2005 and 2019, 105,472 deaths from cervical cancer were recorded. The ASMR was 10.18 deaths/100,000 women. The North region presented the highest magnitude (20.23 deaths/100,000 women) and the Southeast region the lowest (7.83 deaths/100,000 women). We observed a decreasing trend of the ASMR for cervical cancer in the country. The Northeast, Central-West and Southeast regions showed a decreasing trend; South stationary trend and the North region showed an increasing trend. Most of the states showed a stationary or decreasing trend. It was found that the SDI was inversely associated with the ASMR and Annual Percent Change (APC). In conclusion, we observed a decreasing trend of ASMR for cervical cancer and inverse association with SDI in Brazil.
Subject(s)
Uterine Cervical Neoplasms , Adult , Age Factors , Aged , Aged, 80 and over , Brazil/epidemiology , Female , Humans , Middle Aged , Mortality/trends , Time Factors , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/mortality , Young AdultABSTRACT
Objective: This study aimed to analyze the effectiveness of breast shells in preventing pain and nipple injury during breastfeeding. Method: A non-randomized clinical trial was carried out with blinding to the evaluators of the study results. The study included women with ≥35 weeks of singleton pregnancy, no nipple changes, and a desire to breastfeed. Resulting in 62 lactating women. The experimental group used breast shells and health education with clinical demonstration (n = 29), whereas the control group used no breast shells (n = 33). Pain and nipple injury were assessed three times, twice prenatally and once up to 14 days postpartum. Results: Nipple injury (50.0%) and nipple pain (67.7%) presented with similar frequency in both groups (p = 1). Breast engorgement (35,5%) was associated with nipple pain (p = 0.019) and its onset was delayed in the experimental group (p = 0.001). Health education contributes to breast and nipple care and increases favorable breastfeeding patterns. Conclusion: Breast shells do not prevent nipple pain or injury. Innovation: As far as we know, this is the first clinical research evaluating the use of breast shells since the antenatal care to prevent the occurrence of nipple pain and injury.
ABSTRACT
Objetivo: Investigar el efecto de la lanolina sobre el dolor y el traumatismo de los pezones en la lactancia después de la aplicación de educación para la salud. Método: Ensayo clínico controlado aleatorizado, con 2 brazos, sin cegamiento, con 66 participantes durante la atención prenatal en la red básica de salud en Goiânia-Goiás, Brasil. Las participantes fueron aleatorizadas (1:1) utilizando números generados por ordenador en el grupo experimental (GE) y en el grupo de control (GC). El GE recibió lanolina y educación para la salud sobre lactancia materna en 2 momentos diferentes, con demostración clínica y álbum ilustrativo como intervención, mientras que el GC recibió educación para la salud estándar. La educación para la salud fue realizada por los mismos investigadores en ambos grupos. El dolor, la lesión del pezón y la lactancia se midieron en el octavo día posparto. El análisis incluyó estadística descriptiva y análisis inferencial mediante la prueba de Chi-cuadrado o Fisher y la prueba de la t de Student, con un nivel de significación de 0,05. Resultados: La mayoría de las participantes no experimentaron lesiones en el pezón (59,1%) en ambos grupos, y el 60,6% de las mujeres experimentaron dolor. En ambos grupos, las mujeres mostraron comportamientos favorables a la lactancia materna, excepto en la condición de los senos. No hubo diferencias significativas entre los grupos en la prevención del dolor (p=0,61), lesiones de los pezones (p=0,21) y la técnica de lactancia (p>0,05). Conclusión: No está claro si la intervención de lanolina combinada con educación para la salud tiene un efecto positivo en la prevención del dolor y el traumatismo en los pezones. Se necesitan más investigaciones para dilucidar esta cuestión.(AU)
Objective: To investigate the effect of lanolin on nipple pain and trauma in breastfeeding after application of a health education. Method: Randomized controlled clinical trial, with two arms, open, with 66 participants during prenatal care in the primary health care network in Goiania Goias, Brazil. Participants were randomized (1:1) using computer generated numbers in both experimental group (EG) and control group (CG). The EG received lanolin and health education on breastfeeding at two different times with clinical demonstration using cloth didactic breast and illustrative album as the intervention, while the CG received standard health education. Health education was carried out by the same researchers in both groups. Measurement of pain, nipple trauma, and breastfeeding technique occurred on postpartum day eight. The analysis included descriptive statistics and inferential analysis by means chi-square or Fisher test, and Student's t-test, significance level set at 0.05. Results: A majority of the participants experienced no nipple trauma (59.1%) in both groups, and 60.6% of women experienced pain. In both groups, women showed favorable breastfeeding behaviors, except in the condition of the breasts. There were no significant differences between groups in pain prevention (p=0.61), nipple lesions (p=0.21), and breastfeeding technique (p>0.05). Conclusion: It is not clear whether the intervention, lanolin combined with health education, has a positive effect on the prevention of nipple pain and trauma. Further research is needed to elucidate this question.(AU)
