RESUMO
Objective: To estimate the incidence of excess of body weight in the school period and explore possible association with prenatal factors. Methodology: An epidemiological study with a longitudinal design was carried out. All children from the first to the fifth grade of elementary school, aged between seven and 10 years old, enrolled in public and private schools and from families residing in Palhoça City, Santa Catarina State, who had participated in the previous stage of the study in 2015, were included. To obtain the BMI, weight and height were collected in schools. Data related to the prenatal period were obtained with interviews with mothers or guardians, at home. The analyses were performed using Poisson Regression with a robust estimator. Statistically significant variables and those with p ≤ 0.25 in the bivariate analysis were included in the multivariate. Results: 228 students were included. The incidence rate of excess weight was 19.3%, with 17.1% being overweight and 2.2% being obese. The results of the multivariate analysis showed that students who were born with Apgar in the first minute ≤ 7 had a statistically significant risk and 34% higher relative risk of developing excess weight in the school period. Conclusion: The incidence of overweight was 19.3%. Prenatal factors were not associated with incidence, except for a low Apgar score in the first minute.
Objetivo: Estimar a incidência de excesso de peso corporal no período escolar e a associação com fatores pré-natais. Métodos: Estudo epidemiológico de delineamento longitudinal. Incluídas crianças com 10 anos matriculadas em escolas públicas e privadas e de famílias residentes em Palhoça/SC participantes da pesquisa em 2015. Para o índice de massa corporal, coletaram-se peso e estatura. Dados do período pré-natal foram obtidos em entrevistas com as mães ou responsáveis. As análises ocorreram por regressão de Poisson com estimador robusto. As variáveis estatisticamente significativas e aquelas com p ≤ 0,25 na análise bivariada foram incluídas na multivariada. Resultados: Foram incluídos 228 escolares. A taxa de incidência de excesso de peso foi de 19,3% 17,1% de sobrepeso e 2,2% de obesidade. Os resultados da análise multivariada mostraram que escolares que nasceram com Apgar no primeiro minuto ≤ 7 apresentaram risco relativo estatisticamente significativo e independente 34% maior de desenvolver excesso de peso no período escolar. Conclusão: A incidência de excesso de peso foi de 19,3%. Fatores pré-natais não se mostraram associados à incidência, com exceção de baixo Apgar no primeiro minuto.
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The aim of this study was to analyze the temporal trend of leptospirosis incidence according to rainfall levels in Santa Catarina State between 2005 and 2015. This is an ecological time-series study involving data on leptospirosis incidence and rainfall indexes in Santa Catarina State Health Regions. The distribution of leptospirosis, rainfall indexes, and cases/rainfall ratios, according to seasonality and stratified by Health Regions, were evaluated. There were 5,274 cases, with an average rate of 7.03 cases/100,000 inhabitants per year, varying from 24 to 1,458 cases (Serra Catarinense and Northeast regions, respectively) in Santa Catarina, revealing an increase in the rates of 0.70 cases/100,000 inhabitants in Serra Catarinense and 13.99 cases/100,000 inhabitants in the Northeast. Four regions (Foz do Rio Itajaí, Médio Vale do Itajaí, Grande Florianópolis and Northeast) were responsible for 71.8% of the cases, particularly in the Northeast region (38.5%). The five regions with the highest rates presented greater risk of leptospirosis (RR > 1), ranging from 10.9 to 19.9 more new cases of the disease. The average rainfall volume for Santa Catarina State was 158.69 mm, ranging from 136.44 mm in Laguna to 186.81 mm in the Northeast. The five regions contributed with 32.8% of the rainfall index accumulated in the period. In conclusion, leptospirosis occurred all around Santa Catarina State, differing its temporal trend according to the Health Regions. The aim of this study was to analyze the temporal trend of leptospirosis incidence according to rainfall levels in Santa Catarina State between 2005 and 2015. This is an ecological time-series study involving data on leptospirosis incidence and rainfall indexes in Santa Catarina State Health Regions. The distribution of leptospirosis, rainfall indexes, and cases/rainfall ratios, according to seasonality and stratified by Health Regions, were evaluated. There were 5,274 cases, with an average rate of 7.03 cases/100,000 inhabitants per year, varying from 24 to 1,458 cases (Serra Catarinense and Northeast regions, respectively) in Santa Catarina, revealing an increase in the rates of 0.70 cases/100,000 inhabitants in Serra Catarinense and 13.99 cases/100,000 inhabitants in the Northeast. Four regions (Foz do Rio Itajaí, Médio Vale do Itajaí, Grande Florianópolis and Northeast) were responsible for 71.8% of the cases, particularly in the Northeast region (38.5%). The five regions with the highest rates presented greater risk of leptospirosis (RR > 1), ranging from 10.9 to 19.9 more new cases of the disease. The average rainfall volume for Santa Catarina State was 158.69 mm, ranging from 136.44 mm in Laguna to 186.81 mm in the Northeast. The five regions contributed with 32.8% of the rainfall index accumulated in the period. In conclusion, leptospirosis occurred all around Santa Catarina State, differing its temporal trend according to the Health Regions.
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Objective The purpose of this study was to perform the translation, cross-cultural adaptation and validation of the Tilburg Pregnancy Distress Scale (TPDS) in the Brazilian cultural context and to verify its psychometric properties. Design Cross-cultural adaptation and validation of a distress scale. Setting The study was carried out in a prenatal clinic of a reference maternity hospital in southern Brazil. Participants 160 childbearing women. Methods The adaptation of the TPDS to the Portuguese language in its Brazilian version met the methodological criteria proposed by the International Society for Pharmacoeconomics and Outcomes Research. To validate the proposed Brazilian version, the questionnaire was applied to 160 childbearing women from the prenatal clinic of a reference maternity hospital in southern Brazil on two occasions between February and May 2018. The stability of the instrument, its internal consistency through Cronbach's alpha and the construct validity were all evaluated through exploratory factorial analysis. The extraction of main components by rotation of Varimax enabled definition of the communalities of the items of the proposed Brazilian version. The study was approved by the local Ethics Committee. Findings The test-retest technique demonstrated strong stability, with a Pearson correlation coefficient of 0.93 (p < 0.001) and an intraclass correlation coefficient of 0.92 (p < 0.001). The general Cronbach's alpha was found to be 0.73. All items presented a factorial load > 0.44 populations in the factorial analysis. Through the method of extracting components, three domains were obtained among the 16 issues of the proposed tool: (1) affection and involvement of the partner, (2) feelings about childbirth and (3) feelings about the future. Key Conclusions The proposed Brazilian version of the Tilburg Pregnancy Distress Scale to evaluate stress and anxiety in pregnancy maintained the original context of the instrument while adding features specific to Brazilian reality. Implications for Practice This is an easily understood scale that is reliable, valid and adequate to the Brazilian social context; it will aid in the assessment of anxiety and stress in childbearing women during prenatal care.
Assuntos
Ansiedade/diagnóstico , Psicometria/normas , Adolescente , Adulto , Ansiedade/psicologia , Brasil , Comparação Transcultural , Feminino , Humanos , Assistência Perinatal/normas , Gravidez , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários , TraduçãoRESUMO
O objetivo do estudo é analisar a tendência temporal da incidência de leptospirose, de acordo com índices pluviométricos na Região da Grande Florianópolis, conforme sazonalidade - 2005 a 2015. Trata-se de estudo ecológico de séries temporais, com dados de leptospirose, índices pluviométricos e população. Foram analisadas taxas de incidência de leptospirose, excesso relativo da incidência, coeficiente de correlação de Pearson (r), coeficiente angular (ß), a partir do ajuste da regressão linear, com nível de significância de 95%. Apresenta distribuição dos casos de leptospirose, índices pluviométricos e razão casos/índices pluviométricos, estratificados por mês de ocorrência. Foram registrados 1.001 casos de leptospirose, média mensal de 83 casos, com variação de 43, nos meses de agosto, a 146, nos meses de fevereiro. A taxa média de leptospirose foi 8,24/100 mil habitantes. O índice pluviométrico médio foi 154,83 mm, os índices mais baixos ocorreram nos meses de junho, média de 99,48 mm, e, os mais elevados nos meses de janeiro, média de 226,16 mm. Uma correlação positiva entre taxas de leptospirose e níveis pluviométricos, ao longo do período, janeiro a dezembro (r=0,64; p=0,003), aponta para associação temporal positiva entre quantidade de chuva e casos da doença. A doença ocorreu o ano todo e apresentou nítida sazonalidade no período de outubro a março.
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O objetivo do estudo foi estimar a tendência temporal de internação por asma em adultos no Estado de Santa Catarina, entre 2008-2015. Estudo ecológico de séries temporais, com dados das internações hospitalares, de residentes em Santa Catarina, a partir de informações do Sistema Informação Hospitalar do Sistema Único de Saúde (SIH-SUS). Realizada regressão linear segmentada para estimar a variação anual percentual e identificar pontos em que ocorreu modificação da tendência. Houve decréscimo significativo na taxa de internação entre as mulheres (2008-2013), para todas as faixas etárias, com acréscimo não significativo (2013- 2015). No sexo masculino, verificou-se resultados semelhantes. No período 2008-2013 houve queda significativa nas taxas em todas as faixas etárias, com acréscimo não significativo entre 2013-2015. Entre os homens com 80 anos ou mais houve acréscimo não significativo (2008- 2010), seguido por queda significativa (2010-2015). Em conclusão, a tendência das internações por asma no Estado foi descendente entre 2008-2013, com estabilização após esse período. Considerando tratar-se de um problema de saúde que necessita de intervenção prioritária na APS os achados evidenciam a necessidade dos gestores e profissionais do SUS garantirem tratamento adequado aos usuários a partir de programas e centros de atenção aos pacientes, nos serviços públicos em saúde do Estado.
The objective of this study was to estimate the time trend in hospital stay for asthma in adults in the State of Santa Catarina between 2008-2015. Ecological study of time series, with data from hospital admissions, of residents in the State of Santa Catarina, based on information from the Hospital Information System of the Unified Health System (SIH-SUS). Segmented linear regression was performed to estimate the annual percentage variation and to identify points where a change in trend occurred. There was a significant decrease in the hospitalization rate among women in (2008-2013), for all age groups, with a non-significant increase in the period 2013-2015. For the male sex, similar results were observed. In the period (2008-2013), there was a significant fall in rates in all age groups, with a non-significant increase during 2013- 2015. Among men aged 80 years or older there was a non-significant increase (2008-2010), followed by a significant decrease (2010-2015). In conclusion, the trend of hospitalizations for asthma in the state decreased between 2008 and 2013, having stabilized after this period. Considering that this is a health problem that requires priority intervention in primary health care, the findings highlight the need for SUS managers and professionals to ensure adequate treatment for users from programs and patient care centers in State health public services.
RESUMO
The objective of the study is to analyze the temporal trend of leptospirosis incidence, according to rainfall levels in Santa Catarina, according to seasonality, from 2005 to 2015. This is an ecological study of time series, with date of leptospirosis, rainfall levels and population. The incidence rates of leptospirosis, relative excess of incidence, Pearson's correlation coefficient (r) and an angular coefficient (ß) were analyzed from the linear regression adjustment, with a 5% significance level. Distribution of leptospirosis cases, rainfall levels and cases reason/rainfall levels, stratified by month of occurrence were presented. There were 5,274 cases of leptospirosis, with the monthly average being 439 cases, ranging from 211 in September to 770 in January. The mean rate of leptospirosis was 7.03 per 100,000 habitants. The average rainfall level was 158.68 mm, with the lowest levels occurring in August, average of 124.9 mm, and the highest in January average of 213.20 mm. The positive correlation between leptospirosis rates and rainfall levels, during the period from January to December (r = 0.68, p = 0.023), indicates a positive temporal association between the amount of rainfall and the cases of the disease. The disease occurred all year round and presented a distinct seasonality from October to March.
Assuntos
Leptospirose/epidemiologia , Chuva , Estações do Ano , Brasil/epidemiologia , Humanos , IncidênciaRESUMO
O objetivo do estudo foi investigar o impacto da Lei Seca na taxa de mortalidade por acidentes de trânsito, Santa Catarina, 2005 a 2011. Estudo Ecológico baseado nos dados do Sistema de Informações sobre Mortalidade (SIM/Datasus). Foram obtidas as taxas de mortalidade geral, por sexo e faixa etária, pré e pós Lei Seca; foram calculadas as diferenças entre as taxas, Risco Relativo, Fração Etiológica e o número absoluto de casos evitáveis. Os resultados mostram uma queda nas taxas de mortalidade geral por acidentes de trânsito, ao comparar os períodos pré e pós Lei Seca, de 97,18 para 91,80/100 mil (p<0,01).As diferenças relativas mais importantes, se deram nas faixas etárias mais elevadas, com destaque a partir dos 40 anos de idade e ainda que entre os indivíduos do sexo masculino e das faixas etárias mais jovens, as diferenças relativas (RR) não tenham sido tão expressivas quanto para os demais grupos, os números absolutos de casos gerados, foram mais do que o dobro nestes grupos, com 246 e 225 casos atribuíveis, entre os homens e entre indivíduos na faixa etária dos 20-29 anos, respectivamente.Resultados apontam para sexo masculino como fator de risco independente para óbito por acidentes de trânsito, sendo ingestão de álcool um fator potencializador. O presente estudo é original ao enfatizar a importância da fração etiológica, medida de impacto populacional, essencial quando os resultados visam direcionar ações na área da Saúde Pública.
Investigate the impact of alcohol prohibition in the death rate from traffic accidents, in Santa Catarina, from 2005 to 2011. Ecological Study based on data from the Mortality Information System (SIM / DATASUS). The overall mortality rates were obtained by sex and age group, pre- and postprohibition; the differences between rates, Relative Risk, Etiological Fraction and the absolute number of preventable cases, were calculated. The results show a fall in the overall mortality rates from traffic accidents, when comparing the period before and after Prohibition, from 97.18 to 91.80 / 100,000 (p <0.01).The relative differences more important, occurred among the older age groups, especially those with 40 or more years of age. Although, among males and younger age groups, the relative differences (RR) were not as expressive as for other groups, the absolute numbers of cases generated, were more than double for those groups, with 246 and 225 cases attributable, among men and among individuals in the age group of 20-29 years, respectively. Results indicate male as an independent risk factor for death from traffic accidents and, alcohol intake a potentiating factor. This study is unique in emphasizing the importance of the Etiologic Fraction, a measure of population impact, essential when the results are aimed to actions directed to Public Health.
