Psychiatric symptoms in patients with systemic lupus erythematosus: frequency and association with disease activity using the Adult Psychiatric Morbidity Questionnaire.

INTRODUCTION: While the neurolupus criteria are well-established, global psychiatric manifestations are of variable frequency in patients with systemic lupus erythematosus (SLE); their relation with disease activity is unknown. OBJECTIVE: To evaluate the frequency of psychiatric symptoms in SLE using the Adult Psychiatric Morbidity Questionnaire (APMQ); to correlate APMQ changes with disease activity and socio-economic variables. MATERIALS AND METHODS: This cross-sectional study evaluated patients with active or inactive SLE as to the prevalence of psychiatric symptoms utilizing, for the first time, the APMQ. Eight or more affirmative replies out of 45 questions defined the APMQ as abnormal. Patients were classified according to the American College of Rheumatology 1997 criteria, and disease activity was measured by the SLEDAI. RESULTS: Seventy-two SLE patients entered the study, being 68 females (94.4%). Mean age was 46.1 years (± 12 SD). The frequency of abnormal APMQ was of 89%. Out of the 64 SLE patients with altered APMQ, 60 (93.7%) had common mental disorders, mostly anxiety and somatization. There was no correlation of psychiatric symptoms with active disease (rs = 0.09; P = 0.46), or with history of psychosis and/or seizures attributable to SLE (P = 1.00). Psychiatric symptoms also did not correlate with age at disease onset (rs = -0.16) or disease duration (rs = -0.11). There was an association of abnormal APMQ with low education level (P = 0.02), but not with family income allotted to the patient (P = 0.24). CONCLUSION: The frequency of psychiatric symptoms measured by the APMQ was high in our SLE population. An abnormal APMQ was disconnected from SLE activity, but it did associate with low education level.

[The prevalence of exclusive breastfeeding and associated factors: a cross-sectional study of teenage mothers between 14 and 16 years of age in the city of Porto Alegre in the State of Rio Grande do Sul, Brazil]. / Prevalência de aleitamento materno exclusivo e fatores associados: estudo transversal com mães adolescentes de 14 a 16 anos em Porto Alegre, RS, Brasil.

This is a cross-sectional study to verify the prevalence and associated factors related to exclusive breastfeeding in adolescent mothers between 14 and 16 years of age with 6-month-old or younger babies, born in Porto Alegre in the State of Rio Grande do Sul, Brazil, in 2009. The sample was based on 50% of the newborn babies from the population surveyed. A total of 341 adolescent mothers were interviewed in their homes. The variables considered as potential determinants of exclusive breastfeeding were social and demographic, pre- and post-natal assistance, emotional aspects of the mother, birth conditions and baby characteristics. Prevalence ratios (PR) were estimated by Poisson regression by means of hierarchical analysis. The prevalence of exclusive breastfeeding ranged from 47.8% in the first month of life up to 13.8% after six months and declined, on average, 24% for each month of life (RP = 0.76; CI95%: 0.68-0.85). Besides the baby's age, the factors associated with exclusive breastfeeding were maternal education (PR=1.53; CII95%: 1.18-1.98) and multiple births (PR=1.57; CI95%:1.02-2.46), the latter observed in only 4.7% of the sample. Teenage mothers with higher schooling and with live children from earlier pregnancies manifested higher prevalence of exclusive breastfeeding.

Estratégia saúde da família e as internações por condições sensíveis a atenção primária nos idosos / The family health strategy in relation to hospitalization for primary care sensitive conditions in elderly / La estrategia de salud familiar y condiciones hospitalarias por primaria sensible en el anciano

A Estratégia Saúde da Família (ESF) reorganiza o modelo assistencial do Sistema Único de Saúde (SUS) desde a atenção básica, garantindo ações individuais e coletivas de promoção, proteção e reabilitação da saúde a integralidade da atenção e a responsabilidade da equipe da saúde sobre a população em seu território de referência. Trata-se de estudo ecológico com o objetivo de detectar as internações por Condições Sensíveis à Atenção Primária (CSAP) em idosos na cidade de Caxias do Sul (RS), de 2000 a 2003 (antes da implantação da ESF) e 2005 a 2007 (depois da implantação da ESF). Como base de dados foram utilizados o Sistema de Informações Hospitalares do SUS e as estimativas da população residente fornecidas pelo IBGE e disponibilizadas pelo DATASUS. A tabulação dos dados foi realizada pelo programa TabWin. As variáveis estudadas foram os Coeficientes de internação por CSAP, faixa etária, sexo, período; para o ano de 2007, incluiu-se também o local (município vs. estado). Observou-se redução dos coeficientes e percentuais de internação por CSAP no município, em ambos os sexos e em todas as faixas etárias exceto em homens maiores de 80 anos. Os coeficientes em 2007 foram menores no município que no estado. Concluiu-se que a ESF pode ter contribuído para a redução observada.

The Family Health Strategy (ESF) reorganizes the model of care from the Unified Health System (SUS) starting from the primary care, ensuring individual and collective actions of promotion, protection and rehabilitation of health, integrated care and responsibility of the health care team for the population in its reference territory. This is an ecological study that aims to identify hospital admissions for Primary Care Sensitive Conditions (CSAP) in elderly inhabitants of the municipality of Caxias do Sul, RS, Brazil from 2000 to 2003 (before the implementation of the ESF) and from 2005 to 2007 (after the implementation of ESF). For data collection there was examined the Hospital Information System from SUS and the population estimates from IBGE, The Brazilian Institute of Geography and Statistics and supplied by DATASUS. The TabWin program was used for the tabulation of the data. The variables studied were the CSAP hospitalization rate, age, sex, period and for the year 2007. The region was included as well (municipality or the whole State). There was observed a reduction in CSAP hospitalization rates and percentages in the municipality, in both genders of all ages except in men older than 80 years old. In 2007, the municipality rates were lower than the State ones. It could be concluded that the ESF may have contributed to the reduction observed.

La Estrategia de Salud de la Familia (ESF) reorganiza el modelo de la atención primaria de SUS, asegurando las acciones individuales y colectivas de promoción, protección y atención integral a la rehabilitación y la responsabilidad del equipo de salud sobre la población en su territorio de referencia. Este estudio ecológico sobre las tasas de hospitalización en las personas mayores por las Condiciones de Atención Primaria Sensibles (ACSC) en Caxias do Sul, RS, 2000-2003 (antes de la aplicación del ESF) y 2005-2007 (después de la aplicación del ESF). Como base de datos se utilizó Sistema de Información Hospitalaria del SNS y de las estimaciones de la población residente (IBGE) liberadas por DATASUS. Una tabulación de los datos se realizó utilizando el programa TABWIN. Se utilizó la lista de las hospitalizaciones por ACSC en Brasil, según el Ministerio de Salud. Las variables estudiadas fueron los coeficientes de hospitalización por ACSC, edad, sexo, periodo y para el año 2007, local (ciudad vs estado). Una reducción de los coeficientes y porcentajes de hospitalización por ACSC en la ciudad, en ambos sexos y todos los grupos de edad, excepto en los hombres mayores de 80 años. Los coeficientes en 2007 fueron menores en el condado que en el estado. Llegamos a la conclusión de que el ESF puede haber contribuido a la reducción observada.

Prevalência de aleitamento materno exclusivo e fatores associados: estudo transversal com mães adolescentes de 14 a 16 anos em Porto Alegre, RS, Brasil / The prevalence of exclusive breastfeeding and associated factors: a cross-sectional study of teenage mothers between 14 and 16 years of age in the city of Porto Alegre in the State of Rio Grande do Sul, Brazil

Estudo transversal com objetivo de verificar a prevalência e os fatores associados ao aleitamento materno exclusivo (AME) em mães adolescentes de 14 a 16 anos cujos bebês de até seis meses nasceram em Porto Alegre (RS), no ano de 2009. A composição da amostra teve como base 50% dos nascidos vivos da população em estudo. Foram entrevistadas 341 mães adolescentes em seus domicílios. As variáveis investigadas como possíveis determinantes do AME foram: sociodemográficas, de assistência pré e pós-natal, aspectos psicoemocionais maternos, condições de nascimento e características do bebê. As razões de prevalência (RP) foram obtidas por regressão de Poisson mediante análise hierarquizada. A prevalência de aleitamento materno exclusivo variou de 47,8% no primeiro mês de vida do bebê até 13,8% aos seis meses, diminuindo, em média, 24% a cada mês de vida (RP = 0,76; IC95%: 0,68-0,85). Além da idade do bebê, também estiveram associadas ao aleitamento materno exclusivo a escolaridade materna (RP = 1,53; IC95%: 1,18-1,98) e a multiparidade (RP = 1,57; IC95%: 1,02-2,46), esta última observada em apenas 4,7% da amostra. As mães adolescentes com maior escolaridade e que possuem filhos vivos de gestações anteriores apresentaram maior prevalência de aleitamento materno exclusivo.

This is a cross-sectional study to verify the prevalence and associated factors related to exclusive breastfeeding in adolescent mothers between 14 and 16 years of age with 6-month-old or younger babies, born in Porto Alegre in the State of Rio Grande do Sul, Brazil, in 2009. The sample was based on 50% of the newborn babies from the population surveyed. A total of 341 adolescent mothers were interviewed in their homes. The variables considered as potential determinants of exclusive breastfeeding were social and demographic, pre- and post-natal assistance, emotional aspects of the mother, birth conditions and baby characteristics. Prevalence ratios (PR) were estimated by Poisson regression by means of hierarchical analysis. The prevalence of exclusive breastfeeding ranged from 47.8% in the first month of life up to 13.8% after six months and declined, on average, 24% for each month of life (RP = 0.76; CI95%: 0.68-0.85). Besides the baby's age, the factors associated with exclusive breastfeeding were maternal education (PR=1.53; CII95%: 1.18-1.98) and multiple births (PR=1.57; CI95%:1.02-2.46), the latter observed in only 4.7% of the sample. Teenage mothers with higher schooling and with live children from earlier pregnancies manifested higher prevalence of exclusive breastfeeding.

Sintomas psiquiátricos em pacientes com lúpus eritematoso sistêmico: frequência e associação com atividade da doença com o uso do Questionário de Morbidade Psiquiátrica em Adultos / Psychiatric symptoms in patients with systemic lupus erythematosus: frequency and association with disease activity using the Adult Psychiatric Morbidity Questionnaire

INTRODUÇÃO: Enquanto os critérios de neurolúpus estão bem-estabelecidos, manifestações psiquiátricas globais são de frequência variável em pacientes com lúpus eritematoso sistêmico (LES); suas relações com atividade da doença e prognóstico são desconhecidas. OBJETIVO: Avaliar a frequência de sintomas psiquiátricos no LES utilizando o Questionário de Morbidade Psiquiátrica em Adultos (QMPA); correlacionar alterações no QMPA com atividade da doença e variáveis socioeconômicas. MATERIAIS E MÉTODOS: Este estudo transversal avaliou pacientes com LES ativo ou inativo quanto à prevalência de sintomas psiquiátricos utilizando, pela primeira vez, o QMPA. Oito ou mais respostas afirmativas entre 45 perguntas definiram um QMPA como anormal. Os pacientes foram classificados de acordo com os critérios do American College of Rheumatology de 1997, e o grau de atividade da doença foi mensurado pelo SLEDAI. RESULTADOS: Participaram do estudo 72 pacientes com LES, dos quais 68 eram do sexo feminino (94,4%). A média de idade foi de 46,1 anos (± 12 DP). A frequência de QMPA anormal foi de 89%. Entre os 64 pacientes lúpicos com QMPA alterado, 60 (93,7%) apresentavam distúrbios mentais comuns, a maioria ansiedade e somatização. Não houve correlação de sintomas psiquiátricos com atividade da doença (P = 0,46; rs = 0,09) ou com história de psicose e/ou convulsões atribuíveis ao LES (P = 1,00). Sintomas psiquiátricos também não se correlacionaram com idade de início da doença (rs = -0,16) ou duração da doença (rs = -0,11). Houve associação de QMPA anormal com baixo nível educacional (P=0,02), mas não com renda familiar destinada ao paciente (P = 0,24). CONCLUSÃO: A frequência de sintomas psiquiátricos medidos pelo QMPA foi alta em nossa população com LES. Um QMPA anormal esteve dissociado da atividade do LES, mas se associou com baixo nível educacional.

INTRODUCTION: While the neurolupus criteria are well-established, global psychiatric manifestations are of variable frequency in patients with systemic lupus erythematosus (SLE); their relation with disease activity is unknown. OBJECTIVE: To evaluate the frequency of psychiatric symptoms in SLE using the Adult Psychiatric Morbidity Questionnaire (APMQ); to correlate APMQ changes with disease activity and socio-economic variables. MATERIALS AND METHODS: This cross-sectional study evaluated patients with active or inactive SLE as to the prevalence of psychiatric symptoms utilizing, for the first time, the APMQ. Eight or more affirmative replies out of 45 questions defined the APMQ as abnormal. Patients were classified according to the American Collge of Rheumatology 1997 criteria, and disease activity was measured by the SLEDAI. RESULTS: Seventy-two SLE patients entered the study, being 68 females (94.4%). Mean age was 46.1 years (± 12 SD). The frequency of abnormal APMQ was of 89%. Out of the 64 SLE patients with altered APMQ, 60 (93.7%) had common mental disorders, mostly anxiety and somatization. There was no correlation of psychiatric symptoms with active disease (rs = 0.09; P = 0.46), or with history of psychosis and/or seizures attributable to SLE (P = 1.00). Psychiatric symptoms also did not correlate with age at disease onset (rs = -0.16) or disease duration (rs = -0.11). There was an association of abnormal APMQ with low education level (P = 0.02), but not with family income allotted to the patient (P = 0.24). CONCLUSION: The frequency of psychiatric symptoms measured by the APMQ was high in our SLE population. An abnormal APMQ was disconnected from SLE activity, but it did associate with low education level.

Cuidados alimentares e fatores associados em Canoas, RS, Brasil / Concerns about eating habits and associated factors in Canoas, Rio Grande do Sul State, Brazil

Foi realizado um estudo transversal, de base populacional, com 1.951 indivíduos de 14 anos e mais, com o objetivo deinvestigar a associação entre cuidados alimentares e variáveis demográficas, socioeconômicas e outros hábitos relacionados à saúde em Canoas-RS. Desses, 45 por cento referiram consumo de gorduras sem restrições, 61 por cento de doces, 64 por cento de carnes e 81 por cento de farinhas/massas. Ao consumo de carnes sem restrições, associaram-se: sexo masculino; escolaridade entre cinco e oitoanos; idade ≤59 anos; consumo de gorduras e farinhas/massas sem restrições; e não uso de homeopatia. Ao consumo de gorduras sem restrições, associaram-se: sexo masculino; escolaridade ≤8 anos; idade ≤59 anos; auto-percepção de vida não-saudável; tabagismo; uso de álcool, não uso de chás e medicamentos; consumo de carnes, doces e farinhas/massas semrestrições; não realização de exames preventivos. Ao consumo de doces sem restrições, associaram-se: idade ≤59 anos; autopercepção de vida não-saudável; consumo de gorduras e farinhas/massas sem restrições. Ao consumo de farinhas/massassem restrições, associaram-se: sexo masculino, idade ≤59 anos; consumo de carnes, gorduras e doces sem restrições. As associações evidenciadas entre ausência de cuidados alimentares e outros hábitos relacionados ao uso de álcool e tabaco, fatores de risco para doenças crônico-degenerativas, apontam para a necessidade da implementação de políticas intersetoriaisde promoção da saúde.

A cross-sectional population-based study was conducted with 1,951 individuals aged >14 years old to investigate the association between concerns about eating habits and eating habits and demographic, socio-economic, and other health-related habits in residents of Canoas, Rio Grande do Sul. Individuals reported unrestricted consumption of fats (45 percent), meat (64 percent), sweets (61 percent), and flours/pastas (81 percent). The variables associated with unrestricted consumption of meat were: male sex; five to eight years of schooling; people with unrestricted consumption of fats and flours/pastas; and no homeopathic treatment. The variables associated with unrestricted consumption of fats were: male sex; individuals with 8 years of schooling or less; self-perception of their unhealthy lifestyle; smoking; alcohol consumption, no tea drinking and nonuse of medication; unrestricted consumption of meats, sweets and flours/pastas, and absence of preventive exams. The factors associated with unrestricted consumption of sweets were self-perception of their unhealthy lifestyle; and unrestricted consumption of fats and flours/pastas. The variables associated with unrestricted consumption of flours/pastas were: male sex; and unrestricted intake of fats, meats and sweets. Regarding the age group, unrestricted consumption for all variables was associated mainly with people aged less than 59 years old. Theassociations between eating habits and other risk factors for chronic diseases, like those related to alcohol and tobacco,point out the need for the plementation of health promotion inter-organizational policies.

Child sexual abuse in southern Brazil and associated factors: a population-based study.

BACKGROUND: The prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil. METHODS: A two-stage sampling strategy was used and individuals were invited to respond to a confidential questionnaire in their households. CSA was defined as non-consensual oral-genital, genital-genital, genital-rectal, hand-genital, hand-rectal, or hand-breast contact/intercourse between ages 0 and 18. Associations between socio-demographic variables and CSA, before and after age 12, were estimated through multinomial regression. RESULTS: Complete data were available for 1936 respondents from 1040 households. Prevalence of CSA among girls (5.6% 95%CI [4.8;7.5]) was higher than among boys (1.6% 95%CI [0.9;2.6]). Boys experienced CSA at younger ages than girls and 60% of all reported CSA happened before age 12. Physical abuse was frequently associated with CSA at younger (OR 5.6 95%CI [2.5;12.3]) and older (OR 9.4 95%CI [4.5;18.7]) ages. CSA after age 12 was associated with an increased number of sexual partners in the last 2 months. CONCLUSION: Results suggest that CSA takes place at young ages and is associated with physical violence, making it more likely to have serious health and developmental consequences. Except for gender, no other socio-demographic characteristic identified high-risk sub-populations.

[Access by hearing-disabled individuals to health services in a southern Brazilian city]. / Acesso de pessoas deficientes auditivas a serviços de saúde em cidade do Sul do Brasil.

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9% of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U$360/month (42.7%). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95%CI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95%CI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

Acesso de pessoas deficientes auditivas a serviços de saúde em cidade do Sul do Brasil / Access by hearing-disabled individuals to health services in a southern Brazilian city

Este estudo transversal, de base populacional, tem como objetivo comparar o acesso dos portadores de deficiência auditiva incapacitante a serviços assistenciais e de prevenção com os ouvintes de Canoas, Rio Grande do Sul, Brasil. A amostra incluiu 1.842 pessoas com 15 anos ou mais, sendo a maioria mulheres (52,9 por cento). A renda individual de dois salários mínimos ou mais foi a mais freqüente (42,7 por cento). As pessoas com deficiência auditiva incapacitante tiveram 30 por cento maior probabilidade de ter consultado nos dois meses anteriores à entrevista (RP = 1,3, IC95 por cento: 1,10-1,51) e ter sido internado nos 12 meses anteriores à entrevista (RP = 2,1, IC95 por cento: 1,42-3,14). Nas variáveis relativas à saúde mental, os deficientes auditivos tiveram 1,5 mais probabilidade de terem consultado para problemas de nervos (IC95 por cento: 1,18-1,95) e 4,2 mais probabilidades de terem sido internados em hospital psiquiátrico que os ouvintes (IC95 por cento: 2,17-8,16). Assim como encontrado na literatura, as mulheres deficientes auditivas realizaram menos auto-exame das mamas e exame citopatológico de colo uterino. Os dados encontrados indicam a necessidade de investir em educação em saúde e campanhas específicas para o grupo de pessoas investigado.

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9 percent of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U$360/month (42.7 percent). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95 percentCI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95 percentCI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

[Physical violence and associated factors: a population-based study in Southern Brazil]. / Violência física e fatores associados: estudo de base populacional no sul do Brasil.

OBJECTIVE: To estimate the prevalence of physical violence and its association with sociodemographic aspects, stressful life events, and the use of health services due to emotional problems. METHODS: A cross-sectional population-based study was conducted with a sample of 1,954 14-year-old or older inhabitants of the city of Canoas (Southern Brazil). They were selected by means of conglomerate sampling according to a pre-established system. Data were obtained in visits to households by means of a confidential semi-structured questionnaire. A bivariate analysis was carried out through multinomial logistic regression, and the multivariate analysis by polytomous logistic regression, categorizing the outcome by age group. RESULTS: The findings show a prevalence of 9.7% (CI 95%: 8.37;11.03) and association with: women 20 years old and older (OR=2.74; CI 95%: 1.52;4.94); higher schooling rate (p<0.03); higher experience of stressful life events at 20 years of age or more (OR=6.61; CI 95%: 2.71;16.1); and doctors' appointments due to emotional problems as of 10 years of age (p>0.001). CONCLUSIONS: The prevalence of physical violence in the population was significant, resulting in important emotional consequences and impact on health services, requiring capacity building of the professionals in the field.

Violência física e fatores associados: estudo de base populacional no sul do Brasil / Physical violence and associated factors: a population-based study in Southern Brazil / Violencia física y factores asociados: estudio de base poblacional en el sur de Brasil

OBJETIVO: Estimar a prevalência de violência física e sua associação com aspectos sociodemográficos, eventos estressantes e utilização de serviços de saúde por problemas emocionais. MÉTODOS: Estudo transversal de base populacional realizado em amostra de 1.954 sujeitos com 14 anos ou mais, residentes em Canoas, RS, 2002-2003. A amostragem por conglomerados seguiu sistemática pré-estabelecida. Os dados foram coletados em visitas domiciliares com questionário semi-estruturado e confidencial. Foram realizadas as análises: bivariada, por meio de regressão logística multinomial e multivariada, por regressão politômica, categorizando o desfecho por faixa etária. RESULTADOS: Foi encontrada prevalência de 9,7 por cento (IC 95 por cento: 8,37;11,03) e associação com: sexo feminino a partir dos 20 anos de idade (OR=2,74; IC 95 por cento: 1,52;4,94), maior escolaridade (p<0,03), maior vivência de eventos estressantes com 20 anos ou mais (OR=6,61; IC 95 por cento: 2,71;16,1) e consulta por problemas emocionais a partir dos 10 anos de idade (p>0,001). CONCLUSÕES: A prevalência da violência física na população foi significativa, com conseqüências emocionais e impacto nos serviços de saúde, requerendo capacitação dos profissionais da área.

OBJECTIVE: To estimate the prevalence of physical violence and its association with sociodemographic aspects, stressful life events, and the use of health services due to emotional problems. METHODS: A cross-sectional population-based study was conducted with a sample of 1,954 14-year-old or older inhabitants of the city of Canoas (Southern Brazil). They were selected by means of conglomerate sampling according to a pre-established system. Data were obtained in visits to households by means of a confidential semi-structured questionnaire. A bivariate analysis was carried out through multinomial logistic regression, and the multivariate analysis by polytomous logistic regression, categorizing the outcome by age group. RESULTS: The findings show a prevalence of 9.7 percent (CI 95 percent: 8.37;11.03) and association with: women 20 years old and older (OR=2.74; CI 95 percent: 1.52;4.94); higher schooling rate (p<0.03); higher experience of stressful life events at 20 years of age or more (OR=6.61; CI 95 percent: 2.71;16.1); and doctors' appointments due to emotional problems as of 10 years of age (p>0.001). CONCLUSIONS: The prevalence of physical violence in the population was significant, resulting in important emotional consequences and impact on health services, requiring capacity building of the professionals in the field.

OBJETIVO: Estimar la prevalencia de violencia física y sua asociacion con aspectos sociodemográfcos, eventos estresantes y utilizacion de servicios de salud por problemas emocionales. MÉTODOS: Estudio transversal de base poblacional realizado en muestra de 1.954 sujetos con 14 anos o mas, residentes en Canoas, sur de Brasil, 2002-2003. La muestra por conglomerados siguio sistemática pré-estabelecida. Los datos fueron tomados en visitas domiciliarias con cuestionário semi-estructurado y confidencial. Fueron realizadas las analisis: bivariada, por meio de regresión logística multinomial y multivariada, por regresión politómica, según grupo etario. RESULTADOS: Fue encontrada prevalencia de 9,7 por ciento (IC 95 por ciento: 8,37;11,03) y asociación con: sexo feminino a partir dos 20 anos de edad (OR=2,74; IC 95 por ciento: 1,52;4,94), mayor escolaridade (p<0,03), mas vivencia de eventos estresantes con 20 anos o mas (OR=6,61; IC 95 por ciento: 2,71;16,1) y consulta por problemas emocionales a partir de los 10 anos de edad (p>0,001). CONCLUSÕES: La prevalencia de la violencia física en la poblacion fue significativa, con consecuencias emocionales e impacto en los servicios de salud, requiriendo capacitación de los profesionales del área.

Postnatal depression in Southern Brazil: prevalence and its demographic and socioeconomic determinants.

BACKGROUND: Studies investigating the prevalence of postnatal depression (PND) show rates ranging from 5% to 36.7%. The investigation of age, race, educational levels, religion and income as risk factors for PND has yielded conflicting results. The aim of this study is to investigate the prevalence of PND in women residing in Southern Brazil and the associated risk factors. METHODS: This is population-based cross-sectional study of women residing in Porto Alegre who delivered in June 2001. A sample of 271 participants were selected from the Record of Living Newborn Infants of the State Health Department (the official Brazilian database and stores the name and address of all women who give birth to living newborn infants) using a process based on pseudo-random numbers which choose a random sample from 2.000 records. Once the addresses were identified, the women were visited at their place of residence (home, hotel, boarding house and prison), with the interviews taking place between the 6th and the 8th week after delivery. The association between the risk factors and PND was investigated through bivariate analysis using Pearson's chi-square test. Student's t-test was used to analyze the continuous variables. To identify independent risk factors, multivariate analysis was performed using hierarchical levels with a predefined model that took into account the time relationship between PND and the risk factors. Cox's regression was used to calculate the prevalence ratios. RESULTS: The PND prevalence rate found was 20.7% (CI 95% 15.7 - 25.7). After adjusting for confounding variables, per capita income was found to have a significant association with PND. CONCLUSION: The prevalence of PND is higher than the figures found in most developed countries and similar to the figures found in developing countries. Differences in PND by regions or countries can be partially explained by the effect of income on the mediation of risk factors. In low income populations, women should be routinely evaluated for postnatal depression, and those with no partner or spouse are likely to require further care from health services and should be given the benefit of mental health prevention programs.

Acuidade visual de escolares em uma cidade do interior de Santa Catarina, 2003 / Visual acuity in students from in a Santa Catarina state country town

Objetivo: Conhecer a prevalência de baixa acuidade visual em escolares da primeira série do ensino fundamental da rede municipal, na zona urbana, de Correia Pinto, SC, Brasil, e posterior encaminhamento das crianças com baixa acuidade visual para atendimento com oftalmologista. Verificar a prevalência da baixa acuidade visual por sexo e faixa etária, a prevalência de baixa acuidade visual com presença de sintomas e com reprovação na escola. Método: Trata-se de um estudo transversal que visava a avaliar os 240 alunos matriculados em escolas municipais da cidade. Para o teste da acuidade visual, foi utilizada a Tabela de Snellen e foram preenchidos questionários com: sexo, idade e uso de óculos e presença de sintomas oftalmológicos. Resultados: Foi encontrada uma prevalência de 22,8% de baixa acuidade visual nos 162 alunos submetidos ao teste. Destes, 88 eram do sexo feminino (54,3%), 88 (54,3%) estavam com sete anos de idade, apenas 5 (3%) relataram uso de óculos. Os que tiveram acuidade visual igual ou menor a 0,7 foram encaminhados para consulta oftalmológica. Conclusão: A prevalência de baixa acuidade visual encontrada mostra que quase um quarto das crianças precisava de uma consulta oftalmológica. Apresenta-se aos órgãos públicos de saúde a necessidade de organizar uma proposta de avaliação da acuidade visual a ser realizada por professores orientados por profissionais capacitados da área da saúde, originando ações sistemáticas para a melhora na qualidade de vida das crianças do município (AU)

Objective: To find out the prevalence of low visual acuity in first grade students of the municipal school system in the urban area of the city of Correia Pinto ­ SC, Brazil and to direct the children with low visual acuity for treatment with an ophthalmologist. To verify the prevalence of low visual acuity by gender and age, and the prevalence of low visual acuity with symptoms and related to school failure. Method: A cross sectional study was carried out in order to evaluate the 240 students enrolled in the municipal school system. The Snellen Chart and questionnaires about gender, age, glasses wearing and ophthalmologic symptoms were used for the visual acuity testing. Results: It was found a prevalence of 22.8% of low visual acuity in the 162 students submitted to the test. 88 of them were female (54.3%), 88 (54.3%) were seven years old and only 5 (3%) reported glasses wearing. The ones that were found to have visual acuity of 0.7 or less were sent to an ophthalmologist. Conclusion: The prevalence of low visual acuity demonstrates that almost a quarter of the children needed ophthalmologic assistance. It suggests to the Public Healthcare System the need of implementing a visual acuity evaluation program to be executed by teachers guided by healthcare professionals, originating systematic actions in order to improve the life quality of the children in this city (AU)

Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil.

OBJECTIVE: To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS: In 2003, a cross-sectional household survey was conducted of 2,427 persons 4 years old and over. The study population was composed of 1,040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS: It was found that 26.1% of the population studied showed some level of hearing impairment, and 6.8% (95% confidence interval (CI) = 5.5%-8.1%) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4% (95% CI = 4.4%-6.4%); for severe hearing loss, 1.2% (95% CI = 0.7%-1.7%); and for profound hearing loss, 0.2% (95% CI = 0.03%-0.33%). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95% CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95% CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95% CI = 2.14-7.16); and those with lower income (OR = 1.56; 95% CI = 1.06-2.27). CONCLUSIONS: These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.

Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil

OBJECTIVE: To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS: In 2003, a cross-sectional household survey was conducted of 2 427 persons 4 years old and over. The study population was composed of 1 040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS: It was found that 26.1 percent of the population studied showed some level of hearing impairment, and 6.8 percent (95 percent confidence interval (CI) = 5.5 percent-8.1 percent) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4 percent (95 percent CI = 4.4 percent-6.4 percent); for severe hearing loss, 1.2 percent (95 percent CI = 0.7 percent-1.7 percent); and for profound hearing loss, 0.2 percent (95 percent CI = 0.03 percent-0.33 percent). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95 percent CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95 percent CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95 percent CI = 2.14-7.16); and those with lower income (OR = 1.56; 95 percent CI = 1.06-2.27). CONCLUSIONS: These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.

OBJETIVO: Presentar los primeros datos de un estudio de base poblacional sobre sordera y deficiencia auditiva en Brasil. MÉTODOS: Se realizó una encuesta transversal de hogares en 2003 en la que participaron 2 427 personas de 4 años de edad o más. La población de estudio estuvo compuesta por 1 040 hogares escogidos de manera sistemática en 40 sectores censales (conglomerados de viviendas) escogidos al azar en la ciudad de Canoas, estado de Rio Grande do Sul, en el sur de Brasil. Se evaluó la función auditiva de los participantes mediante audiometría tonal liminar y examen físico, según el Protocolo para el Estudio de Trastornos Oticos y Auditivos y las definiciones de niveles auditivos, ambos de la Organización Mundial de la Salud. Entre los datos socioeconómicos colectados estaban los años de escolaridad de las personas estudiadas y los ingresos del jefe del hogar. RESULTADOS: Se encontró que 26,1 por ciento de la población estudiada mostró algún grado de deficiencia auditiva y 6,8 por ciento (intervalo de confianza de 95 por ciento [IC95 por ciento]: 5,5 por ciento a 8,1 por ciento) se clasificó en el grupo con deficiencia auditiva incapacitante. La prevalencia de pérdida auditiva moderada fue de 5,4 por ciento (IC95 por ciento: 4,4 por ciento a 6,4 por ciento); de pérdida auditiva grave, 1,2 por ciento (IC95 por ciento: 0,7 por ciento a 1,7 por ciento); y de pérdida auditiva profunda, 0,2 por ciento (IC95 por ciento: 0,03 por ciento a 0,33 por ciento). Los grupos en mayor riesgo de pérdida auditiva fueron los hombres (razón de posibilidades [odds ratio, OR] = 1,54; IC95 por ciento: 1,06 a 2,23); los participantes de 60 años de edad o más (OR = 12,55; IC95 por ciento: 8,38 a 18,79); los que tenían menos años de escolaridad formal (OR = 3,92; IC95 por ciento: 2,14 a 7,16); y los que tenían menores ingresos (OR = 1,56; IC95 por ciento: 1,06 a 2,27). CONCLUSIONES: Estos resultados respaldan las recomendaciones de los planificadores de...

Prevalência de internação hospitalar e fatores associados: um estudo de base populacional em um centro urbano no Sul do Brasil / Prevalence and factors associated with hospital admissions in a population-based study in a southern Brazilian city

Este estudo transversal investiga a utilização de serviços hospitalares e fatores associados em indivíduos com 14 anos ou mais em Canoas, Rio Grande do Sul, Brasil. Foram entrevistados 1.954 indivíduos de 40 setores censitários. A prevalência de internação hospitalar no período de um ano foi de 9,4 por cento. Na análise ajustada para as demais variáveis, as que permaneceram associadas a uma maior chance de hospitalização foram: idade de 60 anos ou mais (RP = 4,14; IC95 por cento: 2,07-8,25), realização de consulta médica nos últimos dois meses (RP = 2,79; IC95 por cento: 2,03-3,83), a ocorrência de dois ou mais eventos estressantes (RP = 1,83; IC95 por cento: 1,19-2,80). A renda individual, de 2,10 salários mínimos ou mais, esteve associada a uma menor chance de hospitalização (RP = 0,60; IC95 por cento: 0,41-0,87). A prevalência de internações encontrada é compatível com outros estudos. A maior prevalência de hospitalização nos grupos de menor nível sócio-econômico pode indicar um menor acesso aos serviços de atenção básica. Outros fatores envolvidos poderiam ser a maior morbidade e severidade da doença entre os grupos mais pobres. Salienta-se a importância de investigar a relação entre eventos estressantes e morbidade.

This cross-sectional study investigates the use of health services and associated factors in individuals > 14 years of age in Canoas, Rio Grande do Sul, Brazil. 1,954 persons were interviewed in 40 census tracts. One-year prevalence of hospital admissions was 9.4 percent. Adjusted data analysis showed that hospitalization was associated with: age > 60 years (RP = 4.14; 95 percent CI: 2.07-8.25), physician visit in the previous two months (RP = 2.79; 95 percentCI: 2.03-3.83), and > 2 stressful life events (RP = 1.83; 95 percentCI: 1.19-2.80). Individual income of > 2.10 times the prevailing minimum wage was associated with decreased likelihood of hospitalization (RP = 0.60; 95 percent CI: 0.41-0.87). Prevalence of hospital admissions was consistent with other studies. Higher prevalence of hospitalization in lower-income groups may indicate decreased access to primary health care. Other possible factors are higher morbidity and severity of diseases among lower-income groups. Future research should focus on the relationship between morbidity and stressful life events.

[Prevalence and factors associated with hospital admissions in a population-based study in a southern Brazilian city]. / Prevalência de internação hospitalar e fatores associados: um estudo de base populacional em um centro urbano no Sul do Brasil.

This cross-sectional study investigates the use of health services and associated factors in individuals > or = 14 years of age in Canoas, Rio Grande do Sul, Brazil. 1,954 persons were interviewed in 40 census tracts. One-year prevalence of hospital admissions was 9.4%. Adjusted data analysis showed that hospitalization was associated with: age > or = 60 years (RP = 4.14; 95% CI: 2.07-8.25), physician visit in the previous two months (RP = 2.79; 95%CI: 2.03-3.83), and > or = 2 stressful life events (RP = 1.83; 95%CI: 1.19-2.80). Individual income of > or = 2.10 times the prevailing minimum wage was associated with decreased likelihood of hospitalization (RP = 0.60; 95% CI: 0.41-0.87). Prevalence of hospital admissions was consistent with other studies. Higher prevalence of hospitalization in lower-income groups may indicate decreased access to primary health care. Other possible factors are higher morbidity and severity of diseases among lower-income groups. Future research should focus on the relationship between morbidity and stressful life events.

Prevalência da soropositividade do anti-HCV em pacientes dialisados / Anti-HCV seropositivity in dialysis patients

Estudo transversal para verificar a prevalência de anticorpos contra hepatite em pacientes dialisados e fatores associados. Foi realizada revisão de prontuários de todos os pacientes dialisados (n=1.261) de Porto Alegre, RS, de agosto a dezembro de 2003. Os testes estatísticos aplicados foram o qui-quadrado e o teste de tendência linear. A medida de efeito foi a razão de prevalências. A análise de regressão logística múltipla foi realizada por regressão de Cox. A prevalência de anticorpos contra hepatite foi 29,1 por cento, com prevalência maior entre pacientes atendidos em hemodiálise onde não havia separação dos soropositivos e existia reutilização do dialisador. Essa associação permaneceu mesmo após controle para fatores de confusão. Pacientes que receberam transfusão sangüínea tiveram acréscimo linear na prevalência de anticorpos. O tempo de diálise mostrou associação do tipo dose-resposta com os anticorpos contra hepatite.

This cross-sectional study evaluated the prevalence of anti-hepatitis antibodies and associated factors in dialysis patients. Data were collected from records of all patients receiving dialysis treatment [n=1,261] in the city of Porto Alegre, in Southern Brazil, from August to December 2003. The statistical analyses used Chi-squared and the linear tendency test. Prevalence ratios were also calculated. Multiple logistic regression analysis was performed through Cox regression. The prevalence of anti-hepatitis antibodies was of 29.1 percent, and was higher among patients treated by hemo-dialysis where there was no segregation of seropositive and seronegative patients and where dialyzers were reused. This association remained even when controlling for confounding factors. Patients who received blood transfusions had a linear increase in the prevalence of anti-hepatitis antibodies. The duration of dialysis treatment showed a dose-response curve with the prevalence of anti-hepatitis antibodies.

[Anti-HCV seropositivity in dialysis patients]. / Prevalência da soropositividade do anti-HCV em pacientes dialisados.

This cross-sectional study evaluated the prevalence of anti-hepatitis antibodies and associated factors in dialysis patients. Data were collected from records of all patients receiving dialysis treatment [n=1,261] in the city of Porto Alegre, in Southern Brazil, from August to December 2003. The statistical analyses used Chi-squared and the linear tendency test. Prevalence ratios were also calculated. Multiple logistic regression analysis was performed through Cox regression. The prevalence of anti-hepatitis antibodies was of 29.1%, and was higher among patients treated by hemo-dialysis where there was no segregation of seropositive and seronegative patients and where dialyzers were reused. This association remained even when controlling for confounding factors. Patients who received blood transfusions had a linear increase in the prevalence of anti-hepatitis antibodies. The duration of dialysis treatment showed a dose-response curve with the prevalence of anti-hepatitis antibodies.