Impact of an integrated adolescent reproductive health program in Brazil.

An impact evaluation of an integrated school- and health-clinic-based adolescent reproductive health initiative was undertaken by the State Secretariats of Health and Education in Bahia, Brazil during 1997-99. The project was initiated in response to continued high pregnancy rates among adolescents and growing numbers of new HIV infections among young adults. It sought to promote responsible sexual and health-seeking behaviors among public secondary-school students, including the use of public health clinics. The study design included a matched control group used to measure project impact. The findings indicate that the project was successful in increasing the flow of sexual and reproductive health information to secondary-school students and that it had an impact on adolescents' intentions to use public health clinics in the future. No effects on sexual or contraceptive-use behaviors or on use of public clinics were observed, however. Client exit-interview data from a subset of project clinics indicate that adolescents who use clinic-based services are overwhelmingly female and considerably older on average and much more likely ever to have been pregnant than are adolescents in the target population for the project.

[Reliability of arterial blood pressure measurement in an arterial hypertension study]. / Confiabilidade da medida de pressão arterial sangüínea em um estudo de hipertensão arterial.

PURPOSE: To evaluate the relaibility of the blood pressure measurements in an arterial hypertension study. METHODS: It was evaluated 502 nurse workers of a public hospital. After careful training and selection of the observers for the quality control at the fieldwork, it was analyzed the correlation between the 1st and 2nd measurements, final digit preference and mean systolic (SBP) and diastolic pressure (DBP). 5% of the sample had their measures compared with those checked by an expert. RESULTS: There was a great confiability intra-observer (96.2% in the SBP and 93.4% in the DBP). The final digit distribution was almost identical. At the 5% sample, there was a strong correlation between them (96.0% in the SBP and 93.9% in the DBP). CONCLUSION: This methodology is feasible in national studies and confers validity to the results.

[Female mortality in Brazil: the weaker sex or stronger sex?]. / Mortalidade feminina no Brasil: sexo frágil ou sexo forte?

Population ageing in Brazil has been more rapid and more intense among women. This phenomenon is well described in developed countries where mortality rates are higher for men than women. In this regard, the analysis of mortality patterns by cause contributes to elucidate the determinant factors of the present situation in Brazil and provides indications of some future trends in female mortality. This is especially important due to the fact that in Brazil the social role of women has experienced great changes. This study presents data on mortality from ten capital cities in 1985, showing age-standardized overall and cause-specific mortality rates for five of the main groups of causes by sex. Ratios and differences effect estimators were used. The results revealed that regional patterns are associated with the urban and industrial processes with greater differences by sex in more developed regions. External causes and cardiovascular diseases are the main factors responsible for higher mortality among men with special emphasis on violent deaths. It is inferred that the present trend will be maintained, though it is possible that mortality differences by sex could decrease in the near future. The authors discuss that longer survival among women in Brazil does not reveal better life conditions.