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HPV immunization in Brazil and proposals to increase adherence to vaccination campaigns. 巴西的HPV免疫接种和加强疫苗接种运动的建议。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-11-03 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057005410
Wagner Mesojedovas Santos, Debora Mesojedovas Santos, Márcia Santana Fernandes

Objectives: To identify the possible causes of low adherence to vaccination campaigns in Brazil, find and analyze campaigns regarding human papillomavirus (HPV) in Brazil and abroad, and apply quality tools to prepare proposals to increase vaccination coverage (VC) and prevent HPV in the country.

Method: This is a qualitative and deductive-hypothetical research. A narrative review of the literature (especially on the narratives and formats applied in vaccination campaigns in Brazil) was the technique used to develop our method.

Results: Brazil had a 49.6% VC in 2019, unlike countries such as Australia (80.2% in 2017), Mexico (97.5% in 2019), and Peru (91% in 2019). This study found evidence of the use of social marketing strategies to engage communities as good practices in the vaccination campaigns of these countries.

Conclusion: With the retrieved information, three quality tools (Ishikawa diagram, Pareto graph, and 5W2H) classified and quantified the causes of low VC in Brazil and enabled proposals that can direct its Ministry of Health to take more effective strategies to achieve the HPV VC goal recommended by the WHO.

目的:确定巴西疫苗接种活动依从性低的可能原因,发现并分析巴西国内外有关人乳头瘤病毒(HPV)的活动,并应用质量工具制定提高疫苗接种覆盖率和预防该国HPV的建议。方法:这是一个定性和演绎的假设研究。对文献进行叙述性综述(特别是关于巴西疫苗接种运动中应用的叙述和形式)是开发我们方法的技术。结果:2019年,巴西的风险投资率为49.6%,与澳大利亚(2017年为80.2%)、墨西哥(2019年为97.5%)和秘鲁(2019年91%)等国家不同。这项研究发现,有证据表明,在这些国家的疫苗接种运动中,使用社会营销策略让社区参与进来是一种良好的做法。结论:根据检索到的信息,三种质量工具(Ishikawa图、Pareto图和5W2H)对巴西低风险的原因进行了分类和量化,并提出了建议,可以指导其卫生部采取更有效的策略来实现世界卫生组织建议的HPV风险目标。
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引用次数: 0
Evolution of household availability of regional foods in Amazonas. 亚马逊地区家庭食物供应情况的演变。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057004804
Rita de Cássia de Assunção Monteiro, Eliseu Verly Júnior

Objective: To evaluate the evolution of household availability of regional foods in the state of Amazonas, their distribution according to sociodemographic characteristics, and potential differences when compared to the remaining areas of Brazil.

Methods: Data on food acquisition for home consumption from the 2002-2003, 2008-2009, and 2017-2018 Pesquisa de Orçamentos Familiares (POFs - Consumer Expenditure Surveys) were analyzed, covering, respectively, 48,470, 55,970, and 57,920 households in Brazil, of which 1,075, 1,344, and 1,833 are in Amazonas. Foods were categorized into three groups: cassava and its derivatives, freshwater fish, and regional fruits. The study analyzed the amount of regional food purchased, expressed in relative household caloric share, for the entire area of Amazonas. Additionally, the data was stratified and analyzed according to sociodemographic variables, with differences assessed through the overlapping of 95% confidence intervals.

Findings: The household caloric share of the total regional foods in Amazonas was 22.54% in 2002-2003, 18.18% in 2008-2009, and 6.49% in 2017-2018. Across Brazil, those percentages were much lower in the same period: 3.67%, 3.34%, and 1.82%, respectively. Changes in Amazonas were primarily attributed to the steep drop in the cassava and derivatives group, which decreased from 14.30% in 2002-2003 to 12.74% in 2008-2009 and further declined to 3.09% in 2017-2018. Additionally, there was a gradual decline in household availability of freshwater fish, decreasing from 7.30% in 2002-2003 to 4.85% in 2008-2009 and reaching 2.90% in 2017-2018. Households in rural areas and with lower per capita income presented a higher proportion of calories from total regional foods; this particular stratum also experienced the most significant reductions in their consumption.

Conclusion: During the study period, there was a significant decrease in the consumption of regional foods in Amazonas, particularly in lower income households in rural areas. Among them, the family reference person was typically a younger male with a lower educational background.

目的:评估亚马逊州家庭可获得的地区食品的演变,根据社会人口特征进行的分布,以及与巴西其他地区相比的潜在差异,和2017-2018年家庭支出调查(POFs-消费者支出调查)进行了分析,分别覆盖了巴西48470、55970和57920个家庭,其中1075、1344和1833个家庭位于亚马逊地区。食物分为三类:木薯及其衍生物、淡水鱼和地区水果。该研究分析了整个亚马逊地区购买的地区食品数量,以家庭相对热量份额表示。此外,根据社会人口统计学变量对数据进行分层和分析,通过95%置信区间的重叠来评估差异。调查结果:2002-2003年,亚马逊地区家庭热量占地区食品总量的比例为22.54%,2008-2009年为18.18%,2017-2018年为6.49%。同期,巴西的这一比例要低得多:分别为3.67%、3.34%和1.82%。亚马逊地区的变化主要归因于木薯及其衍生物的急剧下降,从2002-2003年的14.30%下降到2008-2009年的12.74%,并在2017-2018年进一步下降到3.09%。此外,家庭淡水鱼供应量逐渐下降,从2002-2003年的7.30%下降到2008-2009年的4.85%,2017-2018年达到2.90%。农村地区和人均收入较低的家庭从地区食品中摄入的热量比例较高;这一特定阶层的消费也出现了最显著的减少。结论:在研究期间,亚马逊地区的地区食品消费量显著下降,尤其是农村地区的低收入家庭。其中,家庭参照人通常是教育背景较低的年轻男性。
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引用次数: 0
Iron salt supplementation during gestation and gestational diabetes mellitus. 妊娠期补充铁盐和妊娠期糖尿病。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057004871
Vanessa Iribarrem Avena Miranda, Tatiane da Silva Dal Pizzol, Marysabel Pinto Telis Silveira, Sotero Serrate Mengue, Mariângela Freitas da Silveira, Bárbara Heather Lutz, Andréa Dâmaso Bertoldi
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引用次数: 0
Proadi-SUS: analysis of financial resources in the three-year periods 2009-2011, 2012-2014 and 2015-2017. Proadi SUS:2009-2011年、2012-2014年和2015-2017年三年期财政资源分析。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057004385
Julia Amorim Santos, Luciana Palhares, Aquilas Mendes

Objective: To characterize the tax exemption resources used in the Support Program for Institutional Development of the Unified Health System (Proadi-SUS) in the 3-year periods 2009-2011, 2012-2014, 2015-2017, considering the total volume of resources linked to the debate on tax expenditures on health and the constitution of a "new form of philanthropy" in the sector.

Methods: To understand the philanthropic sector, tax expenditures between 2001 and 2017 were analyzed. To evaluate the resources used in the program, the values of projects and areas of activity were examined.

Results: A real increase in the values of general tax expenses and tax expenses referring to the philanthropic sector was found. There was also a real increase in the program's resources. A total of 407 projects were carried out, amounting to R$ 3.4 billion for the period. An analysis of the average value of the projects shows an increase in values for all hospitals included in the program, with the exception of one of the institutions. In the 2009-2011 and 2012-2014 periods, the area with the highest number of projects and the most resources was "Management techniques and operation in health services". In the 3-year period 2015-2017, however, the sector that received the most investments and the largest number of projects developed was "Human Resources Training".

Conclusion: The program characterizes a different expression of the public-private partnership in the health sector linked to the principles of the new public management. As a development for future investigations, a qualitative characterization of the projects developed and the actions' impact on the public sector demands is necessary.

目标:描述2009-2011年、2012-2014年和2015-2017年三年期间统一卫生系统机构发展支持计划(Proadi SUS)中使用的免税资源,考虑到与卫生税收支出辩论和该部门“新慈善形式”的构成相关的资源总量。方法:为了了解慈善部门,分析了2001年至2017年的税收支出。为了评估项目中使用的资源,检查了项目和活动领域的价值。结果:慈善部门的一般税收支出和税收支出的价值出现了实际增长。该项目的资源也确实有所增加。在此期间,共执行了407个项目,总额达34亿雷亚尔。对项目平均价值的分析显示,除一家机构外,该项目中所有医院的价值都有所增加。在2009-2011年和2012-2014年期间,项目数量最多、资源最多的领域是“卫生服务的管理技术和运作”。然而,在2015-2017年的三年期间,获得最多投资和开发项目数量最多的行业是“人力资源培训”。结论:该方案体现了与新公共管理原则相联系的卫生部门公私伙伴关系的不同表现。作为未来调查的发展,有必要对所开发的项目和行动对公共部门需求的影响进行定性描述。
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引用次数: 0
Adequacy of prenatal care and associated factors in the State of Rio Grande do Sul, Brazil. 巴西南里奥格兰德州产前护理的充分性及相关因素。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057005146
Aline De Gregori Adami, Leonardo Rapone da Motta, Rosa Dea Sperhacke, Sérgio Kakuta Kato, Gerson Fernando Mendes Pereira, Rosa Maria Rahmi
ABSTRACT OBJECTIVE This study aims to assess the degree of adequacy of prenatal care (PNC) in the state of Rio Grande do Sul (RS) and in its 7 macro-regions considering the time of PNC initiation and the number of appointments attended. It also aims to verify the mode of delivery prevalence and the factors associated with PNC adequacy by mode of delivery. METHODS Sub analysis from a cross-sectional study conducted among 13,432 childbearing women aged 15–49 years assisted in 66 maternity hospitals of the Unified Health System (SUS) and private associated facilities from September 2017 to October 2019. A standardized form was used to collect sociodemographic data, and information about PNC and delivery from the childbearing women’s prenatal cards, hospital records, and medical reports. RESULTS The PNC coverage was (98.4%), but only 57.5% of the participants had an adequate PNC defined as the one initiated until the 12th gestational week, with attendance of at least 6 appointments. The cesarean rate was 57.2%. Among women who performed vaginal delivery, multivariate analysis showed that for each 1-year increase in the age of the parturient, the chance of having an adequate PNC increased by 5%. White parturients with higher education and fewer deliveries residing in the macro-region of Valleys were more likely to have an adequate PNC when compared with non-white parturients, who were illiterate and/or had incomplete elementary school, with 3 or more deliveries and who resided in other macro-regions. During pregnancy, 96.0% of the women performed at least one anti-HIV test, 55.8% a rapid test for syphilis, and 75.0% a Venereal Disease Research Laboratory test (VDRL). CONCLUSIONS Despite the almost universal PNC coverage in RS, the PNC offered by the SUS was adequate for just half of the population, therefore public health policies targeted at women receiving care in this setting shall be revisited.
目的:本研究旨在评估南里奥格兰德州及其7个宏观地区的产前护理(PNC)的充分程度,考虑到PNC的开始时间和预约次数。它还旨在通过分娩方式验证分娩方式的流行率以及与PNC充分性相关的因素。方法:2017年9月至2019年10月,在联合卫生系统(SUS)66家妇产医院和私人相关设施的13432名15-49岁的育龄妇女中进行的横断面研究的子分析。使用标准化表格从育龄妇女的产前卡、医院记录和医疗报告中收集社会人口统计数据、PNC和分娩信息。结果:PNC覆盖率为(98.4%),但只有57.5%的参与者有足够的PNC,定义为在妊娠12周之前开始的PNC至少有6次预约。剖宫产率为57.2%。在进行阴道分娩的女性中,多变量分析显示,产妇年龄每增加1年,获得足够PNC的机会就会增加5%。与非白人产妇相比,居住在山谷宏观区域的受过高等教育、分娩次数较少的白人产妇更有可能获得足够的PNC,非白人产妇是文盲和/或小学不完全,分娩次数为3次或3次以上,居住在其他宏观区域。在怀孕期间,96.0%的妇女至少进行了一次抗HIV检测,55.8%进行了梅毒快速检测,75.0%进行了性病研究实验室检测,因此,应重新审视针对在这种情况下接受护理的妇女的公共卫生政策。
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引用次数: 0
Case-Finding tool for COPD in LMIC (COLA) - translation and cross-cultural adaptation into Brazilian Portuguese language. LMIC中COPD的病例发现工具(COLA)——翻译和跨文化适应巴西葡萄牙语。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057004904
Erika Zavaglia Kabbach, Naiara Tais Leonardi, Trishul Siddharthan, Audrey Borghi-Silva, Jaber Saud Alqahtani, John R Hurst, Renata Gonçalves Mendes

Objective: To translate and cross-culturally adapt the COPD in Low- and middle-income countries (LMICs) Assessment (COLA) questionnaire into Brazilian Portuguese, a case-finding instrument for chronic obstructive pulmonary disease (COPD).

Methods: Translation and cross-cultural adaptation were completed in six steps: the original version was translated into Brazilian Portuguese by two native speakers of the target language; the translated versions were synthesized; back-translation was performed by two native speakers of the original language; the back-translation and the Brazilian Portuguese version of the COLA were reviewed and harmonized by an expert committee of specialists; and, then, the pre-final version was tested by 30 health professionals who were asked if the items were clear to understand. The acceptability, clarity, and understandability of the translated version were evaluated. A final review of the questionnaire was produced by the authors and approved by the author of the original questionnaire.

Results: Some idiomatic, semantic, and experiential inconsistencies were identified and properly adjusted. Item 3 was considered the most unclear item (23,3%). Items 7, 8, and 9 presented clarity above 80% (93%, 90%, and 90%, respectively). Suggestions were discussed and incorporated into the tool and COLA was found to be clear and easy to understand.

Conclusions: The Brazilian version of the COLA was easily understood by healthcare professionals and adapted to Brazilian culture. Translation and cultural adaptation of the COLA instrument into Brazilian Portuguese can be an important case-finding instrument for chronic obstructive pulmonary disease in Brazil.

目的:将低收入和中等收入国家慢性阻塞性肺病(LMIC)评估(COLA)问卷翻译成巴西葡萄牙语并进行跨文化改编,方法:翻译和跨文化适应分六个步骤完成:由两名母语为目的语的人将原文翻译成巴西葡萄牙语;翻译版本被合成;由两名母语为母语的人进行背译;一个专家委员会审查并协调了COLA的背译和巴西-葡萄牙版本;然后,30名卫生专业人员对最终版本进行了测试,他们被问及这些项目是否清晰易懂。对翻译版本的可接受性、清晰度和可理解性进行了评估。调查问卷的最后审查由作者编写,并经原始调查问卷的作者批准。结果:发现并适当调整了一些习语、语义和经验上的不一致。项目3被认为是最不清楚的项目(23,3%)。项目7、8和9的清晰度超过80%(分别为93%、90%和90%)。讨论了建议并将其纳入工具中,发现COLA清晰易懂。结论:巴西版的COLA很容易被医疗专业人员理解,并适应了巴西文化。将COLA仪器翻译成巴西葡萄牙语并进行文化改编,可以成为巴西慢性阻塞性肺病的重要病例发现工具。
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引用次数: 0
Hospital mortality from covid-19 in children and adolescents in Brazil in 2020-2021. 2020-2021年巴西儿童和青少年新冠肺炎住院死亡率。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057005172
Amanda Cilene Cruz Aguiar Castilho da Silva, Ronir Raggio Luiz, José Rodrigo de Moraes, Pedro Henrique Vieira Rocha, Regina Célia Gollner Zeitoune, Arnaldo Prata Barbosa, Jessica Pronestino de Lima Moreira
ABSTRACT OBJECTIVE To describe cases, deaths, and hospital mortality from covid-19 in children and adolescents in Brazil, according to age group, during the evolving phases of the pandemic in 2020 and 2021. METHODS Census of patients aged up to 19 committed with severe acute respiratory syndrome, due to covid-19 or unspecified, notified to the Brazilian Influenza Epidemiological Surveillance Information System, from January 1, 2020, to December 31, 2021. The two years were divided into six phases, covering the spread of the disease—first, second and third wave—as well as the impact of vaccination. The pediatric population was categorized into infants, preschoolers, schoolchildren, and adolescents. Hospital mortality was assessed by pandemic phase and age group. RESULTS A total of 144,041 patients were recorded in the two years, 18.2% of whom had confirmed cases of covid-19. Children under 5 years old (infants and preschoolers) accounted for 62.8% of those hospitalized. A total of 4,471 patients died, representing about 6.1 deaths per day. Infants were the ones who most progressed to the intensive care unit (24.7%) and had the highest gross number of deaths (n = 2,012), but mortality was higher among adolescents (5.7%), reaching 9.8% in phase 1. The first peak of deaths occurred in phase 1 (May/2020), and two other peaks occurred in phase 4 (March/2021 and May/2021). There was an increase in cases and deaths for younger ages since phase 4. Hospital mortality in the pediatric population was higher in phases 1, 4, and 6, following the phenomena of dissemination/interiorization of the virus in the country, beginning of the second wave and beginning of the third wave, respectively. CONCLUSION The absolute number of cases of covid-19 in children and adolescents is significant. Although complete vaccination in descending order of age provided a natural deviation in age range, there was a greater gap between the curve of new hospitalized cases and the curve of deaths, indicating the positive impact of immunization.
目的:描述2020年和2021年疫情演变阶段巴西儿童和青少年新冠肺炎病例、死亡和住院死亡率(按年龄组),于2020年1月1日至2021年12月31日通知巴西流感流行病学监测信息系统。这两年分为六个阶段,涵盖疾病的第一波、第二波和第三波传播以及疫苗接种的影响。儿科人群分为婴儿、学龄前儿童、学童和青少年。医院死亡率按疫情阶段和年龄组进行评估。结果:两年内共记录患者144041例,其中18.2%为新冠肺炎确诊病例。5岁以下儿童(婴儿和学龄前儿童)占住院人数的62.8%。共有4471名患者死亡,相当于每天约6.1人死亡。婴儿是进入重症监护室最多的人(24.7%),总死亡人数最多(n=2012),但青少年的死亡率更高(5.7%),在第一阶段达到9.8%。第一个死亡高峰出现在第一阶段(2020年5月),另外两个高峰出现在第四阶段(2021年3月和2021年5月。自第4阶段以来,年轻人的病例和死亡人数有所增加。在该国出现病毒传播/内部化现象后,第二波和第三波疫情开始时,儿科人群的住院死亡率分别在第1、4和6阶段较高。结论:儿童青少年新冠肺炎绝对病例数显著。尽管按年龄降序完全接种疫苗提供了年龄范围的自然偏差,但新住院病例曲线与死亡曲线之间的差距更大,这表明免疫接种的积极影响。
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引用次数: 0
Entomological Reference Collection: 85 years of contributions to public health. 昆虫学参考资料集:85年来对公共卫生的贡献。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057004963
Mariana de Carvalho Dolci, Fabrício Auad Spina, Maria Anice Mureb Sallum

The Department of Hygiene of the Faculty of Medicine of São Paulo (FMUSP), organized with the support of the Rockefeller Foundation, became the Institute of Hygiene, with the inaugural class taught by Samuel Darling in 1918. The history of Public Health Entomology is mixed with that of the Institute itself, which became the Faculty of Hygiene and Public Health in 1945. Still in the 1930s, Paulo César de Azevedo Antunes and John Lane organized Public Health Entomology within the Medical Parasitology area of the then Institute of Hygiene. During this period, the entomology laboratory came to be recognized for its research in the systematics of hematophagous insects, as well as in the ecology, biology and behavior of vectors. The Entomological Reference Collection (CER) originated naturally from the research of Paulo César Antunes and John Lane and is a national and international heritage covering primary and secondary types of insect species that are of interest to public health. Over the years, it has been consolidated with the efforts of Augusto Ayroza Galvão, Renato Corrêa, José Coutinho, Nelson Cerqueira, Ernesto Rabello, Oswaldo Forattini and others. In its over eighty years of activities, CER has enabled the training of several scientists able to act in programs of surveillance and control of endemic diseases associated with insect vectors throughout Latin America, in addition to training taxonomists focused on insects of interest in Public Health. Researchers from other Brazilian institutes and abroad joined the entomology laboratory because of its importance and the research developed in it. The growing scientific production made it possible for entomological studies developed at the Faculty of Public Health (FSP) to gain international visibility, contributing to the development of disease prevention and epidemic control actions in the country.

圣保罗医学院卫生系在洛克菲勒基金会的支持下成立,成为卫生研究所,1918年由塞缪尔·达林教授首届课程。公共卫生昆虫学的历史与该研究所本身的历史混杂在一起,该研究所于1945年成为卫生与公共卫生学院。还是在20世纪30年代,保罗·塞萨尔·德·阿泽维多·安图内斯和约翰·莱恩在当时的卫生研究所的医学寄生虫学领域组织了公共卫生昆虫学。在此期间,昆虫学实验室因其在吸血昆虫系统学以及媒介生态学、生物学和行为学方面的研究而受到认可。昆虫学参考资料集(CER)自然起源于Paulo César Antunes和John Lane的研究,是一项国家和国际遗产,涵盖了公众健康感兴趣的初级和次级昆虫物种。多年来,在Augusto Ayroza Galvão、Renato Corrêa、JoséCoutinho、Nelson Cerqueira、Ernesto Rabello、Oswaldo Forattini等人的努力下,它得到了巩固。在其80多年的活动中,CER培训了几位能够参与整个拉丁美洲与昆虫媒介相关的地方病监测和控制项目的科学家,此外还培训了专注于公共卫生中感兴趣的昆虫的分类学家。巴西其他研究所和国外的研究人员加入昆虫学实验室是因为它的重要性和在其中开展的研究。不断增长的科学成果使公共卫生学院(FSP)开展的昆虫学研究有可能获得国际知名度,为该国疾病预防和流行病控制行动的发展做出贡献。
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引用次数: 0
Early motor development: risk factors for delay in a population study in Southern Brazil. 早期运动发育:巴西南部一项人口研究延迟的风险因素。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057004991
Ana Carolina Zago, Jéssica Puchalski Trettim, Bárbara Borges Rubin, Carolina Coelho Scholl, Fernanda Teixeira Coelho, Fernanda Ulguim, Luísa Mendonça de Souza Pinheiro, Mariana Bonati de Matos, Ricardo Tavares Pinheiro, Luciana de Avila Quevedo

Objective: To assess risk factors associated with motor development delay at three months of age.

Methods: Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development.

Results: We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors.

Conclusion: Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.

目的:评估与三个月大时运动发育迟缓相关的危险因素。方法:对巴西南部的母亲及其三个月大的婴儿进行横断面研究。Bayley III婴幼儿发育量表(BSID-III)和艾伯塔省婴儿运动量表(AIMS)用于评估运动发育。结果:我们对756名母亲及其三个月大的婴儿进行了评估。BSID-III和AIMS评估的整体平均运动发育分别为104.7(SD 13.5)和55.4(SD 25.4)。通过BSID-III进行评估时,剖宫产婴儿(p=0.002)、早产婴儿(p<0.001)和低出生体重婴儿(p=0.001)的运动发育得分最低。通过AIMS评估时,早产婴儿(p=0.0002)和低体重婴儿(p=0.004)的运动发展平均数最低。经过聚类分析,我们发现剖宫产、低出生体重和早产的婴儿与没有任何危险因素的婴儿相比,运动发育受损更严重。结论:识别风险因素可以实施早期干预措施,防止运动发育迟缓,从而降低未来出现其他问题的可能性。
{"title":"Early motor development: risk factors for delay in a population study in Southern Brazil.","authors":"Ana Carolina Zago,&nbsp;Jéssica Puchalski Trettim,&nbsp;Bárbara Borges Rubin,&nbsp;Carolina Coelho Scholl,&nbsp;Fernanda Teixeira Coelho,&nbsp;Fernanda Ulguim,&nbsp;Luísa Mendonça de Souza Pinheiro,&nbsp;Mariana Bonati de Matos,&nbsp;Ricardo Tavares Pinheiro,&nbsp;Luciana de Avila Quevedo","doi":"10.11606/s1518-8787.2023057004991","DOIUrl":"10.11606/s1518-8787.2023057004991","url":null,"abstract":"<p><strong>Objective: </strong>To assess risk factors associated with motor development delay at three months of age.</p><p><strong>Methods: </strong>Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development.</p><p><strong>Results: </strong>We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors.</p><p><strong>Conclusion: </strong>Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"59"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cerebrovascular mortality: trend and seasonality in Brazilian capitals, 2000-2019. 脑血管死亡率:2000-2019年巴西首都的趋势和季节性。
IF 2.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.11606/s1518-8787.2023057004813
Luis Sauchay Romero, Ludmilla da Silva Viana Jacobson, Sandra de Souza Hacon

Objective: To evaluate the trend and seasonality of cerebrovascular mortality rates in the adult population of Brazilian capitals from 2000 to 2019.

Methods: This is an ecological and descriptive study of a time series of mortality due to cerebrovascular causes in adults (≥ 18 years) living in Brazilian capitals from 2000 to 2019, based on the Brazilian Mortality Information System. Descriptive statistical techniques were applied in the exploratory analysis of data and in the summary of specific, standardized rates and ratios by sociodemographic characteristics. The jointpoint regression model was used to estimate the trend of cerebrovascular mortality rates by gender, age groups, and geographic regions. The seasonal variability of rates by geographic regions was estimated using the generalized additive model by smoothing cubic splines.

Results: People aged over 60 years comprised 77% of all cerebrovascular deaths. Women (52%), white individuals (47%), single people (59%), and those with low schooling (57%, elementary school) predominated in our sample. Recife (20/1,000 inhab.) and Vitória (16/1,000 inhab.) showed the highest crude mortality rates. Recife (49/10,000 inhab.) and Palmas (47/10,000 inhab.) prevailed after we applied standardized rates. Cerebrovascular mortality rates in Brazil show a favorable declining trend for adults of all genders. Seasonality influenced rate increase from July to August in almost all region capitals, except in the North, which rose in March, April, and May.

Conclusions: Deaths due to cerebrovascular causes prevailed in older single adults with low schooling. The trend showed a tendency to decline and winter, the greatest risk. Regional differences can support decision-makers in implementing public policies to reduce cerebrovascular mortality.

目的:评估2000-2009年巴西首都成年人口脑血管死亡率的趋势和季节性。方法:基于巴西死亡率信息系统,对2000-2009年居住在巴西首都的成年人(≥18岁)因脑血管原因死亡的时间序列进行生态学和描述性研究。描述性统计技术被应用于数据的探索性分析,以及根据社会人口特征总结具体的标准化比率和比率。联合点回归模型用于按性别、年龄组和地理区域估计脑血管死亡率的趋势。通过平滑三次样条,使用广义加性模型估计了地理区域费率的季节变化。结果:60岁以上人群占脑血管死亡总数的77%。女性(52%)、白人(47%)、单身人士(59%)和低学历者(57%,小学)在我们的样本中占主导地位。累西腓(20/1000 inhab.)和维托里亚(16/1000 inhab)的粗死亡率最高。在我们应用标准化比率后,累西腓(49/10000 inhab.)和帕尔马(47/10000 inhab)占主导地位。巴西的脑血管死亡率对所有性别的成年人都显示出有利的下降趋势。从7月到8月,季节性影响了几乎所有地区首府的发病率上升,但北部除外,北部在3月、4月和5月有所上升。趋势呈现下降趋势,冬季风险最大。区域差异可以支持决策者实施降低脑血管死亡率的公共政策。
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