Adriana Lúcia Meireles

Avaliação da implantação do cuidado humanizado aos recém-nascidos com baixo peso: método canguru

OBJECTIVE: To evaluate the implementation of the kangaroo mother method in hospitals trained by the Brazilian Ministry of Health. METHOD: Cross-sectional study, evaluating 176 (60.1%) out of 293 hospitals that were trained by the Brazilian Ministry of Health from 2000 to 2003 in Brazil. This study was conducted in two phases. The first phase consisted of sending a questionnaire to 293 hospitals; in the second phase an in loco visit was made in a sample of 29 among those hospitals. The instrument for data collection was sent to all hospitals by mail, fax or e-mail through the Ministry of Health and they addressed the three dimensions of the normative assessment: structure, processes, and results. The second phase consisted of an evaluation of the process, using a structured guide of non-participant observation. To estimate the reliability of the variable “deployment of the steps of the method” between questionnaire and site visit, we used the kappa test. RESULTS: The first stage of the kangaroo mother method was implemented in 84.9% of the hospitals, but only 47.3% of them implemented the three stages according to the Brazilian norm. The kappa test results indicated a moderate agreement for the first stage, and substantial for the second and third stages of the method. CONCLUSION: Hospital training was important for triggering the implementation process of the kangaroo mother method. However, they were not enough to promote the implementation of the three phases of the method.

Self-Rated Health among Urban Adolescents: The Roles of Age, Gender, and Their Associated Factors

Health status is often analyzed in population surveys. Self-rated health (SRH) is a single-item summary measure of the perception of one’s health. In Brazil, studies on the SRH of adolescents remain scarce, especially those aiming to understand the domains that compose this construct. Therefore, the aim of this study is to determine the prevalence of poor SRH and its associated factors among 11- to 13-year-olds and 14- to 17-year-olds living in a large urban center in Brazil. This cross-sectional study was conducted using a household survey across Belo Horizonte that included 1,042 adolescents. Stratified logistic regression models were used for each age group to assess the associations between worse SRH and the following variables: socio-demographic, social and family support, lifestyles, psychological health, and anthropometry. Approximately 11% (95% CIs = 8.7–13.6) of the studied adolescents rated their health as poor, and SHR decreased with age among males and females. This trend was more pronounced among girls (from 6.9% among 11- to 13-year-old girls to 16.9% among 14- to 17-year-old girls) than boys (from 8.3% among 11- to 13-year-old boys to 11% among 14- to 17-year-old boys). Worse SRH was associated with family support (as assessed by the absence of parent-adolescent conversations; odds ratio [OR] = 3.5 among 11- to 13-year-olds), family structure (OR = 2.8 among 14- to 17-year-olds), and argument reporting (OR = 8.2 among 14- to 17-year-olds). Among older adolescents, the consumption of fruit fewer than five times per week (OR = 2.4), life dissatisfaction (OR = 2.8), underweight status (OR = 6.7), and overweight status (OR = 2.7) were associated with poor SRH. As adolescents age, their universe expands from their relationship with their parents to include more complex issues, such as their lifestyles and life satisfaction. Therefore, these results suggest the importance of evaluating SRH across adolescent age groups and demonstrate the influence of the family environment (in addition to other factors) on negative health assessments, particularly among 14- to 17-year-olds.

Influence of individual and socio-environmental factors on self-rated health in adolescents

OBJECTIVE This study aimed to determine if individual and socio-environmental characteristics can influence the self-rated health among Brazilian adolescents. METHODS It included 1,042 adolescents from 11 to 17 years old who participated in the Beagá Health Study (Estudo Saúde em Beagá), a multistage household survey in an urban setting. Logistic regression analyses were performed to determine the association between the self-rated health and the following explanatory variables: sociodemographic factors, social support, lifestyle, physical and psychological health. RESULTS Good/very good and reasonable/poor/very poor self-rated health were reported by 88.5 and 11.5% of adolescents, respectively. The data on sociodemographic factors (SES), social support, lifestyle, psychological and physical health were associated with poor self-rated health (p ≤ 0.05). The associated variables were: age 14 - 17 years (OR =1.71; 95%CI 1.06 - 2.74), low SES (OR =1.68; 95%CI 1.05 - 2.69), few (OR = 2.53; 95%CI 1.44 - 4.46) and many quarrels in family (OR = 9.13; 95%CI 4.53 - 18.39), report of unkind and unhelpful peers (OR = 2.21; 95%CI 1.11 - 4.43), consumption of fruits < 5 times a week (OR = 1.78; 95CI% 1.07 - 2.95), physical inactivity (OR = 2.31; 95%CI 1.15 - 4.69), overweight (OR = 2.42; 95%CI 1.54 - 3.79) and low level of life satisfaction (OR = 2.31; 95%CI 1.34 - 3.98). CONCLUSIONS Poor self-rated health among adolescents was associated with individual and socio-environmental characteristics related to family, school and neighborhood issues. Quantifying the self-rated health according to the theoretical framework of the childs well-being should help in arguing that self-rated health might be a strong indicator of social inequities for the studied population.

O uso de escalas de silhuetas na avaliação da satisfação corporal de adolescentes: revisão sistemática da literatura

O objetivo deste artigo e descrever as recentes mudancas na epidemiologia da pertussis e as politicas de vacinacao voltadas a prevencao da coqueluche para profissionais de saude. Os autores fizeram um levantamento dos artigos publicados no PubMed, SciELO e paginas da Internet da Organizacao Mundial da Saude, Organizacao Pan-Americana da Saude, Centers for Disease Control and Prevention (Estados Unidos) e do Ministerio da Saude usando as palavras-chave: pertussis, vacinas e profissionais de saude. A vacinacao de profissionais de saude contra coqueluche e recomendada pela OMS, OPAS, CDC, e autoridades de saude de nove paises europeus, da Australia, Hong Kong, Cingapura, Costa Rica, Argentina e Uruguai, e em alguns paises e compulsoria. No Brasil, identificamos apenas um artigo abordando a vacinacao de profissionais de saude contra coqueluche, mas considerando a reemergencia da doenca com grande numero de hospitalizacoes e mortes em 2011, consideramos necessario rediscutir as politicas publicas envolvendo a vacinacao dos profissionais de saude, particularmente daqueles que tem contato frequente com lactentes jovens.The aim of this study was to describe recent changes in the epidemiology of pertussis and existing policies regarding recommended and mandatory occupational vaccinations for healthcare professionals (HCPs). The authors carried out an extensive review of references on the PubMed and SciELO databases and the official sites of the World Health Organization, Pan American Health Organization, Centers for Disease Control and Prevention, and Brazilian Ministry of Health, using the keywords pertussis, vaccines and healthcare professionals. Vaccination against pertussis is recommended for HCPs in the United States, Canada, nine European countries, Australia, Hong Kong, Singapore, Costa Rica, Argentina and Uruguay, and in some countries it is compulsory. In Brazil, only one publication discussing the risk of pertussis among HCPs was found. Considering the reemergence of pertussis and the great number of associated hospitalizations and deaths registered in 2011, it is necessary to review public policies regarding HCP pertussis vaccination, particularly among workers in frequent contact with young babies.

Weight excess in adolescents in Belo Horizonte? population-based household survey

Introduction: Weight excess rates have had an alarming growth among adolescents. Of complex and multifactor origins, weight excess is influenced by genetic and contextual factors. Objective: To assess individual factors related to weight excess among adolescents in a large urban center. Methods: A cross-sectional study with data from a population-based household survey conducted in two districts of Belo Horizonte, between 2008 and 2009. Data were collected through confidential self-administered questionnaires and anthropometric measurements. The final sample consisted of 1,030 adolescents aged 11-17 years. We evaluated excess weight, as defined by body mass index, and its association with sociodemographic variables, habits and lifestyles, body satisfaction and self-rated health. Descriptive analysis of the data, including frequency distributions and differences between proportions and means with the Pearson chi-square test were conducted. Results: 21.9% of adolescents were overweight, with a higher prevalence among females (54.2%, p <0.05). The following aspects were significantly associated with weight excess: not eating breakfast, body dissatisfaction and worse self-rated health status. Males were more active compared to females, however without significant differences in nutritional status classifications. Conclusion: This study reinforces the multifactor aspects of exWeight excess in adolescents in Belo Horizonte? population-based household survey Stephanie Bispo1, Adriana Lúcia Meireles2, Marcela Guimarães Côrtes3, César Coelho Xavier4, Fernando Augusto Proietti5, Waleska Teixeira Caiaffa6 1 Nutricionista. Mestranda em Ciências da Saúde: Saúde da Criança e do Adolescente – Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG). Observatório de Saúde Urbana. Belo Horizonte, MG – Brasil. 2 Nutricionista. Doutoranda em Saúde Pública – Faculdade de Medicina da UFMG. Observatório de Saúde Urbana. Belo Horizonte, MG – Brasil. 3 Fonoaudióloga. Doutoranda em Saúde Pública – Faculdade de Medicina da UFMG. Observatório de Saúde Urbana. Belo Horizonte, MG – Brasil. 4 Médico. Professor Associado do Departamento de Pediatria da Faculdade de Medicina da UFMG. Observatório de Saúde Urbana. Belo Horizonte, MG – Brasil. Professor da Faculdade de Saúde e Ecologia Humana (FASEH). Vespasiano, MG – Brasil 5 Médico. Professor Associado do Departamento de Medicina Preventiva e Social da Faculdade de Medicina da UFMG. Observatório de Saúde Urbana, Belo Horizonte, MG – Brasil. Professor da Faculdade de Saúde e Ecologia Humana (FASEH). Vespasiano, MG – Brasil 6 Médica. Professora Titular de Epidemiologia – Departamento de Medicina Preventiva da Faculdade de Medicina da UFMG. Observatório de Saúde Urbana. Belo Horizonte, MG – Brasil. Excesso de peso em adolescentes de Belo Horizonte: inquérito domiciliar de base populacional DOI: 10.5935/2238-3182.20130003

Well-being of children and adolescents: a multidimensional construct

Objectives: To review the literature on the well-being of children and adolescents from a multidimensional perspective. Methods: A narrative review was conducted and articles from the PubMed database, from publications of national and international institutions, dissertations and theses were selected. Results: The production of articles on the wellbeing of children and adolescents still cannot be considered significant when compared to other themes in the scientific production involving individuals in this age group. These findings highlight the importance of a targeted approach to this issue. It is clear that the term well-being, despite being commonly used, is inconsistently defined. A single domain is unable to encompass all the complexity involved in this concept , as attested by the extensive list of studies and reports monitoring well-being throughout the world. Analysis based on data from the Health Beaga Study reveals the existence of important intra-urban differences in the various domains of well-being of adolescents living in Belo Horizonte, a large urban center in Brazil, reinforcing the importance of studying well-being from a multidimensional perspective, one that can visualize is as a potential indicator of social inequities. Conclusion: We found that well-being is influenced not only by individual attributes but also by contextual factors such as family, neighborhood, and country characteristics.

Nutritional profile of adolescents and young adults in Belo Horizonte by anthropometric and neighborhood context

Introduction: Dietary patterns may differ by area of residence and intra-urban differentials, suggesting that adopting healthy eating habits goes beyond individual characteristics. Objective: To compare dietary intake of young people, with and without overweight (OW), living in different areas of health vulnerability. Methods: Cross-sectional study prepared based on information from 563 individuals 15-24 years living in Belo Horizonte obtained through a household survey conducted by the National Cancer Institute and Brazilian Ministry of Health in 2003. The vulnerability of the place of residence was assessed by the Health Vulnerability Index (IVS). Comparisons were made by chi-square test and correlation technique of Spearman. Results: The OW prevalence was 13.4%, being higher in males. The young participants present below the recommended dietary pattern for the country in relation to the consumption of vegetables, fruits and dairy products. It was observed that the higher the risk of vulnerability of lower consumption of vegetables, fruit or fruit juice, dairy products, and meat, fish or poultry. The consumption of beans directly correlated with risk. It was observed that, among subjects without OW the correlations beNutritional profile of adolescents and young adults in Belo Horizonte by anthropometric and neighborhood context Adriana Lúcia Meireles1, César Coelho Xavier2, Aline Dayrell Ferreira Sales3, Mery Natali Silva Abreu4, Deborah Carvalho Malta5, Waleska Teixeira Caiaffa6 Perfil alimentar de adolescentes e adultos jovens em Belo Horizonte segundo perfil antropométrico e contexto de moradia DOI: 10.5935/2238-3182.2013S003