Alexandrina Aparecida Maciel Cardelli

Fatores associados ao uso regular de cigarros por adolescentes estudantes de escolas públicas de Londrina, Paraná, Brasil

This cross-sectional epidemiological study aimed to identify factors associated with regular cigarette smoking among adolescents. The sample included 517 public school 9th graders in Londrina, Paraná State, Brazil. A structured questionnaire was used to collect information, including social and demographic characteristics, social relations, and health risk behaviors. Logistic regression was used in the statistical analysis, with significance set at 5%. 8.9% of the adolescents reported smoking at least one cigarette a day in the previous 30 days. Age ≥ 15 years (OR = 2.28; 95%CI: 1.21-4.32; p = 0.011) and having friends that smoked (OR = 12.62; 95%CI: 4.44-35.89; p < 0.0001) were associated with regular smoking in both the univariate and multivariate analyses. Meanwhile, gender, race, social class, living with father and mother, religion, maternal education, having tried alcohol, physical activity, and paid work were not associated with smoking. These findings support the development of community-based tobacco control strategies targeting adolescents.Estudo epidemiologico transversal com objetivo de identificar fatores associados ao uso regular de cigarros por adolescentes. A amostra foi constituida por 517 alunos do 9o ano do Ensino Fundamental de escolas publicas de Londrina, Parana, Brasil. O instrumento de coleta de dados incluiu caracteristicas sociodemograficas, relacoes sociais e comportamentos de risco. Na analise estatistica, foi utilizado o modelo de regressao logistica com nivel de significância em 5%. Relataram uso de cigarros, pelo menos, um dia nos ultimos trinta dias 8,9% dos alunos. Os fatores idade ≥ 15 anos (OR = 2,28; IC95%: 1,21-4,32; p = 0,011) e possuir amigos fumantes (OR = 12,62; IC95%: 4,44-35,89; p < 0,0001) associaram-se ao uso regular de cigarros, tanto na analise univariada como na multivariada. Por outro lado, sexo, raca, classe social, morar com pai e mae, religiao, escolaridade materna, experimentacao de alcool, atividade fisica e atividade remunerada nao se associaram a essa pratica. Esses achados podem subsidiar a elaboracao de estrategias antitabagicas direcionadas a comunidade, tendo o adolescente como alvo.

Expectations and satisfaction of pregnant women: unveiling prenatal care in primary care

OBJECTIVE To analyze the perception of primiparous women about prenatal care in Basic Health Units in a municipality in southern Brazil. METHODS This is a qualitative research from the perspective of Social Representation Theory, from the following question: How has been the pre-natal care for you? Eighteen pregnant women were interviewed. RESULTS The analysis resulted in three categories: Expectation representation about prenatal care; Rescuing the care offered in prenatal consultation; Unveiling the (dis) satisfaction with prenatal consultation. The prenatal care was apprehended as an essential moment for safe pregnancy, although centered on the doctors figure and guarantee access to early laboratory and imaging tests. On the other hand, dissatisfaction was revealed from the reception at the entrance to the health unit to the consultations access, although some statements suggest timely satisfaction. CONCLUSION Prenatal care did not meet the specific expectations of the study group and unveiled that the nurse did not supply it, as a member of the multidisciplinary team. The organization of the nursing work process in primary care, related to prenatal care, needs to be revisited to promote the effectiveness of its actions.

Association between oral health status and central obesity among Brazilian independent-living elderly.

The aim of this study was to investigate the association between oral health status and central obesity (CO) in Brazilian independent-living elderly. A cross-sectional study was carried out in a sample of 489 elderly, who were participants of the Study on Aging and Longevity, in Londrina, state of Parana. The number of natural teeth and use of prostheses were evaluated according to the World Health Organization criteria. The presence of CO was assessed using measures of waist circumference (WC) and waist-hip ratio (WHR). Information concerning sociodemographic profile and some systemic conditions was also collected. Data were analyzed using stepwise logistic regression, α=5%. According to WC and WHR measures, the prevalence of central obesity was 79.3% and 76.1%, respectively. CO according to WC was not associated with oral status. Considering the WHR measure, the following oral conditions were associated to CO: having fewer natural teeth (OR = 2.61; 95%CI = 1.17-5.80), being edentulous and wearing both upper and lower complete dentures (OR = 2.34; 95%CI = 1.11-4.93), and being edentulous wearing only the upper complete denture (OR = 2.64; 95%CI = 1.01-6.95). Traditional risk factors for CO such as gender, dyslipidemia, hypertension and diabetes were associated with both measures. A poor oral health due to extensive tooth loss, whether partial or complete, even if rehabilitated by removable prostheses, may be considered a good predictor of CO in Brazilian independent-living elderly.

Fatores relacionados a não adesão à realização do exame de Papanicolau

Objetivo: identificar motivos para baixa adesao ao exame de Papanicolau entre mulheres atendidas na atencao primaria de saude. Metodos: estudo transversal. Coleta de dados realizada durante visitas domiciliares, aplicando-se questionario para caracterizar aspectos sociodemograficos, bem como os motivos para nao adesao ao exame e sugestoes facilitadoras para adesao. Resultados: das 169 mulheres, 67% estavam em idade reprodutiva e 73,9% cursaram o ensino fundamental. O nao comparecimento para o exame previamente agendado foi devido, principalmente, as crencas e atitudes (36,1%) e a organizacao do servico (25,4%). Os sentimentos referidos pelas mulheres durante o Papanicolau foram vergonha (55,6%), desconforto (32,5%) e dor (20,7%). Conclusao: embora o rastreamento do câncer de colo de utero seja fundamental para intervencao a tempo oportuno, significativa parcela das mulheres ainda nao adere ao exame por mitos e tabus, crencas e atitudes em saude, bem como organizacao do servico.

Factors associated with regular cigarette smoking by adolescents from public schools in Londrina, Paraná, Brazil

This cross-sectional epidemiological study aimed to identify factors associated with regular cigarette smoking among adolescents. The sample included 517 public school 9th graders in Londrina, Paraná State, Brazil. A structured questionnaire was used to collect information, including social and demographic characteristics, social relations, and health risk behaviors. Logistic regression was used in the statistical analysis, with significance set at 5%. 8.9% of the adolescents reported smoking at least one cigarette a day in the previous 30 days. Age ≥ 15 years (OR = 2.28; 95%CI: 1.21-4.32; p = 0.011) and having friends that smoked (OR = 12.62; 95%CI: 4.44-35.89; p < 0.0001) were associated with regular smoking in both the univariate and multivariate analyses. Meanwhile, gender, race, social class, living with father and mother, religion, maternal education, having tried alcohol, physical activity, and paid work were not associated with smoking. These findings support the development of community-based tobacco control strategies targeting adolescents.Estudo epidemiologico transversal com objetivo de identificar fatores associados ao uso regular de cigarros por adolescentes. A amostra foi constituida por 517 alunos do 9o ano do Ensino Fundamental de escolas publicas de Londrina, Parana, Brasil. O instrumento de coleta de dados incluiu caracteristicas sociodemograficas, relacoes sociais e comportamentos de risco. Na analise estatistica, foi utilizado o modelo de regressao logistica com nivel de significância em 5%. Relataram uso de cigarros, pelo menos, um dia nos ultimos trinta dias 8,9% dos alunos. Os fatores idade ≥ 15 anos (OR = 2,28; IC95%: 1,21-4,32; p = 0,011) e possuir amigos fumantes (OR = 12,62; IC95%: 4,44-35,89; p < 0,0001) associaram-se ao uso regular de cigarros, tanto na analise univariada como na multivariada. Por outro lado, sexo, raca, classe social, morar com pai e mae, religiao, escolaridade materna, experimentacao de alcool, atividade fisica e atividade remunerada nao se associaram a essa pratica. Esses achados podem subsidiar a elaboracao de estrategias antitabagicas direcionadas a comunidade, tendo o adolescente como alvo.

Pré-natal: preparo para o parto na atenção primária à saúde no sul do Brasil

OBJECTIVE To evaluate the relationship between prenatal care and delivery guidelines In Primary Health Care. METHODS This is a cross-sectional study, with 358 puerperal women of a public maternity from the south of Brazil. The data collection was performed from July to October of 2013, with prenatal card data transcription and a structured interview. The data has been analyzed through the use of the Chi-square test (p≤0.05). RESULTS The prenatal care had a high coverage (85,5%) and early start by 71,8% of the women, however, 52% of them did not receive orientation for the childbirth. There was a statistical association between receiving orientation for the childbirth and fewer visits (p=0.028), longer interval between the last prenatal visit and the childbirth (p=0.002), and the classification of the prenatal care as intermediate and inadequate (p=0.024). CONCLUSIONS Despite of the ideal number of visits, the quality of care has been classified as intermediate or inadequate, besides that, precarious access to the orientation for the childbirth during the prenatal care has been evidenced.Objetivo: Avaliar a relacao entre assistencia pre-natal e orientacoes para o parto na Atencao Primaria a Saude. Metodos : Estudo transversal com 358 puerperas de maternidade publica do sul do Brasil. Coleta de dados realizada de julho a outubro de 2013, com transcricao de dados do cartao de pre-natal e entrevista estruturada. Dados analizados pelo Teste Qui-quadrado (p≤0,05). Resultados : O pre-natal teve alta cobertura (85,5%) e inicio precoce em 71,8% das mulheres, porem 52% destas nao receberam orientacao para o parto. Houve associacao estatistica entre o recebimento de orientacao para o parto e menor numero de consultas (p=0,028), maior intervalo entre a ultima consulta pre-natal e o parto (p=0,002) e classificacao do cuidado pre-natal como intermediario e inadequado (p=0,024). Conclusoes : Apesar da oferta ideal do numero de consultas, a qualidade do cuidado foi classificada como intermediaria ou inadequada e evidenciou-se acesso precario a orientacoes para o parto durante o pre-natal. Palavras-chave: Cuidado pre-natal. Parto. Educacao em saude. Enfermagem obstetrica.

Mortality among children under the age of one: analysis of cases after discharge from maternity *

OBJECTIVE To analyze infant death after discharge from maternity in the time period between 2000 and 2013. METHOD A cross-sectional retrospective quantitative study in a municipality northward in the state of Paraná. Data were analyzed using the SPSS®, and were subjected to Chi-square test, logistical regression, 95% confidence interval, and a significance level of p <0.05. RESULTS Two hundred forty-nine children were born, discharged from maternity and subsequently died; 10.1% in the neonatal period and 89.9% in the post-neonatal period. Pregnancy follow-up, birth, and child monitoring took place mainly in the public health system. There was a statistically significant association between the infant component and place of delivery (p =0.002; RR=1.143; IC95%=1.064-1.229), and a lower number of childcare medical visits (p =0.001; RR=1.294; IC95%=1.039-1.613). The causes of death in the neonatal period were perinatal conditions (40%); external causes (32%); and congenital malformations (20%). In the post-neonatal period, congenital malformations (29.9%), external causes (24.1%); and infectious-parasitic diseases (11.2%) were the causes of death. CONCLUSION Virtually all children were born in conditions of good vitality that were worsened due to potentially preventable diseases that led to death. OBJETIVO Analisar as mortes infantis após alta das maternidades ocorridas entre 2000 e 2013. MÉTODO Pesquisa quantitativa retrospectiva transversal, em município no norte do Paraná. Os dados foram analisados no SPSS®. .Aplicaram-se teste qui-quadrado, regressão logística, intervalo de confiança 95% e nível de significância p <0,05. RESULTADOS 249 crianças nasceram, receberam alta e evoluíram para óbito, 10,1% no período neonatal e 89,9% no pós-neonatal. O acompanhamento gestacional, nascimento e seguimento da criança ocorreram, predominantemente, no serviço público. Houve associação estatisticamente significativa entre componente infantil e local de parto (p =0,002; RR=1,143; IC95%=1,064-1,229); realizar menos consultas de puericultura (p =0,001; RR=1,294; IC95%=1,039-1,613). As causas de morte no período neonatal foram afecções perinatais (40%), causas externas (32%) e malformações congênitas (20%). No pós-neonatal, malformações congênitas (29,9%), causas externas (24,1%) e doenças infectoparasitárias (11,2%). CONCLUSÃO A quase totalidade das crianças nasceu em boas condições de vitalidade, apresentou agravos por doenças potencialmente preveníveis que culminaram no óbito.

Groups of diseases among public university male workers

Objetivos: Descrever os principais grupos de doencas em trabalhadores do genero masculino atendidos na divisao ambulatorial de uma universidade publica. Metodos: Estudo descritivo e retrospectivo com dados coletados de prontuarios de consultas medicas realizadas no ano de 2009, no ambulatorio da Divisao de Assistencia a Comunidade da Universidade Estadual de Londrina, em Londrina, estado do Parana. Os diagnosticos medicos foram agrupados e categorizados conforme a Classificacao Estatistica Internacional de Doencas e Problemas Relacionados a Saude (CID-10). A amostragem foi probabilistica sistematizada, mantendo indice de confiabilidade de 95% e margem de erro de 5%. Os resultados foram apresentados em numeros absolutos e frequencias. Resultados: Entre os 367 homens atendidos no periodo cujos prontuarios foram selecionados para estudo, a faixa etaria mais frequente foi acima dos 50 anos, havendo predominio de auxiliares operacionais (67%). O tempo de atuacao na instituicao superior a 11 anos foi o mais encontrado na amostra estudada. As doencas mais frequentemente descritas foram as do aparelho respiratorio, com 66 casos (17,98%), seguidas por doencas do aparelho circulatorio com 58 casos (15,80%), sistema osteomuscular e tecido conjuntivo com 51 casos (13,90%), aparelho geniturinario com 45 casos (12,26%) e transtornos mentais e comportamentais com 40 casos (10,90%). Conclusoes: Constatou-se que muitas das doencas que acometeram os homens que trabalhavam na Universidade Estadual de Londrina sao passiveis de prevencao. Os resultados deste estudo podem contribuir para o planejamento de acoes que visem a promocao da saude e a prevencao de agravos, especificamente voltadas para a populacao de trabalhadores do genero masculino.

Factores asociados con el consumo regular de tabaco en adolescentes de escuelas públicas en Londrina, Paraná, Brasil

This cross-sectional epidemiological study aimed to identify factors associated with regular cigarette smoking among adolescents. The sample included 517 public school 9th graders in Londrina, Paraná State, Brazil. A structured questionnaire was used to collect information, including social and demographic characteristics, social relations, and health risk behaviors. Logistic regression was used in the statistical analysis, with significance set at 5%. 8.9% of the adolescents reported smoking at least one cigarette a day in the previous 30 days. Age ≥ 15 years (OR = 2.28; 95%CI: 1.21-4.32; p = 0.011) and having friends that smoked (OR = 12.62; 95%CI: 4.44-35.89; p < 0.0001) were associated with regular smoking in both the univariate and multivariate analyses. Meanwhile, gender, race, social class, living with father and mother, religion, maternal education, having tried alcohol, physical activity, and paid work were not associated with smoking. These findings support the development of community-based tobacco control strategies targeting adolescents.Estudo epidemiologico transversal com objetivo de identificar fatores associados ao uso regular de cigarros por adolescentes. A amostra foi constituida por 517 alunos do 9o ano do Ensino Fundamental de escolas publicas de Londrina, Parana, Brasil. O instrumento de coleta de dados incluiu caracteristicas sociodemograficas, relacoes sociais e comportamentos de risco. Na analise estatistica, foi utilizado o modelo de regressao logistica com nivel de significância em 5%. Relataram uso de cigarros, pelo menos, um dia nos ultimos trinta dias 8,9% dos alunos. Os fatores idade ≥ 15 anos (OR = 2,28; IC95%: 1,21-4,32; p = 0,011) e possuir amigos fumantes (OR = 12,62; IC95%: 4,44-35,89; p < 0,0001) associaram-se ao uso regular de cigarros, tanto na analise univariada como na multivariada. Por outro lado, sexo, raca, classe social, morar com pai e mae, religiao, escolaridade materna, experimentacao de alcool, atividade fisica e atividade remunerada nao se associaram a essa pratica. Esses achados podem subsidiar a elaboracao de estrategias antitabagicas direcionadas a comunidade, tendo o adolescente como alvo.