Jessica Pronestino de Lima Moreira

Utilização de consulta médica e hipertensão arterial sistêmica nas áreas urbanas e rurais do Brasil, segundo dados da PNAD 2008

The use of medical consultations is influenced by determinants such as healthcare needs and service characteristics, which depend on whether the environment is urban or rural. The scope was to estimate the proportions of individuals attending medical consultations over the previous 12 months with and without self-reported systemic arterial hypertension (SAH) living in urban and rural areas, and to analyze the patterns of consultation use and associations. This was a sectional study, using PNAD 2008. Logistic regression was performed to obtain crude and adjusted odds ratios (ORs), according to self-reported SAH and household situation. 70.6% of adult Brazilians consult physicians. The association between the presence of SAH and attending medical consultations was 3.63 (OR) times greater in urban areas. The incidence of consultation with physicians was greater among women, individuals using continuous medication or who had health insurance plans or funding for the last consultation, people who reported a disease or restriction in mobility and those with self-reported poor health, in all strata. Multivariate analysis modified the associations of all variables. The differences between the two areas suggested that access policies need to be implemented, with the aim of reducing inequalities.

Associação entre o estado de saúde autorreferido de adultos e a área de localização do domicílio: uma análise de regressão logística ordinal usando a PNAD 2008

The urban environment influences human health and behavior, and a clearer understanding of the health determinants of populations living in cities is needed. Using data from the National Household Sampling Survey (PNAD) 2008, with ordinal logistic models incorporating the sampling plan, this study assessed the association between the location of the home (urban or rural) and the self-reported state of health of the adult Brazilian population, taking into account a set of individual and environmental factors inside and outside the home. The results indicated that after allowing for individual and environmental factors, the association between the location of the home and the self-reported state of health is changing (going from OR = 1.51 to OR = 0.96) and losing its statistical significance (p-value = 0.208). However, statistically significant interactions were observed between the location of the home and the following variables: sex, color/race, self-reported morbidity, possession of basic goods and percentage of households with adequate living conditions.

Prevalence of self-reported systemic arterial hypertension in urban and rural environments in Brazil: a population-based study

Rape is a global public health problem, and steps have been taken to encourage studies on the issue and propose interventions for its prevention and appropriate care. This study aimed to characterize the population of female rape victims and describe the characteristics of the sexual assault and the care provided at a university referral center. This was a quantitative retrospective study of care provided to female rape victims from June 2006 to December 2010. The majority of the women (n = 687) were white, single, had no children, with a mean age of 23.7 years and primary to secondary schooling, employed, and practiced a religion. One-fourth of the victims reported no sexual intercourse prior to the sexual assault. Rape occurred mainly at night, on the street, perpetrated by a single stranger, with vaginal penetration, and with threatened or actual force. Most of the victims had reported the rape to someone and felt supported. Early care occurred for almost 90% of women, allowing preventive measures. From 2006 to 2010 there was an increase in the proportion of women that sought help. Better knowledge of the characteristics of this group and the event itself can help improve the structure and functioning of models to assist rape victims.The aims of this paper were to estimate the prevalence rates of self-reported high blood pressure among adults in urban and rural environments in Brazil and identify possible associations stratified according to household location. Data from the Brazilian National Household Sample Survey (PNAD) was used, incorporating information from the sampling plan. Logistic regression was used to obtain the odds ratio (OR) as a measure of association between variables and the outcome. The prevalence of self-reported high blood pressure in Brazil was 20.9%: 21% in urban areas and 20.1% in rural areas (OR = 1.06). In both areas, the likelihood of reporting high blood pressure increased with age and women, former smokers, migrants and individuals with morbidities, non-white individuals and individuals with health insurance were more likely to report this disease. Also, in both rural and urban areas, prevalence of high blood pressure was lower among workers and decreased with increasing levels of schooling. All variables showed an association with self-reported high blood pressure in both rural and urban areas, but differences in magnitude were observed in relation to sex and age group. These differences could help justify the promotion of better access and intervention methods at prevention clinics for different population groups.Rape is a global public health problem, and steps have been taken to encourage studies on the issue and propose interventions for its prevention and appropriate care. This study aimed to characterize the population of female rape victims and describe the characteristics of the sexual assault and the care provided at a university referral center. This was a quantitative retrospective study of care provided to female rape victims from June 2006 to December 2010. The majority of the women (n = 687) were white, single, had no children, with a mean age of 23.7 years and primary to secondary schooling, employed, and practiced a religion. One-fourth of the victims reported no sexual intercourse prior to the sexual assault. Rape occurred mainly at night, on the street, perpetrated by a single stranger, with vaginal penetration, and with threatened or actual force. Most of the victims had reported the rape to someone and felt supported. Early care occurred for almost 90% of women, allowing preventive measures. From 2006 to 2010 there was an increase in the proportion of women that sought help. Better knowledge of the characteristics of this group and the event itself can help improve the structure and functioning of models to assist rape victims.

Ecological study of gastric cancer in Brazil: Geographic and time trend analysis

AIM To investigate the geographic distributions and time trends of gastric cancer (GC) incidence and mortality in Brazil. METHODS An ecological study of the DATASUS registry was conducted by identifying hospitalizations for GC between January 2005 and December 2010. The data included information on the gender, age, and town of residence at the time of hospital admission and death. RESULTS The GC rates, adjusted according to available hospital beds, decreased from 13.8 per 100000 in 2005 to 12.7 per 100000 in 2010. The GC rates decreased more among the younger age groups, in which the male-to-female difference also decreased in comparison to the older age groups. Although the lethality rates tended to increase with age, young patients were proportionally more affected. The spatial GC distribution showed that the rates were higher in the south and southeast. However, while the rates decreased in the central-west and south, they increased in the northern regions. A geographic analysis showed higher rates of GC in more urbanized areas, with a coast-to-inland gradient. Geographically, GC lethality overlapped greatly with the hospital admission rates. CONCLUSION The results of this study support the hypothesis of a critical role for environmental factors in GC pathogenesis. The declining rates in young patients, particularly males, suggest a relatively recent decrease in the exposure to risk factors associated with GC. The spatial distribution of GC indicates an ongoing dynamic change within the Brazilian environment.

The socio-economic impact of work disability due to inflammatory bowel disease in Brazil

BackgroundInflammatory bowel disease (IBD) might have economic and social impacts in Brazil, where its prevalence has increased recently. This study aimed to assess disability due to IBD in the Brazilian population and demographic factors potentially associated with absence from work.MethodsAnalysis was performed using the computerized Single System of Social Security Benefits Information, with a cross-check for aid pension and disability retirement, for Crohn’s disease (CD) and ulcerative colitis (UC). Additional data were obtained from the platform, including the average values, benefit duration, age, gender and region of the country.ResultsTemporary disability occurred more frequently with UC, whereas permanent disability was more frequent with CD. Temporary disability affected more younger patients with CD than patients with UC. Temporary work absences due to UC and CD were greater in the South, and the lowest absence rates due to CD were noted in the North and Northeast. Absence from work was longer (extending for nearly a year) in patients with CD compared to those with UC. The rates of temporary and permanent disability were greater among women. Permanent disability rates were higher in the South (UC) and Southeast (CD). The value of benefits paid for IBD represented approximately 1% of all social security benefits. The benefits paid for CD were higher than for UC, whereas both tended to decrease from 2010 to 2014.ConclusionsIn Brazil, IBD frequently causes disability for prolonged periods and contributes to early retirement. Reduction trends may reflect improvements in access to health care and medication. Vocational rehabilitation programs may positively impact social security and the patients’ quality of life.

[Rural workers' health in Brazil].

La salud del trabajador es el tema central en investigaciones en salud publica, sin embargo, se debe considerar la especificidad de las actividades ejercidas. Se trata de analizar la salud de los trabajadores dentro del sector agricola en Brasil, que poseen una ocupacion tambien agricola o no agricola, por medio de la autopercepcion de salud y morbilidades referidas. Se utilizo la Encuesta Nacional por Muestra de Domicilios (PNAD 2008), incorporando la informacion del diseno por muestra del complejo. Se seleccionaron trabajadores del sector agricola con 18 anos o mas, estratificando entre los que poseian una ocupacion agricola y no agricola. Se realizo una regresion logistica para autopercepcion de salud y se calcularon las razones de posibilidades para las morbilidades referidas. La ocupacion agricola disminuye la posibilidad de informar sobre la salud positivamente y aumenta la posibilidad de informar sobre enfermedades de la columna/espalda, hipertension arterial y artritis/reumatismo. Los trabajadores con ocupacion agricola presentan mas morbilidades referidas y peores condiciones de vida. La autopercepcion de salud de los trabajadores, en general, fue mejor entre quienes cuentan con una ocupacion no agricola.A saude do trabalhador e tema central em pesquisas de saude publica, entretanto se deve considerar a especificidade das atividades exercidas. Objetiva-se analisar a saude dos trabalhadores da atividade agricola no Brasil, que possuem ocupacao tambem agricola ou nao agricola, por meio da autopercepcao de saude e morbidades referidas. Utilizou-se a Pesquisa Nacional por Amostra de Domicilios (PNAD 2008), incorporando as informacoes do plano amostral complexo. Selecionaram-se trabalhadores da atividade agricola com 18 anos ou mais, estratificando em: os que possuiam ocupacao agricola e nao agricola. Foi realizada regressao logistica para autopercepcao de saude e calculadas as razoes de chances para as morbidades referidas. A ocupacao agricola diminui a chance de referir saude como Boa e aumenta a chance de referir doenca de coluna/costas, hipertensao arterial e artrite/reumatismo. Os trabalhadores com ocupacao agricola apresentam mais morbidades referidas e piores condicoes de vida. A autopercepcao de saude dos trabalhadores, em geral, foi melhor entre os ocupados nao agricolas.

Prevalência de hipertensão arterial sistêmica autorreferida nos ambientes urbano e rural do Brasil: um estudo de base populacional

Este artigo objetiva estimar as prevalencias da hipertensao arterial sistemica autorreferida de adultos nos ambientes urbano e rural do Brasil e identificar possiveis associacoes, estratificadas por situacao do domicilio. Utilizou-se a Pesquisa Nacional por Amostra de Domicilios (PNAD), incorporando as informacoes do plano amostral. Regressoes logisticas foram utilizadas para obter as medidas de associacao odds ratio (OR). A prevalencia da hipertensao arterial sistemica autorreferida no Brasil foi 20,9%, sendo 21% (urbana) e 20,1% (rural) (OR = 1,06). Em ambas as areas, a chance de referir hipertensao arterial sistemica aumentou com a idade, foi maior entre as mulheres, ex-fumantes, migrantes, portadores de morbidade, os de cor/raca nao branca e portadores de plano de saude. Tambem nas duas areas, a hipertensao arterial sistemica foi menor entre os trabalhadores e diminuiu com o aumento do numero de anos de estudo. Todas as variaveis se mostraram associadas com hipertensao arterial sistemica autorreferida, em ambas as areas, entretanto puderam ser observadas diferencas nas magnitudes em sexo e faixa etaria. Essas diferencas podem auxiliar na melhor forma de intervir nos servicos de prevencao e acesso de cada populacao.The aims of this paper were to estimate the prevalence rates of self-reported high blood pressure among adults in urban and rural environments in Brazil and identify possible associations stratified according to household location. Data from the Brazilian National Household Sample Survey (PNAD) was used, incorporating information from the sampling plan. Logistic regression was used to obtain the odds ratio (OR) as a measure of association between variables and the outcome. The prevalence of self-reported high blood pressure in Brazil was 20.9%: 21% in urban areas and 20.1% in rural areas (OR = 1.06). In both areas, the likelihood of reporting high blood pressure increased with age and women, former smokers, migrants and individuals with morbidities, non-white individuals and individuals with health insurance were more likely to report this disease. Also, in both rural and urban areas, prevalence of high blood pressure was lower among workers and decreased with increasing levels of schooling. All variables showed an association with self-reported high blood pressure in both rural and urban areas, but differences in magnitude were observed in relation to sex and age group. These differences could help justify the promotion of better access and intervention methods at prevention clinics for different population groups.

Pancreatic Cancer Incidence and Lethality Rates in Brazil: An Ecological Study

Objectives To describe incidence and lethality time trends rates of pancreatic cancer (PC) in Brazil. Methods Data from Brazilian Health National Public System (SUS) were retrospectively collected with regard to PC from January 2005 to December 2012. Pancreatic cancer incidence and lethality rates were estimated from SUS hospitalizations and in-hospital PC deaths and adjusted to total available hospital beds. Results From 2005 to 2012, a total of 36,332 admissions for PC were registered in Brazil. Pancreatic cancer incidence nearly doubled from 2.4/100,000 to 4.5/100,000, particularly among patients older than 70 years, whereas no difference in sex was noted. The greatest incidence rates increase (+109%) occurred in the northeast, a less developed region that has recently achieved significant economic advances. Dynamic changes were observed, notably a shift to increasing PC incidence in rural areas. Lethality rates increased from mean 25% to 27%, the highest rates registered in those 70 years or older. Conclusions Overall increase trends in PC incidence and lethality were observed. Pancreatic cancer remains an urban disease in Brazil, the highest incidence found in the most developed regions as in large metropolitan integrated municipalities. Improvement in diagnosis, notification quality, a rapidly aging population, and a great demographic dynamism could in part explain this fact.

Insatisfação com o peso e a massa corporal em estudantes do ensino fundamental e médio do sexo feminino no município do Rio de Janeiro

The aim of this study was to verify the prevalence of body dissatisfaction among adolescent girls in the city of Rio de Janeiro. 2,149 female students aged between 14 and 18 years were investigated. Informed and desired weights, heights and the body mass index (BMI) were also investigated. The body dissatisfaction was addressed in two ways: a) by the desire to change the BMI and b) the desire to change the weight (in kg) over 10% of body informed. Of the total, 93.58% expressed a desire to modify their BMI. We also observed that 42.48% reported dissatisfaction with the weight. Therefore, it was possible to conclude that female students showed a tendency to be dissatisfied with their body weight.

Insatisfacción com el peso y masa corporal entre los estudiantes de la escuela primaria y secundaria del sexo femenino em la ciudad de Rio de Janeiro

The aim of this study was to verify the prevalence of body dissatisfaction among adolescent girls in the city of Rio de Janeiro. 2,149 female students aged between 14 and 18 years were investigated. Informed and desired weights, heights and the body mass index (BMI) were also investigated. The body dissatisfaction was addressed in two ways: a) by the desire to change the BMI and b) the desire to change the weight (in kg) over 10% of body informed. Of the total, 93.58% expressed a desire to modify their BMI. We also observed that 42.48% reported dissatisfaction with the weight. Therefore, it was possible to conclude that female students showed a tendency to be dissatisfied with their body weight.