Liana Wernersbach Pinto

Effects of non-nutritive sucking and oral stimulation on breastfeeding rates for preterm, low birth weight infants: a randomized clinical trial

OBJECTIVE To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight. METHODS Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding. RESULTS Fifty-nine infants (61.5%) were breastfeeding at the time of hospital discharge, 31 (36.9%) at 3 months, and only 18 (20.5%) at 6 months of corrected age. At discharge, 46.9% of the control group and 76.5% of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76%), 3 months (18 vs. 47%) and 6 months after discharge (10 vs. 27%). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). CONCLUSION Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.

Factors associated with physical aggression in pregnant women and adverse outcomes for the newborn.

OBJECTIVE To assess the socioeconomic, demographic, and reproductive factors associated with physical aggression during pregnancy, and the negative outcomes for the newborn in two groups of women: adolescents and young adults. METHOD Cross-sectional study with a sample of 8,961 mothers who were admitted to hospitals of the city of Rio de Janeiro during delivery. To test the hypothesis of homogeneity of proportions, the chi-squared test was used. Odds ratio and confidence intervals were estimated using logistic regression. RESULTS 5.0% of the adolescents and 2.5% of the young adult women suffered physical violence during pregnancy. In both groups, the variables associated with physical abuse were lower educational level, lower support from the childs father, and more attempts to interrupt the pregnancy. The increase in alcohol consumption was associated with physical abuse only in the group of adolescents; illicit drug use was only associated with physical abuse in young adults. The children of abused mothers had a two-fold increased chance of neonatal death, and a three-fold increased chance of post-neonatal death. Conversely, good quality prenatal care reduced the chance of physical aggression during pregnancy. CONCLUSIONS The results emphasize the increased chance of neonatal and post-neonatal mortality among children of victims of physical abuse during pregnancy, and indicate the importance of prenatal care to identify women at higher risk of suffering aggression, the appropriate time to provide measures of protection and care for mother and baby.

Tendência da mortalidade por suicídio na população brasileira e idosa, 1980-2006

OBJECTIVE To describe mortality from suicide in Brazil, with emphasis on the older adult population. METHODS Temporal analysis and trend analysis by polynomial regression were conducted on suicide in the population above 10 years old in Brazil and the State of Rio de Janeiro (Southeastern Brazil) from 1980-2006. The data were extracted from the Mortality Information System, and the rates calculated by gender and age per 100,000 inhabitants, considering the resident population provided by DATASUS. For the period between 1980 and 1995, the ninth revision of International Statistical Classification of Diseases and Related Health Problems was used, and for 1996 to 2006, the tenth revision. RESULTS Suicide rates significantly increased in Brazil and in Rio de Janeiro (respectively reaching 5.7 and 3.1 deaths per 100,000 inhabitants in 2006). The change was caused by the increase in suicides among the male population at all ages. The increase occurred especially among men over 60 years. In Rio de Janeiro, the increase was not statistically significant among men, while there was a decrease among women. The principal means utilized for suicide by men were hanging, suffocation, strangulation and firearms. For women, death by hanging also ranks first, followed by ingestion of solids or liquids, smoke or fire, and jumping from heights. The high rate of suicide by unspecified means reveals problems with data quality. CONCLUSIONS Suicides are important events in the male population, especially among older men over time. In Rio de Janeiro, the suicide rate is also higher in men, although the difference is not statistically significant. According to the World Health Organization and the Ministry of Health, suicide is preventable, and established interventions exist for each age group.OBJETIVO: Descrever a mortalidade por suicidio no Brasil, com destaque para a populacao idosa. METODOS: Analise temporal e estudo de tendencia por regressao polinomial de suicidios na populacao acima de dez anos no Brasil e no Estado do Rio de Janeiro de 1980 a 2006. Os dados foram extraidos do Sistema de Informacoes sobre Mortalidade e as taxas, calculadas segundo sexo e faixa etaria, considerando-se a populacao residente fornecida pelo Datasus por 100 mil habitantes. Para os anos de 1980 a 1995, utilizou-se a nona revisao da Classificacao Internacional de Doencas e Problemas Relacionados a Saude, e para 1996 a 2006, a decima revisao. RESULTADOS: Crescimento significativo foi observado nas taxas de suicidio na populacao brasileira e no Rio de Janeiro (5,7 e 3,1 para cada 100 mil habitantes, respectivamente) em 2006. Esse incremento ocorreu pelo aumento dos suicidios na populacao masculina em todas as idades. A curva crescente aconteceu principalmente entre homens maiores de 60 anos. O incremento nao foi estatisticamente significativo entre homens e houve decrescimo entre mulheres no Rio de Janeiro. Os principais meios de suicidio utilizados pelos homens foram enforcamento, sufocacao, estrangulamento e armas de fogo. Para as mulheres, o enforcamento tambem ocupou a primeira posicao, seguido pela ingestao de substâncias, atiramento ao fogo e precipitacao de altura. A elevada taxa de indefinicao dos meios ressaltou problemas na qualidade dos dados. CONCLUSOES: Suicidios sao eventos significantes na populacao masculina, sobretudo entre homens idosos, ao longo do tempo. No Rio de Janeiro, as taxas entre homens idosos tambem sao maiores, mas nao estatisticamente significantes. Segundo a Organizacao Mundial da Saude e o Ministerio da Saude, o suicidio e passivel de prevencao e existem cuidados preconizados para cada grupo etario.

Mortalidade por suicídio em pessoas com 60 anos ou mais nos municípios brasileiros no período de 1996 a 2007

The scope of this article was to assess the nationwide scale of suicides among the elderly. An overview of suicides in Brazilian municipalities was conducted to identify municipalities with the highest incidence of suicide. Data from the Mortality Information System (SIM/MS) were used for the period from 1996 to 2007, using the events with codes X60 through X84 and Y87.0 of the 10th review of the International Classification of Diseases (CID-10). The rates were standardized according to the criteria of the WHO. It was discovered that 3,039 Brazilian municipalities have records of suicide cases of people aged 60 and more in at least one of the triennia analyzed (54.6% of all the municipalities). A total of 29.3% of those municipalities were in the Southern Region, 29.6% in the Southeast and 27.5% in the Northeast. The State of Rio Grande do Sul has the highest percentage of municipalities with suicide cases in the four triennia (27.3%), followed by the States of Sao Paulo (17.4%) and Santa Catarina (9.1%). Between the first and the final triennium, it was observed that there was a reduction in 32 of the 51 municipalities with higher rates. The mean ratio of male/female deaths was 2.8 male deaths for every female death. The main method used is hanging, strangulation and suffocation among both men (58.2%) and women (49.8%).

Trends in suicide mortality among Brazilian adults and elderly, 1980 - 2006

OBJECTIVE To describe mortality from suicide in Brazil, with emphasis on the older adult population. METHODS Temporal analysis and trend analysis by polynomial regression were conducted on suicide in the population above 10 years old in Brazil and the State of Rio de Janeiro (Southeastern Brazil) from 1980-2006. The data were extracted from the Mortality Information System, and the rates calculated by gender and age per 100,000 inhabitants, considering the resident population provided by DATASUS. For the period between 1980 and 1995, the ninth revision of International Statistical Classification of Diseases and Related Health Problems was used, and for 1996 to 2006, the tenth revision. RESULTS Suicide rates significantly increased in Brazil and in Rio de Janeiro (respectively reaching 5.7 and 3.1 deaths per 100,000 inhabitants in 2006). The change was caused by the increase in suicides among the male population at all ages. The increase occurred especially among men over 60 years. In Rio de Janeiro, the increase was not statistically significant among men, while there was a decrease among women. The principal means utilized for suicide by men were hanging, suffocation, strangulation and firearms. For women, death by hanging also ranks first, followed by ingestion of solids or liquids, smoke or fire, and jumping from heights. The high rate of suicide by unspecified means reveals problems with data quality. CONCLUSIONS Suicides are important events in the male population, especially among older men over time. In Rio de Janeiro, the suicide rate is also higher in men, although the difference is not statistically significant. According to the World Health Organization and the Ministry of Health, suicide is preventable, and established interventions exist for each age group.OBJETIVO: Descrever a mortalidade por suicidio no Brasil, com destaque para a populacao idosa. METODOS: Analise temporal e estudo de tendencia por regressao polinomial de suicidios na populacao acima de dez anos no Brasil e no Estado do Rio de Janeiro de 1980 a 2006. Os dados foram extraidos do Sistema de Informacoes sobre Mortalidade e as taxas, calculadas segundo sexo e faixa etaria, considerando-se a populacao residente fornecida pelo Datasus por 100 mil habitantes. Para os anos de 1980 a 1995, utilizou-se a nona revisao da Classificacao Internacional de Doencas e Problemas Relacionados a Saude, e para 1996 a 2006, a decima revisao. RESULTADOS: Crescimento significativo foi observado nas taxas de suicidio na populacao brasileira e no Rio de Janeiro (5,7 e 3,1 para cada 100 mil habitantes, respectivamente) em 2006. Esse incremento ocorreu pelo aumento dos suicidios na populacao masculina em todas as idades. A curva crescente aconteceu principalmente entre homens maiores de 60 anos. O incremento nao foi estatisticamente significativo entre homens e houve decrescimo entre mulheres no Rio de Janeiro. Os principais meios de suicidio utilizados pelos homens foram enforcamento, sufocacao, estrangulamento e armas de fogo. Para as mulheres, o enforcamento tambem ocupou a primeira posicao, seguido pela ingestao de substâncias, atiramento ao fogo e precipitacao de altura. A elevada taxa de indefinicao dos meios ressaltou problemas na qualidade dos dados. CONCLUSOES: Suicidios sao eventos significantes na populacao masculina, sobretudo entre homens idosos, ao longo do tempo. No Rio de Janeiro, as taxas entre homens idosos tambem sao maiores, mas nao estatisticamente significantes. Segundo a Organizacao Mundial da Saude e o Ministerio da Saude, o suicidio e passivel de prevencao e existem cuidados preconizados para cada grupo etario.

Prevalência e fatores de risco da doença arterial periférica sintomática e assintomática em hospital terciário, Rio de Janeiro, Brasil

BACKGROUND: Peripheral arterial disease (PAD) is defined as an ankle-brachial index (ABI) 74 years (1.35:1). The prevalence of asymptomatic and symptomatic PAD was affected by smoking, hypertension, diabetes (both self-reported and confirmed), obesity, acute coronary heart disease and stroke (p < 0005). Mean ABI was lower in symptomatic PAD (0.57±0.17) (p < 0.005). CONCLUSION: ABI was able to detect PAD with variable degrees of severity, associated with risk factors, by identifying symptomatic and asymptomatic PAD patients at a tertiary center.

Fatores associados com a mortalidade por suicídio de idosos nos municípios brasileiros no período de 2005-2007

This scope of this paper was to conduct an ecological analysis of suicide mortality of people aged 60 years or more in Brazilian municipalities between 2005 and 2007, by investigating factors associated with the event. Data on suicide deaths were extracted from the Mortality Information System, codes X60 to X86 and Y87.0 (ICD-10). Poisson, negative binomial and zero-inflated negative binomial (ZINB) regression models were adjusted. The latter exhibited the best results when comparing models. The proportion of non-whites (negative association), the rate of hospitalization for mood disorders (positive association) and sex ratio (negative association) were identified as factors associated with suicide.

Sofrimento psíquico em policiais civis do Estado do Rio de Janeiro

The paper discusses the relationship between work and psychic suffering among police officers in the State of Rio de Janeiro. A questionnaire was filled out by these professionals in three separate studies: Capital Baixada Fluminense and Interior. The socio-demographic profile, quality of life, health and working conditions were investigated. Psychic suffering was measured by the SRQ-20. A logistic regression model was used to identify factors associated with psychic suffering. The results showed it to be associated with the following variables: level of satisfaction with the ability to react to difficult situations; performing the work for which the officers were trained; suffering some victimization; unit location; problems in the nervous system; and degree of satisfaction with life in general. Those who reported problems in the nervous system and victimization showed an OR of 7.25 and 3.08, respectively. The professionals who considered themselves dissatisfied or very dissatisfied with the ability to react to difficult situations and life in general showed an OR of 10.85 and 6.69, respectively, compared with those who considered themselves satisfied or very satisfied. Professionals from the Baixada showed an increased risk of psychic suffering compared to a reduced risk among those from the Interior.

Estudo descritivo das tentativas de suicídio na população idosa brasileira, 2000 – 2014

The study describes hospital admission rates for suicide attempts among the Brazilian elderly and discusses the weaknesses of data from information systems. Data were extracted from the Hospital Information System (HIS) and from the Violence and Injury Surveillance System (VIVA). The analyzes included: (1) temporal evolution of rates by age group (1-9; 10-19; 20-39; 40-59 and 60 or over) from 2000 to 2014 by region; (2) triennial hospital admission rates by sex for age groups 60-69, 70-79 and 80 or over by region and state; (3) hospital admission rates for the elderly from the two information systems. Temporal evolution showed higher rates in the north and lower ones in the northeast. The analysis by age group and sex showed higher rates for older men of the three investigated age groups. The comparison of rates obtained from the two information systems showed a gradual increase in rates from VIVA. After 2012, rates obtained from VIVA were higher in the Southeast, South and Midwest regions. The study highlights the need for further improvement of information on hospital morbidity and data from compulsory notification of violence.The study describes hospital admission rates for suicide attempts among the Brazilian elderly and discusses the weaknesses of data from information systems. Data were extracted from the Hospital Information System (HIS) and from the Violence and Injury Surveillance System (VIVA). The analyzes included: (1) temporal evolution of rates by age group (1-9; 10-19; 20-39; 40-59 and 60 or over) from 2000 to 2014 by region; (2) triennial hospital admission rates by sex for age groups 60-69, 70-79 and 80 or over by region and state; (3) hospital admission rates for the elderly from the two information systems. Temporal evolution showed higher rates in the north and lower ones in the northeast. The analysis by age group and sex showed higher rates for older men of the three investigated age groups. The comparison of rates obtained from the two information systems showed a gradual increase in rates from VIVA. After 2012, rates obtained from VIVA were higher in the Southeast, South and Midwest regions. The study highlights the need for further improvement of information on hospital morbidity and data from compulsory notification of violence.

Spatial study of homicide rates in the state of Bahia, Brazil, 1996-2010

OBJECTIVE To analyze the spatial distribution of homicide mortality in the state of Bahia, Northeastern Brazil. METHODS Ecological study of the 15 to 39-year old male population in the state of Bahia in the period 1996-2010. Data from the Mortality Information System, relating to homicide (X85-Y09) and population estimates from the Brazilian Institute of Geography and Statistics were used. The existence of spatial correlation, the presence of clusters and critical areas of the event studied were analyzed using Moran’s I Global and Local indices. RESULTS A non-random spatial pattern was observed in the distribution of rates, as was the presence of three clusters, the first in the north health district, the second in the eastern region, and the third cluster included townships in the south and the far south of Bahia. CONCLUSIONS The homicide mortality in the three different critical areas requires further studies that consider the socioeconomic, cultural and environmental characteristics in order to guide specific preventive and interventionist practices.