BackgroundThe menopause is associated with a tendency to gain weight. Several alterations in fat deposits occur, leading to changes in the distribution of body fat. There are strong indications that, in middle age, obesity is associated with increased mortality. This study set out to determine the factors associated with the prevalence of overweight and abdominal obesity in postmenopausal women in a population-based study in Brazil.MethodsThe sample included 456 women, aged 45–69 years, residing in the urban area of Maringa, Parana. Systematic sampling, with a probability proportional to the size of the census sector, was performed. Behavioral, economic, and sociodemographic data were collected, and body mass index (BMI) and waist circumference (WC) were determined.ResultsAccording to BMI criteria (≥25.0 kg/m2), 72.6% of the women were overweight, and according to WC (≥88 cm), 63.6% had abdominal obesity. Based on logistic regression analysis, the factors that were most closely associated with overweight were: having three or more children (odds ratio (OR): 1.78; 95% confidence interval (CI): 1.06–3.00); and not taking hormone replacement therapy (OR: 1.69; 95% CI: 1.06–2.63). The prevalence of abdominal obesity was positively associated with greater parity (OR: 1.34, 95% CI: 1.05–1.72) and age older than 65 years (OR: 1.50; 95% CI: 1.03–2.19).ConclusionsThis study found that the prevalences of overweight and abdominal obesity were higher for postmenopausal women who had three or more children. Age over 65 years was also a risk factor for abdominal obesity and no use of hormonal replacement therapy was a risk factor for overweight.

RESUMOEstudo com abordagem qualitativa que objetivou compreender, a partir da perspectiva do paciente adulto, a experiência de se vivenciar uma internação em Unidade de Terapia Intensiva (UTI), de modo a contribuir para melhoria na qualidade da assistência e facilitar a adaptação em um ambiente tão estigmatizado. Os dados foram coletados na UTI de um hospital do sudoeste de São Paulo, Brasil. Foram entrevistados dez pacientes, e identificadas temáticas relacionadas à percepção prévia da UTI; diferenciação com a assistência nos setores de internamento; tecnologia e assistência especializada; alterações ambientais e de hábitos em UTI. Inicialmente, os informantes relacionavam a UTI com a terminalidade e passaram a retratar o setor como local para o tratamento e recuperação, passando a ter uma visão positiva do ambiente de terapia intensiva.Descritores: Unidades de terapia intensiva. Hospitalização. Pacientes internados. Conhecimento. RESUMEN Estudio cualitativo tuvo como objetivo entender, desde la perspectiva de un paciente adulto, la experiencia de experimentar una estancia en Unidad de Cuidados Intensivos (UCI), contribuyendo así para mejorar la calidad de la atención y facilitar la adaptación en un entorno tan estigmatizada. Los datos fueron recolectados en una UCI de un hospital del suroeste de São Paulo, Brasil. Fueron entrevistados diez pacientes y se identificaron las cuestiones relacionadas con la percepción anterior de la UCI, la diferenciación con la asistencia en las zonas de reubicación, la tecnología y la asistencia de expertos, y los cambios ambientales de los hábitos en la UCI. Inicialmente, los informantes relacionados con la UCI con los enfermos terminales y empezó a retratar a la industria como un lugar para el tratamiento y recuperación, de tal modo que tiene una visión positiva del entorno de cuidados intensivos. Descriptores

ResumoOBJETIVO: Analisar os sintomas climatéricos e estado nutricional em mulheres na pós-menopausa, usuárias e não usuárias de terapia hormonal (TH). MÉTODOS: Estudo analítico, exploratório, tipo inquérito populacional domiciliar, realizado na área urbana do município de Maringá, Paraná, incluindo 456 mulheres com idade entre 45 e 69 anos, no período pós-menopausa. A coleta teve como base de referência os setores censitários urbanizados (368) do município, de acordo com o Censo Demográfico Brasileiro. Foi utilizada amostra aleatória simples proporcional às mulheres residentes em cada setor censitário e, por meio de visita domiciliar, aplicou-se um questionário e verificaramse as medidas antropométricas e pressão arterial. Para avaliação dos sintomas climatéricos, foi utilizado o Índice Menopausal de Blatt e Kupperman. A variável desfecho foi o uso de TH. RESULTADOS: A média de idade foi de 58,7 anos. O excesso de peso esteve presente em 72,6% das mulheres e a obesidade abdominal em 81,4% delas. Sintomas climatéricos de intensidade leve foram evidenciados em 69,5% das mulheres. Apenas 18,4% das mulheres faziam uso de TH e eram, na sua maioria, brancas, não fumantes, sem comorbidades e sem companheiro. Usuárias de TH apresentaram menor frequência de excesso de peso e obesidade abdominal e tiveram menor prevalência de sintomas climatéricos de intensidade severa. CONCLUSÃO: O excesso de peso e a obesidade abdominal foram prevalentes na amostra estudada. Embora em menor número, as usuárias de TH apresentaram uma frequência menor de excesso de peso e sintomas climatéricos leves e intensos na pós-menopausa. Abstract PURPOSE:To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69 years. Data collection was based on the urbanized census sector (368) of the municipality, according to the Brazilian Demographic Census. A simple random sample proportional to women residing in each census sector was used, and a questionnaire was applied during a home visit, when anthropometric measurements were performed and blood pressure was determined. The Blatt and Kupperman Menopausal Index was used for the evaluation of climacteric symptoms. The outcome variable was the use of hormone therapy. RESULTS: Mean subject age was 58.7 years. Overweight was present in 72.6% of the women and abdominal obesity in 81.4% of them. Mild climacteric symptoms were observed in 69.5% of the women. Only 18.4% of the women studied were using hormone therapy and they were white, non-smokers, had no comorbidities, and had a partner. Users of hormone therapy had a lower frequency of overweight and obesity and had a lower prevalence of severe climacteric symptoms. CONCLUSION: Overweight and obesity were prevalent in this sample. Although fewer in number, the hormone therapy users had a lower frequency of overweight an...

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Objective: To conduct a geospatial analysis of suicide deaths among young people in the state of Paraná , southern Brazil, and evaluate their association with socioeconomic and spatial determinants. Methods: Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics. Data on suicide mortality rates (SMR) were extracted for three age groups (15-19, 20-24, and 25-29 years) from two 5-year periods (1998-2002 and 2008-2012). Geospatial data were analyzed through exploratory spatial data analysis. We applied Bayesian networks algorithms to explore the network structure of the socioeconomic predictors of SMR. Results: We observed spatial dependency in SMR in both periods, revealing geospatial clusters of high SMR. Our results show that socioeconomic deprivation at the municipality level was an important determinant of suicide in the youth population in Paraná , and significantly influenced the formation of high-risk SMR clusters. Conclusion: While youth suicide is multifactorial, there are predictable geospatial and sociodemographic factors associated with high SMR among municipalities in Paraná. Suicide among youth aged 15-29 occurs in geographic clusters which are associated with socioeconomic deprivation. Rural settings with poor infrastructure and development also correlate with increased SMR clusters.

Background: To investigate the prevalence of and factors associated with performance of annual mammography by women above 40 years of age. Materials and Methods: This cross-sectional retrospective study was conducted at an oncology reference service in Southern Brazil from October 2013 to October 2014 with 525 women aged 40 years or older. Results: The prevalence of annual mammography was 54.1%; annual mammographic screening was performed for women without private medical insurance, who were under hormone replacement therapy and who had used contraception in the past. An association was found between non-performance of breast clinical and self-examination and non-performance of mammographic screening. Conclusions: Use of mammography for breast cancer screening in the public health care setting proved to be accessible; nevertheless, the proportion of screened women was low, and they exhibited poor adherence to the basic measures of care recommended for breast assessment. Thus, control of breast cancer requires implementing actions targeting the population most vulnerable to non-adherence to screening in addition to continuously monitoring and assessing that population to reduce the prevalence of this disease.

RESUMO Objetivo Caracterizar as tentativas de suicídio e suicídios ocorridos em um município do noroeste do Estado do Paraná, atendidos em serviço pré-hospitalar. Métodos Estudo descritivo, transversal, dos registros de atendimentos pré-hospitalares de 257 vítimas de tentativa de suicídio e suicídio, no período de 2005 a 2012, por meio de análise bidimensional por qui-quadrado. Resultados Ocorreram 180 tentativas de suicídio e 76 suicídios. A idade variou de 13 a 93 anos, com média de 33,5 ± 15,1 anos e maior prevalência na população jovem do sexo masculino. As ocorrências se concentraram nos meses da primavera e verão, na zona urbana. O uso de objeto cortante foi o método mais empregado, seguido por intoxicação e precipitação de locais elevados. Conclusão Conhecer características, métodos e fatores agravantes fornecem subsídios para implementação de medidas de prevenção.

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