Resumo: Este artigo tem o objetivo de discutir a construção da gravidez na adolescência enquanto um problema social. Visa também apresentar e analisar os dados da etapa qualitativa da pesquisa Gravidez naEste artigo é resultado das discussões coletivas dos dados qualitativos da pesquisa GRAVAD por todos os seus participantes. Por isto que, pouco usual na área da Antropologia, sua autoria é creditada a todos eles.
BackgroundThe global burden of diabetes mellitus and other chronic diseases is high, and 80% of those with diabetes now live in low and middle income countries. Yet, little information is available regarding prevalence of diabetes and intermediate hyperglycemia in these countries, especially when a full range of diagnostic tests is employed. The purpose of this study is to provide a full accounting of these prevalences in a large, free-living Brazilian population.MethodsWe report baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 civil servants aged 35-74 years. Diabetes mellitus was ascertained by self-report of diagnosis, medication use, fasting glucose, an oral glucose tolerance test, and/or glycated hemoglobin. Cut-offs for diabetes and intermediate hyperglycemia followed the recommendations of the World Health Organization and the American Diabetes Association. Adjusted prevalences were estimated through logistic regression.FindingsWith this full accounting, 19.7% (19.0%-20.3%) had diabetes mellitus, 50.4% being previously undiagnosed. Frequencies of intermediate hyperglycemia according to various criteria ranged from 16.1% to 52.6%. Diabetes or intermediate hyperglycemia was present in 79.1% of participants when using the most comprehensive definitions. The burden was greatest in the elderly, the obese, non-whites, and those with less formal education (p < 0.001).InterpretationThat four of every five free-living individuals aged 35-74 years working in selected public institutions in six Brazilian state capitals presented either diabetes or intermediate hyperglycemia highlights the advanced stage of the obesity – diabetes epidemic in urban Brazil and indicates the need for urgent action.
Buscou-se avaliar a cobertura do teste Papanicolaou no Estado de Pernambuco, Brasil, nos três anos anteriores à pesquisa, entre mulheres de 18-69 anos, e identificar fatores associados à sua não-realização. Trata-se de um estudo transversal, de base populacional, utilizando-se dados de inquérito realizado no período 2005-2006 com 640 indivíduos, selecionados por amostragem por conglomerados em três estágios de seleção. Foram analisadas informações sobre 258 mulheres. A cobertura do Papanicolaou entre mulheres de 18-69 anos foi de 58,7% e de 25-59 anos de 66,2%. Viver sem companheiro, não ter dado à luz e não ter realizado consulta médica no último ano mostraram associação com a não-realização do teste. Na análise multivariada, o baixo grau de escolaridade mostrou também efeito significativo. A cobertura do Papani-colaou em Pernambuco foi satisfatória, porém insuficiente para impactar no perfil epidemiológico do câncer do colo uterino. É preciso fortalecer e qualificar as ações de promoção da saúde, visando reduzir as desigualdades e estimular o protagonismo das mulheres nas ações de prevenção do câncer do colo uterino.
The differences in health between men and women have been object of great interest, but interpretations tend to be naturalized and essentialists. Gender-oriented studies have criticized this literature and offered new analythical alternatives. The present study was intended to describe the profile and trends of scientific production on gender and health in Brazil. Data sources comprised the Research Groups Directory of Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Research Council), CAPES (Coordination for the Improvement of Higher Education Personnel) Thesis Bank, and four journals available in SciELO -Scientific Eletronic Library Online. Fifty-one groups with at least one line of research in the subject were identified, with regional and institutional concentrations. The results confirmed the marked growth of scientific production in this field as 98 master and 42 doctoral dissertations and 665 articles on gender and health were retrieved. Women authored 86.0% and 89.0% of doctoral and master dissertations respectively, and 70.5% of the articles. Most were published in the 2000s when diversification of the studied topics was also seen. The studied subjects can be divided into five subgroups: reproduction and contraception; gender and violence; sexuality and health with emphasis on STD/ AIDS; work and health, including domestic and night work; other emergent or less explored topics. There are major political, epistemological and methodological challenges for strengthening these advancements. The gender perspective offers possibilities for enlightment of theoretical dilemmas in public health. Furthermore, it can be added to other intellectual and political efforts towards understanding health and its determinants and fighting against inequalities and for social justice.
This paper provides a review of abortion studies produced in the field of public health inNas últimas três décadas, emergiu e se consolidou, no Brasil, um novo campo de produção científica articulando as temáticas de gênero, sexualidade e saúde reprodutiva 1 . Dentre os objetos que vêm sendo investigados nesse campo, o aborto tem sido estudado, reconhecendo-se sua importância como problema de saúde pública no país, buscando-se um diálogo com movimentos sociais nacionais e internacionais que incluem o tema como prioridade em suas agendas.O estudo sobre o aborto tem o potencial de articular questões centrais e relevantes ao campo da saúde reprodutiva, desde as relações de gêne-ro e os processos de decisão na esfera reprodutiva até a provisão de assistência e a garantia dos direitos sexuais e reprodutivos.Na última década, coletâneas publicadas no país sobre saúde reprodutiva incluem a discussão sobre o aborto 2,3 e publicações inteiras foram dedicadas ao tema 4,5,6 .Recente e ampla revisão sobre vinte anos de pesquisa acerca do aborto no país aponta que na saúde coletiva esta produção, comparativamente a outras áreas, é oriunda majoritariamente de pesquisas empíricas. Esse acervo conta com a participação autoral importante de pesquisadoras de disciplinas como medicina -particularmente da gineco-obstetrícia -e enfermagem, cuja garantia de sigilo profissional viabilizou a realização de estudos em contextos hospitalares da rede pública de saúde, superando os limites impostos pela ilegalidade da prática do aborto 6 . REVISÃO REVIEW Menezes G, Aquino EML S194 Cad. Saúde Pública, Rio de Janeiro,
The high proportion of clustering cardiovascular risk factors in Salvador, with or without hypertension, especially in the population with little schooling and in black individuals, suggests the need for broad social strategies to reduce social inequality, promote health, and facilitate the treatment of cardiovascular risk factors.
This article describes the development of the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) questionnaire. We fi rst address the selection of topics whose contents have to cover the knowledge available on the complex causal network of outcomes and allow comparability with similar studies. Then we deal with the "translation and adaptation of measurement instruments" including neighborhood environment rating scales, depression and anxiety disorder rating scale and a food frequency questionnaire and discuss criteria that guided "theme block sequencing". And fi nally we focus on the practical importance of "pretesting and pilot studies". The ELSA may provide an original contribution regarding factors that cause or aggravate the outcomes of interest in the Brazilian population, as well as protective factors. Good quality questionnaires are prerequisite to validity of study results. 5 Information from general objective questions (e.g., smoke/do not smoke) or questions on abstract concepts (e.g., job stress), collected using rating scales, can only be captured using a questionnaire as compared with assessments or measurements. A questionnaire can provide information on, for example, psychosocial aspects of childhood and adolescence or the respondent's perceived health. Understanding causal mechanisms of health outcomes as complex and comprehensive and determinants that are not closely related to the outcome of interest (e.g., parental education) have gained momentum in the investigation of chronic diseases. DESCRIPTORS:The questionnaire is a key component of the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). The relationships of its contents and results of assessments and measurements can substantially contribute to understanding factors that may cause, aggravate or protect against cardiovascular diseases and type 2 diabetes in the Brazilian context. Potential variability of results between the six ELSA investigation centers in different Brazilian regions may improve the original contribution of the study. Bearing in mind distinctive characteristics of the Brazilian scenario, we opted to focus on social determinants of health. Capturing the potential impact of some factors (e.g., socioeconomic status), social and racial inequalities and health-related living conditions on outcomes of interest over the course of life may make the difference between what is already known and what the ELSA fi ndings can add to scientifi c knowledge. 1
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