Aims:We performed the first large population-based study to evaluate lower urinary tract symptoms (LUTS) in Brazil. The study objective was to assess the prevalence and bother of LUTS in the population aged ≥40 years in five major cities of Brazil. Methods: This study was conducted as a telephone survey with assessment of LUTS using a standardized protocol, which included the International Prostate Symptom Score (IPSS) and, for overactive bladder (OAB), the OAB-V8 questionnaire. Participants were asked to rate how often they experienced individual LUTS and the degree of associated bother. Results: Of the 5184 participants, 53% were women, and the age group with most participants (34%) was 50-59 years. The prevalence of LUTS (symptoms occurring less than half the time or more) was 75%: 69% in men and 82% in women. There was a statistically significant association between the frequency and bother intensity of each symptom (P < 0.001). The prevalence of OAB was similar in men and women (25% and 24%, respectively). According to the IPSS questionnaire, moderate-tosevere symptoms were present in 21% of men and 24% of women. LUTS detrimentally affected quality of life in many individuals: 39% would be "mostly dissatisfied," "unhappy," or consider it "terrible" to spend the rest of their life with their urinary condition as it is currently. Conclusions: This was the first nationwide, population-based epidemiological study of LUTS to be performed in Brazil. LUTS are highly prevalent and often bothersome among men and women aged ≥40 years. K E Y W O R D SBrazil, lower urinary tract symptoms, men, prevalence, womenThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
OBJECTIVE:To identify discriminatory attitudes in two moments of the Brazilian HIV/AIDS epidemic, as well as the occurrence of possible changes. METHODS:The Intention of Discrimination Index was obtained by scoring 1 for discriminatory situations or 0, when the opposite was the case. Intention of discrimination ranges were established by means of the clustering technique, and made compatible between the 1998 and 2005 surveys. Mean comparisons, chi-square test and ordered logit adjusted regression models were used to verify association between the index and socio-demographic variables. RESULTS:Between the 1998 and 2005 surveys, there was a statistically signifi cant reduction in the proportion of people who answered "yes" to anti-HIV test's being mandatory in the following cases: admission for employment, before getting married, when joining the military service, drug users, foreigners entering the country, sex professionals, and for all the people. To have lower level of education, to be female, to live in the North/Northeast regions of Brazil, and to be aged over 45 years are factors associated with higher intention of discrimination level. CONCLUSIONS:The growth of intention of discrimination shows that information about ways of AIDS transmission and non-transmission still needs to be better planned and promoted, especially among populations that have lower level of education, live in the North/Northeast regions, are female and aged over 45 years.
Neste artigo se apresentam os principais resultados de levantamentos feitos em São Paulo e Belo Horizonte sobre as condições de trabalho e de saúde dos motoristas do transporte de passageiros. Constataram-se condições de trabalho bastante desfavoráveis e estabeleceram-se associações estatísticas entre essas condições e sérios sintomas de morbidade declarados pelos motoristas. Sugere-se a necessidade de políticas públicas para o setor.
Sexual behavior and practices among men and women, Brazil 1998 and 2005ABSTRACT OBJECTIVE: To compare basic findings from two studies on sexual behavior and practices among women and men and their associations with sociodemographic characteristics of this population. METHODS:Data analyzed were obtained by a questionnaire applied to a probabilistic sample comprised of 3,423 people in 1998, and 5,040 people in 2005, all aged between 16 and 65 years, and living in urban areas of Brazil. Comparative analyses were performed by sex and year of research, and according to sociodemographic variables, using Pearson's chi-square test. RESULTS:The number of sexual partners in the year that preceded the interview decreased from 29.5% to 23.1% among men. Variability in sexual behavior and practices according to age, level of education, marital status, religion and place of residence, in addition to specifi c characteristics based on sex, was observed. There was also an increase in the proportion of women who began their sexual life in the 16-to-19-year age group and had completed up to elementary school, or lived in Southern Brazil. Moreover, it was observed an increase of sexual activity reported by women in the last year, and a decrease among men over 55 years of age, Protestant/Pentecostal, or separated/widowed. The proportion of men with more than one sexual partner in the last year decreased among those aged between 25 and 44 years or who have completed up to high-school. There was an increase in oral sex practice reported by women who are over 35 years of age or live in Northern/ Northeastern Brazil. CONCLUSIONS:Comparative analysis from 1998 to 2005 suggested a tendency towards differences between women and men decreasing. This probably results from a pattern of change characterized by an increase in the frequency of female behavior investigated and a decrease in the frequency of male behavior.
IntroduçãoNo Brasil, o tema da sexualidade está presente, ainda que de forma periférica, no campo da saúde coletiva e dos estudos de população há pelo menos três décadas nos debates em torno das políticas e dos programas de controle da fecundidade. É nos anos 1980 que se criam as condições históricas, políticas e culturais para a sua constituição como campo temático ligado às questões de saúde reprodutiva das mulheres 1 . Com a emergência da epidemia de AIDS, observa-se uma crescente preocupação com a sexualidade, particularmente questões referentes à homossexualidade masculina. O tema da homossexualidade feminina e sua relação com a saúde mantiveram-se marginais a todo esse processo.Os estudos existentes a esse respeito concentram-se majoritariamente nos Estados Unidos e apontam para a existência de vários fatores associados a diferentes problemas de saú-de, tais como câncer de mama e de colo de úte-ro, menor utilização de serviços de saúde, uso abusivo de álcool, uso de drogas ilícitas, tabagismo e níveis elevados de sofrimento psíqui-co, com estabelecimento de consenso apenas para um número exíguo de questões 2,3 .Remanescem incertezas no campo constituído por uma diversidade de estudos que, algumas vezes, apresentam fragilidades metodológicas, problemas nas definições conceituais
AimsTo report on the impact of lower urinary tract symptoms (LUTS) on treatment‐related behaviors and quality of life in Brazilian adults greater than or equal to 40 years.MethodsData were from a computer‐assisted telephone survey conducted in Brazil between 1 September and 31 December 2015 (Brazil LUTS study). Participants were adults greater than or equal to 40 years with landlines living in major cities from five geographical regions in Brazil. Participants rated how often they experienced individual LUTS during the previous month and associated bother, and the impact on quality of life (QoL), treatment seeking, treatment, treatment satisfaction, and treatment discontinuation. Multiple logistic regression models were adjusted to analyze the simultaneous effects of predictor variables on each dependent variable.ResultsWhen the presence of LUTS was defined as symptoms occurring less than half the time or more, one‐quarter of respondents sought treatment but 6% fewer actually received treatment. Of these, around 25% reported dissatisfaction with treatment and almost 10% reported treatment discontinuation. The occurrence of some symptoms and, in particular, the resultant bother were significantly related to worse QoL and to treatment‐related outcomes, such as treatment seeking, actual treatment, treatment dissatisfaction, and treatment discontinuation. Symptoms of all three categories were associated with all these domains for both sexes.ConclusionsThis is the first population‐based study carried out in South America showing that treatment seeking and treatment rates for LUTS are low. Since the LUTS prevalence is high, this reinforces the importance of a comprehensive medical assessment, focusing on the resulting bother, for more appropriate and personalized patient management.
Objective: To evaluate the effect of individual lower urinary tract symptoms (LUTS) and LUTS-specific bother on daily/leisure activities, work productivity and treatment behaviors and satisfaction in a Brazilian population reporting symptoms of the overactive bladder (OAB) syndrome. Methods: Secondary analysis of Brazil LUTS study data, including individuals 40 years old with a possible diagnosis of OAB, based on a score of 8 on the OAB-V8 questionnaire. Participants used a 5-point Likert scale to rate occurrence of LUTS during the previous month. Regression models were constructed to analyze association of symptom frequency and bother, controlled for demographics, comorbid conditions, habits and body mass index, to outcomes related to people's lives and treatment patterns. Results: This analysis included 5184 individuals (53% female), 24.4% of whom received a possible diagnosis of OAB. There was a greater likelihood of OAB symptoms in men reporting depression/anxiety (2.0 times), diabetes (1.8 times), or constipation (1.9 times) and women reporting depression/anxiety (2.6 times), constipation (1.7 times), and being overweight (1.4 times) or obese (1.8 times). Symptoms of all categories, including voiding, storage, and post-micturition, were associated with a negative impact on individuals' lives, quality of life and treatment-related outcomes. Treatment seeking for OAB was low among men and women overall (35.1 and 43.6%, respectively), with highest rates among individuals in the 60-69 age group. Conclusions: LUTS of all categories impacted all domains studied. These results highlight the importance of comprehensive LUTS assessment in OAB patients, including voiding, storage and post-micturition symptoms.
Resumo: A contracepção é fundamental para que as mulheres possam regular sua fecundidade, exercendo uma das dimensões dos direitos reprodutivos. No entanto, desconhecemos como elas enfrentam esse desafio na maior cidade do Brasil, São Paulo. Para preencher essa lacuna, o inquérito populacional Ouvindo Mulheres: Contracepção no Município de São Paulo foi realizado junto a uma amostra probabilística de 4 mil mulheres com 15 a 44 anos de idade, residentes nessa cidade, em 2015. Neste artigo, apresenta-se a prevalência da prática contraceptiva, analisam-se os fatores associados ao não uso de contracepção e aos tipos de contraceptivos em uso. A prevalência da anticoncepção foi estimada para mulheres com, pelo menos, uma relação heterossexual nos 12 meses anteriores à entrevista e que não estavam grávidas. Regressão logística foi utilizada para verificar fatores associados ao não uso de contracepção, e o modelo CHAID, para identificar associações aos tipos de contraceptivo em uso. A prevalência da anticoncepção foi 84,8% (IC95%: 83,2-86,3). Os contraceptivos mais prevalentes foram pílula e preservativo masculino. Associaram-se ao não uso de anticoncepção, religião (Pentecostal), número de filhos (menos do que 3), não ter usado contraceptivo na primeira relação sexual, não ter parceiro e não ter tido relação sexual no mês anterior. O número de filhos tidos e a idade da mulher foram os dois primeiros níveis de discriminação dos tipos de contraceptivo utilizados. A prevalência da anticoncepção é alta, mas mantém-se a concentração em dois métodos: anteriormente, laqueadura e pílula, agora, pílula e preservativo masculino. É necessário incorporar novos contraceptivos hormonais no Sistema Único de Saúde (SUS) e promover o uso de métodos de longa duração como o DIU.
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