Abstract This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan–Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3–5.8; P < 0.001), neurological diseases (HR 3.9; 95% CI 1.9–7.8; P < 0.001), pneumopathies (HR 2.6; 95% CI 1.4–4.7; P < 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4–14.5; P < 0.001). In conclusion, mortality by COVID-19 in Ceará is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.

RESUMENEn el estudio se investigó los conflictos vivenciados por las adolescentes al descubrir su embarazo. Esta investigación descriptiva realizada con 12 adolescentes embarazadas se llevó a cabo en Jucás-Ceará. Los hallazgos fueron analizados después del agrupamiento en categorías temáticas que emergieron de los discursos de las entrevistadas al responder a la pregunta: Cómo has vivenciado el embarazo en la adolescencia? Se verificó que el embarazo era visto como un problema indeseado y que las adolescentes tenían miedo de compartir su descubrimiento con la familia o el compañero. Fueron observadas reacciones de los padres o responsables y el bajo nivel socioeconómico como determinantes de la no aceptación de la gestación. Se concluyó que el embarazo en la adolescencia se constituye en un problema de Salud Pú-blica, que debe ser visualizado ampliamente, percibiéndose a la adolescente y sus problemas cotidianos. DESCRIPTORESEmbarazo en adolescencia. Conducta del adolescente. Salud pública. ABSTRACTThis descriptive research with 12 pregnant teenagers was conducted in Jucás, State of Ceará. The findings were analyzed after being grouped in the thematic categories that emerged from the interviews carried out with the young women, who were asked to answer the question: How have you been experiencing pregnancy in adolescence?It was verified that pregnancy was seen as an undesired problem and that the pregnant teenagers were afraid to share their state with their family or partner. It was observed that the reaction from parents or legal guardians and the low socio-economic level were determinant for the non-acceptance of pregnancy. It was concluded that pregnancy in adolescence is an issue that belong to the realm of Public Health, and that it must be seen as part of a wider picture, in which the adolescents and their daily problems need to be considered. KEY WORDS

Empowerment is a process whereby people achieve mastery over their lives, acquiring knowledge to make decisions about their health. Chronic diseases are increasingly common in the health service, requiring the attention of health professionals and empowering those affected by them. The scope of this study was to analyze the perceptions of users with chronic diseases and monitored by the Family Health Program with respect to empowerment. This was a qualitative study in which open interviews and systematic observations were conducted and NVIVO software was used for data analysis. Users indicate the existence of some geographical barriers in access to health, which caused fatigue, discouragement and low continuity of care. It was noted that adherence and practices of care were linked to differentiated service, based on trust and respect for the wishes of users. This includes healthcare guidance and education as key elements to encourage the practice of self-care. It is necessary to restructure the conduct of health professionals involved in the Family Health Strategy because its function is to promote health in a logical intersectoral and interdisciplinary manner.

Objective:To develop and validate an educational technology focused on prevention of metabolic syndrome among adolescents. Methods:This was methodological research. Using an integrative review, the available publications on the subject were analyzed. Then, this knowledge was used to describe the theoretical content and, with the help of a graphic designer, the art and layout of the pages were developed. In the third phase, the booklet was evaluated and validated by 21 specialists and 39 adolescents. Data collection included three different questionnaires, according to the focus of evaluation of each group of participants, analyzed for reliability (Cronbach’s Alpha) and agreement by Infraclass Correlation Coefficient. Results:The mean score attributed by technical content experts was 91.7%, and the content validity index, measured by experts responses, was 0.98, showing high reliability and agreement. In addition, the level of agreement of the positive responses given by adolescents was 88.4%. Conclusion:the educational booklet has proved to be a valid and reliable tool to be used for promoting adolescent health.

Objective: To analyze the association between the presence of stress in nursing students and sociodemographic and academic vulnerabilities. Methods: Analytical research conducted with 455 nursing students, whose data were obtained by means of a questionnaire to identify sociodemographic and academic vulnerabilities, and by the Lipp's Stress Symptoms Inventory. The association between variables was tested by Pearson's chi-square (p <0.05), the strength of this association by odds ratio, and logistic regression (backward method) was used to fit the model. Results: Among all students, 64% presented stress with the following associated factors: sex (p <0.010), age group (p <0.029), marital status (p <0.001), children (p <0.001), occupational status (p <0.001), cost of education (p <0.009) and current study period (p <0.001). In the final model these factors remained: sex, marital status and current study period. Conclusion: Women, students with partners, and those in the senior year of college were more likely to present stress. ResumoObjetivo: Analisar a associação entre a presença de estresse em estudantes de enfermagem e vulnerabilidades sociodemográficas e acadêmicas. Métodos: Pesquisa analítica, realizada com 455 acadêmicos de Enfermagem cujos dados foram obtidos por meio de um questionário para identificar vulnerabilidades sociodemográficas e acadêmicas e pelo Inventário de Sintomas de Stress de Lipp. A associação entre as variáveis foi testada pelo qui-quadrado de Pearson (p<0,05), a força dessa associação pela razão de chance, sendo a regressão logística (método backward) utilizada para ajuste do modelo. Resultados: Do total de discentes, 64% apresentou estresse, tendo como fatores associados: sexo (p<0,010), faixa etária (p<0,029), situação conjugal (p<0,001), presença de filhos (p<0,001), situação ocupacional (p<0,001), custeio dos estudos (p<0,009) e ano em curso (p<0,001), permanecendo no modelo final: sexo, situação conjugal e ano em curso. Conclusão: As mulheres, os estudantes com companheiro e aqueles no último ano da faculdade tiveram maiores chances de apresentar estresse.

IntroduçãoA hipertensão arterial é considerada um dos fatores de risco mais importantes para o desenvolvimento de doenças cardiovasculares e sofre influência multifatorial, com destaque para o estilo de vida 1 .Conforme se indica, concomitante à terapêu-tica para o controle da hipertensão arterial, os indivíduos devem adotar um estilo de vida saudável, eliminando hábitos que constituam fatores de risco para a doença. Entretanto, no acompanhamento à saúde dos pacientes, segundo se observa, é grande a dificuldade para a aquisição de hábitos saudáveis, pois a tomada de decisão com vistas à superação de hábitos nocivos à saú-de, apesar de necessária, constitui uma decisão pessoal.Diante dessas polêmicas, é cada vez mais freqüente o interesse pelo assunto e a produção de pesquisas sobre avaliações de qualidade. A expressão qualidade de vida pode indicar diferentes aspectos do cotidiano do indivíduo ou de grupos específicos.De acordo com a definição da Organização Mundial da Saúde (OMS), qualidade de vida é a percepção do indivíduo sobre sua posição na vida, considerada no contexto da cultura e dos valores nos quais vive e elabora seus objetivos, expectativas, padrões e preocupações 2,3 . Dessa forma, a percepção que o paciente possui da doença influenciará na sua qualidade de vida, NOTE RESEARCH NOTE

Objetivou-se com este estudo identificar os fatores de risco e a complicações associadas em usuários com hipertensão/diabetes, cadastrados no HIPERDIA da Secretaria Executiva Regional VI em Fortaleza, CE. O estudo documental analítico abordou 2.691 pessoas. Do total, 73,6% eram mulheres; 44,6% tinham 60-79 anos, com média de 60,8 anos; 87,4% eram brancos, amarelos ou pardos; 63,7% tinham até oito anos de estudo; 79,7% não eram fumantes; 56,6% sedentários; 59,6% apresentavam sobrepeso/obesidade; 48,4% possuíam antecedente familiar de doença cardiovascular. Verificou-se associação entre sedentarismo e sobrepeso/obesidade com diabéticos e diabéticos hipertensos; antecedente familiar de doença cardiovascular com os hipertensos e diabéticos hipertensos; acidente vascular encefálico, doença arterial coronariana e insuficiência renal crônica com hipertensos e diabéticos hipertensos; infarto e acidente vascular encefálico com diabéticos. O antecedente familiar cardiovascular associou-se com doença arterial coronariana e infarto. Evidenciou-se a presença relevante de fatores de risco e complicações, destacando a necessidade da educação em saúde com os usuários.

OBJECTIVE To verify the effects of antihypertensive treatment (pharmacological and non-pharmacological) on the health-related quality of life of individuals with hypertension.METHODS We conducted a systematic review with meta-analysis using the following databases: IBECS, LILACS, SciELO, Medline, Cochrane, Science Direct, Scopus and the Brazilian Capes Theses and Dissertations Database. The statistical analysis was performed using Review Manager, version 5.2. The average difference was used for the summarization of meta-analytic effect by the fixed-effect model. Twenty studies were included.RESULTS The summarization of the effect showed an average increase of 2.45 points (95%CI 1.02–3.87; p < 0.0008) in the quality of life of individuals adhering to non-pharmacological treatment for arterial hypertension. Adherence to pharmacological treatment indicated an average increase of 9.24 points (95%CI 8.16–10.33; p < 0.00001) in the quality of life of individuals with arterial hypertension.CONCLUSIONS Non-pharmacological treatment improves the overall quality of life and physical domain of people with arterial hypertension. Adherence to pharmacological treatment has a positive impact on the mental and physical domains of patients, as it did on the overall quality of life score.