RESUMO
Teachers' voices and psychological symptoms are the main reasons for absence from work. The objectives of this study were: (i) to spatially represent, through a webGIS, the standardized rates of teachers' absences due to voice (outcome 1) and psychological symptoms (outcome 2) in each Brazilian Federative Unit (FU = 26 states plus Federal District) and (ii) to analyze the relationship between each national outcome rate and the Social Vulnerability Index (SVI) of the municipality where urban schools are located, adjusted for sex, age, and working conditions. This cross-sectional study comprised 4979 randomly sampled teachers working in basic education urban schools, of which 83.3% are women. The national absence rates were 17.25% for voice symptoms and 14.93% for psychological symptoms. The rates, SVI, and school locations in the 27 FUs are dynamically visualized in webGIS. The multilevel multivariate logistic regression model showed a positive association between voice outcome and high/very high SVI (OR = 1.05 [1.03; 1.07]), whereas psychological symptoms were negatively associated with high/very high SVI (OR = 0.86 [0.85 0.88]) and positively associated with intermediate SVI (OR = 1.15 [1.13; 1.16]), in contrast with low/very low SVI. Being a woman (voice: OR = 1.36 [1.35; 1.38]; psychological: 1.22 [1.21; 1.24]) and working in schools with various precarious conditions (17 variables) increased the odds of being absent due to voice and psychological symptoms. The results confirm the need for investments to improve working conditions in schools.
Assuntos
Doenças Profissionais , Distúrbios da Voz , Humanos , Feminino , Masculino , Brasil , Estudos Transversais , Vulnerabilidade Social , Análise Multinível , Instituições Acadêmicas , Doenças Profissionais/diagnóstico , Professores EscolaresRESUMO
OBJECTIVE: To compare body composition between women with premature ovarian insufficiency (POI) using hormone therapy and controls with normal ovarian function, and to correlate body composition with cardiovascular risk markers in the POI group. PATIENTS AND DESIGN: A case-control study of 70 women with POI matched by age and body mass index with 70 controls. MEASUREMENTS: All were submitted to whole-body dual-energy X-ray absorptiometry (DXA) to analyse body composition. In the POI group, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, triglycerides, glucose, insulin, transaminases and C-reactive protein levels were measured, as well as the thickness of the carotid artery intima-media complex. RESULTS: Total mass, fat mass, lean mass (total, percentage and index) and the android/gynoid (A/G) ratio were similar in both groups; however, bone mineral content was lower (P < .001) in the POI group. Lean and fat mass indexes were 14.19 ± 1.63 and 11.04 ± 3.58, respectively, and the percentage of gynoid to android fat was higher (51.17 ± 6.71% versus 47.74 ± 9.19%; A/G ratio = 0.93 ± 0.15) in the POI group. In addition, the increase in total mass correlated positively with glucose and ALT levels and negatively with HDL-cholesterol. Increased A/G ratio was the measurement most frequently associated with cardiovascular risk markers. CONCLUSION: The body composition of women with POI using hormone therapy is similar to that of women with normal ovarian function with regard to lean and fat mass content and fat distribution. In women with POI, the higher the A/G ratio, the worse the cardiovascular risk markers.
Assuntos
Doenças Cardiovasculares , Absorciometria de Fóton , Composição Corporal , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Insulina , Fatores de RiscoRESUMO
Mental health indicators are essential for monitoring people's mental health status, developing mental health policies, and evaluating the performance of such policies. The aim of this paper is to describe the development of a web-based tool for mental health indicators capable to support the management of Brazilian mental health care networks. The SISAM is a web information system responsible for management and provision of mental health information in Brazil and it was chosen as the use case of this study. The indicators were developed as a decision support web tool for public health managers. The tool is able to calculate 11 indicators related to inpatient care. A descriptive analysis of all indicators is presented using SISAM data from 2017. The results generated by the tool are promising and could provide improvements on care monitoring, evaluation of possible trends and investments in prevention and promotion in mental health care.
Assuntos
Atenção à Saúde , Internet , Transtornos Mentais , Saúde Mental , Brasil , Política de Saúde , Indicadores Básicos de Saúde , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapiaRESUMO
BACKGROUND: Burns are a major public health concern, affecting mostly low- and middle-income countries. However, there is a lack of epidemiological studies on burns in these countries, particularly in Latin American countries. Our aim was to analyze nationwide demographic, epidemiological and economic characteristics of hospitalized burn patients in Brazil. METHODS: A retrospective study was conducted including inpatients admitted with a diagnosis of burns (ICD-10:T20-T31) from all hospitals in Brazil from 2000 to 2014. We calculated hospitalization and in-hospital mortality rates. Length of stay (LoS), charges and premature mortality were also assessed. RESULTS: A total of 412,541 burn hospitalizations were found, with a hospitalization rate of 14.56 hospitalizations/100,000 inhabitants/year. This rate is decreasing since 2003, mostly due to the reduction among children and elderly. Children below 5 years old accounted for 24% of all admissions. In-hospital mortality rate was 8.1% and median LoS was 5 days. Mean hospitalization charge was 856 international dollars. Substantial regional discrepancies were found in several indicators. CONCLUSION: In this first Latin American nationwide study of burn patients, a decreasing trend of hospitalization rate and a low charge contrasted with a high in-hospital mortality rate. This latter indicator, associated with a low LoS, may raise concerns regarding the quality of healthcare. Important discrepancies were found between regions, which may indicate important differences in regard to healthcare access and risk of burns. Targeting effective prevention, improving healthcare quality and providing more widespread and accurate burn registry are recommended.
Assuntos
Queimaduras/economia , Efeitos Psicossociais da Doença , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Queimaduras/epidemiologia , Queimaduras/mortalidade , Criança , Pré-Escolar , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Lactente , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adulto JovemRESUMO
Em entrevista ao jornalista Roberto D'avila, Carlos Chagas filho fala de sua vida, do seu trabalho científico, e de seu pai, Carlos Chagas, descobridor da doença de chagas.