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OBJECTIVE: To analyze the temporal and spatial distribution of polio vaccine coverage in Brazilian states. METHODS: An ecological time series study was conducted using data from the National Immunization Program Information System. The analyzed period was from 1997 to 2021. Joinpoint software was used to calculate the annual percentage change and average annual percentage change through regressions. QGIS 3.10.7 software was used to construct thematic maps. GeoDa 1.20.0.10 software was used to estimate spatial autocorrelation using the Global Moran's Index and Local Moran's Index. RESULTS: National vaccine coverage in 1997 was 89.27%, decreasing to 61.32% in 2021. The trend analysis indicated an average annual decrease of 1.5% in polio vaccine coverage in Brazil. Across the country, 17 states showed a statistically significant reduction in the average annual percentage change rate. The highest average reduction rates in vaccine coverage among Brazilian states were observed in Amapá (-3.7%; 95%CI -6.0; -1.4) and Pernambuco (-3.3%; 95%CI -4.0; -2.5). In the spatial analysis, in Moran Global, a positive autocorrelation was identified in the years 2012 to 2021 (p<0.02), with an index value of 0.361, which means that geographically close areas tended to have similar levels of vaccination coverage. CONCLUSION: There was significant heterogeneity in coverage among states and a strong decrease trend in vaccination rates, which could facilitate the circulation of the poliovirus and pose a threat to the susceptible population.

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Objetivo: avaliar a efetividade de atividade educativa on line sobre aleitamento materno (AM) para conhecimento cognitivo de agentes comunitários de saúde (ACS). Métodos: estudo quase-experimental, realizado com agentes comunitários de saúde. Aplicou-se, previamente, teste do conhecimento sobre aleitamento materno. Em seguida, os participantes foram submetidos à atividade educativa on-line teórica e prática. Posteriormente, foi aplicado o pós-teste. Resultados: a amostra foi constituída por 53 profissionais. A atividade se mostrou efetiva, pois foi capaz de melhorar o conhecimento cognitivo dos profissionais sobre o aleitamento materno. Houve estatística significativa nas variáveis sobre fisiologia (p<0,001) e benefícios da amamentação (p<0,003), posição para amamentar (p<0,002), intervalos entre as mamadas (p<0,001), intercorrências mamárias (p<0,001) e conservação do leite (p<0,005). Conclusão: a estratégia educativa on-line obteve efetividade na melhora do conhecimento cognitivo dos ACS sobre AM em todos os aspectos abordados. Destacam-se evidências estatísticas referentes à diferença entre o conhecimento cognitivo prévio e o conhecimento posterior à atividade educativa on-line nas variáveis sobre fisiologia e benefícios da amamentação, técnica de amamentação, intervalos entre as mamadas, intercorrências mamárias e conservação do leite.(AU)

Objective: to evaluate the efficacy of an online educational activity on breastfeeding (BF) for the cognitive knowledge of community health agents (CHAs). Methods: quasi-experimental study, carried out with community health agents. Previously, a knowledge test on breastfeeding was applied. Then, the participants were submitted to the theoretical and practical online educational activity. Subsequently, the post-test was applied. Results: the sample consisted of 53 professionals. The activity proved to be effective, as it was able to improve the professionals' cognitive knowledge about breastfeeding. There were significant statistics in the variables on physiology (p<0.001) and benefits of breastfeeding (p<0.003), breastfeeding position (p<0.002), intervals between feedings (p<0.001), breast complications (p<0.001) and conservation of milk (p<0.005). Conclusion: the online educational strategy was effective in improving the CHAs' cognitive knowledge about BF in all aspects addressed. Statistical evidence is highlighted regarding the difference between prior cognitive knowledge and knowledge after the online educational activity in the variables on physiology and benefits of breastfeeding, breastfeeding technique, intervals between feedings, breast complications and milk conservation.(AU)

Objetivo: evaluar la eficacia de una actividad educativa online sobre lactancia materna para el conocimiento cognitivo de los agentes de salud comunitarios. Métodos: estudio cuasi experimental, realizado con agentes de salud comunitarios. Previamente, se aplicó una prueba de conocimientos sobre lactancia materna, tras lo cual, los participantes fueron sometidos a una actividad educativa teórica y práctica en línea y, posteriormente, se aplicó una pos prueba. Resultados: la muestra estaba formada por 53 profesionales. La actividad demostró ser eficaz porque consiguió mejorar los conocimientos cognitivos de los profesionales sobre la lactancia materna. Hubo estadísticas significativas en las variables sobre fisiología (p<0,001) y beneficios de la lactancia (p<0,003), posición para amamantar (p<0,002), intervalos entre tomas (p<0,001), complicaciones mamarias (p<0,001) y conservación de la leche (p<0,005). Conclusiones: la estrategia educativa online fue eficaz para mejorar los conocimientos cognitivos de los TSC sobre LM en todos los aspectos abordados. Destacamos la evidencia estadística respecto a la diferencia entre los conocimientos cognitivos antes y después de la actividad educativa online en las variables sobre fisiología y beneficios de la lactancia materna, técnica de lactancia, intervalos entre tomas, complicaciones mamarias y conservación de la leche.(AU)

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ABSTRACT Objective: To analyze the temporal and spatial distribution of polio vaccine coverage in Brazilian states. Methods: An ecological time series study was conducted using data from the National Immunization Program Information System. The analyzed period was from 1997 to 2021. Joinpoint software was used to calculate the annual percentage change and average annual percentage change through regressions. QGIS 3.10.7 software was used to construct thematic maps. GeoDa 1.20.0.10 software was used to estimate spatial autocorrelation using the Global Moran's Index and Local Moran's Index. Results: National vaccine coverage in 1997 was 89.27%, decreasing to 61.32% in 2021. The trend analysis indicated an average annual decrease of 1.5% in polio vaccine coverage in Brazil. Across the country, 17 states showed a statistically significant reduction in the average annual percentage change rate. The highest average reduction rates in vaccine coverage among Brazilian states were observed in Amapá (−3.7%; 95%CI −6.0; −1.4) and Pernambuco (−3.3%; 95%CI −4.0; −2.5). In the spatial analysis, in Moran Global, a positive autocorrelation was identified in the years 2012 to 2021 (p<0.02), with an index value of 0.361, which means that geographically close areas tended to have similar levels of vaccination coverage. Conclusion: There was significant heterogeneity in coverage among states and a strong decrease trend in vaccination rates, which could facilitate the circulation of the poliovirus and pose a threat to the susceptible population.

RESUMO Objetivo: Analisar a distribuição temporal e espacial da cobertura da vacina contra poliomielite nos estados brasileiros. Métodos: Estudo ecológico de séries temporais, cuja fonte de dados foi o Sistema de Informação do Programa Nacional de Imunizações. O período analisado foi de 1997 a 2021. Utilizou-se o software Joinpoint para calcular a variação percentual anual e variação percentual anual média por meio de regressões. Para construção de mapas temáticos foi utilizado o software QGis 3.10.7. Para estimar a autocorrelação espacial com o Índice de Moran Global e Índice de Moran Local foi utilizado o software GeoDa 1.20.0.10. Resultados: A cobertura vacinal nacional em 1997 foi de 89,27%, passando para 61,32% em 2021. A análise de tendência apontou o decréscimo médio de 1,5% ao ano na cobertura da vacina contra poliomielite no Brasil. Em todo o país, 17 estados apresentaram redução estatisticamente significativa na taxa de variação percentual anual média. As maiores taxas médias de redução da cobertura vacinal entre os estados brasileiros foram observadas no Amapá (−3,7%; IC95% −6,0; −1,4) e em Pernambuco (−3,3%; IC95% −4,0; −2,5). Na análise espacial, no Moran Global, foi identificada autocorrelação positiva nos anos de 2012 a 2021 (p<0,02), com valor de índice de 0,361, o que significa que as áreas geograficamente próximas tenderam a ter níveis semelhantes de cobertura vacinal. Conclusão: Evidenciou-se expressiva heterogeneidade na cobertura entre os estados e forte tendência de queda dos índices, o que pode propiciar a circulação do poliovírus e colocar sob ameaça a população susceptível.

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OBJECTIVES: to identify cardiovascular risk and cardiovascular risk factors in adolescents and verify correlations between these variables and biochemical markers, and between blood pressure percentiles, Body Mass Index, and biochemical markers. METHODS: a cross-sectional study, conducted at a Brazilian school, from August to September 2019, including 205 participants who were interviewed. After the interview, anthropometric assessments, including weight, height, arm circumference, blood pressure checking, and blood collection for laboratory tests were performed. Descriptive and inferential analysis using the chi-square test was conducted. RESULTS: a total of 18.5% had blood pressure percentiles >95%, 25.4% were overweight, and 25.9% were at very high cardiovascular risk. Statistically significant associations were found between cardiovascular risk and sex, Body Mass Index and blood pressure percentiles, and between blood pressure percentiles and triglycerides. CONCLUSIONS: high prevalence of risk factors among school adolescents reinforces the need for interventions for cardiovascular risk reduction in this population.

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PURPOSE: to analyze accuracy measures of the clinical indicators of Readiness for enhanced health management in patients with arterial hypertension and/or diabetes mellitus METHODS: prospective diagnostic accuracy study conducted with 359 patients with hypertension and/or diabetes mellitus, followed up in primary healthcare. Stratified random sampling was used to recruit participants. An assessment form was applied with sociodemographic data, health conditions, and information related to the clinical indicators under investigation. Sensitivity, specificity, predictive values, and likelihood ratios were analyzed FINDINGS: the sample was composed of 359 participants. The prevalence of Readiness for enhanced health management was 93.8%. There was a statistically significant association between the diagnosis and age under 60 years (p < 0.001), having only one chronic condition (p < 0.001), having normal blood pressure (p = 0.017) and blood glucose (p = 0.013) values, and having a nonsedentary (p = 0.026) and nonalcoholic (p = 0.044) lifestyle. All clinical indicators had high predictive values in predicting the nursing diagnosis under investigation. The indicator expresses desire to enhance management of symptoms was the most sensitive (99.7%) and specific (100%). The indicator expresses desire to enhance management of prescribed regimens was also highly specific (100%) CONCLUSION: all clinical indicators were accurate in predicting Readiness for enhanced health management IMPLICATIONS FOR NURSING PRACTICE: knowing which clinical indicators and sociodemographic/clinical characteristics best predict Readiness for enhanced health management, nurses in primary care can better plan nursing interventions and direct their goals.

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ABSTRACT Objectives: to identify cardiovascular risk and cardiovascular risk factors in adolescents and verify correlations between these variables and biochemical markers, and between blood pressure percentiles, Body Mass Index, and biochemical markers. Methods: a cross-sectional study, conducted at a Brazilian school, from August to September 2019, including 205 participants who were interviewed. After the interview, anthropometric assessments, including weight, height, arm circumference, blood pressure checking, and blood collection for laboratory tests were performed. Descriptive and inferential analysis using the chi-square test was conducted. Results: a total of 18.5% had blood pressure percentiles >95%, 25.4% were overweight, and 25.9% were at very high cardiovascular risk. Statistically significant associations were found between cardiovascular risk and sex, Body Mass Index and blood pressure percentiles, and between blood pressure percentiles and triglycerides. Conclusions: high prevalence of risk factors among school adolescents reinforces the need for interventions for cardiovascular risk reduction in this population.

RESUMO Objetivos: identificar o risco cardiovascular e os fatores de risco cardiovascular em adolescentes e verificar correlações entre essas variáveis e marcadores bioquímicos, e entre percentis de pressão arterial, Índice de Massa Corporal e marcadores bioquímicos. Métodos: estudo transversal, realizado em escola brasileira, de agosto-setembro de 2019, incluindo 205 participantes que foram entrevistados. Após a entrevista, foram realizadas avaliações antropométricas, incluindo peso, altura, circunferência do braço, aferição da pressão arterial e coleta de sangue. Foi realizada análise descritiva e inferencial por meio do Teste do Qui-Quadrado. Resultados: 18,5% apresentavam percentis de pressão arterial>95%, 25,4% com sobrepeso e 25,9% com risco cardiovascular muito alto. Foram encontradas associações estatisticamente significativas entre risco cardiovascular e sexo, Índice de Massa Corporal e percentis de pressão arterial e entre percentis de pressão arterial e triglicérides. Conclusões: a alta prevalência de fatores de risco em adolescentes escolares reforça a necessidade de intervenções para redução do risco cardiovascular nessa população.

RESUMEN Objetivos: identificar riesgo cardiovascular y factores de riesgo cardiovascular en adolescentes y verificar las correlaciones entre estas variables y marcadores bioquímicos, y entre percentiles de presión arterial, Índice de Masa Corporal y marcadores bioquímicos. Métodos: estudio transversal, realizado en una escuela brasileña, de agosto a septiembre de 2019, que incluyó a 205 participantes que fueron entrevistados. Después de la entrevista, se realizaron evaluaciones antropométricas que incluyeron peso, talla, perímetro del brazo, medición de la presión arterial y extracción de sangre para pruebas de laboratorio. El análisis descriptivo e inferencial se realizó mediante la prueba de chi-cuadrado. Resultados: el 18,5% tenía percentiles de presión arterial>95%, el 25,4% tenía sobrepeso y el 25,9% tenía un riesgo cardiovascular muy alto.Se encontraron asociaciones estadísticamente significativas entre el riesgo cardiovascular y el sexo, el Índice de Masa Corporal y los percentiles de presión arterial, y entre los percentiles de presión arterial y los triglicéridos. Conclusiones: la alta prevalencia de factores de riesgo en estudiantes adolescentes refuerza la necesidad de intervenciones para reducir el riesgo cardiovascular en esta población.

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Objetivo: compreender os sentimentos maternos em relação ao cuidado com o filho dentro da unidade penal. Método: a pesquisa tem abordagem qualitativa. Participaram do estudo gestantes a partir do terceiro trimestre e mães que se encontravam com os filhos no berçário de uma unidade Penal em Aquiráz/Ceará, totalizando 17 participantes nos 9 encontros realizados. A coleta se deu entre junho e outubro de 2018. Foi usada a técnica de Desenho-Estória. A análise dos desenhos foi feita de forma individual com cada detenta e categorizada pelas pesquisadoras. O trabalho obteve aprovação do Comitê de Ética. Resultados: a atividade de Desenho-Estória possibilitou a compreensão do sentimento materno em relação aos cuidados com os filhos e, a partir disso, foi possível a definição de ações vistas como cuidado dentro da unidade. Conclusão: a partir da análise da vivência da maternidade na prisão, é possível a compreensão de sentimentos que perpassam o desenvolvimento do papel materno.

Objective: to understand mothers' feelings about caring for their children in prison. Method: the participants in this qualitative study were women in the seventh to ninth months of pregnancy, and mothers with children in the nursery, at a Prison Unit in Aquiráz, Ceará, totaling 17 participants in the 9 meetings held. Data were collected between June and October 2018 using the story-drawing technique. The drawings were analyzed individually with each prisoner and categorized by the researchers. The study had research ethics committee approval. Results: the story-drawing activity made it possible to understand how the mothers' felt about caring for their children and, from that, it was possible to specify measures seen as care inside the prison. Conclusion: from analysis of the experience of motherhood in prison, it is possible to comprehend the feelings running through the role of motherhood.

Objetivo: comprender los sentimientos maternos respecto al cuidado con el hijo dentro de una cárcel. Método: la investigación tiene enfoque cualitativo. Se analizaron mujeres a partir del tercer trimestre de embarazo y madres cuyos hijos se encontraban en la guardería de una prisión en Aquiraz/Ceará, totalizando 17 participantes en los 9 encuentros realizados. La recolección de datos se hizo entre junio y octubre de 2018. Se usó la técnica de historia a través de dibujos. El análisis de los dibujos se hizo de forma individual con cada reclusa y fue categorizado por las investigadoras. El trabajo obtuvo aprobación del Comité de Ética. Resultados: la actividad de historia a través de dibujos posibilitó la comprensión del sentimiento materno respeto al cuidado con sus hijos y, a partir de ello, se hizo posible definir acciones consideradas como atención dentro de la cárcel. Conclusión: a partir del análisis de la vivencia de la maternidad en la prisión, se posibilita la comprensión de sentimientos que atraviesan el desarrollo del rol materno.

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OBJECTIVES: To analyze the Nursing Diagnosis risk for falls indicators in aged with hypertension and to verify the association of this diagnosis with sociodemographic variables and antihypertensive agents used by the aged. METHODS: Analytical study, cross-sectional with quantitative approach. It was carried out in three health units in the city of Redenção, Ceará, Brazil, in the Brazilian Northeast. A total of 153 elderly subjects participated in the study. Statistical analysis was performed using Fisher's exact test, Pearson's chi-square test and multinomial logistic regression of variables that presented association with the Nursing Diagnosis. RESULTS: Use of throw rugs, difficulties with gait, acute illness (p = .004), age greater than or equal to 65 years and impaired vision were associated with the Nursing Diagnosis risk for falls (00155). The work situation (retired) was the only sociodemographic variable that had a significant association with the risk for falls. Antihypertensive agents were not associated with the diagnosis. CONCLUSION: Age greater than or equal to 65 years, use of throw rugs, difficulties with gait, acute illness, and impaired vision can be useful to infer the risk for falls and to confirm their presence in the aged with hypertension. IMPLICATIONS FOR NURSING PRACTICE: This study provides data that can help nurses in the process of inferring the diagnosis risk for falls in the aged with hypertension, which streamlines the planning and implementation of preventive interventions.

OBJETIVOS: analisar os elementos estruturais do Diagnóstico de Enfermagem Risco de quedas em idosos com hipertensão arterial e verificar a associação desse diagnóstico com variáveis sociodemográficas e agentes anti-hipertensivos utilizados pelos idosos. MÉTODOS: estudo analítico, transversal com abordagem quantitativa. Foi realizado em três unidades de saúde do município de Redenção, no Nordeste brasileiro. Um total de 153 idosos participaram deste estudo. A análise estatística foi pelo teste exato de Fisher, qui-quadrado de Pearson e a regressão logística multinominal de variáveis que apresentaram associação com o Diagnóstico de Enfermagem. RESULTADOS: uso de tapetes soltos, dificuldades na marcha, doença aguda (p = 0,004), idade maior ou igual a 65 anos e visão prejudicada foram associados ao Diagnóstico de Enfermagem Risco de quedas (00155). A situação de trabalho (aposentado) foi a única variável sociodemográfica que teve associação significante com o Risco de quedas. Os agentes anti-hipertensivos não foram associados ao diagnóstico. CONCLUSÃO: a idade maior ou igual a 65 anos, uso de tapetes soltos, dificuldades na marcha, doença aguda e visão prejudicada podem ser úteis para inferir o Diagnóstico de Enfermagem Risco de quedas e para confirmar sua presença em idosos com hipertensão arterial. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: este estudo fornece dados que podem ajudar o enfermeiro no processo de inferência do diagnóstico Risco de quedas em idosos com hipertensão arterial, o que agiliza o planejamento e a implementação de intervenções preventivas.

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OBJECTIVE: Evaluate how coverage and quality of primary health care (PHC) and a conditional cash transfer (CCT) program associate with child mortality in Brazil. METHODS: Multivariate linear regression models and least absolute shrinkage and selection estimator (LASSO) were utilized with the municipal level child mortality rate as the key dependent variable. PHC quality with PHC and CCT coverage were the independent variables. The quality of the Brazilian PHC was assessed using the Brazilian National Program for Access and Quality Improvement in PHC data. PHC and CCT coverage were calculated based on Brazilian official databases. Human developmental index (HDI), municipality size, and country region were used as control variables. A total of 3441 municipalities were evaluated. RESULTS: We found that ESF (Estratégia Saúde da Família) quality variables PLANNING [Family Health Team Planning activities], CITYSUPPORT [municipality support for Family Health Strategy activities], EXAMS [exams offered and priority groups seen by the family health team], and PRENATAL [prenatal care and exams provided by the family health team], as well as HDI, percentage of PHC coverage, percentage of CCT coverage, and population size have significant and negative relationships with 1-year-old child mortality. LASSO regression results confirmed these associations. Quality is an important element of effective social service provision. CONCLUSION: This exploration represents one of the first investigations into the role of PHC system quality, and how it is related to health outcomes, while also considering PHC and conditional cash transfer program coverage. Quality of PHC, measured by work process variables, plays an important role in child mortality. Efforts on PHC quality and coverage, as well as on CCT program coverage, are important to child mortality reduction. Therefore, this is an important finding to other PHC public health services.

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Objetivo: mapear atividades de enfermagem relacionadas ao diagnóstico "atraso no crescimento e no desenvolvimento" da NANDA-I e compará-las com as atividades preconizadas pela Classificação de Intervenções em Enfermagem. Métodos: estudo quantitativo realizado com enfermeiros da Atenção Básica. Foram coletadas variáveis de identificação profissional e uma relação das características definidoras do diagnóstico em estudo para que os enfermeiros listassem as atividades de enfermagem. Resultados: todos os participantes eram do sexo feminino, com idade média de 42,2 anos, e de 8,2 anos de exercício na atenção básica. Listaram-se 42 atividades de enfermagem, as quais foram comparadas com quatro intervenções de enfermagem: 1) melhora do desenvolvimento infantil; 2) cuidados com o desenvolvimento; 3) melhora do desenvolvimento: adolescente; 4) orientação aos pais: educando os filhos. Conclusão: a maioria das atividades de enfermagem desenvolvida pelos participantes corresponde ao preconizado pela Classificação de Intervenções em Enfermagem (AU).

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