SUMMARY OBJECTIVE The association between gynecological diagnoses and their distribution across healthcare sectors benefits health promotion and the identification of topics for continued education of gynecological care. This study aimed to identify healthcare diagnoses and referral flow in climacteric women. METHODS This is a cross-sectional study conducted at the Women’s Health Clinic of the University Hospital, University of São Paulo, with a reference to gynecology and training for Residents of Family and Community Medicine, between 2017 and 2018. The medical records of 242 women whose sociodemographic and clinical information, gynecological diagnoses, and distribution of healthcare services (primary, secondary, and tertiary) had been processed were collected. Statistical analysis included the chi-square test and odds ratio. RESULTS Smoking (OR = 2.27, 95% CI 1.05–4.89; p = 0.035) was associated with the referral of climacteric women to higher complexity services. Considering the distribution of non-oncological diagnoses in climacteric patients, the chance of women being referred to medium- and high-complexity health services presented a 2-fold increase in cases of breast diseases, a 2.35-fold increase in cases of noninflammatory disorders of the female genital tract, and a 3-fold increase in cases of inflammatory diseases of the pelvic organs. CONCLUSION Climacteric women aged over 55 years, postmenopausal women, and smoking women were most frequently referred to medium- and high-complexity outpatient surgery.

Background: The practice of regular physical activity can alter the lipid profile in populations according to diverse demographic characteristics. Objective: To evaluate the association of physical inactivity with the lipid profile among vulnerable populations. Methods: A cross-sectional study was conducted among 349 vulnerable individuals from Tocantins state, northern Brazil. The International Physical Activity Questionnaire 7 Day short form was used to measure self-reported physical activity levels. Venous blood samples were drawn to evaluate lipid profile. Logistic regression adjusted by the socioeconomic variables was used to analyse the effects of physical inactivity on the lipidic profile. The level of significance was 5% and Stata® (StataCorp, LC) version 11 was used. Results: We observe an inverse relationship between physical inactivity and HDL-C—that is, those who were sedentary or below the WHO Recommendations for physical activity were at 2.6 greater odds (IC95% 1.21, 5.67; p = 0.015) of having a lower HDL compared with those meeting or exceeding WHO physical activity recommendations. Conclusion: On the vulnerable populations studied, the insufficiently active or sedentary individuals (called the physical inactivity individuals) have more risk of the altered HDL-C.

SUMMARY PURPOSE To analyze the level of knowledge about and the acceptability of the HPV vaccine among vaccinated and unvaccinated adolescents in the Western Amazon. METHODS A cross-sectional study on adolescents aged 10 to 19 years. The instrument used to collect data contains demographic and socioeconomic information and 27 questions that assess the knowledge and acceptability of the HPV vaccine. To compare the prevalence of vaccinated adolescents with the correct answers to questions about HPV and acceptability and vaccination, the robust variance Poisson regression model was used in the Stata 13.0 software. FINDINGS A total of 190 adolescents participated in the study, 60.5% in the age group of vaccination recommended by the Brazilian government, among them, 53.9% reported not having been vaccinated (p <0.001). A total of 150 (78.9%) adolescents correctly recognized HPV as a virus; 121 (63.7%) recognized HPV as a cause of cervical cancer. Participants who know HPV is a causative factor for cervical cancer are 1.94 times more likely to have been vaccinated than those who do not. Among the interviewees, the main sources of knowledge about the vaccine were schools (51.6%) and health professionals (22.6%). CONCLUSION Unvaccinated adolescents have knowledge gaps about HPV and its vaccine when compared to those vaccinated. Our results emphasize the need for effective campaigns to deliver adequate information about HPV and its vaccine to adolescents, their parents, and health professionals.

To analyze a combination of socioeconomic and demographic characteristics, chronotype, stress perception and level of physical activity with the perception of quality of life in artisanal fishermen. Several variables were associated with lower scores of quality of life domains: workload (P = 0.047), age (P = 0.01), economic class D–E (P = 0.04) and perceived stress scores (P = 0.01) for scores physical domain; workload (P = 0.03) and perceived stress (P < 0.001) for scores psychological domain; Perceived stress (P < 0.001) and age (P = 0.01) for social domain scores; economic class D–E (P = 0.03) and perceived stress (P = 0.01) for environment domain scores; perceived stress (P = 0.01) and age (P = 0.01) for general quality of life scores and; female sex (P = 0.04) and age (P = 0.02) for the score of satisfaction with quality of life.

Este estudo tem objetivo de analisar os fatores associados à insegurança alimentar e nutricional em comunidades quilombolas do estado do Tocantins, Região Norte do Brasil. Estudo de desenho transversal, realizado em 4 comunidades quilombolas do Norte do Brasil. Foram analisadas características socioeconômicas e demográficas por meio de um formulário semiestruturado e, o nível de insegurança alimentar foi mensurado pela Escala Brasileira de Insegurança Alimentar. Para analisar a aderência dos dados quantitativos à distribuição normal, utilizou-se o teste de Shapiro-Wilk. Para analisar a associação entre as características socioeconômicas e a prevalência de insegurança alimentar utilizou-se o teste de Qui-quadrado. Para estimar os fatores associados a insegurança alimentar, utilizou-se regressão de Poisson com variância robusta. O nível de significância adotado foi de 5%. Verificou-se uma prevalência de 71,2% (n=47) em situação de insegurança alimentar. Dos indivíduos que viviam em situação de insegurança alimentar, 15,79% (n=3) apresentavam alteração dos níveis de hemoglobina. Pode-se observar uma prevalência de insegurança alimentar de 71,2% e que ser mulher chefe de família aumenta as chances de insegurança alimentar e nutricional entre os quilombolas do estado do Tocantins.

Aim:This study aims to evaluate the relationship between perceived level of stress and quality of life of professionals working in Prompt Service Units in the city of Palmas, Tocantins.Methods:A cross-sectional study was performed among 164 professionals from Prompt Service Units. Stress levels were evaluated using the Perceived Stress Scale. The WHOQOL-bref was used to evaluate the perception of quality of life. Quantitative variables distribution was evaluated using Shapiro-Wilk's test. For the analyses of correlations among perceived level of stress, total quality of life score, and the physical health domain of the WHOQOL-bref, Pearson's correlation test was applied. The significance level adopted for this trial was 95%. The study was approved by the Committee of Ethics in Research with Human Beings.Results:When assessing the perceived level of stress with the total quality of life score, there was no significant correlation between those variables. However, there was an association between the perceived level of stress and the physical health domain of quality of life.Conclusion:Perceived quality of life was correlated with the physical health domain, and this result reinforces the importance of the facets that make up this area.