Objective: the complexity of heart-rate variability (HRV) in amyotrophic lateral sclerosis (ALS) patients with different pulmonary capacities was evaluated. Methods: We set these according to their pulmonary capacity, and specifically forced vital capacity (FVC). We split the groups according to FVC (FVC > 50% (n = 29) and FVC < 50% (n = 28)). In ALS, the presence of an FVC below 50% is indicative of noninvasive ventilation with two pressure levels and with the absence of other respiratory symptoms. As the number of subjects per group was different, we applied the unbalanced one-way analysis of variance (uANOVA1) test after three tests of normality, and effect size by Cohen’s d to assess parameter significance. Results: with regard to chaotic global analysis, CFP4 (p < 0.001; d = 0.91), CFP5 (p = 0.0022; d = 0.85), and CFP6 (p = 0.0009; d = 0.92) were enlarged. All entropies significantly increased. Shannon (p = 0.0005; d = 0.98), Renyi (p = 0.0002; d = 1.02), Tsallis (p = 0.0004; d = 0.99), approximate (p = 0.0005; d = 0.97), and sample (p < 0.0001; d = 1.22). Detrended fluctuation analysis (DFA) (p = 0.0358) and Higuchi fractal dimension (HFD) (p = 0.15) were statistically inconsequential between the two groups. Conclusions: HRV complexity in ALS subjects with different pulmonary capacities increased via chaotic global analysis, especially CFP5 and 3 out of 5 entropies.

Sexual violence against children and adolescents is considered a public health problem of worldwide scope. The objective is to analyze the findings in the literature that address the phenomenon of sexual violence against children and adolescents in the school environment; is an integrative literature review that has as its element-problem of interest children and adolescent victims of sexual violence in schools. The research filters used were: the availability of the text (free full text) and publication date (in the last five years); Initially, 1199 studies were identified, then, after application of filters and the removal of duplicated studies, a total of 175 studies was reached. Subsequently, the selection of articles occurred with the sieve of the titles, resulting in 20 studies. From these, 13 proceeded to the eligibility stage, with three being excluded after a full reading. Therefore, nine studies composed the final sample. One of the factors related to the occurrence of sexual violence against children and adolescents in schools is the absence of educational spaces on the subject, being the main parameter for approaching the outline of identification and prevention strategies, with the insertion of sexual education on the school routine, with the participation of the family.

Among the main types of neoplasms in the female population, breast and cervical cancers are the most important due to their high morbidity and mortality rates. The mortality has been proportionally higher in developing countries. Analysis of the trend of cancer mortality in Brazil revealed a considerable difference in the pattern of deaths between the regions. To analyze the trend of mortality due to breast and cervical cancers in women. Retrospective study of a series of death cases, using secondary data from the mortality information system (SIM) of the Ministry of Health. The deaths were identified as the underlying cause of breast and cervical cancers, including malignant neoplasms of the uterus without other specifications, occurring from 1980 to 2014. Thus, the annual standardized age-specific mortality rates by the world population were applied. For trend analysis, regression models were utilized in which the mortality rates were considered dependent variables and years the independent variable. Polynomial regression models and a Prais–Winsten regression model were adopted. Cervical cancer presented a mortality rate ranging from 2.15 to 10.69 per 100,000 women from 1980 to 2014, with a tendency for stability. Breast cancer mortality rate varied from 3.81 to 11.47 per 100,000 women from 1981 to 2014, indicating a growing trend. There is a significant increase in the mortality rate for breast cancer and stability of cervical cancers in the State of Acre from 1980 to 2014, evidencing a concern in their care and monitoring. Above all, guaranteed access, especially to the population of women at social risk, and the search for effective screening should be emphasized in the formation of the care line and the Health Care Network in the State of Acre.

Backgroung: Restrictive Brazilian legislation allows abortion in exceptional cases, such as pregnancy resulting from a sexual crime. However, little is known about women who give up on having an abortion after receiving approval for the procedure. Objective: To verify the association between religion and abandonment of legal abortion in women with pregnancies resulting from sexual violence. Method: Cross-sectional study with 941 women with pregnancy due to sexual crime treated at the Pérola Byington Hospital, São Paulo, Brazil, from August 1994 to December 2012. The cases were grouped according to whether or not they gave up on abortion. The study variables were age, education, race/color, marital status, gestational age, religion, aggressor and type of intimidation. Odds Ratio and Wald chi-square test (χ2W) were calculated. Logistic regression adjusted by analyzing the variables with stepwise backward analysis was used. Data analyzed using SPSS15.0 software. Research approved by the Ethics and Research Committee with opinion nº 6767, CAAE nº 00957512.3.0000.5505. Results: In 92 cases (9.8%) the legal abortion was abandoned and in 849 (90.2%) the abortion was completed. Women who declared religion and who were raped by a known aggressor gave up abortion almost 2.5 times more often (OR=2.46; p<0.001). Those who declared they had no religion and had low education were 13 times more likely to give up on abortion (OR=13.23; p=0.017). Women without low education and who declared religion were 16 times more likely to give up on abortion (OR=16.32; p=0.014). Those who declared having a religion and were victims of known aggressors gave up on abortion 16 times more than those who had no religion (OR=16.32; p=0.014) Conclusion: The results suggest that religious beliefs can influence the abandonment of legal abortion in certain subpopulations of women.

Introduction: women with intellectual disabilities are particularly vulnerable to sexual violence and its consequences. However, little is known about the pregnancy resulting from this crime and outcomes for these women. Objective: to compare the characteristics of sexual crime and pregnancy outcomes resulting from sexual violence between women with and without intellectual disabilities. Methods: cross-sectional study with 1,478 pregnant women due to a sexual crime aged ≥14 years who requested a legal abortion, treated at Hospital Pérola Byington, São Paulo, Brazil, between 1994-2015. A total of 88 pregnancies of women with and 1,390 without intellectual disabilities were compared regarding sociodemographic variables, sexual crime, aggressor, pregnancy and abortion. For statistical analysis, Person’s chi-square, adjusted binary logistic regression and Student’s t test for independent samples were used, with significant p<0.05 and a 95% Confidence Interval. Research approved by the Pérola Byington Hospital Research Ethics Committee, opinion 1,396,893. Results: pregnant women with intellectual disabilities had less education than those without (84.1% versus 23.4%) (p<0.001), declared less religion (68.2% versus 85.0%) (p<0.001), and they were not married or in a relationship (96.6% versus 81.1%) (p<0.001). Domestic sexual crime was more frequent (57.8% versus 18.8%) (p<0.001), related aggressor (44.9% versus 11.2%) (p<0.001), referral by public security (80, 7% versus 50.4%) (p<0.001), police report (86.4% versus 65.3%) (p<0.001), and medical-legal examination (83.0% versus 61.5%) (p<0.001). There was no difference in abortion, but in pregnant women with intellectual disabilities, the medical method was more frequent (55.6% versus 34.2%) (p=0.03) due to higher gestational age. Conclusion: pregnant women with intellectual disorders are more vulnerable to domestic sexual violence perpetrated by related aggressors, with greater involvement of public security, and later seeking abortion.

Background/Objectives: to analyze the effects of vaccination against SARS-CoV-2 on the incidence, lethality and mortality from COVID-19, in the city of São Paulo, in the period 2020-2022. Methods: this is a population-based time series study, with official public data, relating to the period from 2020 to 2022. The population data were extracted from the Municipal Health Department of São Paulo, according to the geographic division of the Regional Health Coordination (CRS). The Prais-Winsten regression model was used, calculating the percentage variation of daily change (DPC). This procedure made it possible to classify the trend of epidemiological rates as increasing, decreasing or stationary. Results: the city of São Paulo recorded that 17% of its total population was infected at least once by the SARS CoV-2 virus, with a fatal outcome in 0.4% of its total population. When comparing the differences between the CRS, it was observed that the North region had a higher lethality rate at the beginning of the pandemic, decreasing significantly over the period. The Central region, in 2021, showed an increasing trend different from the other regions. Regarding mortality, the North, Center and West coordinators showed decreasing trends in all periods analyzed, unlike the East, Southeast and South coordinators, which in 2020 showed stationary trends. Conclusions: there was a reduction in the epidemiological outcomes of COVID-19 after the mass application of vaccination against SARS-CoV-2. Strategies to increase vaccination coverage should be implemented in all regions of the city of São Paulo, especially in those with high social vulnerability.