SUMMARY OBJECTIVE: The aim of this study was to perform a cross-cultural adaptation of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding for use in a Brazilian-Portuguese context. METHODS: The cross-cultural adaptation process involved the translation from original English into Brazilian Portuguese by two qualified and independent translators. Both translations were synthesized into a single version that was back-translated into English. An expert committee was created to assess linguistic equivalences, formulating a pre-final version that was tested on ten nursing women attending a maternity hospital. To assess its psychometric properties, a cross-sectional study was carried out. The population consisted of 99 nursing women from a reference maternity hospital in southern Brazil. The scale’s stability and internal consistency were measured through Cronbach’s alpha. The Pearson’s correlation coefficient and the intraclass correlation coefficient between two applications were assessed to ascertain the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br scale’s reliability. The construct validity was evaluated through exploratory factorial analysis. RESULTS: The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br showed a general Cronbach’s alpha of 0.849. The test-retest analysis showed a Pearson’s correlation coefficient of 0.483 and intraclass correlation coefficient of 0.645. The exploratory factorial analysis showed two domains among the nine items of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br: the functional domain, including six items, and the cognitive domain, including three items, explaining 59.77% of the variance. CONCLUSION: The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br was considered adequate for the cultural context and reliable and valid for Brazilian nursing women. OBJECTIVE crosscultural cross SelfEfficacy Self Efficacy BrazilianPortuguese METHODS translators backtranslated back translated equivalences prefinal pre final properties crosssectional sectional out 9 Brazil scales scale s Cronbachs Cronbach Pearsons Pearson BreastfeedingBr Br reliability RESULTS 0849 0 849 0.849 testretest test retest 0483 483 0.48 0645 645 0.645 domain 5977 59 77 59.77 variance CONCLUSION 084 84 0.84 048 48 0.4 064 64 0.64 597 5 7 59.7 08 8 0.8 04 4 0. 06 6 0.6 59.

Resumo Objetivos: proceder a adaptação transcultural da escala The Postpartum Childcare Stress Checklist para ser utilizada no Brasil. Métodos: o processo de adaptação transcultural seguiu diretrizes definidas internacionalmente: dupla tradução, síntese e retrotradução, análise por comitê de especialistas, proposta de uma versão pré-final e pré-teste, avaliação das propriedades psicométricas e geração da versão final. A confabilidade e validade da versão final foram analisadas por meio de estudo epidemiológico transversal envolvendo 190 mulheres em período pós-parto. Foram estimados o indicador α-Cronbach para análise da confabilidade e análise fatorial exploratória com extração de componentes principais para análise da validade. Resultados: o indicador α- Cronbach foi de 0,894. A versão brasileira testada mostrou-se unidimensional e a análise fatorial apontou quatro fatores distribuídos de maneira muito próxima e que explicaram 57,8% da variância. Todos os itens do instrumento original foram mantidos na versão final proposta. Conclusão: a versão brasileira proposta mostrou-se válida e confável para aplicação em populações brasileiras.

Abstract Objectives: to carry out the cross-cultural adaptation of The Postpartum Childcare Stress Checklist scale to be used in Brazil. Methods: the cross-cultural adaptation process followed internationally defined guidelines: double translation, synthesis and back-translation, analysis by a committee of experts, proposal for a pre-final and pre-test version, analysis of the psychometrics properties and generation of the final version. The reliability and validity of the final version were analyzed through a cross-sectional epidemiological study involving 190 women in the postpartum period. Cronbach’s α indicator for reliability analysis and exploratory factor analysis with main component extraction were estimated for validity analysis. Results: α-Cronbach’s was 0.894. The tested Brazilian version proved to be one-dimensional and the factor analysis pointed to four factors that were very closely distributed and explained 57.8% of the variance. All items of the original instrument were maintained in the proposed final version. Conclusions: the proposed Brazilian version proved to be valid and reliable for application in Brazilian populations.

Abstract Overview and Aims: Indiscriminate increasing number of caesarean section has raised interest worldwide and has been subject of countless discussion. The aim of this study was to analyze the caesarean section rate according to Robson classification and to identify associated factors in a referral hospital in Southern Brazil. Study Design: Cross-sectional study. Population: Data from all births occurred in one-year-period carried out at a referral hospital in the southern Brazilian state of Santa Catarina. Methods: Gestational characteristics were categorized according to Robson classification criteria. The dependent variable was caesarean section rate and the clinical-obstetric characteristics were the independent variables. Adjusted models were obtained through Poisson Regression analysis. Results: The caesarean section rate was 35.5%. According to Robson classification, group 3 showed the highest occurrence. Among the groups with greatest impact in caesarean section rates, group 5 showed the highest proportion among all cesareans. Prevalence of statistically higher caesarean section rate was found in women aged 25 and 35 years and who had previously performed caesarean section. Statistically lower prevalence was found in women who had previous vaginal delivery, with spontaneous labor and those with induced labor. Conclusion: The highest caesarean section rate was observed in group 3 of Robson classification. Age and previous caesarean section were shown to be associated with the higher caesarean section rates.

Resumo Visão Geral e Objetivos: O aumento indiscriminado do número de cesarianas tem despertado interesse em todo o mundo e tem sido objeto de inúmeras discussões. O objetivo deste estudo foi analisar a taxa de cesarianas segundo a classificação de Robson e identificar os fatores associados em um hospital de referência no sul do Brasil. Desenho do Estudo: Estudo transversal. População: Dados de todos os partos ocorridos no período de um ano realizados em um hospital de referência no sul do estado brasileiro de Santa Catarina. Métodos: As características gestacionais foram categorizadas de acordo com os critérios de classificação de Robson. A variável dependente foi a taxa de cesariana e as características clínico-obstétricas foram as variáveis independentes. Os modelos ajustados foram obtidos por meio da análise de Regressão de Poisson. Resultados: A taxa de cesariana foi de 35,5%. De acordo com a classificação de Robson, o grupo 3 apresentou a maior ocorrência. Entre os grupos com maior impacto nas taxas de cesarianas, o grupo 5 apresentou a maior proporção entre todas as cesarianas. A prevalência de taxa de cesariana estatisticamente maior foi encontrada em mulheres com idade entre 25 e 35 anos e que já haviam realizado cesariana anteriormente. Prevalência estatisticamente menor foi encontrada em mulheres que tiveram parto vaginal prévio, com trabalho de parto espontâneo e naquelas com trabalho de parto induzido. Conclusão: A maior taxa de cesariana foi observada no grupo 3 da classificação de Robson. A idade e cesariana anterior mostraram-se associadas às maiores taxas de cesariana.

Resumo O objetivo foi estimar a associação entre fatores pré-natais e neonatais e sintomas de asma em crianças aos seis anos de idade. Foi realizado um estudo epidemiológico transversal com dados secundários provenientes de estudo de coorte com amostragem de 578 crianças. Os dados foram analisados por meio de regressão de Poisson. Do total de 578 crianças incluídas no estudo, 43,4% (IC 95% 39,4; 47,4) apresentavam sintomas de asma. As variáveis com prevalências significativamente maiores de sintomas de asma aos seis anos de idade foram: sexo masculino, com prevalência 5% maior (RP = 1,05 IC 95% 1,01; 1,11) (p = 0,043); crianças de gestantes portadoras de doenças infecciosas, com prevalência 7% maior (RP = 1,07; IC 95% 1,02; 1,13) (p = 0,011); crianças que não foram amamentadas, com prevalência 12% maior (RP = 1,12; IC 95% 1,02; 1,24) (p = 0,022), e crianças com problemas respiratórios no primeiro mês de vida, com prevalência 14% maior (RP = 1,14; IC 95% 1,01; 1,29) (p = 0,033). Concluiu-se que sexo masculino, privação de amamentação, independentemente do tempo, e problemas respiratórios no primeiro mês de vida foram associados de forma independente aos sintomas de asma aos seis anos de idade. A ocorrência de doenças infecciosas durante a gravidez foi o único fator fisiológico intra-uterino associado à ocorrência de sintomas de asma aos seis anos de idade.

Abstract The objective was to estimate association between prenatal and neonatal factors and asthma symptoms in children at six years of age. A cross-sectional study using secondary data from a cohort study with a sample of 578 children was carried out. Data were analyzed using three levels hierarchical Poisson Regression. Of the 578 children included in the study, 43.4% (95% CI 39.4; 47.4) had asthma symptoms. The variables with significantly higher prevalence of symptoms and asthma at six years of age were: male gender, with 5% higher prevalence (PR = 1.05 95% CI 1.01; 1.11) (p = 0.043); children of pregnant women presenting infectious diseases with 7% higher prevalence (PR = 1.07; 95% CI 1.02; 1.13) (p = 0.011); children who were not breastfed, with a 12% higher prevalence (PR = 1.12; 95% CI 1.02; 1.24) (p = 0.022) and children with respiratory problems in the first month of life, with a 14% higher prevalence (PR = 1.14; 95% CI 1.01; 1.29) (p = 0.033). It could be concluded that male gender, time-independent breastfeeding deprivation and respiratory problems in the first month of life were independently associated with asthma symptoms at six years of age. The occurrence of infectious diseases during pregnancy was the only factor with intrauterine physiology that was associated with the occurrence of asthma symptoms at six years of age.

Resumo O objetivo foi estimar a associação entre fatores pré-natais e neonatais e sintomas de asma em crianças aos seis anos de idade. Foi realizado um estudo epidemiológico transversal com dados secundários provenientes de estudo de coorte com amostragem de 578 crianças. Os dados foram analisados por meio de regressão de Poisson. Do total de 578 crianças incluídas no estudo, 43,4% (IC 95% 39,4; 47,4) apresentavam sintomas de asma. As variáveis com prevalências significativamente maiores de sintomas de asma aos seis anos de idade foram: sexo masculino, com prevalência 5% maior (RP = 1,05 IC 95% 1,01; 1,11) (p = 0,043); crianças de gestantes portadoras de doenças infecciosas, com prevalência 7% maior (RP = 1,07; IC 95% 1,02; 1,13) (p = 0,011); crianças que não foram amamentadas, com prevalência 12% maior (RP = 1,12; IC 95% 1,02; 1,24) (p = 0,022), e crianças com problemas respiratórios no primeiro mês de vida, com prevalência 14% maior (RP = 1,14; IC 95% 1,01; 1,29) (p = 0,033). Concluiu-se que sexo masculino, privação de amamentação, independentemente do tempo, e problemas respiratórios no primeiro mês de vida foram associados de forma independente aos sintomas de asma aos seis anos de idade. A ocorrência de doenças infecciosas durante a gravidez foi o único fator fisiológico intra-uterino associado à ocorrência de sintomas de asma aos seis anos de idade.

Abstract The objective was to estimate association between prenatal and neonatal factors and asthma symptoms in children at six years of age. A cross-sectional study using secondary data from a cohort study with a sample of 578 children was carried out. Data were analyzed using three levels hierarchical Poisson Regression. Of the 578 children included in the study, 43.4% (95% CI 39.4; 47.4) had asthma symptoms. The variables with significantly higher prevalence of symptoms and asthma at six years of age were: male gender, with 5% higher prevalence (PR = 1.05 95% CI 1.01; 1.11) (p = 0.043); children of pregnant women presenting infectious diseases with 7% higher prevalence (PR = 1.07; 95% CI 1.02; 1.13) (p = 0.011); children who were not breastfed, with a 12% higher prevalence (PR = 1.12; 95% CI 1.02; 1.24) (p = 0.022) and children with respiratory problems in the first month of life, with a 14% higher prevalence (PR = 1.14; 95% CI 1.01; 1.29) (p = 0.033). It could be concluded that male gender, time-independent breastfeeding deprivation and respiratory problems in the first month of life were independently associated with asthma symptoms at six years of age. The occurrence of infectious diseases during pregnancy was the only factor with intrauterine physiology that was associated with the occurrence of asthma symptoms at six years of age.

ABSTRACT: Objective: To perform a cross-cultural adaptation and validation in the Brazilian cultural context of questionnaire Patient-Reported Outcomes in Obesity (PROS). Methods: The cross-cultural adaptation process involved the translation from original English language into Brazilian Portuguese by two qualified and independent translators. The back-translation was performed by two English language teachers who were native speakers, without any medical knowledge of the original scale. An expert committee was created with researchers to assess semantic, idiomatic, experiential and conceptual equivalence. The pre-test of the Brazilian version, named PROS-Br, was carried out with ten adults with obesity. To assess the psychometric properties of the instrument, a cross-sectional epidemiological study was carried out. The population consisted of 120 Brazilian adults with obesity who went to the appointment at a school-clinic. The Item Response Theory and Factor Analysis with Principal Component Extraction was used for the psychometrics analysis. To measure reliability, the α-Cronbach indicator was used. Results: In the reliability analysis, α-Cronbach was 0.82. Two factors explained 58.3% of the total variance in the principal component analysis, involving behavioral and physical aspects. Item Response Theory curves showed that all questions have discriminatory characteristics, pointing to the adequacy of the proposed version. Conclusion: The Brazilian version was proven valid and reliable to measure the quality of life of individuals with obesity, allowing one to develop intervention strategies, plan and execute actions at services and for public health policies.

RESUMO: Objetivo: Realizar a adaptação transcultural e a validação, no contexto cultural brasileiro, do instrumento de impacto da obesidade Patient-Reported Outcomes in Obesity (PROS). Métodos: O processo de adaptação transcultural contou com a tradução do idioma original, inglês, para o português, executada por dois tradutores qualificados e independentes. A retrotradução foi realizada por dois professores de inglês, nativos, sem qualquer conhecimento médico nem da escala original. Um comitê de especialistas foi composto de pesquisadores para avaliar as equivalências semântica, idiomática, experiencial e conceitual. O pré-teste da versão brasileira, denominada PROS-Br, foi realizado com dez indivíduos adultos com obesidade. Para a avaliação das propriedades psicométricas, foi realizado um estudo epidemiológico de delineamento transversal. A população foi composta de 120 indivíduos adultos com obesidade, brasileiros, presentes para consulta médica em ambulatório-escola. Para análises psicométricas, foram utilizadas a Teoria de Resposta ao Item e análise fatorial com extração de componentes principais. Para aferição da confiabilidade foi utilizado o indicador α-Cronbach. Resultados: Na análise de confiabilidade, o PROS-Br apresentou α-Cronbach de 0,82. Dois fatores explicaram 58,3% da variância total na análise de componentes principais, envolvendo aspectos comportamentais e físicos. As curvas da Teoria de Resposta ao Item mostraram que todas as perguntas apresentam características discriminatórias, apontando para a adequação da versão brasileira proposta. Conclusão: A versão brasileira mostrou-se válida e confiável para aferir a qualidade de vida de indivíduos com obesidade, possibilitando desenvolver estratégias de intervenção, planejamento e execução de ações nos serviços e na política pública de saúde.

RESUMO: Objetivo: Realizar a adaptação transcultural e a validação, no contexto cultural brasileiro, do instrumento de impacto da obesidade Patient-Reported Outcomes in Obesity (PROS). Métodos: O processo de adaptação transcultural contou com a tradução do idioma original, inglês, para o português, executada por dois tradutores qualificados e independentes. A retrotradução foi realizada por dois professores de inglês, nativos, sem qualquer conhecimento médico nem da escala original. Um comitê de especialistas foi composto de pesquisadores para avaliar as equivalências semântica, idiomática, experiencial e conceitual. O pré-teste da versão brasileira, denominada PROS-Br, foi realizado com dez indivíduos adultos com obesidade. Para a avaliação das propriedades psicométricas, foi realizado um estudo epidemiológico de delineamento transversal. A população foi composta de 120 indivíduos adultos com obesidade, brasileiros, presentes para consulta médica em ambulatório-escola. Para análises psicométricas, foram utilizadas a Teoria de Resposta ao Item e análise fatorial com extração de componentes principais. Para aferição da confiabilidade foi utilizado o indicador α-Cronbach. Resultados: Na análise de confiabilidade, o PROS-Br apresentou α-Cronbach de 0,82. Dois fatores explicaram 58,3% da variância total na análise de componentes principais, envolvendo aspectos comportamentais e físicos. As curvas da Teoria de Resposta ao Item mostraram que todas as perguntas apresentam características discriminatórias, apontando para a adequação da versão brasileira proposta. Conclusão: A versão brasileira mostrou-se válida e confiável para aferir a qualidade de vida de indivíduos com obesidade, possibilitando desenvolver estratégias de intervenção, planejamento e execução de ações nos serviços e na política pública de saúde.

ABSTRACT: Objective: To perform a cross-cultural adaptation and validation in the Brazilian cultural context of questionnaire Patient-Reported Outcomes in Obesity (PROS). Methods: The cross-cultural adaptation process involved the translation from original English language into Brazilian Portuguese by two qualified and independent translators. The back-translation was performed by two English language teachers who were native speakers, without any medical knowledge of the original scale. An expert committee was created with researchers to assess semantic, idiomatic, experiential and conceptual equivalence. The pre-test of the Brazilian version, named PROS-Br, was carried out with ten adults with obesity. To assess the psychometric properties of the instrument, a cross-sectional epidemiological study was carried out. The population consisted of 120 Brazilian adults with obesity who went to the appointment at a school-clinic. The Item Response Theory and Factor Analysis with Principal Component Extraction was used for the psychometrics analysis. To measure reliability, the α-Cronbach indicator was used. Results: In the reliability analysis, α-Cronbach was 0.82. Two factors explained 58.3% of the total variance in the principal component analysis, involving behavioral and physical aspects. Item Response Theory curves showed that all questions have discriminatory characteristics, pointing to the adequacy of the proposed version. Conclusion: The Brazilian version was proven valid and reliable to measure the quality of life of individuals with obesity, allowing one to develop intervention strategies, plan and execute actions at services and for public health policies.

Abstract Objective: To estimate the accuracy of neck circumference measurement as a method of diagnosing excess weight of six and seven-year-old children. Methods: 1026 six and seven-year-old children were included and anthropometric data were collected using cut-off points for the Body Mass Index (BMI) Z-score, in addition to the measurement of their neck circumference in centimeters. Pearson’s correlation coefficient was used to assess the correlation between neck circumference and BMI. Sensitivity, specificity, positive and negative predictive values were calculated. The Receiver Operating Characteristic curve was used to measure the accuracy of neck circumference as a diagnostic method for excess weight. Results: A positive linear correlation value was observed between neck circumference and BMI 0.572 (p < 0.001). The accuracy value of the global ROC curve was 0.772 (p < 0.001). Sensitivity and specificity showed low values, but high positive predictive values were observed, especially between measures of 30 and 31 cm. Conclusion: Neck circumference showed accuracy of 77.2% as a diagnostic method for overweightness in six and seven-year-old children.

RESUMO Objetivo Identificar a prevalência e fatores associados à síndrome de Burnout nos estudantes de Medicina. Métodos Estudo transversal com estudantes de Medicina de uma instituição privada de ensino na região Sul do Brasil. Utilizou-se o Maslach Burnout Inventory – Student Survey para a identificação da síndrome e um instrumento para a coleta de informações sociodemográficas, hábitos, rotina e situação acadêmica. Realizou-se análise descritiva dos dados e avaliaram-se associações entre as informações obtidas a partir do instrumento de coleta com a presença da síndrome de Burnout, utilizando-se razões de prevalência por meio do teste qui-quadrado ou teste de Fisher. Associações com valor de p < 0,25 foram inseridas em um modelo multivariado, em formato step-forward, utilizando-se regressão de Poisson. Foram consideradas significativas associações com valor de p < 0,05. Resultado Quinhentos e vinte e dois (88,2%) alunos participaram da pesquisa. A prevalência da síndrome de Burnout foi de 12,3%. As associações com síndrome de Burnout que possuíram valor de p < 0,25 foram “não viver com parceiro”, “residir sozinho”, “dormir até cinco horas por dia”, “ter até cinco horas semanais de lazer”, “possuir pensamento suicida” e “realizar acompanhamento psicológico”. Após inserir essas variáveis no modelo multivariado, identificou-se apenas 10% de maior probabilidade de síndrome de Burnout no estudante que relatou pensamento suicida, sendo esse o único fator associado encontrado à ocorrência de burnout (p < 0,001). Conclusão A prevalência de síndrome de Burnout entre os acadêmicos de Medicina foi de 12,3%, e apenas a presença de pensamentos suicidas durante o curso foi associada à sua ocorrência.

ABSTRACT Objective To identify the prevalence and factors associated with Burnout syndrome in medical students. Methods Cross-sectional study with medical students from a private educational institution in southern Brazil. The Maslach Burnout Inventory – Student Survey was used to identify the syndrome and an instrument for collecting sociodemographic information, habits, routine and academic situation. Descriptive analysis of the data was carried out and associations between related information were assessed using the collection instrument with the presence of Burnout syndrome, using the prevalence ratios using the chi-test or Fisher’s test. Associations with a p-value < 0.25 were inserted in a multivariate model, in a step-forward format, using Poisson regression. They were considered signed with p value < 0.05. Result Five hundred and twenty-two (88.2%) students participated in the survey. The prevalence of Burnout syndrome was 12.3%. Associations with Burnout syndrome that had a value of p < 0.25 were “not living with a partner”, “living alone”, “sleeping up to five hours a day”, “having up to five hours a week of leisure”, “having thoughts suicide” and “psychological counseling”. After inserting these variables in the multivariate model, only 10% higher likelihood of Burnout syndrome was identified in the student who reported suicidal thinking, which is the only associated factor found with the occurrence of burnout (p < 0.001). Conclusion The prevalence of Burnout syndrome among medical students was 12.3% and only the presence of suicidal thoughts during the course was associated with its occurrence.

ABSTRACT Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted.

The aim of this study was to analyze the temporal trend of leptospirosis incidence according to rainfall levels in Santa Catarina State between 2005 and 2015. This is an ecological time-series study involving data on leptospirosis incidence and rainfall indexes in Santa Catarina State Health Regions. The distribution of leptospirosis, rainfall indexes, and cases/rainfall ratios, according to seasonality and stratified by Health Regions, were evaluated. There were 5,274 cases, with an average rate of 7.03 cases/100,000 inhabitants per year, varying from 24 to 1,458 cases (Serra Catarinense and Northeast regions, respectively) in Santa Catarina, revealing an increase in the rates of 0.70 cases/100,000 inhabitants in Serra Catarinense and 13.99 cases/100,000 inhabitants in the Northeast. Four regions (Foz do Rio Itajaí, Médio Vale do Itajaí, Grande Florianópolis and Northeast) were responsible for 71.8% of the cases, particularly in the Northeast region (38.5%). The five regions with the highest rates presented greater risk of leptospirosis (RR &gt; 1), ranging from 10.9 to 19.9 more new cases of the disease. The average rainfall volume for Santa Catarina State was 158.69 mm, ranging from 136.44 mm in Laguna to 186.81 mm in the Northeast. The five regions contributed with 32.8% of the rainfall index accumulated in the period. In conclusion, leptospirosis occurred all around Santa Catarina State, differing its temporal trend according to the Health Regions. The aim of this study was to analyze the temporal trend of leptospirosis incidence according to rainfall levels in Santa Catarina State between 2005 and 2015. This is an ecological time-series study involving data on leptospirosis incidence and rainfall indexes in Santa Catarina State Health Regions. The distribution of leptospirosis, rainfall indexes, and cases/rainfall ratios, according to seasonality and stratified by Health Regions, were evaluated. There were 5,274 cases, with an average rate of 7.03 cases/100,000 inhabitants per year, varying from 24 to 1,458 cases (Serra Catarinense and Northeast regions, respectively) in Santa Catarina, revealing an increase in the rates of 0.70 cases/100,000 inhabitants in Serra Catarinense and 13.99 cases/100,000 inhabitants in the Northeast. Four regions (Foz do Rio Itajaí, Médio Vale do Itajaí, Grande Florianópolis and Northeast) were responsible for 71.8% of the cases, particularly in the Northeast region (38.5%). The five regions with the highest rates presented greater risk of leptospirosis (RR &gt; 1), ranging from 10.9 to 19.9 more new cases of the disease. The average rainfall volume for Santa Catarina State was 158.69 mm, ranging from 136.44 mm in Laguna to 186.81 mm in the Northeast. The five regions contributed with 32.8% of the rainfall index accumulated in the period. In conclusion, leptospirosis occurred all around Santa Catarina State, differing its temporal trend according to the Health Regions.

RESUMO OBJETIVO Avaliar dois critérios distintos, um ou dois valores de corte, do teste oral de tolerância à glicose com 75 g de glicose para o diagnóstico de diabetes mellitus gestacional. Métodos Estudo transversal envolvendo 120 prontuários de gestantes que realizaram pré-natal em um ambulatório de uma universidade brasileira. Análise bivariada dos resultados obstétricos e perinatais foi realizada pelo teste do qui-quadrado. Resultados Considerando o critério I, 12,5% das pacientes foram diagnosticadas com diabetes mellitus gestacional. As pacientes apresentaram uma chance 3,57 maior de ter um feto grande para a idade gestacional (p=0,038). Utilizando o critério II, o diabetes mellitus gestacional foi diagnosticado em 5,8% das pacientes. Mediante esse critério diagnóstico, a chance de macrossomia foi 7,73 vezes mais provável na presença de diabetes mellitus gestacional (p=0,004) e a chance de um feto grande para a idade gestacional foi 8,17 vezes maior de ocorrer (p=0,004). Conclusões Observou-se diferença na prevalência de diabetes melittus gestacional entre os dois critérios analisados, sendo que o novo critério proposto aumentou a prevalência.

SUMMARY OBJECTIVE To evaluate two different criteria, one or two cut-off values, of oral glucose tolerance test with 75g of glucose for the diagnosis of gestational diabetes mellitus. METHODS A cross-sectional study involving 120 records of pregnant women who received prenatal care at the service of a Brazilian university was carried out. Bivariate analysis of obstetric and perinatal outcomes was performed using the chi-square test. RESULTS Considering criterion I, 12.5% of patients were diagnosed with gestational diabetes mellitus. Patients were 3.57 times more likely to have a large fetus for the gestational age at birth (p=0.038). Using criterion II, gestational diabetes mellitus was diagnosed in 5.8% of patients, macrosomia was 7.73 times more likely to be found in the presence of gestational diabetes mellitus (p=0.004), and a large fetus for the gestational age at birth was 8.17 times more likely (p=0.004). CONCLUSIONS There was a difference in the prevalence of gestational diabetes mellitus between the two criteria analyzed. The new criterion proposed increased prevalence.

Abstract Malocclusions are changes in the development of craniofacial structures of high prevalence. Associated risk factors are diverse and nutritional and non-nutritional suction habits are the most reported. The aim of this study was to estimate the prevalence of malocclusions in the mixed dentition and to study possible association with practices of breastfeeding and suction habits among Brazilian schoolchildren. A cross-sectional study involving a sample of 664 6-year-old children and their families was carried out. Data collection was done through interviews with mothers in the homes and oral examinations of children in schools. Multivariate analyses were performed using the Poisson regression with a robust estimator. The prevalence of overjet over 4 mm was 21.1% and of posterior crossbite was 12.2%; 91.9% of the children were breastfed, 79.0% used a nursing bottle and 49.4% used a pacifier. Significant and independent associations were observed between father’s unemployment, private school, interruption of breastfeeding before the fourth month and pacifier use with certain malocclusions. High rates of malocclusion were found in the studied sample. Socioeconomic conditions, breastfeeding practices and suction habits were shown to be statistically associated with their occurrence.