ABSTRACT BACKGROUND: The identification and understanding of dietary factors and other characteristics that influence gestational weight gain can contribute to the formulation of strategies to promote healthy eating habits before and during pregnancy. OBJECTIVE: To investigate the association between dietary patterns, sociodemographic and obstetric characteristics, and health-related behaviors in pregnant women. DESIGN AND SETTING: A cross-sectional study was conducted on women undergoing prenatal care in the Unified Health System of Colombo, Paraná, Brazil, from February 2018 to September 2019. METHOD: A weekly food frequency questionnaire was administered, and dietary patterns were identified through factor analysis. Median regression models were constructed to identify the associations between dietary pattern scores and variables. RESULTS: Complete data were obtained from 495 pregnant women. Three dietary patterns were identified: 1) “healthy,” with higher factor loadings for the weekly consumption of raw vegetables, cooked vegetables, and fresh fruits; 2) “Western,” including soft drinks or artificial juice, candies, milk, and dairy products, and processed cold meat; and 3) “traditional,” beans and meat. Pregnant women aged 30 years or older (coefficient [Coef.] 0.86, 95% confidence interval [CI] 0.38–1.33) with moderate/intense physical activity (Coef. 0.32, 95% CI 0.02–0.62) had higher adherence to the “healthy” pattern. Adolescents and smokers adhered more to the “traditional” pattern (Coef. 0.17, 95% CI 0.01–0.33). CONCLUSION: Age, smoking status, and physical activity were associated with dietary patterns in pregnant women. BACKGROUND pregnancy OBJECTIVE healthrelated health related SETTING crosssectional cross sectional Colombo Paraná Brazil 201 2019 METHOD administered analysis variables RESULTS 49 1 healthy, “healthy, vegetables fruits 2 Western, Western “Western, juice candies milk products meat 3 traditional, traditional “traditional, coefficient Coef. Coef [Coef. 086 0 86 0.86 95 [CI 0.38–1.33 038133 38 33 moderateintense moderate intense (Coef 032 32 0.32 0.02–0.62 002062 02 62 “healthy “traditional 017 17 0.17 0.01–0.33. 001033 0.01–0.33 . 01 0.01–0.33) CONCLUSION Age status 20 4 “Western [Coef 08 8 0.8 9 0.38–1.3 03813 03 0.3 0.02–0.6 00206 6 0.1 00103 0.01–0.3 0. 0.38–1. 0381 0.02–0. 0020 0010 0.01–0. 0.38–1 038 0.02–0 002 001 0.01–0 0.38– 0.02– 00 0.01– 0.38 0.02 0.01 0.0

Abstract Adolescents from 30 state schools in Curitiba, State of Paraná, reported total screen time, namely television, video games and laptops. Diet quality was assessed by the frequency of food consumption. The income of the school environment was taken from the Census. The built environment for physical activity was investigated by systematic observation of the school surroundings. Multilevel Poisson Regression was used to estimate associations with the exposure variables. Among 1,200 adolescents, 50.9% being male, and 74.4% were found to be exposed to excessive screen time. Excessive TV screen time (56.5%) was associated with poor diet quality. Excessive video game time (22.0%) was lower among females (PR 0.25; 95%CI 0.18;0.36), associated with poor diet quality, lower school environment income, and the worst classification of the built environment for physical activity. Excessive use of portable screens (53.2%) tended to increase with the income of the school environment. Excessive use of TV and laptops was widespread among adolescents, with different demographic and contextual variables associated according to the type of device used.

Resumo Objetivou-se investigar a associação entre o tempo de uso excessivo de diferentes telas, a qualidade da dieta em adolescentes e características do entorno escolar. Adolescentes de 30 escolas estaduais de Curitiba/PR relataram tempo de tela: televisão, videogame e portáteis. A qualidade da dieta foi avaliada pela frequência de consumo de alimentos. A renda do entorno escolar foi obtida do Censo. O ambiente construído para atividade física investigado por observação sistemática do entorno escolar. A regressão de Poisson multinível foi empregada para estimar associações com as variáveis de exposição. Entre 1.200 adolescentes, 50,9% do sexo masculino, 74,4% tiveram tempo excessivo de tela. O tempo excessivo de TV (56,5%) esteve associado à pior qualidade da alimentação. O tempo excessivo de videogame (22,0%) foi menor no sexo feminino (RP 0,25; IC95% 0,18;0,36), associado à pior qualidade da alimentação, à menor renda do entorno escolar, e à pior classificação do ambiente construído para atividade física. O tempo excessivo de telas portáteis (53,2%) apresentou tendência de aumento com a renda do entorno escolar. O uso excessivo de TV e telas portáteis foi amplamente praticado por adolescentes, com diferentes variáveis demográficas e contextuais associadas de acordo com o tipo de dispositivo utilizado.

Abstract Adolescents from 30 state schools in Curitiba, State of Paraná, reported total screen time, namely television, video games and laptops. Diet quality was assessed by the frequency of food consumption. The income of the school environment was taken from the Census. The built environment for physical activity was investigated by systematic observation of the school surroundings. Multilevel Poisson Regression was used to estimate associations with the exposure variables. Among 1,200 adolescents, 50.9% being male, and 74.4% were found to be exposed to excessive screen time. Excessive TV screen time (56.5%) was associated with poor diet quality. Excessive video game time (22.0%) was lower among females (PR 0.25; 95%CI 0.18;0.36), associated with poor diet quality, lower school environment income, and the worst classification of the built environment for physical activity. Excessive use of portable screens (53.2%) tended to increase with the income of the school environment. Excessive use of TV and laptops was widespread among adolescents, with different demographic and contextual variables associated according to the type of device used. 3 Curitiba Paraná television consumption Census surroundings 1200 1 200 1,20 adolescents 509 50 9 50.9 male 744 74 4 74.4 56.5% 565 56 5 (56.5% 22.0% 220 22 0 (22.0% PR 0.25 025 25 95CI CI 95 0.180.36, 018036 0.18 0.36 , 18 36 0.18;0.36) 53.2% 532 53 2 (53.2% 120 20 1,2 50. 7 74. 56.5 (56.5 22.0 (22.0 0.2 02 180 0.180.36 01803 018 0.1 036 0.3 0.18;0.36 53.2 (53.2 12 1, 56. (56. 22. (22. 0. 0.180.3 0180 01 03 0.18;0.3 53. (53. (56 (22 0.180. 0.18;0. (53 (5 (2 0.180 0.18;0 ( 0.18;

Resumo Objetivou-se investigar a associação entre o tempo de uso excessivo de diferentes telas, a qualidade da dieta em adolescentes e características do entorno escolar. Adolescentes de 30 escolas estaduais de Curitiba/PR relataram tempo de tela: televisão, videogame e portáteis. A qualidade da dieta foi avaliada pela frequência de consumo de alimentos. A renda do entorno escolar foi obtida do Censo. O ambiente construído para atividade física investigado por observação sistemática do entorno escolar. A regressão de Poisson multinível foi empregada para estimar associações com as variáveis de exposição. Entre 1.200 adolescentes, 50,9% do sexo masculino, 74,4% tiveram tempo excessivo de tela. O tempo excessivo de TV (56,5%) esteve associado à pior qualidade da alimentação. O tempo excessivo de videogame (22,0%) foi menor no sexo feminino (RP 0,25; IC95% 0,18;0,36), associado à pior qualidade da alimentação, à menor renda do entorno escolar, e à pior classificação do ambiente construído para atividade física. O tempo excessivo de telas portáteis (53,2%) apresentou tendência de aumento com a renda do entorno escolar. O uso excessivo de TV e telas portáteis foi amplamente praticado por adolescentes, com diferentes variáveis demográficas e contextuais associadas de acordo com o tipo de dispositivo utilizado. Objetivouse Objetivou se 3 CuritibaPR Curitiba PR tela televisão alimentos Censo exposição 1200 1 200 1.20 509 50 9 50,9 masculino 744 74 4 74,4 56,5% 565 56 5 (56,5% alimentação 22,0% 220 22 0 (22,0% RP 0,25 025 25 IC95 IC 0,180,36, 018036 0,18 0,36 , 18 36 0,18;0,36) 53,2% 532 53 2 (53,2% utilizado 120 20 1.2 50, 7 74, 56,5 (56,5 22,0 (22,0 0,2 02 IC9 180 0,180,36 01803 018 0,1 036 0,3 0,18;0,36 53,2 (53,2 12 1. 56, (56, 22, (22, 0, 0,180,3 0180 01 03 0,18;0,3 53, (53, (56 (22 0,180, 0,18;0, (53 (5 (2 0,180 0,18;0 ( 0,18;

Resumo Introdução: Embora a utilização de Marcadores de Consumo Alimentar esteja prevista na atenção primária à saúde, seu uso pelas equipes de saúde bucal ainda é incipiente. Objetivo: Analisar a associação do consumo de alimentos cariogênicos, avaliado através de marcadores do consumo alimentar, com a ocorrência de cárie dentária não tratada em pré-escolares. Método: Envolveu 432 crianças (18-36 meses) em uma amostra representativa dos Centros Municipais de Educação Infantil (São José dos Pinhais-PR). Os pais/responsáveis responderam um questionário socioeconômico e demográfico, e as crianças foram avaliadas por examinadora calibrada (Kappa=0,80). O consumo de alimentos cariogênicos foi mensurado através do instrumento Marcadores de Consumo Alimentar (Ministério da Saúde; Brasil). O escore de consumo de alimentos cariogênicos (EAC) foi obtido pela soma de relatos de consumo de alimentos com açúcar livre. Resultados: A prevalência de cárie dentária não tratada foi 21% (IC95% 17–24). Na regressão múltipla de Poisson com variância robusta, a maior prevalência de cárie dentária não tratada foi associada ao maior EAC (RPa=1,16; IC95% 1,01–1,34; p=0,035), a maior idade das crianças (RPa=1,05; IC95% 1.01–1.10; p=0,021) e inversamente a maior escolaridade dos responsáveis (RPa=0,62; IC95% 0,42–0,92; p=0,017). Conclusão: O consumo de alimentos cariogênicos, medido através do Marcadores de Consumo Alimentar, foi associado com uma maior prevalência de cárie dentária não tratada em pré-escolares. Introdução incipiente Objetivo alimentar préescolares. préescolares pré escolares. escolares pré-escolares Método 43 1836 18 36 (18-3 meses São PinhaisPR. PinhaisPR Pinhais PR . Pinhais-PR) paisresponsáveis pais demográfico Kappa=0,80. Kappa080 Kappa Kappa=0,80 0 80 (Kappa=0,80) Ministério Saúde Brasil. Brasil Brasil) (EAC livre Resultados 21 IC95 IC (IC95 17–24. 1724 17–24 17 24 17–24) robusta RPa=1,16 RPa116 RPa 1 16 (RPa=1,16 1,01–1,34 101134 01 34 p=0,035, p0035 p p=0,035 , 035 p=0,035) RPa=1,05 RPa105 05 (RPa=1,05 1.01–1.10 101110 10 p=0,021 p0021 021 RPa=0,62 RPa062 62 (RPa=0,62 0,42–0,92 042092 42 92 p=0,017. p0017 p=0,017 017 p=0,017) Conclusão 4 183 3 (18- Pinhais-PR Kappa08 Kappa=0,8 8 (Kappa=0,80 2 IC9 (IC9 172 17–2 RPa=1,1 RPa11 (RPa=1,1 1,01–1,3 10113 p003 p=0,03 03 RPa=1,0 RPa10 (RPa=1,0 1.01–1.1 10111 p=0,02 p002 02 RPa=0,6 RPa06 6 (RPa=0,6 0,42–0,9 04209 9 p001 p=0,01 (18 Kappa0 Kappa=0, (Kappa=0,8 (IC 17– RPa=1, RPa1 (RPa=1, 1,01–1, 1011 p00 p=0,0 1.01–1. RPa=0, RPa0 (RPa=0, 0,42–0, 0420 (1 Kappa=0 (Kappa=0, RPa=1 (RPa=1 1,01–1 101 p0 p=0, 1.01–1 RPa=0 (RPa=0 0,42–0 042 ( Kappa= (Kappa=0 RPa= (RPa= 1,01– p=0 1.01– 0,42– 04 (Kappa= (RPa 1,01 p= 1.01 0,42 (Kappa 1,0 1.0 0,4 1, 1. 0,

Abstract Background: Although the use of Food Consumption Markers is foreseen in primary health care, their use by oral health teams is still incipient. Objective: The objective of this study was to investigate the association of cariogenic food consumption, measured through the food consumption markers, with the occurrence of untreated dental caries in preschoolers. Method: The study included 432 children (aged 18–36 months) in a representative sample of the Municipal Centers for Early Childhood Education (São José dos Pinhais, Pr). The parents/guardians answered a socioeconomic and demographic questionnaire, and the children were examined by a calibrated examiner (kappa=0.80). Cariogenic food consumption was measured using the Food Consumption Markers instrument (Ministry of Health, Brazil). The score of consumption of cariogenic foods was obtained by the sum of reports of consumption of foods with free sugar (SCF). Results: The prevalence of untreated dental caries was 21% (95%CI 17–24). In the multiple Poisson regression with robust variance, the higher prevalence of untreated dental caries was associated with the higher SCF (RPa=1.16; 95%CI 1.01–1.34; p=0.035), with the older age of the children (PRa=1.05; 95%CI 1.01–1.10; p=0.021), and inversely to the higher guardians’ education (PRa=0.62; 95%CI: 0.42–0.92; p=0.017). Conclusion: Cariogenic food consumption, measured through the Food Consumption Markers instrument, was associated with a higher prevalence of untreated dental caries in preschoolers. Background care incipient Objective markers preschoolers Method 43 aged 1836 18 36 18–3 months São Pinhais Pr. Pr . Pr) parentsguardians parents guardians questionnaire kappa=0.80. kappa080 kappa kappa=0.80 0 80 (kappa=0.80) Ministry Health Brazil. Brazil Brazil) SCF. (SCF) Results 21 95CI CI 95 17–24. 1724 17–24 17 24 17–24) variance RPa=1.16 RPa116 RPa 1 16 (RPa=1.16 1.01–1.34 101134 01 34 p=0.035, p0035 p p=0.035 , 035 p=0.035) PRa=1.05 PRa105 PRa 05 (PRa=1.05 1.01–1.10 101110 10 p=0.021, p0021 p=0.021 021 p=0.021) PRa=0.62 PRa062 62 (PRa=0.62 0.42–0.92 042092 42 92 p=0.017. p0017 p=0.017 017 p=0.017) Conclusion 4 183 3 18– kappa08 kappa=0.8 8 (kappa=0.80 (SCF 2 9 172 17–2 RPa=1.1 RPa11 (RPa=1.1 1.01–1.3 10113 p003 p=0.03 03 PRa=1.0 PRa10 (PRa=1.0 1.01–1.1 10111 p002 p=0.02 02 PRa=0.6 PRa06 6 (PRa=0.6 0.42–0.9 04209 p001 p=0.01 kappa0 kappa=0. (kappa=0.8 17– RPa=1. RPa1 (RPa=1. 1.01–1. 1011 p00 p=0.0 PRa=1. PRa1 (PRa=1. PRa=0. PRa0 (PRa=0. 0.42–0. 0420 kappa=0 (kappa=0. RPa=1 (RPa=1 1.01–1 101 p0 p=0. PRa=1 (PRa=1 PRa=0 (PRa=0 0.42–0 042 kappa= (kappa=0 RPa= (RPa= 1.01– p=0 PRa= (PRa= 0.42– 04 (kappa= (RPa 1.01 p= (PRa 0.42 (kappa 1.0 0.4 1. 0.

Resumo Os comportamentos relacionados ao balanço de energia corporal (CRBEC) durante a gestação podem estar associados às repercussões de curto e longo prazo. Este estudo objetivou identificar os padrões de CRBEC e sua associação com a insegurança alimentar (IA) em gestantes. Estudo transversal com mulheres em acompanhamento pré-natal em unidades públicas de saúde de Colombo (PR), Brasil em 2018/2019. Padrões de CRBEC foram identificados por análise fatorial e os escores foram comparados de acordo com os níveis de IA (IA leve, IA moderada/grave (M/G) por meio de regressão quantílica. Quatro padrões de CRBEC foram identificados entre 535 gestantes: Fator 1- atividades domésticas/cuidados, exercícios/esporte e inatividade física; Fator 2- frutas e vegetais; Fator 3 - trabalho remunerado e deslocamento; Fator 4 - refrigerantes e bebidas açucaradas, doces e guloseimas. Após análise ajustada as mulheres com IA leve apresentaram maiores escores para o Fator 1 e menores escores para o Fator 3. Maiores escores foram observados entre as mulheres com IA leve no Fator 4 (p25) na regressão quantílica simultânea. IA M/G foi associada a escores mais baixos para o Fator 3 (p75). Padrões mistos com fatores negativa e positivamente associados ao balanço de energia foram identificados entre as gestantes com IA.

Abstract The behaviors related to caloric balance during pregnancy can lead to short- and long-term repercussion over the life course. This study aimed to identify patterns of energy balance-related behavior (EBRB) and its association with food insecurity (FI) in pregnant women. Cross-sectional, with pregnant women undergoing prenatal care in public health units in Colombo, Brazil, in 2018/2019. EBRB patterns were identified by factor analysis, and the scores were compared according to FI levels (mild and moderate/severe (M/S) through quantile regression. Four EBRB patterns were identified among 535 pregnant women: Factor 1- household/caregiving activities, exercise/sport, and physical inactivity; Factor 2 - fruits and vegetables; Factor 3 - paid work and commuting; Factor 4 - soda and sweetened beverage, sweets, and goodies. After adjusted analyses, women with mild FI presented higher scores for Factor 1 and lower scores for Factor 3. Higher scores for Factor 4 (p25) were observed among women with mild FI in simultaneous quantile regression. M/S FI was associated with lower scores for Factor 3 (p75). Mixed patterns with factors negatively and positively associated with energy balance were identified among pregnant women with FI.

Abstract The behaviors related to caloric balance during pregnancy can lead to short- and long-term repercussion over the life course. This study aimed to identify patterns of energy balance-related behavior (EBRB) and its association with food insecurity (FI) in pregnant women. Cross-sectional, with pregnant women undergoing prenatal care in public health units in Colombo, Brazil, in 2018/2019. EBRB patterns were identified by factor analysis, and the scores were compared according to FI levels (mild and moderate/severe (M/S) through quantile regression. Four EBRB patterns were identified among 535 pregnant women: Factor 1- household/caregiving activities, exercise/sport, and physical inactivity; Factor 2 - fruits and vegetables; Factor 3 - paid work and commuting; Factor 4 - soda and sweetened beverage, sweets, and goodies. After adjusted analyses, women with mild FI presented higher scores for Factor 1 and lower scores for Factor 3. Higher scores for Factor 4 (p25) were observed among women with mild FI in simultaneous quantile regression. M/S FI was associated with lower scores for Factor 3 (p75). Mixed patterns with factors negatively and positively associated with energy balance were identified among pregnant women with FI. short longterm long term course balancerelated (EBRB (FI Crosssectional, Crosssectional Cross sectional, sectional Cross-sectional Colombo Brazil 20182019 2018 2019 2018/2019 analysis moderatesevere moderate severe MS M S (M/S regression 53 householdcaregiving household caregiving activities exercisesport exercise sport exercise/sport inactivity vegetables commuting beverage sweets goodies analyses p25 p (p25 p75. p75 . (p75) 2018201 201 2018/201 5 p2 (p2 p7 (p75 201820 20 2018/20 (p (p7 20182 2018/2 2018/

Resumo Os comportamentos relacionados ao balanço de energia corporal (CRBEC) durante a gestação podem estar associados às repercussões de curto e longo prazo. Este estudo objetivou identificar os padrões de CRBEC e sua associação com a insegurança alimentar (IA) em gestantes. Estudo transversal com mulheres em acompanhamento pré-natal em unidades públicas de saúde de Colombo (PR), Brasil em 2018/2019. Padrões de CRBEC foram identificados por análise fatorial e os escores foram comparados de acordo com os níveis de IA (IA leve, IA moderada/grave (M/G) por meio de regressão quantílica. Quatro padrões de CRBEC foram identificados entre 535 gestantes: Fator 1- atividades domésticas/cuidados, exercícios/esporte e inatividade física; Fator 2- frutas e vegetais; Fator 3 - trabalho remunerado e deslocamento; Fator 4 - refrigerantes e bebidas açucaradas, doces e guloseimas. Após análise ajustada as mulheres com IA leve apresentaram maiores escores para o Fator 1 e menores escores para o Fator 3. Maiores escores foram observados entre as mulheres com IA leve no Fator 4 (p25) na regressão quantílica simultânea. IA M/G foi associada a escores mais baixos para o Fator 3 (p75). Padrões mistos com fatores negativa e positivamente associados ao balanço de energia foram identificados entre as gestantes com IA. (CRBEC prazo prénatal pré natal PR, PR , (PR) 20182019 2018 2019 2018/2019 moderadagrave moderada grave MG M G (M/G 53 domésticascuidados domésticas cuidados domésticas/cuidados exercíciosesporte exercícios esporte física 2 vegetais deslocamento açucaradas guloseimas p25 p (p25 simultânea p75. p75 . (p75) (PR 2018201 201 2018/201 5 p2 (p2 p7 (p75 201820 20 2018/20 (p (p7 20182 2018/2 2018/

Abstract Background Overweight is a risk factor for chronic diseases. Objective To estimate the prevalence of overweight and obesity and to investigate its association with demographic, socioeconomic, reproductive and health behaviors related among women users of specialized care units. Method Cross-sectional study with women in care by a mastologist. Nutritional status was classified by Body Mass Index (BMI). Gross and adjusted multinomial logistic regression models were used, to estimate an Odds Ratios (OR) and 95% Confidence Intervals (95% CI). Eutrophy was considered as a reference category. Results 182 women with a mean age of 51 years. The prevalence of overweight was 34.1% (CI 95% 27.1-41.0) and obesity was 31.8% (CI 95% 25.0-38.7). Women were more likely to be obese: 60 years of age or older, who were gainfully employed, who had menarche before age 13, and with three or more pregnancies. After adjusted analysis, they remained associated with a greater chance of the development of obesity to menarche before 13 years (OR 4.40 CI 95% 1.76-10.99) and three or more pregnancies (OR 8.50 CI 95% 2.14-33.70). Conclusion There was a high prevalence of overweight and obesity among the participants, associated with reproductive characteristics. diseases demographic socioeconomic units Crosssectional Cross sectional mastologist BMI. BMI . (BMI) used OR 95 (95 CI. CI) category 18 5 341 34 1 34.1 27.141.0 271410 27.1 41.0 27 41 0 27.1-41.0 318 31 8 31.8 25.038.7. 250387 25.0 38.7 25 38 7 25.0-38.7) obese 6 older employed analysis 440 4 40 4.4 1.7610.99 1761099 1.76 10.99 76 10 99 1.76-10.99 850 50 8.5 2.1433.70. 2143370 2.14 33.70 2 14 33 70 2.14-33.70) participants characteristics (BMI 9 (9 3 34. 141 27.141. 27141 271 27. 410 41. 27.1-41. 31. 038 25.038.7 25038 250 25. 387 38. 25.0-38.7 44 4. 7610 1.7610.9 176109 176 1.7 1099 10.9 1.76-10.9 85 8. 1433 2.1433.70 214337 214 2.1 3370 33.7 2.14-33.70 ( 27.141 2714 27.1-41 03 25.038. 2503 25.0-38. 761 1.7610. 17610 17 1. 109 10. 1.76-10. 143 2.1433.7 21433 21 2. 337 33. 2.14-33.7 27.14 27.1-4 25.038 25.0-38 1.7610 1761 1.76-10 2.1433. 2143 2.14-33. 27.1- 25.03 25.0-3 1.761 1.76-1 2.1433 2.14-33 25.0- 1.76- 2.143 2.14-3 2.14-

Resumo Introdução O excesso de peso é um fator de risco para doenças crônicas. Objetivo Estimar a prevalência de sobrepeso e obesidade, e investigar sua associação com variáveis demográficas, socioeconômicas e reprodutivas e com comportamentos relacionados à saúde entre mulheres usuárias de unidade de atenção especializada. Método Estudo transversal com mulheres em atendimento por mastologista. O estado nutricional foi classificado por meio do índice de massa corporal. Foram utilizados modelos de regressão logística multinomial brutos e ajustados, com estimativa de razões de chance (RC) e intervalos de confiança de 95% (IC95%). A eutrofia foi considerada como categoria de referência. Resultados Participaram 182 mulheres com média de idade de 51 anos. A prevalência de sobrepeso foi de 34,1% (IC95% 27,1-41,0) e de obesidade foi de 31,8% (IC95% 25,0-38,7). Apresentaram maiores chances de obesidade as mulheres: com 60 anos ou mais, que exerciam atividade remunerada, que tiveram menarca antes dos 13 anos e com três ou mais gestações. Após análise ajustada, permaneceram associadas à maior chance de obesidade a menarca antes dos 13 anos (RC 4,40; IC95% 1,76-10,99) e três ou mais gestações (RC 8,50; IC95% 2,14-33,70). Conclusão Verificou-se elevada prevalência de sobrepeso e obesidade entre as participantes, associada às características reprodutivas. crônicas demográficas especializada mastologista corporal ajustados RC 95 IC95%. IC95 IC . (IC95%) referência 18 5 341 34 1 34,1 (IC95 27,141,0 271410 27,1 41,0 27 41 0 27,1-41,0 318 31 8 31,8 25,038,7. 250387 25,0 38,7 25 38 7 25,0-38,7) 6 remunerada ajustada 4,40 440 4 40 1,7610,99 1761099 1,76 10,99 76 10 99 1,76-10,99 8,50 850 50 2,1433,70. 2143370 2,14 33,70 2 14 33 70 2,14-33,70) Verificouse Verificou se participantes 9 IC9 3 34, (IC9 141 27,141, 27141 271 27, 410 41, 27,1-41, 31, 038 25,038,7 25038 250 25, 387 38, 25,0-38,7 4,4 44 7610 1,7610,9 176109 176 1,7 1099 10,9 1,76-10,9 8,5 85 1433 2,1433,70 214337 214 2,1 3370 33,7 2,14-33,70 (IC 27,141 2714 27,1-41 03 25,038, 2503 25,0-38, 4, 761 1,7610, 17610 17 1, 109 10, 1,76-10, 8, 143 2,1433,7 21433 21 2, 337 33, 2,14-33,7 27,14 27,1-4 25,038 25,0-38 1,7610 1761 1,76-10 2,1433, 2143 2,14-33, 27,1- 25,03 25,0-3 1,761 1,76-1 2,1433 2,14-33 25,0- 1,76- 2,143 2,14-3 2,14-

ABSTRACT Objective The objective of this study was to cross-culturally adapt the Perceived Nutrition Environment Measures Survey for use in the Brazilian context. Methods Independent translations into Portuguese of the original version and respective back-translations into English were performed. The steps were evaluated by an expert committee and the translated version was applied in a group of both genders, of different ages and education. Results After suggested modifications in the translation processes, the expert committee considered that the translated and adapted version presented conceptual and semantic equivalence. The translated version was applied to a sample of twenty people and only one question related to the amount of fat in the food required a new round to obtain understanding and clarity. Conclusion We present an adapted version of Perceived Nutrition Environment Measures Survey for the Brazilian context, which has adequate conceptual, cultural, and semantic equivalence, being objective and comparable to the original version. Future studies should confirm clarity, reliability, and validity. crossculturally cross culturally context backtranslations back performed genders education processes equivalence clarity cultural reliability validity

RESUMO Objetivo O objetivo deste estudo foi adaptar transculturalmente o Perceived Nutrition Environment Measures Survey para uso no contexto brasileiro. Métodos Foram realizadas traduções independentes da versão original para o português e respectivas retrotraduções para o inglês. As etapas foram avaliadas por um comitê de especialistas e a versão traduzida foi aplicada em um grupo com pacientes de ambos os sexos, de diferentes idades e níveis de escolaridade. Resultados Após modificações sugeridas nos processos de tradução, o comitê de especialistas considerou que a versão traduzida e adaptada apresentou equivalência conceitual e semântica. A versão traduzida foi aplicada a uma amostra de 20 pessoas e apenas uma questão, relacionada à quantidade de gordura no alimento, requereu nova rodada para obter compreensão e clareza. Conclusão Uma versão do Perceived Nutrition Environment Measures Survey adaptada ao contexto brasileiro, a qual possui equivalências conceitual, cultural e semântica adequadas, sendo objetiva e comparável à versão original, é apresentada. Futuros estudos devem confirmar a clareza, confiabilidade e validade. brasileiro inglês sexos escolaridade tradução 2 questão alimento clareza adequadas apresentada validade

Abstract Objectives: to estimate the intention of breastfeeding (IBF) duration and its association with sociodemographic, obstetric characteristics and experience with breastfeeding among pregnant women undergoing prenatal care. Methods: cross-sectional study, with pregnant women undergoing prenatal care in public health services in Colombo, Paraná, Brazil. The duration of IBF was questioned to pregnant women. Negative binomial Poisson regression with robust variance adjustment allowed estimating crude and adjusted prevalence ratios (PR), and 95% confidence intervals (CI95%) of the association between IBF duration and exposure variables. Results: among the participating pregnant women (n = 604), 7.9% reported having IBF for less than six months, 28.0% from six to 11 months, 38.3% from 12 to 23 and 25.9% for 24 months or more. The mean IBF time was 13.5 ± 8.4 and median of 12 months. Pregnant women with moderate food insecurity (PR=1.34; CI95%=1.04-1.73), multiparous women (PR=1.13; CI95%=1.00-1.26), and who reported having been breastfed as babies (PR=1.19; CI95%=1.02-1.40) had a longer IBF time. Conclusions: food security situation, primiparity and exposure to breastfeeding in childhood are determinants of IBF during pregnancy. Objectives (IBF sociodemographic Methods crosssectional cross sectional study Colombo Paraná Brazil PR, PR , (PR) 95 CI95% CI95 CI (CI95% variables Results n 604, 604 604) 79 7 9 7.9 280 28 0 28.0 1 383 38 3 38.3 2 259 25 25.9 more 135 13 5 13. 84 8 4 8. PR=1.34 PR134 34 (PR=1.34 CI95%=1.041.73, CI95104173 CI95%=1.04 1.73 04 73 CI95%=1.04-1.73) PR=1.13 PR113 (PR=1.13 CI95%=1.001.26, CI95100126 CI95%=1.00 1.26 00 26 CI95%=1.00-1.26) PR=1.19 PR119 19 (PR=1.19 CI95%=1.021.40 CI95102140 CI95%=1.02 1.40 02 40 CI95%=1.02-1.40 Conclusions situation pregnancy (PR CI9 (CI95 60 7. 28. 38. 25. PR=1.3 PR13 (PR=1.3 041 CI95%=1.041.73 CI9510417 CI95104 CI95%=1.0 173 1.7 CI95%=1.04-1.73 PR=1.1 PR11 (PR=1.1 001 CI95%=1.001.26 CI9510012 CI95100 126 1.2 CI95%=1.00-1.26 021 CI95%=1.021.4 CI9510214 CI95102 140 1.4 CI95%=1.02-1.4 (CI9 6 PR=1. PR1 (PR=1. CI95%=1.041.7 CI951041 CI9510 CI95%=1. 17 1. CI95%=1.04-1.7 CI95%=1.001.2 CI951001 CI95%=1.00-1.2 CI95%=1.021. CI951021 14 CI95%=1.02-1. (CI PR=1 (PR=1 CI95%=1.041. CI951 CI95%=1 CI95%=1.04-1. CI95%=1.001. CI95%=1.00-1. CI95%=1.021 CI95%=1.02-1 PR= (PR= CI95%=1.041 CI95%= CI95%=1.04-1 CI95%=1.001 CI95%=1.00-1 CI95%=1.02- CI95%=1.04- CI95%=1.00-

Resumo Objetivos: estimar o tempo de intenção de amamentar (IA) e sua associação com características sociodemográficas, obstétricas e experiência com amamentação entre gestantes em acompanhamento pré-natal. Métodos: estudo transversal com gestantes em serviços públicos de saúde em Colombo, Paraná. O tempo de IA foi questionado às gestantes. Regressão de Poisson binomial negativa com ajuste robusto da variância permitiu estimar razões de prevalência (RP) brutas e ajustadas, e intervalos de confiança de 95% (IC95%) da associação entre tempo de IA e variáveis de exposição. Resultados: dentre as gestantes (n = 604), 7,9% afirmaram IA por menos de 6 meses, 28,0% de 6 a 11 meses, 38,3% de 12 a 23 e 25,9% por 24 meses ou mais. O tempo médio de IA foi de 13,5 ± 8,4 e mediana de 12 meses. Gestantes em insegurança alimentar moderada (RP=1,34; IC95%=1,04-1,73), multíparas (RP=1,13; IC95%=1,00-1,26), e que referiram terem sido amamentadas quando bebês (RP=1,19; IC95%=1,02-1,40) apresentaram maior tempo de IA. Conclusões: situação de segurança alimentar, primiparidade e exposição ao aleitamento materno na infância são determinantes da IA na gestação. Objetivos (IA sociodemográficas prénatal. prénatal pré natal. natal pré-natal Métodos Colombo Paraná RP (RP ajustadas 95 IC95% IC95 IC (IC95% Resultados n 604, 604 , 604) 79 7 9 7,9 280 28 0 28,0 1 383 38 3 38,3 2 259 25 25,9 mais 135 13 5 13, 84 8 4 8, RP=1,34 RP134 34 (RP=1,34 IC95%=1,041,73, IC95104173 IC95%=1,04 1,73 04 73 IC95%=1,04-1,73) RP=1,13 RP113 (RP=1,13 IC95%=1,001,26, IC95100126 IC95%=1,00 1,26 00 26 IC95%=1,00-1,26) RP=1,19 RP119 19 (RP=1,19 IC95%=1,021,40 IC95102140 IC95%=1,02 1,40 02 40 IC95%=1,02-1,40 Conclusões gestação IC9 (IC95 60 7, 28, 38, 25, RP=1,3 RP13 (RP=1,3 041 IC95%=1,041,73 IC9510417 IC95104 IC95%=1,0 173 1,7 IC95%=1,04-1,73 RP=1,1 RP11 (RP=1,1 001 IC95%=1,001,26 IC9510012 IC95100 126 1,2 IC95%=1,00-1,26 021 IC95%=1,021,4 IC9510214 IC95102 140 1,4 IC95%=1,02-1,4 (IC9 RP=1, RP1 (RP=1, IC95%=1,041,7 IC951041 IC9510 IC95%=1, 17 1, IC95%=1,04-1,7 IC95%=1,001,2 IC951001 IC95%=1,00-1,2 IC95%=1,021, IC951021 14 IC95%=1,02-1, (IC RP=1 (RP=1 IC95%=1,041, IC951 IC95%=1 IC95%=1,04-1, IC95%=1,001, IC95%=1,00-1, IC95%=1,021 IC95%=1,02-1 RP= (RP= IC95%=1,041 IC95%= IC95%=1,04-1 IC95%=1,001 IC95%=1,00-1 IC95%=1,02- IC95%=1,04- IC95%=1,00-

ABSTRACT Objective To evaluate prenatal and puerperium care levels received and identify their association with sociodemographic and obstetric characteristics. Methods This cross-sectional study was conducted from May to December 2020 and included women who gave birth at the Municipal Hospital of Fazenda Rio Grande, Paraná, Brazil. Data were collected through interviews and review of portfolios and medical records. The variables extracted from the prenatal protocols of Paraná and the Ministry of Health were grouped into five compliance indices: CI1 - clinical examination; CI2 - health education; CI3 - queries; CI4 - examinations and vaccines; and CI5 - postpartum appointments. Prenatal care was considered adequate when 80% or more adequacy was obtained. Results A total of 307 women participated in this study. Prenatal compliance was 16.6% considering the entire set of variables. The best performance was for CI4 (54.7%) and the worst for CI5 (13.3%). The lowest adequacy occurred among single women (10.9%) compared to those who lived with a partner (19.9%) (p=0.043) and among women with black/brown skin color (9.5%) compared to those with white/yellow skin color (20.3%) (p=0.016). Conclusion Most women did not receive adequate care, with those in situations of greater social vulnerability received worse quality care. characteristics crosssectional cross sectional 202 Grande Brazil records indices CI examination education queries vaccines appointments 80 obtained 30 166 16 6 16.6 54.7% 547 54 7 (54.7% 13.3%. 133 13.3% . 13 3 (13.3%) 10.9% 109 10 9 (10.9% 19.9% 199 19 (19.9% p=0.043 p0043 p 0 043 (p=0.043 blackbrown black brown 9.5% 95 5 (9.5% whiteyellow white yellow 20.3% 203 20 (20.3% p=0.016. p0016 p=0.016 016 (p=0.016) 8 1 16. 54.7 (54.7 13.3 (13.3% 10.9 (10.9 19.9 (19.9 p=0.04 p004 04 (p=0.04 9.5 (9.5 20.3 2 (20.3 p001 p=0.01 01 (p=0.016 54. (54. 13. (13.3 10. (10. 19. (19. p=0.0 p00 (p=0.0 9. (9. 20. (20. (p=0.01 (54 (13. (10 (19 p=0. p0 (p=0. (9 (20 (5 (13 (1 p=0 (p=0 ( (2 p= (p= (p

ABSTRACT Antiretroviral therapy interferes with the replication of the HIV virus, stops the progression of infection, and prevents early mortality in infected children. This research investigated the sociodemographic profile and parameters related to the antiretroviral treatment of HIV positive children living in the state of Paraná. This is a descriptive observational and analytical study, carried out with secondary data from the year 2020, referring to children up to 12 years of age. The profile, prevalence, medicines in use, treatment abandonment, viral resistance, and viral suppression were investigated. A total of 148 children were identified, with a prevalence equal to 8.1/100,000 in Paraná. All infants had begun their treatment, but 17,2% abandoned it. Among children who remained on treatment, 9.8% did not achieve viral suppression and their viral loads commonly exceeded 1000 viral copies/mL. There was a predominance of drug regimens probably prescribed after treatment failures. The results indicate that Paraná presents good results in terms of rapid initiation of therapy and viral suppression in children. However, there is a considerable number of abandonments of therapy and therapeutic failures, indicating the need to strengthen the link between this population and health services. virus infection study 2020 1 age use abandonment resistance 14 identified 81100000 8 100 000 8.1/100,00 172 17 2 17,2 it 98 9 9.8 copiesmL copies mL copies/mL failures However services 202 8110000 10 00 8.1/100,0 17, 9. 20 811000 0 8.1/100, 81100 8.1/100 8110 8.1/10 811 8.1/1 81 8.1/ 8.1 8.

RESUMO A terapia antirretroviral interfere na replicação do vírus HIV, impede a progressão da infecção para a Aids e previne a mortalidade precoce das crianças infectadas. Esta pesquisa investigou o perfil sociodemográfico e os parâmetros relacionados com o tratamento antirretroviral das crianças HIV positivas residentes no estado do Paraná. Trata-se de um estudo observacional descritivo e analítico realizado com dados secundários do ano de 2020 referentes às crianças com até 12 anos de idade. Foram investigados: perfil, prevalência, medicamentos em uso, abandono da terapia, resistência e supressão viral. Foram identificadas 148 crianças, com uma prevalência igual a 8,1/100 mil no Paraná. Apesar de todas as crianças diagnosticadas com HIV terem iniciado o tratamento, 17,2% encontravam-se em abandono da terapia antirretroviral. Entre as crianças que permaneciam em tratamento, 9,8% não atingiram a supressão viral e suas cargas virais comumente ultrapassavam mil cópias virais/mL. Houve um predomínio de esquemas medicamentosos provavelmente prescritos após falhas terapêuticas. Os resultados indicam que o Paraná apresenta bons resultados quanto ao início rápido da terapia e à supressão viral das crianças. Entretanto, existe um número considerável de abandonos da terapia e de falhas terapêuticas, indicando a necessidade de reforçar a vinculação desta população aos serviços de saúde. infectadas Tratase Trata se 202 1 idade investigados uso 14 81100 8 100 8,1/10 172 17 2 17,2 encontravamse encontravam 98 9 9,8 viraismL mL virais/mL terapêuticas Entretanto saúde 20 8110 10 8,1/1 17, 9, 811 8,1/ 81 8,1 8,

Abstract Introduction During pregnancy, there are changes that influence a woman’s quality of life. Objective To analyze the quality of life and its association with demographic, socioeconomic, obstetric, and health conditions in pregnant women. Method Quality of life was measured using the WHOQOL-BREF, and to evaluate the association between quality of life domains and exposure variables (demographics, socioeconomic, obstetrics, and health conditions) the inflated beta regression was used. Results In the physical domain, pregnant women had lower scores: with higher parity (OR = .71; 95% CI = [.59, .84]), third pregnancy trimester (OR = .74; 95% CI [.61, .89]), reported common symptom (OR = .80; 95% CI = [.67, .95]), or morbidity (OR = .67; 95% CI [.57, .79]). In the psychological domain, women with planned pregnancy had higher scores (OR = 1.20; 95% CI= [1.04, 1.37]), while those who reported common symptoms (OR = .75; 95% CI = [.63, .89]), or morbidity (OR = .82; 95% CI = [.70, .95]) had the worst scores. Higher income was associated with higher scores in the social relationships domain (OR = 1.22; 95% CI = [1.03, 1.45]). Women in their second pregnancy had lower scores in the environment domain (OR = .84; 95% CI = [.72, .98]), while those with intermediate income had higher scores (OR = 1.23; 95% CI = [1.05, 1.43]). Discussion and conclusion Lower quality of life scores were associated with obstetrics and health conditions variables, while higher scores were related with demographics and socioeconomics variables. The multidimensionality of factors associated with the domains of quality of life during pregnancy is also highlighted, which stresses the importance of intersectoral actions for women in social vulnerability.

Resumen Introducción Durante el embarazo hay cambios que influyen en la calidad de vida de la mujer. Objetivo Analizar la calidad de vida y su asociación con las condiciones demográficas, socioeconómicas, obstétricas y de salud en gestantes. Método La calidad de vida se midió utilizando el WHOQOL-BREF, en tanto que para evaluar la asociación entre los dominios de la calidad de vida y las variables de exposición (demográficas, socioeconómicas, obstétricas y condiciones de salud) se utilizó la regresión beta inflada. Resultados en el dominio físico, las gestantes tuvieron puntuaciones más bajas: con mayor paridad (OR = .71; IC 95% [.59, .84]), tercer trimestre de gestación (OR = .74; IC 95% = [.61, .89]), síntoma común reportado (OR = .80; IC 95% = [.67, .95]) o morbilidad (OR = .67; IC 95% = [.57, .79]). En el dominio psicológico, las mujeres con embarazo planificado tuvieron puntuaciones más altas (OR = 1.20; IC 95% = [1.04, 1.37]), mientras que aquellas que informaron síntomas comunes (OR = .75; IC 95% = [63, .89]) o morbilidad (OR = .82; IC 95% = [.70, .95]) obtuvieron las peores puntuaciones. Los ingresos más altos se asociaron con puntuaciones más altas en el dominio de las relaciones sociales (OR = 1.22; IC 95% = [1.03, 1.45]). Las mujeres que estaban en su segundo embarazo tuvieron puntuaciones más bajas en el dominio del medio ambiente (OR = .84; IC 95% = [.72, .98]), mientras que aquellas con ingresos intermedios tuvieron puntuaciones más altas (OR = 1.23; IC 95% = [1.05, 1.43]). Discusión y conclusión Los puntajes más bajos de calidad de vida se asociaron con variables obstétricas y condiciones de salud, mientras que los puntajes más altos se asociaron con variables demográficas y socioeconómicas. También sobresale la multidimensionalidad de los factores asociados a los dominios de la calidad de vida durante el embarazo, lo que destaca la importancia de las acciones transversales para las mujeres en situación de vulnerabilidad social.

ABSTRACT Antiretroviral therapy interferes with the replication of the HIV virus, stops the progression of infection, and prevents early mortality in infected children. This research investigated the sociodemographic profile and parameters related to the antiretroviral treatment of HIV positive children living in the state of Paraná. This is a descriptive observational and analytical study, carried out with secondary data from the year 2020, referring to children up to 12 years of age. The profile, prevalence, medicines in use, treatment abandonment, viral resistance, and viral suppression were investigated. A total of 148 children were identified, with a prevalence equal to 8.1/100,000 in Paraná. All infants had begun their treatment, but 17,2% abandoned it. Among children who remained on treatment, 9.8% did not achieve viral suppression and their viral loads commonly exceeded 1000 viral copies/mL. There was a predominance of drug regimens probably prescribed after treatment failures. The results indicate that Paraná presents good results in terms of rapid initiation of therapy and viral suppression in children. However, there is a considerable number of abandonments of therapy and therapeutic failures, indicating the need to strengthen the link between this population and health services.

RESUMO A terapia antirretroviral interfere na replicação do vírus HIV, impede a progressão da infecção para a Aids e previne a mortalidade precoce das crianças infectadas. Esta pesquisa investigou o perfil sociodemográfico e os parâmetros relacionados com o tratamento antirretroviral das crianças HIV positivas residentes no estado do Paraná. Trata-se de um estudo observacional descritivo e analítico realizado com dados secundários do ano de 2020 referentes às crianças com até 12 anos de idade. Foram investigados: perfil, prevalência, medicamentos em uso, abandono da terapia, resistência e supressão viral. Foram identificadas 148 crianças, com uma prevalência igual a 8,1/100 mil no Paraná. Apesar de todas as crianças diagnosticadas com HIV terem iniciado o tratamento, 17,2% encontravam-se em abandono da terapia antirretroviral. Entre as crianças que permaneciam em tratamento, 9,8% não atingiram a supressão viral e suas cargas virais comumente ultrapassavam mil cópias virais/mL. Houve um predomínio de esquemas medicamentosos provavelmente prescritos após falhas terapêuticas. Os resultados indicam que o Paraná apresenta bons resultados quanto ao início rápido da terapia e à supressão viral das crianças. Entretanto, existe um número considerável de abandonos da terapia e de falhas terapêuticas, indicando a necessidade de reforçar a vinculação desta população aos serviços de saúde.