Risk factors involved in adolescent obesity: an integrative review

The scope of this study was to examine the risk factors for the development of obesity in adolescence. The objective was to identify risk factors for adolescent obesity by means of an Integrative Review of the Literature. The PICO strategy was used to formulate the following central line of inquiry: What are the risk factors for the development of obesity during adolescence? The VHL and EBSCOhost research databases were consulted, resulting in a selection of 25 articles for in-depth study. The phenomenon of obesity was understood as the result of biological, social, psychological, and nutritional factors. The research revealed a lack of consensus on the risks and benefits, which makes evidence-based recommendations difficult. The study identified proposals that can be implemented, such as a change in eating habits, weight control and the practice of physical exercise. Such behavioral changes can be recommended within the context of the family, schools, and health services. The review recommends prevention strategies and the recognition of school as the ideal medium for health promotion through education. From a political and social standpoint, it is necessary to challenge the prevalence of publicity of the food industry that entices adolescents to consume processed foods with high fat and sugar content.

Transition to exclusive palliative care for women with breast cancer

OBJECTIVE

to analyze the perspectives that affect the transition to exclusive palliative care for women with breast cancer.

METHODS

qualitative, descriptive study, carried out in a public health institution in Rio de Janeiro, Brazil, between December 2018 and May 2019. 28 health professionals were interviewed. Content analysis was used in the thematic modality.

RESULTS

the operational difficulties were linked to the fragmented physical structure, the late and unplanned nature of the referral, the ineffective communication, and the deficit of human resources. In general, women and family members resist referral because they do not know palliative care. There is no consensus among oncologists on the most appropriate time to stop systemic therapy for disease control.

FINAL CONSIDERATIONS

the perceived difficulties configure an abrupt referral, accompanied by false hopes and, often, limited to end-of-life care.

On the way to interrupting the gestation or not: experiences of pregnant women with anencephalic fetuses

Anencephaly is a malformation characterized by the total or partial absence of the brain, and Brazil records the fourth largest number of births of anencephalic fetuses in the world. Fetal anencephaly is associated with a more significant number of maternal complications. As of 2012, women with anencephalic gestation were empowered with the right to carry the pregnancy to term or terminate it, if they so desired, without any judicial authorization. Objectives: to understand the experiences of women with fetal anencephaly and to identify the determinant factors for interrupting the gestation or not. This is a qualitative study using the Life Narratives method with 12 women over 18 years old diagnosed with an anencephalic fetus, who interrupted gestation or delivery in a public maternity hospital in Rio de Janeiro. Data were collected between June and November 2016, and the process was finalized when the narrative patterns reached progressive saturation from the recurrences. The statements that emerged following floating and in-depth reading were articulated in Narrative Nuclei, and data comparative and comprehensive analysis was performed. The reports brought to light the intense experiences of these women, as well as the weaknesses existing concerning care and the pregnancy termination issue.

The experience of illness of women with endometriosis: narratives about institutional violence

This paper conjures up the centrality of the relational category of gender to shed a light on women's life narratives with a chronic disease named endometriosis. It aims to discuss the meaning of the illness experience of women with endometriosis in the interface with institutional violence. Based on Bertaux reference, in the Narratives of Life method, twenty women participated in this research. They were invited from two virtual spaces of discussion and gatherings about living with endometriosis. Interviews were conducted in person in the States of Rio de Janeiro, São Paulo and Minas Gerais circuit. Authors sustained the theoretical approach and addressed the experience of chronic illness as a sociocultural phenomenon, metaphorical readings of the problem and criticism of institutional violence. The results identify situations of gender/institutional violence perpetrated in various women care settings. They are expressed through the trivialization of women's discourses; user-physician tensions, where the supposed lay knowledge appears as an insult to official biomedical knowledge and, mainly, the difficult access to services, leading women to a care pilgrimage and to submit themselves to care types not necessarily based on best practices.

Realização da episiotomia nos dias atuais à luz da produção científica: uma revisão

A episiotomia é um procedimento cirúrgico realizado no períneo da mulher no momento do parto, feita por obstetras e enfermeiros obstetras. Atualmente tem sido empregada de forma rotineira, e esta prática vem sendo questionada. O presente estudo foi concebido a partir do levantamento bibliográfico da produção científica sobre episiotomia. Deu-se com busca eletrônica no banco de dados informatizado da LILACS. Foram levantados 60 estudos, sendo analisados 22 trabalhos sobre episiotomia especificamente, separados por décadas: 1980, 1990, e de 2000 a 2005. As discussões orientaram-se pela característica de estudo e do profissional que o produziu, e de que forma analisou a questão sobre a episiotomia. Conclui-se que a maioria dos estudos publicados sobre episiotomia foi elaborada por médicos, predominando os aspectos técnico-científicos e revelando-se o reflexo de uma formação cartesiana, com enfoque biologicista, também reflexo da visão política voltada à saúde da mulher, que ao longo dos anos foi definida como ser da reprodução, figura feita para o lar e para os filhos, ideologia impressa nos programas políticos que definiram a saúde deste grupo.