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Despite being a priority population in malaria elimination, there is scant literature on malaria-related behavior among gold miners. This study explores the prevalence and factors influencing malaria prevention, care seeking and treatment behaviors in Guyana gold mining camps. A cross sectional survey was conducted among adult gold miners living in mining camps in the hinterland Regions 1 (Barima-Waini), 7 (Cuyuni-Mazaruni), and 8 (Potaro-Siparuni). Multivariable logistic regressions explored factors associated with miners' self-report of mosquito net use, prompt care-seeking; self-medication; and testing for malaria. A third of miners used a mosquito net the night preceding the survey and net use was higher among those who believed that net use was the norm in their camp (aOR: 3.11; 95% CI:1.65, 5.88). Less than half (45%) of miners had a fever in the past 12 months, among whom 36% sought care promptly, 48% tested positive for malaria while 54% self-medicated before seeking care. Prompt care-seeking was higher among miners with high malaria knowledge (aOR: 1.44; 95% CI: 1.01, 2.05). Similarly, testing rates increased with secondary education (aOR: 1.71; 95% CI: (1.16, 2.51), high malaria knowledge (aOR: 1.45; 95% CI: 1.02, 2.05), positive beliefs regarding malaria transmission, threat, self-diagnosis, testing and treatment, and, trust in government services (aOR: 1.59; 95% CI (1.12, 2.27) and experience of a prior malaria episode (aOR: 2.62; 95% CI: 1.71, 4.00). Self-medication was lower among male miners (aOR: 0. 52; 95% CI: 0.32, 0.86). Malaria prevention and care seeking behaviors among miners are somewhat low and influenced by mosquito net usage, perceived norms, malaria knowledge and prior episode of confirmed malaria. Study findings have implications for malaria interventions in the hinterland regions of Guyana such as the mass and continuous distribution of insecticide treated nets as well as community case management initiatives using trained malaria testing and treatment volunteers to curb malaria transmission among remote gold mining populations. These include efforts to identify and address gaps in distributing mosquito nets to miners and address miners' barriers to prompt care seeking, malaria testing and treatment adherence. Targeted social and behavior change messaging is needed on net acquisition, use and care, prompt care-seeking, malaria testing and treatment adherence. Additional efforts to ensure the overall sustainability of the community case management initiative include increased publicity of the community case management initiative among miners, use of incentives to promote retention rates among the community case management volunteer testers and public private partnerships between the Guyana Ministry of Health and relevant mining organizations.
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Conocimientos, Actitudes y Práctica en Salud , Malaria/prevención & control , Mineros/psicología , Aceptación de la Atención de Salud/psicología , Adolescente , Adulto , Servicios de Salud Comunitaria/organización & administración , Estudios Transversales , Femenino , Oro , Guyana , Humanos , Malaria/tratamiento farmacológico , Malaria/parasitología , Malaria/transmisión , Masculino , Persona de Mediana Edad , Mineros/estadística & datos numéricos , Minería/organización & administración , Mosquiteros/estadística & datos numéricos , Motivación , Aceptación de la Atención de Salud/estadística & datos numéricos , Asociación entre el Sector Público-Privado , Automedicación/psicología , Automedicación/estadística & datos numéricos , Autoinforme/estadística & datos numéricos , Adulto JovenRESUMEN
BACKGROUND: Self-reported pre-pregnancy weight and weight measured in the first trimester are both used to estimate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) but there is limited information on how they compare, especially in low- and middle-income countries, where access to a weight scale can be limited. Thus, the main goal of this study was to evaluate the agreement between self-reported pre-pregnancy weight and weight measured during the first trimester of pregnancy among Brazilian women so as to assess whether self-reported pre-pregnancy weight is reliable and can be used for calculation of BMI and GWG. METHODS: Data from the Brazilian Maternal and Child Nutrition Consortium (BMCNC, n = 5563) and the National Food and Nutritional Surveillance System (SISVAN, n = 393,095) were used to evaluate the agreement between self-reported pre-pregnancy weight and weights measured in three overlapping intervals (30-94, 30-60 and 30-45 days of pregnancy) and their impact in BMI classification. We calculated intraclass correlation and Lin's concordance coefficients, constructed Bland and Altman plots, and determined Kappa coefficient for the categories of BMI. RESULTS: The mean of the differences between self-reported and measured weights was < 2 kg during the three intervals examined for BMCNC (1.42, 1.39 and 1.56 kg) and about 1 kg for SISVAN (1.0, 1.1 and 1.2 kg). Intraclass correlation and Lin's coefficient were > 0.90 for both datasets in all time intervals. Bland and Altman plots showed that the majority of the difference laid in the ±2 kg interval and that the differences did not vary according to measured first-trimester BMI. Kappa coefficient values were > 0.80 for both datasets at all intervals. Using self-reported pre-pregnancy or measured weight would change, in total, the classification of BMI in 15.9, 13.5, and 12.2% of women in the BMCNC and 12.1, 10.7, and 10.2% in the SISVAN, at 30-94, 30-60 and 30-45 days, respectively. CONCLUSION: In Brazil, self-reported pre-pregnancy weight can be used for calculation of BMI and GWG when an early measurement of weight during pregnancy is not available. These results are especially important in a country where the majority of woman do not initiate prenatal care early in pregnancy.
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Índice de Masa Corporal , Peso Corporal , Ganancia de Peso Gestacional , Autoinforme/estadística & datos numéricos , Adolescente , Adulto , Brasil , Interpretación Estadística de Datos , Conjuntos de Datos como Asunto , Femenino , Humanos , Persona de Mediana Edad , Periodo Periparto , Embarazo , Primer Trimestre del Embarazo , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
OBJECTIVE: to cross-culturally adapt the Student Nurse Stress Index to the Brazilian context. METHOD: this is a methodological study of translation and cross-cultural adaptation. We used a sample of specialists (n = 3) and nursing students (n = 40). Socioeconomic and academic questionnaires were used for data collection, assessment and the translated instrument (SNSI-Brazil). RESULTS: most students were female (90.0%), single (87.5%), unemployed (80.0%), they studied on average 11 hours per week, slept 6 hours per day; and rated the face and the content of the instrument as very good, agreeing substantially (kappa = 0.74 and p-value < 0.01). The judges showed regular agreement in their assessments, and the SNSI-Brazil showed a good internal consistency (Cronbach's alpha = 0.80). CONCLUSION: The SNSI-Brazil was validated for face and content, has a good internal consistency if compared to versions used in other countries.
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Estrés Laboral/clasificación , Estrés Laboral/etiología , Estudiantes de Enfermería/psicología , Brasil , Comparación Transcultural , Femenino , Humanos , Masculino , Estrés Laboral/psicología , Reproducibilidad de los Resultados , Autoinforme/estadística & datos numéricos , Estudiantes de Enfermería/clasificación , Estudiantes de Enfermería/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
INTRODUCTION: Exploratory data reduction techniques, such as Factor Analysis (FA) and Principal Component Analysis (PCA), are widely used in questionnaire validation with ordinal data, such as Likert Scale data, even though both techniques are indicated to metric measures. In this context, this study presents an e-survey, conducted to obtain self-reported behaviors between Brazilian drivers (Nâ¯=â¯1,354, 55.2% of males) and Portuguese drivers (Nâ¯=â¯348, 46.6% of males) based on 20 items from the Driver Behavior Questionnaire (DBQ) on a five-point Likert Scale. This paper aimed to examine DBQ validation using FA and PCA compared to Categorical Principal Component Analysis (CATPCA) which is more indicative to use with Likert Scale data. RESULTS: The results from all techniques confirmed the most replicated factor structure of DBQ, distinguishing behaviors as errors, ordinary violations, and aggressive violation. However, after Varimax rotation, CATPCA explained 11% more variance compared to FA and 2% more than PCA. We identified cross-loadings among the component of the techniques. An item changed its dimension in the CATPCA results but did not change the structural interpretability. Individual scores from dimension 1 of CATPCA were significantly different from FA and PCA. Individual scores from factor 1 of CATPCA were significantly different from FA and PCA. Practical applications: The CATPCA seems to be more advantageous in order to represent the original data and considering data constrains. In addition to finding an interpretable factorial structure, the representation of the original data is regarded as relevant since the factor scores could be used for crash prediction in future analyses.
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Conducción de Automóvil/estadística & datos numéricos , Autoinforme/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Portugal , Análisis de Componente Principal , Adulto JovenRESUMEN
BACKGROUND: Chile has one of the highest life expectancies at 60 years in South America. This study was aimed to determine healthy life expectancies among Chilean older people, according to self-rated health and disability, and to explore gender differences. METHODS: Data from the National Survey of Health (2009 and 2016) were used to estimate prevalence of less than good self-rated health and disability among people aged 60 years and above. Health expectancies were calculated with the Sullivan method. RESULTS: In both years, women expected to live a lower proportion of their life expectancy in good self-rated health (54.5% [95% CI 50.0-58.8] for men and 37.6% [95% CI 34.3-40.8] for women in 2009; 46.1% [95% CI 42.6-49.7] for men and 38.5% [95% CI 35.6-41.4] for women in 2016). Life expectancy in less than good self-rated health increased for men (9.4 years [95% CI 8.4-10.3] in 2009; 11.5 years [95% CI 10.7-12.2]). Women expected to live a lower proportion of their remaining life without disabilities (65.3% [95% CI 61.2-69.4] for men and 44.9% [95% CI 41.9-47.9] for women in 2009; 71.9% [95% CI 68.7-75.0] for men and 61.1% [95% CI 58.5-63.8] for women in 2016). In 2016, disability-free life expectancy increased among women, but they still had a higher life expectancy with mild disability (2.8 years [95% CI 2.3-3.4] for men and 6.0 years [95% CI 5.4-6.7] for women). CONCLUSIONS: Women expected to spend more years in less than good self-rated health and disabled. There was an expansion of life expectancy in less than good SRH among men and a compression of disability in both sexes. The high proportion of years expected to be lived in less than good self-rated health and gender differences in disability-free life expectancy of older adults should be addressed by public health policies in Chile.
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Anticipación Psicológica , Autoevaluación Diagnóstica , Esperanza de Vida , Autoinforme/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Chile , Evaluación de la Discapacidad , Femenino , Evaluación Geriátrica/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Morbilidad , Factores SexualesRESUMEN
BACKGROUND: Allergic respiratory diseases such as asthma and allergic rhinitis have increased considerably in the last decades. OBJECTIVE: The present study estimates prevalence trends of asthma, allergic rhinitis and pollinosis in the population of a city of Southern Brazil, without restriction of age, from 2011 to 2018, using the ISAAC standardized questionnaire. METHODS: Data was collected from March to June of 2011 and during the same months in 2018, in order to verify trends in the prevalence of these allergic conditions. The total sample consisted of 3132 individuals of both sexes living in the municipality of Santo Ângelo, in the state of Rio Grande do Sul, Brazil. RESULTS: No differences were observed in the prevalence of asthma diagnosis (15.1% in 2011 and 13.8% in 2018), however the prevalence of current wheeze was significantly reduced from 24.7% in 2011 to 21.2% in 2018 (p<0.05). Regarding allergic conditions in 2011 and in 2018, a significant reduction was observed (p<0.001) in reported current rhinitis (63.3% vs. 50.5%), rhinoconjunctivitis (48.9% vs. 38.8%), hay fever (52.0% vs. 43.3%), and pollinosis (29.0% vs 17.0%). Moreover, we observed an inverse relation between age and rhinoconjunctivitis and hay fever, and all symptoms were more frequent in females. Rhinoconjunctivitis and hay fever, as well as current rhinitis and pollinosis were highly prevalent among 30-39 years-old individuals, whereas current wheeze affected mainly the age group 10-19 years-old. CONCLUSION: While the prevalence of asthma remained similar after seven years, allergic rhinitis and pollinosis declined between 2011 and 2018.
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Asma/epidemiología , Conjuntivitis Alérgica/epidemiología , Exposición a Riesgos Ambientales/efectos adversos , Monitoreo del Ambiente/estadística & datos numéricos , Rinitis Alérgica Estacional/epidemiología , Adolescente , Adulto , Factores de Edad , Alérgenos/efectos adversos , Alérgenos/inmunología , Asma/inmunología , Brasil/epidemiología , Niño , Ciudades/estadística & datos numéricos , Conjuntivitis Alérgica/inmunología , Estudios Transversales , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Humanos , Masculino , Prevalencia , Rinitis Alérgica Estacional/inmunología , Factores de Riesgo , Autoinforme/estadística & datos numéricos , Adulto JovenRESUMEN
OBJECTIVE: This cross-sectional study aimed to investigate self-reported stress level and coping ability as well as mental status (anxiety and depression) via the 12-item General Health Questionnaire (GHQ-12) questionnaire and periodontal status among police academy recruits during their 8 months of training. METHODS: Eighty-five consenting police recruits were examined at baseline during the first month of training and again during the last month of training. Full mouth plaque score (FMPS), full mouth bleeding score, basic periodontal examination, self-reported stress level (scale of 1-10) and GHQ-12 questionnaire (mental status) were recorded at both visits. Ability to cope (yes/no) with stress was recorded at the final visit. Periodontal diagnosis was derived based on clinical examination. t test and regression analyses (p < .05) were performed. RESULTS: High stress (odds ratio: 1.25) and inability to cope with stress (odds ratio: 1.31) were statistically significant (p < .05) predictors of high FMPS. Inability to cope with stress (odds ratio: 1.45) was also a statistically significant (p < .05) predictor for periodontitis compared to gingivitis. Mental status (anxiety and depression) may play a greater role in gingivitis (mean 1.75) as opposed to periodontitis (mean 1.00) as reflected by the higher mean GHQ-12 (t test, p = .04). CONCLUSIONS: In this study, both self-reporting of stress level and ability to cope with stress were statistically significant predictors of higher plaque score (FMPS). Ability to cope with stress was also a statistically significant predictor of periodontitis compared to gingivitis. Recording of both self-reported stress level and ability to cope may be valuable variables to note in the management of plaque and periodontal diseases.
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Adaptación Psicológica , Enfermedades Periodontales/epidemiología , Policia/estadística & datos numéricos , Autoinforme/estadística & datos numéricos , Estrés Psicológico/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Cuestionario de Salud del Paciente , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/etiología , Enfermedades Periodontales/psicología , Policia/educación , Instituciones Académicas/estadística & datos numéricos , Estrés Psicológico/complicaciones , Estrés Psicológico/diagnóstico , Estrés Psicológico/psicología , Adulto JovenRESUMEN
Tamoxifen efficacy in breast cancer is suspected to depend on adherence and intact drug metabolism. We evaluated the role of adherence behavior and pharmacogenetics on the formation rate of (Z)-endoxifen. In 192 Brazilian patients, we assessed plasma levels of tamoxifen and its metabolites at 3, 6, and 12 months of treatment (liquid-chromatography tandem mass spectrometry), adherence behavior (Morisky, Green, and Levine medication adherence scale), and cytochrome P450 2D6 (CYP2D6) and other pharmacogene polymorphisms (matrix-assisted laser-desorption-ionization time of flight) mass spectrometry, real-time polymerase chain reaction). Adherence explained 47% of the variability of tamoxifen plasma concentrations (P < 0.001). Although CYP2D6 alone explained 26.4%, the combination with adherence explained 40% of (Z)-endoxifen variability at 12 months (P < 0.001). The influence of low adherence to not achieving relevant (Z)-endoxifen levels was highest in patients with noncompromised CYP2D6 function (relative risk 3.65; 95% confidence interval 1.48-8.99). As a proof-of-concept, we demonstrated that (Z)-endoxifen levels are influenced both by patient adherence to tamoxifen and CYP2D6, which is particularly relevant for patients with full CYP2D6 function.
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Antineoplásicos Hormonales/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Citocromo P-450 CYP2D6/genética , Cumplimiento de la Medicación/estadística & datos numéricos , Tamoxifeno/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos Hormonales/farmacocinética , Brasil , Neoplasias de la Mama/sangre , Neoplasias de la Mama/genética , Citocromo P-450 CYP2D6/metabolismo , Monitoreo de Drogas/estadística & datos numéricos , Femenino , Humanos , Persona de Mediana Edad , Pruebas de Farmacogenómica/estadística & datos numéricos , Variantes Farmacogenómicas , Autoinforme/estadística & datos numéricos , Tamoxifeno/análogos & derivados , Tamoxifeno/sangre , Tamoxifeno/metabolismo , Tamoxifeno/farmacocinética , Adulto JovenRESUMEN
Objetivo: validar o peso corporal autorreferido de usuários do Programa Academia da Saúde (PAS), Belo Horizonte, MG, Brasil, e verificar fatores associados ao erro do peso Métodos: o peso corporal autorreferido, obtido por entrevista telefônica, foi comparado ao peso mensurado; empregou-se teste t de Student, método ANOVA, coeficiente de correlação de concordância de Lin, método Bland-Altman e índice Kappa; para mulheres, o peso autorreferido foi corrigido, frente ao mensurado, por regressão múltipla. Resultados: participaram 441 usuários; homens relataram seu peso de forma válida (erro=0; p=0,15); a concordância para classificação de excesso de peso foi de 94,3% (Kappa=0,88); mulheres com >30 anos e excesso de peso apresentaram maior erro no relato (-0,8kg; erro≠0; p<0,01); após correção por regressão múltipla, a validade do peso autorreferido foi satisfatória (erro=0; p=0,99). Conclusão: para homens, medidas autorreferidas de peso podem ser utilizadas em pesquisas e na vigilância à saúde; para mulheres, fez-se necessária a correção.
Objetivo: validar el peso autoinformado de los usuarios del Programa Academia de Salud (PAS) en Belo Horizonte, MG, Brasil, e identificar los factores asociados al error de peso. Métodos: el peso autoinformado por entrevista telefónica, fue comparado al peso medido; se usó la prueba t de Student, ANOVA, coeficiente de correlación de concordancia de Lin, método Bland-Altman e índice Kappa; para las mujeres, se corrigió el peso mediante regresión múltiple. Resultados: se investigaron 441 usuarios; los hombres reportaron su peso válido (error=0; p=0,15); la concordancia para el exceso de peso fue 94,3% (Kappa=0,88); las mujeres con >30 años y con sobrepeso tenían error en el peso autoinformado (-0,8kg; error≠0; p<0,01); después de la corrección por regresión múltiple la validación fue satisfactoria (error=0; p=0,99). Conclusión: para hombres, puede usarse el peso autoinformado para investigación y vigilancia de la salud, para las mujeres se requiere corrección.
Objective: to validate self-reported body weight of Programa Academia da Saúde (PAS) users in Belo Horizonte, MG, Brazil, and to identify factors associated with weight error. Methods: self-reported body weight, obtained by telephone interview, was compared to measured weight; we used Student's t-test, ANOVA, Lin's concordance correlation coefficient, the Bland-Altman method and Kappa coefficient; women's self-reported weight was corrected according to measured weight using multiple regression. Results: 441 users participated; weight self-reported by men was valid (error=0; p=0.15); overweight classification concordance was 94.3% (Kappa=0.88); errors were greater in the case of self-reported weight by women over 30 years old and overweight women (-0.8kg; error≠0; p<0.01); after correction using multiple regression, self-reported weight validity was satisfactory (error=0; p=0.99). Conclusion: self-reported weight of men can be used for research and health surveillance, but for women correction is required.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Peso Corporal , Pesos y Medidas Corporales/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Evaluación Nutricional , Brasil , Ejercicio Físico , Autoinforme/estadística & datos numéricos , Exactitud de los DatosRESUMEN
Background Self-reported health is subjective and depends on external factors such as socioeconomic status, presence of chronic diseases and working status, among others. Aim To determine which factors influence self-reported health among older people in Chile. Material and Methods A secondary analysis of the National Socioeconomic Characterization survey done in 2015. A dichotomous response model was used classifying health status as good or bad. A logit regression model was carried out. Results The model had a good calibration and correctly classified 72 and 68% of men and women, respectively. The main factors that influenced health status self-perception were: not having health problems; having undergone a mental health interview, to receive supplemental nutrition, education, to have a productive work; and to having a social network. Conclusions There are health, cultural, economic and environmental factors that influence self-perceived health status.
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Humanos , Masculino , Femenino , Anciano , Autoimagen , Autoinforme/estadística & datos numéricos , Factores Socioeconómicos , Chile , Estado de Salud , Encuestas EpidemiológicasRESUMEN
OBJECTIVE: To analyze the risk factors associated with the self-reported medical diagnosis of heart disease in Brazil. METHODS: This is a cross-sectional study, analyzing information from 60,202 adult participants of the Brazilian National Health Survey in 2013. Heart disease was defined by self-reported medical diagnosis of heart disease. We analyzed associations between the occurrence of disease and sociodemographic characteristics, health conditions and lifestyle. A hierarchical binary logistic regression model was used. RESULTS: The prevalence of self-reported diagnosis of heart disease in Brazil was 4.2% (confidence interval of 95% [95%CI] 4.0 â 4.3) and was associated with females (odds ratio [OR] = 1.1; 95%CI 1.1 â 1.1), people 65 years old or older (OR = 4.7; 95%CI 3.3 â 5.6), poor or very poor health conditions (OR = 4.1; 95%CI 3.5 â 4.6) and fair health conditions (OR = 2.4; 95%CI 2.2 â 2.7), hypertensive individuals (OR = 2.4; 95%CI 2.2 â 2.7), those with increased cholesterol (OR = 1.6; 95%CI 1.5 â 1.8), overweight individuals (OR = 1.5; 95%CI 1.4 â 1.8) and obese individuals (OR = 2.0; 95%CI 1.7 â 2.2), sedentary behavior (OR = 1.5; 95%CI 1.02 â 2.1), former smokers (OR = 1.4; 95%CI 1.3 â 1.6) or current smokers (OR = 1.2; 95%CI 1.03 â 1.3) and the consumption of fruits and vegetables 5 or more days each week (OR = 1.5; 95%CI 1.1 â 1.5). CONCLUSION: The importance of knowledge on the prevalence of heart disease and associated risk factors in the present Brazilian epidemiological context must be emphasized because it guides actions to control and prevent cardiovascular diseases, the leading cause of death in Brazil and worldwide.
OBJETIVO: Analisar os fatores de risco associados ao diagnóstico médico autorreferido de doença cardíaca no Brasil. MÉTODOS: Trata-se de um estudo transversal que analisa informações da Pesquisa Nacional de Saúde (PNS), realizada em 2013. A amostra consistiu de 60.202 adultos. A doença cardíaca foi definida pelo diagnóstico médico autorreferido de doença do coração. Foram analisadas associações entre a ocorrência de doença e as características sociodemográficas, as condições de saúde e o estilo de vida. Foi empregado o modelo de regressão logística binária hierarquizado. RESULTADOS: A prevalência de diagnóstico autorreferido de doença cardíaca no Brasil foi de 4,2% (intervalo de confiança de 95% [IC95%] 4,0 â 4,3) e esteve associada a sexo feminino (odds ratio [OR] = 1,1; IC95% 1,1 â 1,1), idade igual ou maior que 65 anos (OR = 4,7; IC95% 3,3 â 5,6), avaliação do estado de saúde ruim/muito ruim (OR = 4,1; IC95% 3,5 â 4,6) e regular (OR = 2,4; IC95% 2,2 â 2,7), indivíduos hipertensos (OR = 2,4; IC95% 2,2 â 2,7), colesterol elevado (OR = 1,6; IC95% 1,5 â 1,8), sobrepeso (OR = 1,5; IC95% 1,4 â 1,8) e obesidade (OR = 2,0; IC95% 1,7 â 2,2), insuficientemente ativo nos quatro domínios (OR = 1,5; IC95% 1,02 â 2,1), ser ex-fumante (OR = 1,4; IC95% 1,3 â 1,6) ou ser fumante (OR = 1,2; IC95% 1,03 â 1,3) e consumir frutas e hortaliças 5 ou mais dias da semana (OR = 1,5; IC95% 1,1 â 1,5). CONCLUSÃO: A importância do conhecimento da prevalência de doença cardíaca e fatores de riscos associados no atual contexto epidemiológico brasileiro deve ser ressaltada para orientar as ações de prevenção das doenças cardiovasculares, que representam a primeira causa de óbito no Brasil e no mundo.
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Autoevaluación Diagnóstica , Encuestas Epidemiológicas/métodos , Cardiopatías/diagnóstico , Cardiopatías/epidemiología , Autoinforme/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Valores de Referencia , Medición de Riesgo , Factores de Riesgo , Distribución por Sexo , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVE: To determinate the prevalence of hearing loss (HL) and visual impairment (VI) among adult population from Tlaxcala, Mexico. MATERIALS AND METHODS: A populationbased cross-sectional study comprising persons 50 years and older was conducted in 2013. Self-reported HL was measured using the Hearing Impairment Inventory for the Elderly (SHIIE) questionnaire; VI was determined using the Snellen tumbling E chart. RESULTS: 900 women and 611 men (mean age 66.1 years) were included. 481(31.8%) individuals had HL (415 alone and 66 combined with VI). Prevalence of HL alone and together with VI was associated with age (per two years, OR=1.03 and OR=1.18, respectively) and self-reported poor health status (OR=1.90 and OR=3.69, respectively). CONCLUSIONS: The high prevalence of these disabilities calls for the implementation of public health interventions that help to reduce its impact in the population.
OBJETIVO: Determinar la prevalencia de discapacidad auditiva (DA) y visual (DV) en adultos del estado de Tlaxcala, México. MATERIAL Y MÉTODOS: Estudio transversal de base poblacional realizado en 2013 que incluye sujetos ≥50 años de edad. La DA se evaluó por autorreporte con el cuestionario Hearing Impairment Inventory for the Elderly (SHIIE); la DV se midió usando la cartilla E rotatoria de Snellen. RESULTADOS: Se evaluaron 900 mujeres y 611 hombres (media=66.1 años). El 31.8% (481) tenía DA (415 sola y 66 con DV). La prevalencia de DA sola o con DV se asoció con edad (por cada dos años, RM=1.03 y RM=1.18, respectivamente) y con autorreporte del estado de salud deficiente (RM=1.90 y RM=3.69, respectivamente). CONCLUSIONES: Se requiere la implementación de intervenciones en salud pública que reduzcan el impacto de estas dos condiciones en la población.
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Pérdida Auditiva/epidemiología , Autoinforme/estadística & datos numéricos , Trastornos de la Visión/epidemiología , Factores de Edad , Anciano , Estudios Transversales , Femenino , Estado de Salud , Encuestas Epidemiológicas , Pérdida Auditiva/complicaciones , Pruebas Auditivas , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , Trastornos de la Visión/complicaciones , Agudeza VisualRESUMEN
Abstract: Objective: To determinate the prevalence of hearing loss (HL) and visual impairment (VI) among adult population from Tlaxcala, Mexico. Materials and methods: A population-based cross-sectional study comprising persons 50 years and older was conducted in 2013. Self-reported HL was measured using the Hearing Impairment Inventory for the Elderly (SHIIE) questionnaire; VI was determined using the Snellen tumbling E chart. Results: 900 women and 611 men (mean age 66.1 years) were included. 481(31.8%) individuals had HL (415 alone and 66 combined with VI). Prevalence of HL alone and together with VI was associated with age (per two years, OR=1.03 and OR=1.18, respectively) and self-reported poor health status (OR=1.90 and OR=3.69, respectively). Conclusion: The high prevalence of these disabilities calls for the implementation of public health interventions that help to reduce its impact in the population.
Resumen: Objetivo: Determinar la prevalencia de discapacidad auditiva (DA) y visual (DV) en adultos del estado de Tlaxcala, México. Material y métodos: Estudio transversal de base poblacional realizado en 2013 que incluye sujetos ≥50 años de edad. La DA se evaluó por autorreporte con el cuestionario Hearing Impairment Inventory for the Elderly (SHIIE); la DV se midió usando la cartilla E rotatoria de Snellen. Resultados: Se evaluaron 900 mujeres y 611 hombres (media=66.1 años). El 31.8% (481) tenía DA (415 sola y 66 con DV). La prevalencia de DA sola o con DV se asoció con edad (por cada dos años, RM=1.03 y RM=1.18, respectivamente) y con autorreporte del estado de salud deficiente (RM=1.90 y RM=3.69, respectivamente). Conclusiones: Se requiere la implementación de intervenciones en salud pública que reduzcan el impacto de estas dos condiciones en la población.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Trastornos de la Visión/epidemiología , Autoinforme/estadística & datos numéricos , Pérdida Auditiva/epidemiología , Agudeza Visual , Oportunidad Relativa , Estado de Salud , Prevalencia , Estudios Transversales , Factores de Riesgo , Encuestas Epidemiológicas , Factores de Edad , Pérdida Auditiva/complicaciones , Pruebas Auditivas , México/epidemiologíaRESUMEN
INTRODUCTION: Dengue is an endemic and epidemic disease in Brazil, with a high burden of disease. Amazonas State has a high risk of transmission. This study aimed to assess the self-reported prevalence of dengue in adults living in Manaus Metropolitan Region. METHODS: A cross-sectional study was conducted with adults living in Manaus Metropolitan Region in 2015. We performed a three-phase probabilistic sampling to collect participants' clinical and sociodemographic data. Self-reported dengue infection in the previous year was the primary outcome. Descriptive statistics and Poisson regression analysis with robust variance were used to calculate the prevalence ratio (PR) of dengue infections with 95% confidence intervals (95% CIs). Multilevel analysis including city and neighborhood variables was calculated. All analyses considered the complex sampling. RESULTS: Among the 4,001 participants, dengue in the previous year was self-reported by 7.0% (95% CI 6.3%-7.8%). Dengue was more frequent in women(PR 1.51; 95% CI 1.06-2.13), elderly participants (≥60 years old, PR 2.54; 95% CI 1.19-5.45), White and Asian participants (PR, 1.57; 95% CI, 1.11-2.23), and individuals who had not received endemic agent visits (PR, 2.28; 95% CI, 1.31-3.99). After multilevel analysis, sex was no longer a significant variable, with the remaining associations still significant. CONCLUSIONS: Seven out of 100 inhabitants of Manaus Metropolitan Region reported dengue in the previous year. Dengue was predominantly observed in women, elderly individuals, White and Asian individuals, and individuals who did not receive endemic agent visits. The setting plays an important role in dengue infections.
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Dengue/epidemiología , Autoinforme/estadística & datos numéricos , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores Socioeconómicos , Población Urbana , Adulto JovenRESUMEN
INTRODUCTION: Efficacy of daily emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) for PrEP is strongly dependent on the adherence. We examined the concordance between indirect adherence measures and protective drug levels among participants retained through 48 weeks in the PrEP Brasil Study. METHODS: PrEP Brasil was a prospective, multicenter, open-label demonstration project evaluating PrEP provision for men who have sex with men (MSM) and transgender women (TGW) at higher risk for HIV infection within the setting of Brazilian Public Health System. Three indirect adherence measures were obtained at week 48: medication possession ratio (MPR), pill count and self-report (30-days recall). Tenofovir diphosphate (TFV-DP) concentration in Dried Blood Spot (DBS) was measured at week 48. Areas under (AUC) the receiver operating characteristics (ROC) curve were used to evaluate the concordance between achieving protective drug levels (TFV-DP≥700fmol/punch) and the indirect adherence measures. Youden's index and distance to corner were used to determine the optimal cutoff points for each indirect adherence measure. We calculated sensitivity, specificity, negative (NPV) and positive (PPV) predictive values for the found cutoff points. Finally, Delong test was used to compare AUCs. RESULTS AND DISCUSSION: From April, 2014 to July, 2016, 450 participants initiated PrEP, 375(83.3%) were retained through 48 weeks. Of these, 74% (277/375) had TFV-DP ≥700fmol/punch. All adherence measures discriminated between participants with and without protective drug levels (AUC>0.5). High indirect adherence measure was predictive of protective drug levels (PPV>0.8) while low indirect adherence measure was not predictive of lack of protective drug levels (NPV<0.5). No significant differences were found between the adherence methods (p = 0.44). CONCLUSIONS: Low-burden measurements such as MPR and self-report can be used to predict PrEP adherence in a public health context in Brazil for MSM and TGW retained through 48 weeks. Clinical Trial Number: NCT01989611.
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Combinación Emtricitabina y Fumarato de Tenofovir Disoproxil/uso terapéutico , Infecciones por VIH/prevención & control , Cumplimiento de la Medicación/estadística & datos numéricos , Profilaxis Pre-Exposición/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Personas Transgénero/estadística & datos numéricos , Adolescente , Adulto , Fármacos Anti-VIH , Brasil , Pruebas con Sangre Seca , Combinación Emtricitabina y Fumarato de Tenofovir Disoproxil/sangre , Estudios de Factibilidad , Femenino , Humanos , Masculino , Profilaxis Pre-Exposición/métodos , Estudios Prospectivos , Autoinforme/estadística & datos numéricos , Resultado del Tratamiento , Adulto JovenRESUMEN
Likert-type self-report scales are frequently used in large-scale educational assessment of social-emotional skills. Self-report scales rely on the assumption that their items elicit information only about the trait they are supposed to measure. However, different response biases may threaten this assumption. Specifically, in children, the response style of acquiescence is an important source of systematic error. Balanced scales, including an equal number of positively and negatively keyed items, have been proposed as a solution to control for acquiescence, but the reasons why this design feature worked from the perspective of modern psychometric models have been underexplored. Three methods for controlling for acquiescence are compared: classical method by partialling out the mean; an item response theory method to measure differential person functioning (DPF); and multidimensional item response theory (MIRT) with random intercept. Comparative analyses are conducted on simulated ratings and on self-ratings provided by 40,649 students (aged 11-18) on a fully balanced 30-item scale assessing conscientious self-management. Acquiescence bias was explained as DPF and it was demonstrated that: the acquiescence index is highly related to DPF; balanced scales produce scores controlled for DPF; and MIRT factor scores are highly related to scores controlled for DPF and the random intercept is highly related to DPF.
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Sesgo , Proyectos de Investigación , Adolescente , Niño , Femenino , Humanos , Masculino , Inventario de Personalidad/estadística & datos numéricos , Psicología Social , Psicometría , Autoinforme/estadística & datos numéricosRESUMEN
BACKGROUND: Both cholera and food insecurity tend to occur in impoverished communities where poor access to food, inadequate sanitation, and an unsafe water supply often coexist. The relationship between the two, however, has not been well-characterized. METHODS: We performed a secondary analysis of household-level data from the 2012 Demographic and Health Survey in Haiti, a nationally and sub-nationally representative cross-sectional household survey conducted every five years. We used multivariable logistic regression to evaluate the relationship between household food security (as measured by the Household Hunger Scale) and (1) reported history of cholera since 2010 by any person in the household and (2) reported death by any person in the household from cholera (among households reporting at least one case). We performed a complete case analysis because there were <1% missing data for all variables. RESULTS: There were 13,181 households in the survey, 2,104 of which reported at least one household member with history of cholera. After adjustment for potential confounders, both moderate hunger in the household [Adjusted Odds Ratio (AOR) 1.51, 95% Confidence Interval (CI) 1.30-1.76; p <.0001] and severe hunger in the household (AOR 1.73, 95% CI 1.45-2.08; p <.0001) were significantly associated with reported history of cholera in the household. Severe hunger in the household (AOR 1.85, 95% CI 1.05-3.26; p = 0.03), but not moderate hunger in the household, was independently associated with reported death from cholera in households with at least one case of cholera. CONCLUSIONS: In this study we identified an independent relationship between household food insecurity and both reported history of cholera and death from cholera in a general population. The directionality of this relationship is uncertain and should be further explored in future prospective research.
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Cólera/epidemiología , Abastecimiento de Alimentos/estadística & datos numéricos , Autoinforme/estadística & datos numéricos , Cólera/prevención & control , Estudios Transversales , Demografía/estadística & datos numéricos , Haití/epidemiología , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Modelos Logísticos , Oportunidad RelativaRESUMEN
Background: In Brazil, the Baby-Friendly Hospital Initiative (BFHI) proposes following the criteria, the "Ten Steps to Successful Breastfeeding", International Code of Marketing of Breast-milk Substitutes and Good birth and delivery practices. Brazilian Baby-Friendly Hospitals are reassessed triennially by external evaluators and annually by self-monitoring. This study aimed to verify if the self-monitoring system fulfills its role of enabling accredited hospitals to assess and improve their compliance with the BFHI criteria. In this sense, we will analyze the self-monitoring evaluation results and compare them with those of the external reassessment. Methods: This descriptive evaluation study of the compliance with the BFHI criteria by the Brazilian Baby-Friendly Hospitals by self-monitoring evaluators from 2010 to 2015 and by external evaluators in 2015. Results: Self-monitoring was performed in all years from 2010 to 2015 by 143 BFHI accredited hospitals. The trend of the levels of compliance with BFHI's criteria according to self-monitoring evaluations was stable over the assessed period. Most criteria presented compliance above 70%, except Step 4 (skin-to-skin contact and breastfeeding in the first hour of life), with mean compliance of 67%. Steps 1 (written policy), 7 (rooming-in) and 9 (give no artificial teats) showed mean compliance above 90%. Regarding the external evaluation carried out in 2015, the criteria with lowest compliance were Step 4 and Woman-Friendly care, both below 50%. Steps 9 and 10 (refer mothers to breastfeeding support groups) reached levels of compliance above 90%. For 2015, self-monitoring provided significant higher compliance levels than those from external evaluations in most criteria, except Step 3 (prenatal information on breastfeeding) and Step 10. There was a difference of more than 30% points between evaluations of Steps 1 (written policy), 2 (training), 5 (show mothers how to breastfeed), Woman-Friendly Care and father or mother stay with their newborn. Conclusions: The self-monitoring system fulfilled partially its role of allowing accredited hospitals to self-assess and improve rates of compliance with BFHI criteria. Future trainings of hospital managers need to address difficulties and identify solutions to improve implementation of Steps 4 and 6.