Australian Headache Epidemiology Data (AHEAD): a pilot study to assess sampling and engagement methodology for a nationwide population-based survey.

BACKGROUND: There are no robust population-based Australian data on prevalence and attributed burden of migraine and medication-overuse headache (MOH) data. In this pilot cross-sectional study, we aimed to capture the participation rate, preferred response method, and acceptability of self-report questionnaires to inform the conduct of a future nationwide migraine/MOH epidemiological study. METHODS: We developed a self-report questionnaire, available in hard-copy and online, including modules from the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, the Eq. 5D (quality of life), and enquiry into treatment gaps. Study invitations were mailed to 20,000 randomly selected households across Australia's two most populous states. The household member who most recently had a birthday and was aged ≥ 18 years was invited to participate, and could do so by returning a hard-copy questionnaire via reply-paid mail, or by entering responses directly into an online platform. RESULTS: The participation rate was 5.0% (N = 1,000). Participants' median age was 60 years (IQR 44-71 years), and 64.7% (n = 647) were female. Significantly more responses were received from areas with relatively older populations and middle-level socioeconomic status. Hard copy was the more commonly chosen response method (n = 736). Females and younger respondents were significantly more likely to respond online than via hard-copy. CONCLUSIONS: This pilot study indicates that alternative methodology is needed to achieve satisfactory engagement in a future nationwide migraine/MOH epidemiological study, for example through inclusion of migraine screening questions in well-resourced, interview-based national health surveys that are conducted regularly by government agencies. Meanwhile, additional future research directions include defining and addressing treatment gaps to improve migraine awareness, and minimise under-diagnosis and under-treatment.

Ascertaining the Francophone population in Ontario: validating the language variable in health data.

BACKGROUND: Language barriers can impact health care and outcomes. Valid and reliable language data is central to studying health inequalities in linguistic minorities. In Canada, language variables are available in administrative health databases; however, the validity of these variables has not been studied. This study assessed concordance between language variables from administrative health databases and language variables from the Canadian Community Health Survey (CCHS) to identify Francophones in Ontario. METHODS: An Ontario combined sample of CCHS cycles from 2000 to 2012 (from participants who consented to link their data) was individually linked to three administrative databases (home care, long-term care [LTC], and mental health admissions). In total, 27,111 respondents had at least one encounter in one of the three databases. Language spoken at home (LOSH) and first official language spoken (FOLS) from CCHS were used as reference standards to assess their concordance with the language variables in administrative health databases, using the Cohen kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV). RESULTS: Language variables from home care and LTC databases had the highest agreement with LOSH (kappa = 0.76 [95%CI, 0.735-0.793] and 0.75 [95%CI, 0.70-0.80], respectively) and FOLS (kappa = 0.66 for both). Sensitivity was higher with LOSH as the reference standard (75.5% [95%CI, 71.6-79.0] and 74.2% [95%CI, 67.3-80.1] for home care and LTC, respectively). With FOLS as the reference standard, the language variables in both data sources had modest sensitivity (53.1% [95%CI, 49.8-56.4] and 54.1% [95%CI, 48.3-59.7] in home care and LTC, respectively) but very high specificity (99.8% [95%CI, 99.7-99.9] and 99.6% [95%CI, 99.4-99.8]) and predictive values. The language variable from mental health admissions had poor agreement with all language variables in the CCHS. CONCLUSIONS: Language variables in home care and LTC health databases were most consistent with the language often spoken at home. Studies using language variables from administrative data can use the sensitivity and specificity reported from this study to gauge the level of mis-ascertainment error and the resulting bias.

Novel methodologies using history to document the effects of African American sexual trauma: Perspectives of Gail E. Wyatt, PhD.

This article describes the nearly half a century career of Dr. Gail E. Wyatt, PhD, and her development of novel methodologies and measures of sexual trauma, specifically the Wyatt Sex History Questionnaire and the University of California, Los Angeles, Life Adversities Screener. These approaches broke the silence around experiences of sexual violence, particularly among African Americans, identifying their effects on sexual functioning and mental health. These novel methods are designed without assuming sexual literacy of respondents, knowledge of anatomy, or that discussing sex is easy or common; they include topics that are considered private and may evoke emotions. Trained professionals administering face-to-face interviews can serve to establish rapport and educate the participant or client while minimizing possible discomfort and shame around the disclosure of sexual practices. In this article, four topics are discussed focusing on African Americans, but they may also be relevant to other racial/ethnic groups: (a) breaking the silence about sex, (b) sexual harassment: its disclosure and effects in the workplace, (c) racial discrimination: identifying its effects as a form of trauma, and (d) the cultural relevance of promoting sexual health. Historical patterns of abuse and trauma can no longer be ignored but need to be better understood by psychologists and used to improve policy and treatment standards. Recommendations for advancing the field using novel methods are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Evaluating the Use of Online Self-Report Questionnaires as Clinically Valid Mental Health Monitoring Tools in the Clinical Whitespace.

Although digital health solutions are increasingly popular in clinical psychiatry, one application that has not been fully explored is the utilization of survey technology to monitor patients outside of the clinic. Supplementing routine care with digital information collected in the "clinical whitespace" between visits could improve care for patients with severe mental illness. This study evaluated the feasibility and validity of using online self-report questionnaires to supplement in-person clinical evaluations in persons with and without psychiatric diagnoses. We performed a rigorous in-person clinical diagnostic and assessment battery in 54 participants with schizophrenia (N = 23), depressive disorder (N = 14), and healthy controls (N = 17) using standard assessments for depressive and psychotic symptomatology. Participants were then asked to complete brief online assessments of depressive (Quick Inventory of Depressive Symptomatology) and psychotic (Community Assessment of Psychic Experiences) symptoms outside of the clinic for comparison with the ground-truth in-person assessments. We found that online self-report ratings of severity were significantly correlated with the clinical assessments for depression (two assessments used: R = 0.63, p < 0.001; R = 0.73, p < 0.001) and psychosis (R = 0.62, p < 0.001). Our results demonstrate the feasibility and validity of collecting psychiatric symptom ratings through online surveys. Surveillance of this kind may be especially useful in detecting acute mental health crises between patient visits and can generally contribute to more comprehensive psychiatric treatment.

Identifying subtle functional change in individuals with mild cognitive impairment: development and validation of the Healthy Brain Ageing - Functional Assessment Questionnaire.

Accumulating research suggests that individuals with Mild Cognitive Impairment (MCI) experience subtle functional changes, but that available functional assessment tools are insensitive to this. To address this gap, we describe the development and validation of the self-report, "Healthy Brain Ageing Functional Assessment Questionnaire" (HBA-FAQ). We examined the factor structure and psychometric properties of the HBA-FAQ in 503 participants with normal cognition, subjective cognitive decline (SCD), MCI or dementia. Our results found the HBA-FAQ to have good reliability, validity and stronger discriminative ability between healthy control participants and those with SCD (0.734, p = .001), MCI (0.666, p = .012) and dementia (0.798, p < .001) compared to a widely-used instrumental activities of daily living screener. In conclusion, the HBA-FAQ is a valid, reliable self-report tool, providing an efficient and sensitive approach to identifying subtle changes in daily functioning in older people at risk of dementia.

Cognitive Dysfunction and Health-Related Quality of Life in Patients with End-Stage Renal Disease Undergoing Hemodialysis in Comparison with Patients Undergoing Peritoneal Dialysis: A Cross-Sectional Study.

BACKGROUND This study compared the effects of peritoneal dialysis and hemodialysis on cognitive dysfunction and health-related quality of life (HRQOL) in end-stage renal disease (ESRD) patients and analyzed other potential influencing factors. MATERIAL AND METHODS A total of 265 patients who received dialysis at our hospital were included and divided into the hemodialysis group (n=115) and the peritoneal dialysis group (n=150). The cognitive performance was assessed by the Beijing version of the Montreal Cognitive Assessment. The Kidney Disease Quality of 36-Item Short Form Survey and a kidney disease-related quality of life assessment were used for evaluating HRQOL. Univariate and multivariate linear regression analyses were used to explore the effects of dialysis on cognitive dysfunction and HRQOL. RESULTS As compared with the hemodialysis group, the peritoneal dialysis group had lower scores on the Montreal Cognitive Assessment (ß=-8.35, 95% CI: -9.85 to -6.86), 36-Item Short Form Survey (ß=-10.20, 95% CI: -11.94 to -8.45), and kidney disease-related quality of life assessment (ß=-8.67, 95% CI: -10.10 to -7.23). After adjustment for sex, age, BMI, marital status, educational level, income level, presence of diabetes, duration of kidney disease, duration of dialysis, and dialysis frequency, the results were consistent with that of the crude model. CONCLUSIONS In the present study, patients receiving peritoneal dialysis had worse cognitive dysfunction and worse HRQOL compared to patients receiving hemodialysis, which might lead to poorer outcomes of ESRD patients. The related factors affecting cognitive dysfunction and HRQOL were also explored, which could help clinicians to determine the optimal treatment for ESRD patients.

Snakebite epidemiology in humans and domestic animals across the Terai region in Nepal: a multicluster random survey.

BACKGROUND: Each year, 2 million people worldwide are bitten by snakes, resulting in an estimated 81 000-138 000 deaths. WHO has added snakebite envenoming to the list of neglected tropical diseases, highlighting the need for stronger epidemiological evidence in endemic countries, such as Nepal. METHODS: We conducted a cross-sectional survey in villages randomly geospatially selected from aerial images from across the Nepal's Terai lowlands region (excluding towns and cities). We collected data between Nov 30, 2018 and May 7, 2019, and analysed snakebite incidence rates and outcomes in humans and domestic animals. FINDINGS: Among 63 454 human participants living in 13 879 households (249 villages), 166 were bitten by a snake over the previous 12 months; 48·8% were envenomed and 7·8% died. This corresponded to an annual crude incidence rate of 262 snakebites (adjusted incidence of 251·1 [95% CI 201·7-312·6]) and 20 deaths (22·4 [11·9-42·1]) per 100 000 people, extrapolating to 26 749-37 661 yearly bitten people and 2386-3225 deaths. Bitten people had a median age of 30 years (IQR 20-45) and with available data, 64% were female. Children younger than 15 years (n=6; 46%) and females (n=10; 77%) were disproportionately affected among the 13 people who died. The incidence was higher in the Eastern region, and mortality was higher in the Central region. Of 183 949 animals, owners reported 144 snakebites, with an annual incidence rate of 42-202 per 100 000 and mortality of 79-100%, varying by animal type. Spatial and seasonal incidence were similar in humans and in animals. INTERPRETATION: This study provides the first epidemiological estimates of snakebite envenoming in humans and domestic animals across Nepal's Terai lowlands. It was also the first to use a community-based, transdisciplinary, and One Health design. These findings call for a strengthening of preventive measures and better access to life-saving treatments. FUNDING: Swiss National Science Foundation project 315130_176271 (SNAKE-BYTE).

Assessment of the effect of snakebite on health and socioeconomic factors using a One Health perspective in the Terai region of Nepal: a cross-sectional study.

BACKGROUND: Snakebite envenoming has a substantial health and socioeconomic effect in rural communities. However, there are insufficient epidemiological and animal data, which prevents accurate assessment on the effects of snakebite. We aimed to assess the health and socioeconomic effect of snakebite using a One Health perspective. METHODS: In this cross-sectional survey-based study, we assessed the health and socioeconomic effects of snakebite data using a multicluster survey that was previously done as part of the SNAKE-BYTE project in the Terai region, Nepal. Health effect was measured in terms of disability-adjusted life years (DALYs). Livelihood losses encompassed out-of-pocket health-care expenditures, losses of productivity due to days off work, and the losses due to mortality and treatment costs in domestic animals. Mortality losses in domestic animals were also estimated as animal loss equivalents, and overall human and animal health effect expressed using modified DALYs for zoonotic disease (zDALYs). FINDINGS: We estimate an annual snakebite burden of 200 799 DALYs (95% CI 103 137-357 805), mostly due to mortality in children and women. Snakebite is estimated to lead to US$2·8 million in yearly livelihood losses associated with human and animal cases. Overall, we estimate a yearly human and animal health burden of 202 595 zDALYs (104 300-360 284). INTERPRETATION: These findings present robust evidence on the extent of snakebite's health and socioeconomic effect and emphasise the need for a One Health perspective. The results also stress how improved data collection at the community level is crucial for improved assessments of its effect. FUNDING: Swiss National Science Foundation.

Use of statins for the prevention of cardiovascular disease in 41 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data.

BACKGROUND: In the prevention of cardiovascular disease, a WHO target is that at least 50% of eligible people use statins. Robust evidence is needed to monitor progress towards this target in low-income and middle-income countries (LMICs), where most cardiovascular disease deaths occur. The objectives of this study were to benchmark statin use in LMICs and to investigate country-level and individual-level characteristics associated with statin use. METHODS: We did a cross-sectional analysis of pooled, individual-level data from nationally representative health surveys done in 41 LMICs between 2013 and 2019. Our sample consisted of non-pregnant adults aged 40-69 years. We prioritised WHO Stepwise Approach to Surveillance (STEPS) surveys because these are WHO's recommended method for population monitoring of non-communicable disease targets. For countries in which no STEPS survey was available, a systematic search was done to identify other surveys. We included surveys that were done in an LMIC as classified by the World Bank in the survey year; were done in 2013 or later; were nationally representative; had individual-level data available; and asked questions on statin use and previous history of cardiovascular disease. Primary outcomes were the proportion of eligible individuals self-reporting use of statins for the primary and secondary prevention of cardiovascular disease. Eligibility for statin therapy for primary prevention was defined among individuals with a history of diagnosed diabetes or a 10-year cardiovascular disease risk of at least 20%. Eligibility for statin therapy for secondary prevention was defined among individuals with a history of self-reported cardiovascular disease. At the country level, we estimated statin use by per-capita health spending, per-capita income, burden of cardiovascular diseases, and commitment to non-communicable disease policy. At the individual level, we used modified Poisson regression models to assess statin use alongside individual-level characteristics of age, sex, education, and rural versus urban residence. Countries were weighted in proportion to their population size in pooled analyses. FINDINGS: The final pooled sample included 116 449 non-pregnant individuals. 9229 individuals reported a previous history of cardiovascular disease (7·9% [95% CI 7·4-8·3] of the population-weighted sample). Among those without a previous history of cardiovascular disease, 8453 were eligible for a statin for primary prevention of cardiovascular disease (9·7% [95% CI 9·3-10·1] of the population-weighted sample). For primary prevention of cardiovascular disease, statin use was 8·0% (95% CI 6·9-9·3) and for secondary prevention statin use was 21·9% (20·0-24·0). The WHO target that at least 50% of eligible individuals receive statin therapy to prevent cardiovascular disease was achieved by no region or income group. Statin use was less common in countries with lower health spending. At the individual level, there was generally higher statin use among women (primary prevention only, risk ratio [RR] 1·83 [95% CI 1·22-2·76), and individuals who were older (primary prevention, 60-69 years, RR 1·86 [1·04-3·33]; secondary prevention, 50-59 years RR 1·71 [1·35-2·18]; and 60-69 years RR 2·09 [1·65-2·65]), more educated (primary prevention, RR 1·61 [1·09-2·37]; secondary prevention, RR 1·28 [0·97-1·69]), and lived in urban areas (secondary prevention only, RR 0·82 [0·66-1·00]). INTERPRETATION: In a diverse sample of LMICs, statins are used by about one in ten eligible people for the primary prevention of cardiovascular diseases and one in five eligible people for secondary prevention. There is an urgent need to scale up statin use in LMICs to achieve WHO targets. Policies and programmes that facilitate implementation of statins into primary health systems in these settings should be investigated for the future. FUNDING: National Clinician Scholars Program at the University of Michigan Institute for Healthcare Policy and Innovation, and National Institute of Diabetes and Digestive and Kidney Diseases. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.

Association Between Caries Experience and School Performance in an Island Community: Full-Time versus Part-Time Public Schools

Abstract Objective: To investigate the association between caries experience and school performance among children and adolescents living in an island community without fluoridated water supply and to compare data according to the type of attended school (full-time or part-time). Material and Methods: A cross-sectional oral health survey in a convenience sample of students (n=147) attending four public schools was performed. Students were examined by one calibrated dentist in the school environment to the obtain prevalence of dental caries (DMFT/dmft) and its consequences using the PUFA/pufa index. Self-reported oral health behavior was also accessed. Data from each student's school performance and absenteeism were extracted from official sources and the school performance was classified into "good" and "fair". The final sample consisted of 120 students. Descriptive statistics, Mann-Whitney, Kruskal-Wallis, chi-square tests and binary logistic regression were performed to evaluate collected data. Results: Students´ age ranged between 5 to 19 years (10±4.3). DMFT/dmft mean were 1.3 (±2.3) and 3.05 (±3.4), respectively. Conclusion: Participants from the full-time school presented better oral health status than their peers in the part-time schools (p<0.05). A significant association was found between the prevalence of caries-free participants and good school performance when the factor age range was controlled (OR=2.87). Moreover, attendance to full-time schools appeared to be a protective factor for good oral health conditions (AU).

Utilização de serviços odontológicos no Brasil / Use of dental services in Brazil

O objetivo do presente estudo foi analisar a utilização de serviços odontológicos no Brasil. Trata-se de um estudo quantitativo, observacional, transversal, analítico. Os dados individuais foram obtidos das Pesquisas Nacionais de Saúde desenvolvidas nos anos de 2013 e 2019. Os dados foram analisados considerando os pesos amostrais decorrentes de amostras complexas. Para cada estudo, foram desenvolvidas técnicas de análise múltipla que contemplaram os objetivos do estudo. Os resultados foram discutidos em três artigos científicos aceitos para publicação em periódicos e um artigo em fase de finalização. Os resultados encontrados indicam que a população negra, residente na região Norte e Nordeste, de menor classe social e escolaridade apresentam maior chance de ter ido ao dentista há mais de dois anos e de nunca ter ido ao dentista, bem como maior chance de realizar procedimentos odontológicos cirúrgicos ou de urgência na última consulta odontológica. Observou-se em relação às características do domicílio, que morar em área rural, maior aglomeração e menor renda familiar reduziram as chances de ter utilizado serviços odontológicos no último ano. Por outro lado, pessoas que residiam em domicílios cadastrados na Estratégia de Saúde da Família tiveram menor chance de não ter realizado uma consulta odontológica ao longo da vida, ou de terem ido ao dentista há mais de um ano. Ao analisar especificamente a utilização de serviços públicos odontológicos, após ajuste para idade e sexo, a escolaridade, a cor da pele ou raça e a renda familiar demonstraram efeito predisponente na utilização de serviços públicos odontológicos. Os fatores facilitadores foram residir em domicílios cadastrados em equipes de atenção primária ou localizados em áreas rurais. Os fatores de necessidade associados à utilização de serviço odontológico público foram autopercepção de saúde bucal ruim ou péssima e não ter realizado tratamento restaurador no último atendimento odontológico. Em relação aos fatores contextuais, a utilização de serviço público odontológico esteve associada à maior cobertura populacional por equipes de saúde bucal na atenção primária. De forma geral, observamos um acesso desigual aos serviços odontológicos no Brasil. Esse cenário ocorre quando fatores sociais e facilitadores determinam quem utiliza os serviços, em detrimento da necessidade de utilização. Apesar disso, observamos um efeito importante, decorrente da oferta de serviços odontológicos na atenção primária como um fator mitigador de tais desigualdades, o que demonstra um efeito positivo das estratégias adotadas na Política Nacional de Saúde Bucal (AU).

The present study aimed to analyze dental services utilization in Brazil. This is a quantitative, observational, cross-sectional, analytical study. Individual data from the National Health Surveys developed in 2013 and 2019. Data were analyzed by adjusting the sample weights resulting from complex samples. For each study, multivariate analysis techniques addressed the study's objectives. The results will be discussed in three scientific papers accepted for publication in journals and one article in the process of being finalized. It was noticed that the population subgroups comprising Blacks and those residing in the North or Northeast, with lower social class and education, had a greater chance of having a last dental appointment more than two years and never having been to the dentist. In addition, this population stratum also had a greater chance of undergoing surgical or emergency dental procedures in the last dental appointment. The outcome never had a dental appointment was significantly associated with illiterate, males, without private dental insurance, self-rated oral health as bad or very bad, household not enrolled in primary care teams, household in a rural area, high household crowding, and low household income per capita. The highest prevalence of public dental service utilization on an individual level was observed among unable to read or write people, indigenous, black or brown, with lower per capita household income, living in the rural area, and who self-rated oral health as regular or very bad/bad. On the contextual level, highest public dental service utilization was observed among those living in federal units with increased oral health coverage in primary health care. In general, we observe inequalities in dental services utilization in Brazil. This scenario occurs when social characteristics and facilitating aspects determine who uses the services, to the detriment of the need to use them. Despite this, we observed an important effect resulting from the provision of dental services in primary care as a mitigating factor for such inequalities, demonstrating a positive effect of the strategies adopted in the National Oral Health Policy (AU).

Prevalência de depressão autorreferida no Brasil: Pesquisa Nacional de Saúde 2019 e 2013 / Prevalencia de depresión autoinformada en Brasil: Encuesta Nacional de Salud 2019 y 2013 / Prevalence of self-reported depression in Brazil: National Health Survey 2019 and 2013

Objetivo: Descrever a prevalência de depressão autorreferida na população brasileira adulta a partir da Pesquisa Nacional de Saúde (PNS) 2019, e comparar com a PNS 2013. Métodos: Estudo transversal descritivo no qual se calcularam prevalências de diagnóstico autorreferido de depressão, segundo localidade e variáveis demográficas, e intervalos de confiança de 95% (IC95%). Análises bivariadas foram realizadas com teste qui-quadrado. Resultados: Participaram 90.846 indivíduos com idade ≥ 18 anos, na PNS 2019, e 60.202, na PNS 2013. Entre 2013 e 2019, as prevalências de depressão autorreferida aumentaram de 7,6% (IC95% 7,2;8,1) para 10,2% (IC95% 9,9;10,6), e de busca por atendimento nos últimos 12 meses anteriores à entrevista, de 46,4% (IC95% 43,75;49,1) para 52,8% (IC95% 50,7;55,0). Consultórios privados foram o principal local de assistência. Conclusão: A depressão é um transtorno altamente prevalente. O diagnóstico de depressão e a busca por atendimento aumentaram no período. Entretanto, o predomínio de atendimentos em consultórios privados sugere desigualdades na melhoria da cobertura assistencial.

Objetivo: Describir la prevalencia de depresión autoinformada en la población adulta brasileña en la Encuesta Nacional de Salud (PNS) 2019 y compararla con la PNS 2013. Métodos: Estudio descriptivo donde se calcularon prevalencias del diagnóstico autoinformado de depresión e intervalos de confianza del 95% (IC95%) según localización y variables demográficas. Análisis bivariados se realizaron mediante la prueba chi-cuadrado. Resultados: Participaron 90.846 individuos en edad ≥ 18 años en la PNS 2019, y 60.202 en 2013. Entre 2013 y 2019, la prevalencia de diagnóstico autoinformado de depresión aumentó de 7,6% (IC95% 7,2;8,1) a 10,2% (IC95% 9,9;10,6) y búsqueda de atención del 46,4% (IC95% 43,75;49,1) a 52,8% (IC95% 50,7;55,0). Oficinas privadas fueron el principal lugar de asistencia. Conclusión: La depresión es un trastorno altamente prevalente. La prevalencia de diagnóstico de depresión y búsqueda de atención aumentaron en el período. El predominio de la atención en oficinas privadas sugiere desigualdades en la mejora de la cobertura de atención.

Objective: To describe the prevalence of self-reported depression among Brazilian adults in the 2019 National Health Survey (PNS) and compare to the 2013 PNS. Methods: Cross-sectional study of Brazilian adults using data from the 2019 and 2013 PNS. Prevalence and 95% confidence intervals (95%CI) of self-reported depression were estimated by region and demographic characteristics. Bivariate analyses were conducted using chi-squared tests. Results: There were 90,846 participants aged ≥ 18 years in 2019, and 60,202 in 2013. Between 2013 and 2019, prevalence of self-reported depression increased from 7.6% (95%CI 7.2;8.1) to 10.2% (95%CI 9.9;10.6) and of individuals who sought healthcare, from 46.4% (95%CI 43.8;49.1) to 52.8% (95%CI 50.7;55.0). Private clinics were the main source of healthcare. Conclusion: Depression is highly prevalent in Brazil. Prevalence of diagnosis of depression and use of health services increased in the studied period. The predominance of care in private clinics suggests inequalities in the improvement of mental healthcare coverage.

Inquérito telefônico de fatores de risco e proteção para doenças e agravos não transmissíveis no Estado de Goiás: Vigitel Goiás / Vigitel Goiás Telephone survey of risk and protective factors for non-communicable diseases and conditions in the State of Goiás

As Doenças e Agravos Não Transmissíveis (DANT) representam a maior causa de morbimortalidade no Brasil e no mundo. Compreendem dois grandes grupos de eventos: as Doenças Crônicas não Transmissíveis (DCNT), caracterizadas principalmente pelas doenças cardiovasculares, doenças respiratórias crônicas, neoplasias e diabetes mellitus, e as causas externas, tais como os acidentes e as violências. Nesse sentido, o VIGITEL nacional, realizado a partir de 2006, forneceu dados importantes de fatores de risco para o Brasil e capitais. Este relatório é o resultado do primeiro inquérito realizado no Estado, com representatividade para o Estado de Goiás e as cinco macrorregiões. Esses dados subsidiarão o novo Plano de Enfrentamento das DANT de Goiás (2023-2032)

Non-communicable Diseases and Conditions (NCDs) represent the biggest cause of morbidity and mortality in Brazil and the world. They comprise two large groups of events: Chronic Non-Communicable Diseases (NCDs), characterized mainly by cardiovascular diseases, chronic respiratory diseases, neoplasms and diabetes mellitus, and external causes, such as accidents and violence. In this sense, the national VIGITEL, carried out since 2006, provided important data on risk factors for Brazil and capitals. This report is the result of the first survey carried out in the State, with representation for the State of Goiás and the five macro-regions. This data will support the new Goiás DANT Coping Plan (2023-2032)

Ongoing Refinement and Innovation in the Data Collection Protocols of the Third Round of the National Social Life, Health, and Aging Project.

OBJECTIVES: The third round (R3) of the National Social Life, Health, and Aging Project, a nationally representative, longitudinal survey of community-residing older adults, consisted of 4,777 in-person interviews and 6,100 completed visits to households to identify newly eligible respondents. It revisited respondents from the first rounds (Cohort 1), born in the years 1920 through 1947, and added new respondents (Cohort 2) born in the years 1948 through 1965. Coresidential romantic partners of both cohorts were also eligible. Data collection included in-person questionnaires, up to 11 biomeasures, and a self-administered, postinterview paper questionnaire. METHODS: Questionnaire domains included social network and social support, elder mistreatment, physical health, cognitive function, romantic partners and sexuality, fertility and menopause, mental health, and employment and finances. Biomeasure collection included height, weight, waist circumference, blood pressure and heart rate, timed walk, balance, chair stands, smell, saliva passive drool in a tube (cortisol, dehydroepiandrosterone, estradiol, progesterone, testosterone), dried blood spots (C-reactive protein, Epstein-Barr virus antibodies, high-density lipoprotein cholesterol, hemoglobin, glycosylated hemoglobin [HbA1c], total cholesterol), and accelerometry (sleep patterns and physical activity). A brief questionnaire also collected data on respondents who were deceased or in too poor health to participate. RESULTS: Measures such as response and cooperation rates are provided to evaluate the design and implementation. DISCUSSION: This article describes innovation in the development and implementation of R3, the recruitment of a new cohort of respondents, and fidelity to prior rounds' study design and data collection procedures.

Elder Mistreatment Methods and Measures in Round 3 of the National Social Life, Health, and Aging Project.

OBJECTIVES: Elder mistreatment has negative consequences for older adults' health and well-being. As such, scholars aim to understand its causes, the contexts in which it occurs, how to prevent victimization, and how to design interventions for mistreated older adults. This paper provides a detailed overview of the 2015-2016 National Social Life, Health, and Aging Project (NSHAP) Round 3 Elder Mistreatment Module (EMM) to encourage further research on the topic. METHOD: This paper reviews previous elder mistreatment scholarship, describes the EMM, provides descriptive analyses of elder mistreatment among community-dwelling older adults, and discusses promising approaches and limitations to future research with these data. RESULTS: The EMM includes 10 stem questions to measure elder mistreatment behaviors experienced since age 60 and 2 follow-up questions about perceived severity and the identity of the perpetrator. The stem questions can be analyzed individually or combined into a scale, and researchers can account for severity as a robustness check. Analysts can also group the measures into specific types of elder mistreatment. A major strength of the EMM is its ability to identify perpetrators in victims' core social networks. DISCUSSION: The NSHAP Round 3 EMM provides scholars an opportunity to study older Americans' mistreatment experiences, particularly as they relate to their physical and mental health, their social networks and personal relationships, and their broader social contexts.

Sample Design and Estimation in the National Social Life, Health, and Aging Project: Round 3 (2015-2016).

OBJECTIVES: This article, and corresponding articles for the earlier rounds of the National Social Life, Health, and Aging Project (NSHAP), provide the scientific underpinning for the statistical analysis of NSHAP data. The 2015-2016 round of data collection for NSHAP comprised the third wave of data collection for the original cohort born 1920-1947 (C1) and the first wave of data collection for a second cohort born 1948-1965 (C2). Here we describe (a) our protocol for reinterviewing C1; (b) our approach to the sample design for C2, including the frame construction, stratification, clustering, and within-household selection; and (c) the construction of cross-sectional weights for the entire 2015-2016 sample when analyzed at the individual level or when analyzed as a sample of cohabiting couples. We also provide guidance on computing design-based standard errors. METHODS: The sample for C2 was drawn independently of the C1 sample using the NORC U.S. National Sampling Frame. A probability sample of households containing at least one individual born 1948-1965 was drawn, and from these, each age-eligible individual was included together with their cohabiting spouse or partner (even if not age-eligible). This C2 sample was combined with the C1 sample to yield a sample representative of the U.S. population of adults born 1920-1965. RESULTS: Among C1, we conducted 2,409 interviews corresponding to a 91% conditional response rate (i.e., among previous respondents); the unconditional three-wave response rate for the original C1 sample was 71%. Among C2, we conducted 2,368 interviews corresponding to a response rate of 76%. DISCUSSION: Together C1 and C2 permit inference about the U.S. population of home-dwelling adults born from 1920 to 1965. In addition, three waves of data from C1 are now available, permitting longitudinal analyses of health outcomes and their determinants among older adults.

Novel Insights From Interviewer Assessments of Personal Attributes, Home Environment, and Residential Context in NSHAP.

OBJECTIVES: This study was aimed to describe the interviewer-assessed measures present in the 2015/2016 Round of National Social Life, Health, and Aging Project (NSHAP), outline strengths of interviewer-assessed measures, and explore how interviewer assessments in the domains of home environment and personal characteristics are associated with older adult health. METHOD: Data come from the 2015/2016 Round of the NSHAP. RESULTS: We provide descriptive results from the interviewer assessments of personal attributes, indoor home environment, and outdoor residential context. We present an illustrative analysis of reports of falls, a health outcome that might be predicted by characteristics assessed by the interviewer, and we suggest directions for further research. DISCUSSION: Interviewer assessments collected in NSHAP are useful as proxy measures and can be used in combination with respondent's reports and ecological measures to generate insights into healthy aging.

Couple Analysis in the National Social Life, Health, and Aging Project.

OBJECTIVES: Marital and intimate partner relationships are some of the most important social ties that shape older adults' health and well-being. This paper provides analytic guidelines for the couple data in Round 2 (2010-2011) and Round 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP) to encourage more research on marriage and partnership in late life. METHOD: First, we describe the recruitment of couples and outline how to identify partners in the data sets. Second, we provide descriptive information about the couple sample. Third, we offer guidance for analyzing the dyadic data cross-sectionally and longitudinally. RESULTS: Round 2 interviewed all primary respondents and a sample of their current cohabiting partners and spouses (n = 955 couples). In Round 3, NSHAP reinterviewed the primary respondents and partners who participated in Round 2 (Cohort 1; n = 621 couples) and recruited a new sample of age-eligible adults along with any cohabiting romantic partners (Cohort 2; n = 766 couples). Couples can be identified using a household ID variable in Round 2 and a partner ID variable in Round 3. Demographic characteristics of the couple sample vary by round and cohort. DISCUSSION: Researchers can use data from either round to conduct cross-sectional dyadic analyses to examine issues faced by older couples. A common strategy for couple analysis is the actor-partner interdependence model. With 2 rounds of couple-level data, researchers may consider using cross-lagged models in their research.