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1.
Isr Med Assoc J ; 21(8): 538-541, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474016

RESUMO

BACKGROUND: Travelers' diarrhea (TD) is frequently encountered in people traveling from high-income to low-income countries; however, its epidemiology in those traveling between high-income countries is not known. OBJECTIVES: To evaluate the incidence of diarrhea in North American students relocating to Israel. METHODS: A retrospective cohort study involving medical students from the United States and Canada relocating to Israel was conducted. Students who relocated to Israel during 2010-2016 were contacted by email to participate in an anonymous survey. Data included demographic information as well as occurrence, timing, duration, and outcome of diarrhea after relocation. RESULTS: Ninety-seven students participated in the survey. Most (93.7%) students relocated from the United States or Canada. The period-prevalence of diarrhea was 69.1%. The incidence of diarrhea declined from 34.8 cases per 100 student-months during the first month after relocation to 1.3 cases per 100 student-months after 1 year. The duration of diarrhea was up to 1 week in 72.7%. Students who reported diarrhea were younger than students who did not (mean age 24.0 ± 2.2 and 28.4 ± 1.8 years, respectively, P < 0.001). No other demographic parameter was significantly associated with a higher likelihood of diarrhea. CONCLUSIONS: A high proportion of North American medical students relocating to Israel reported diarrhea with clinical and epidemiological features similar to classic TD. Further studies are needed to elucidate the causative agents of TD in Israel.


Assuntos
Diarreia/epidemiologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Doença Relacionada a Viagens , Doença Aguda , Adulto , Canadá/etnologia , Estudos de Coortes , Diarreia/etnologia , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Projetos Piloto , Estudos Retrospectivos , Viagem , Estados Unidos/etnologia , Adulto Jovem
2.
Rev Bras Epidemiol ; 22: e190049, 2019 Aug 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31460664

RESUMO

OBJECTIVE: To investigate the role of the domiciliary situation in the prevalence of general and abdominal obesity through the National Health Survey of 2013. METHODOLOGY: General obesity (body mass index ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women) in rural and urban areas were described according to sex and macroregion. Crude and adjusted Poisson regression models were used to test the association between obesity and household situation, with the significance level of 5%. RESULTS: The study included 59,226 individuals. Out of these, 20.7% presented general obesity and 38% abdominal obesity (higher in women: 24.3 and 52%, respectively). The highest prevalences of general obesity were observed in southern urban areas, for both sexes (20.8% in men and 26.5% in women). In rural areas, the highest prevalences were observed for the central-west region (17.2%) in men and in the south region (27.4%) in women. In males, after adjusting for demographic variables, living in rural areas was associated with lower prevalences of general obesity in the North (prevalence ratios - PR = 0.60; confidence interval of 95% - 95%CI 0.40 - 0.89) and Northeast (PR = 0.47, 95%CI 0,38 - 0.59), and for abdominal obesity in all regions. For women in the Midwest, the rural household situation was associated with lower prevalences of obesity. (PR = 1.11, 95%CI 1.01 - 1.23). CONCLUSIONS: The results evidenced the role of the domiciliary situation among outcomes at the national level, with lower prevalence of general and abdominal obesity in men living in rural areas. However, higher prevalences were found among women, especially for abdominal obesity.


Assuntos
Inquéritos Epidemiológicos/estatística & dados numéricos , Obesidade Abdominal/epidemiologia , Obesidade/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo , Circunferência da Cintura , Adulto Jovem
3.
BMC Public Health ; 19(Suppl 2): 453, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159771

RESUMO

BACKGROUND: Behaviour has diverse economic, social and health consequences. Linking time spent in different daily activities to energy expenditure (EE) is one way of investigating the health and physiological consequences of behaviour and identifying targets to improve population health and well-being. METHODS: We estimated behaviour-related EE for respondents to time use surveys (TUS) from three countries: UK 2001, Poland 2012 and US 2003-13. The Harmonised Multinational Time Use Survey (MTUS) activity categories were matched to MET estimates from the 2011 Compendium of Physical Activities. We attach METs values to each successive activity in the TUS, together with both the original UK, Polish and US activity classifications and the 68-category MTUS activity classification. We used TUS estimates of activity durations across 24-h to estimate the Physical Activity Level (PAL) for respondents from the three countries and the average time spent and MET values for different activity categories. RESULTS: PAL values ranged from 1.59 in the US to 1.74 in Poland. The main sources of daily EE from PA were paid and unpaid work activities. Discretionary PA accounted for only a very small part (~ 3%) of adult daily energy expenditures. Using the harmonised MTUS 68-activity classification reduced the variability of the aggregate PAEE measure by ~ 20%, but the patterns of association between key demographics (age, sex, educational attainment) were unaffected. TUS data were further used to (1) identify sources of daily PA, and (2) assess adherence to physical activity guidelines (PAG) on a single-day basis. Estimated adherence levels were similar to those reported from other TUS as well as frequency based estimates. CONCLUSIONS: Comparative studies of energy expenditure based on harmonised time use activity categories could provide insight into the relative importance of different activities for energy expenditure across different countries and demographic groups. However, new observational studies combining TUS data with accelerometer, direct observation and other measures of activity intensity are required for more accurate MET assignments to activity categories in TUS.


Assuntos
Metabolismo Energético , Exercício , Inquéritos Epidemiológicos/estatística & dados numéricos , Atividades Humanas/estatística & dados numéricos , Fatores de Tempo , Atividades Cotidianas , Adulto , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Reino Unido , Estados Unidos
4.
BMC Public Health ; 19(Suppl 2): 454, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159781

RESUMO

BACKGROUND: Over the last 150 years, advanced economies have seen the burden of disease shift to non-communicable diseases. The risk factors for these diseases are often co-morbidities associated with unhealthy weight. The prevalence of overweight/obesity among adults in the advanced countries of the English-speaking world is currently more than two-thirds of the adult population. However, while much attention has concentrated on changes in diet that might have provoked this rapid increase in unhealthy weight, changes in patterns of eating have received little attention. METHODS: This article examines a sequence of large-scale, time use surveys in urban Australia stretching from 1974 to 2006. The earliest survey in 1974 (conducted by the Cities Commission) was limited to respondents aged between 18 and 69 years, while the later surveys (by the Australian Bureau of Statistics) included all adult (15 years of age or over) living private dwellings. Since time use surveys capture every activity in a day, they contain much information about mealtimes and the patterns of eating. This includes duration of eating, number of eating occasions and the timing of eating. Inferential statistics were used to test the statistical significance of these changes and the size of the effects. RESULTS: The eating patterns of urban Australian adults have changed significantly over a 32-year period and the magnitude of this change is non-trivial. Total average eating time as main activity has diminished by about a third, as have eating occasions, affecting particularly luncheon and evening meals. However, there is evidence that eating as secondary activity that accompanies another activity is now almost as frequent as eating at mealtimes. Moreover, participants seem not to report it. CONCLUSIONS: Contemporary urban Australians are spending less time in organized shared meals. These changes have occurred the over same period during which there has been a public health concern about the prevalence of unhealthy weight. Preliminary indications are that societies that emphasize eating as a commensal, shared activity through maintaining definite, generous lunch breaks and prioritizing eating at mealtimes, achieve better public health outcomes. This has implications for a strategy of health promotion, but to be sure of this we need to study countries with these more socially organized eating patterns.


Assuntos
Ingestão de Alimentos/psicologia , Comportamento Alimentar/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Adolescente , Adulto , Idoso , Anomia (Social) , Austrália/epidemiologia , Peso Corporal , Estudos Transversais , Dieta/psicologia , Dieta/estatística & dados numéricos , Epidemias , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Refeições , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Comportamento Social , Fatores de Tempo , População Urbana/estatística & dados numéricos , Adulto Jovem
5.
J Urol ; 202(3): 484-489, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31009297

RESUMO

PURPOSE: Inflammatory reaction has been linked to bladder cancer. Diet, which drives systemic inflammation, may be considered a modifiable risk factor for bladder cancer. We examined the association of diet with pro-inflammatory potential and bladder cancer risk using the novel EDIP (empirical dietary inflammatory pattern) score comprising predefined food groups determining a pattern most predictive of plasma inflammatory markers. MATERIALS AND METHODS: We followed a total of 172,802 women in the NHS (Nurses' Health Study) from 1984 to 2012 and the NHS II from 1991 to 2013 as well as 45,272 men in the HPFS (Health Professionals Follow-Up Study) from 1986 to 2012. Multivariable adjusted Cox regression models were used to estimate the RR and 95% CI of bladder cancer across EDIP score quintiles. We performed inverse variance weighted meta-analysis to pool estimates across cohorts stratified by smoking status. RESULTS: During 4,872,188 person-years of observation 1,042 incident bladder cancer cases were identified. Overall, high EDIP scores reflecting dietary patterns with pro-inflammatory potential were not associated with a higher risk of bladder cancer (quintile 5 vs 1 pooled multivariable adjusted RR 0.92, 95% CI 0.75-1.12, ptrend = 0.67). Results were consistent across individual cohorts (quintile 5 vs 1 in the NHS RR 1.04, 95% CI 0.78-1.37, ptrend = 0.71; in the NHS II RR 1.44, 95% CI 0.53-3.91, ptrend = 0.13; and in the HPFS RR 0.74, 95% CI 0.55-1.01, ptrend = 0.11). Results were similar regardless of smoking status. CONCLUSIONS: We observed no association between diets with pro-inflammatory potential and bladder cancer risk. Although additional studies are needed to explore other nutritional pathways with the potential for bladder cancer prevention, our results suggest that diets associated with inflammation are not associated with bladder cancer risk.


Assuntos
Comportamento Alimentar , Inflamação/sangue , Neoplasias da Bexiga Urinária/epidemiologia , Adulto , Idoso , Biomarcadores/sangue , Feminino , Seguimentos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Inflamação/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Neoplasias da Bexiga Urinária/etiologia
6.
BMC Res Notes ; 12(1): 140, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30876448

RESUMO

OBJECTIVE: The objective of this study is to assess the quality of life and to identify factors associated with good global quality of life among people living with HIV/AIDS (PLWHA) in Togo. RESULTS: In total, 880 PLWHA with mean age (standard deviation) of 39.6 (10.1) years, were interviewed. Most of them (78.4%) were female. The global score of quality of life was ranged from 42.6 to 112, with a mean (standard deviation) estimated at 86.3 ± (13.3). More than the three-quarters (76.2%) of the participants had a good global quality of life. In multivariate analysis, secondary education level or higher (adjusted odds ratio = 1.78, 95% confident interval (CI) [1.10-2.85]), living in Kara health region (adjusted odds ratio = 4.39, 95% CI [2.94-6.57]), being on antiretroviral therapy (adjusted odds ratio = 6.99, 95% CI [4.11-11.9]) and HIV sero-status disclosure (adjusted odds ratio = 1.83, 95% CI [1.28-2.61]) were associated with a better overall quality of life (score ≥ 77.3).


Assuntos
Síndrome de Imunodeficiência Adquirida/fisiopatologia , Infecções por HIV/fisiopatologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Qualidade de Vida , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , Adulto , Antirretrovirais/uso terapêutico , Estudos Transversais , Feminino , HIV/efeitos dos fármacos , HIV/fisiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco , Togo
7.
Pediatr Surg Int ; 35(5): 547-550, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30847604

RESUMO

PURPOSE: Hirschsprung's disease-related short bowel syndrome (HDSBS) is characterized by aganglionosis that extends orally to 75 cm from Treitz's band. The condition is reported be associated with a high mortality rate of 50-80%. This retrospective study aimed to survey the current trends in HDSBS treatment in Japan. METHODS: Patient data were extracted from the results of a nationwide survey we conducted, resulting in the retrospective collection of the data of 1087 HD patients from 2008 to 2012 in Japan. RESULTS: A total of 11 (0.9%) cases of HDSBS were noted. All patients underwent jejunostomy as neonates. Radical procedures performed in five patients (A-colon patch method in four, Duhamel's procedure in one). Ziegler's myotomy-myectomy and serial transverse enteroplasty (STEP) were performed in each patient as palliative procedures. No radical operations were performed in 4 of the 11 cases. The mortality rate was 36.4%. Four patients died, 1 patient who underwent STEP and 3 patients who received no radical procedures. The causes of death were sepsis due to enterocolitis or central intravenous catheter infection, and hepatic failure. All patients who underwent radical procedures survived and showed satisfactory outcomes. CONCLUSION: HDSBS still showed a high mortality rate, although surgical approaches such as the A-colon patch method resulted in satisfactory outcomes.


Assuntos
Inquéritos Epidemiológicos/estatística & dados numéricos , Doença de Hirschsprung/complicações , Doença de Hirschsprung/cirurgia , Síndrome do Intestino Curto/etiologia , Síndrome do Intestino Curto/cirurgia , Feminino , Humanos , Lactente , Recém-Nascido , Japão , Masculino , Estudos Retrospectivos , Resultado do Tratamento
8.
J Consult Clin Psychol ; 87(4): 321-331, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30883161

RESUMO

OBJECTIVE: Sexual minority individuals display elevated rates of psychiatric and substance use disorders compared with heterosexuals. Racial/ethnic minority individuals report lower prevalence of disorders compared with White individuals. Research on sexual minority mental health often neglects research on racial/ethnic minority mental health and vice versa. Therefore, at the intersection of sexual and racial/ethnic minority status, the prevalence of disorders remains unclear. METHOD: In a nationally representative sample (N = 36,309), we compared disorder prevalence between sexual minorities and same-race/ethnicity heterosexuals. We then examined the extent to which differences in disorder prevalence between sexual minorities and heterosexuals can be attributed to differences in discrimination experiences related to sexual minority status. We next compared prevalence of disorders for Black and Hispanic with White sexual minority individuals. We examined whether these patterns of associations were reflective of transdiagnostic factor differences among groups. RESULTS: Regardless of race/ethnicity, sexual minority individuals experience higher prevalence of disorders than heterosexuals. Controlling for discrimination experiences partially negates these disparities. At the intersection of racial/ethnic and sexual minority status, disorder prevalence is more nuanced: Although Black sexual minority individuals experience lower prevalence of disorders than Whites, Hispanic sexual minority individuals experience similar prevalence of disorders to Whites. Similar findings are observed using a transdiagnostic factors framework. CONCLUSIONS: These findings reveal important intersectional nuances in the prevalence of psychopathology often overlooked in the race/ethnicity and sexual orientation literatures. These results can inform future scholarship on risk and resilience among marginalized populations, including identifying protective factors associated with possessing certain multiple minority statuses. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Grupos de Populações Continentais/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Sexualidade/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupos de Populações Continentais/psicologia , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Sexualidade/psicologia , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
9.
BMC Public Health ; 19(1): 242, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30819127

RESUMO

BACKGROUND: Immunization is one of the most effective measures for preventing disease when vaccination coverage is sufficient. Although vaccination coverage is known to be influenced by social and cultural barriers, the determinants of childhood immunization in Myanmar remain poorly understood. This study analyzed factors that influenced complete vaccination status (one dose each for Bacillus Calmette-Guérin and measles and three doses each for diphtheria-pertussis and polio) using 2015 data from the Myanmar Demographic Health and Survey. METHODS: Data from 12 to 23-month-old children and their mothers were extracted from the nationally representative survey results. Bivariate and multivariate analyses with survey-weighted logistic regression were performed to examine the relationships between vaccination status and various sociodemographic and medical factors. The independent variables for the analyses included area of residence, economic status, maternal age, marital status, education, literacy, employment status, antenatal care attendance, tetanus vaccination, place of delivery, postnatal evaluations, child's sex, number of children, previous child death, decision maker(s) regarding child's health, frequency of healthcare visits, paternal education, and paternal occupation. RESULTS: A representative sample of 904 cases were extracted for the analysis. The overall complete vaccination rate was 55.4%. In the multivariate analysis with backward step-wise selection, complete vaccination was independently associated with middle or high economic status (adjusted odds ratio [AOR]: 2.64, 95% confidence interval [CI]: 1.85-3.78), older maternal age (AOR: 2.87, 95% CI: 1.62-5.10), ≥4 antenatal care visits (AOR: 1.87, 95% CI: 1.28-2.73), and maternal tetanus vaccination before delivery (AOR: 3.26, 95% CI: 1.82-5.85). CONCLUSION: The first Demographic and Health Survey in Myanmar revealed that only approximately one-half of 12-23-year-old children had received complete vaccination, which was lower than the estimated rate from routine administrative coverage. Our results indicate that incomplete immunization status was associated with low economic status, younger maternal age, fewer antenatal care visits, and no maternal tetanus vaccination. These findings may help improve the targeting and strategic implementation of the Expanded Programme on Immunization.


Assuntos
Pai/psicologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Programas de Imunização/estatística & dados numéricos , Mães/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Difteria/prevenção & controle , Análise Fatorial , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Sarampo/prevenção & controle , Pessoa de Meia-Idade , Análise Multivariada , Mianmar , Razão de Chances , Poliomielite/prevenção & controle , Gravidez , Fatores Socioeconômicos , Coqueluche/prevenção & controle , Adulto Jovem
10.
Int J Public Health ; 64(4): 479-486, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30824951

RESUMO

OBJECTIVES: To determine whether there is a relationship between source-country individualism and depression among different immigrant groups. METHODS: Pooled data from the 2009-2014 waves of the Canadian Community Health Survey (CCHS) were used. The CCHS is a cross-sectional, nationally representative household survey. A sample of 4347 immigrants in Canada were studied, representing 101 source countries. RESULTS: Multi-level logistic regression analysis showed a curvilinear relationship between source-country individualism and depression. A positive relationship was found among immigrants from countries with mid- to high levels of individualism. However, an inverse relationship was observed among immigrants from countries with low to mid-levels of individualism. Depression was significantly associated with the linear form of the source-country individualism measure [odds ratio (OR) 0.950; 95% confidence interval (CI) 0.915-0.987] and its squared term (OR 1.063; 95% CI 1.026-1.102). CONCLUSIONS: A high level of source-country individualism tends to increase the prevalence of depression among immigrants. There is also a cultural shock effect: the prevalence of depression was stronger in the initial years after immigration for those who migrated from countries with low levels of individualism.


Assuntos
Transtorno Depressivo/epidemiologia , Emigrantes e Imigrantes/psicologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Individualidade , Inquéritos e Questionários/estatística & dados numéricos , Adulto , Canadá/epidemiologia , Estudos Transversais , Feminino , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
11.
BMC Public Health ; 19(1): 200, 2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30770737

RESUMO

BACKGROUND: The health impacts of community design have been studied extensively over the past two decades. In particular, public transportation use is associated with more walking between transit stops and shops, work, home and other destinations. Change in transit access has been linked with physical activity and obesity but seldom to health outcomes and associated costs, especially within a causal framework. Health related fiscal impacts of transit investment should be a key consideration in major transit investment decisions. METHODS: The Rails & Health study is a natural experiment evaluating changes in clinical measures, health care utilization and health care costs among Kaiser Permanente Northwest (KPNW) members following the opening of a new light rail transit (LRT) line in Portland, Oregon. The study is prospectively following 3036 adults exposed to the new LRT line and a similar cohort of 4386 adults who do not live close to the new line. Individual-level outcomes and covariates are extracted from the electronic medical record at KPNW, including member demographics and comorbidities, blood pressure, body mass index, lipids, glycosylated hemoglobin, and health care utilization and costs. In addition, participants are surveyed about additional demographics, travel patterns, physical activity (PA), and perceived neighborhood walkability. In a subsample of the study population, we are collecting direct measures of travel-related behavior-physical activity (accelerometry), global positioning system (GPS) tracking, and travel diaries-to document mechanisms responsible for observed changes in health outcomes and cost. Comprehensive measures of the built environment at baseline and after rail construction are also collected. Statistical analyses will (1) examine the effects of opening a new LRT line on chronic disease indicators, health care utilization, and health care costs and (2) evaluate the degree to which observed effects of the LRT line on health measures and costs are mediated by changes in total and transportation-associated PA. DISCUSSION: The results of the Rails & Health study will provide urban planners, transportation engineers, health practitioners, developers, and decision makers with critical information needed to document how transit investments impact population health and related costs.


Assuntos
Doença Crônica/epidemiologia , Planejamento Ambiental/economia , Planejamento Ambiental/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Ferrovias/economia , Ferrovias/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oregon/epidemiologia , Estudos Prospectivos , Características de Residência , Adulto Jovem
12.
Rev Bras Epidemiol ; 21Suppl 02(Suppl 02): e180002, 2019 Feb 04.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30726347

RESUMO

The Health, Wellbeing and Aging Study (SABE) began in 2000 under the coordination of the Pan American Health Organization as a multicenter study developed in seven urban centers of Latin America and the Caribbean, to determine the health and living conditions of elderly in this region. In Brazil, the study was developed in the city of São Paulo, where 2,143 individuals (cohort A) aged 60 years or older were selected through probabilistic sampling. In 2006, 1,115 of these individuals were interviewed a second time, and a new probabilistic cohort of individuals aged 60 to 64 years was added (cohort B; n=298). Thus the SABE Study - Brazil was transformed into a multi-cohort longitudinal study, with the objective of identifying changes that occur in the aging process among different generations. In 2010, a longitudinal follow-up was developed with cohorts A and B, with the addition of a new cohort of individuals aged 60 to 64 years (cohort C; n=355). Thethree surveys (2000, 2006 and 2010) involved the application of a questionnaire, anthropometric evaluation and functional tests, with the subsequent inclusion of blood collection for the evaluation of biochemical, immunological and genetic variables, as well as an accelerometer for the measuring of caloric expenditure.


Assuntos
Envelhecimento , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Brasil , Feminino , Envelhecimento Saudável , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Padrões de Referência , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários
13.
Pediatr Surg Int ; 35(5): 583-590, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30729983

RESUMO

PURPOSE: The aim was to investigate the quality of life and bowel function in children with low anorectal malformations (ARM). ADDITIONAL AIM: To evaluate the Swedish version the Hirschsprung's Disease/Anorectal Malformation Quality of life Questionnaire (HAQL). METHODS: Forty-four children and their parents were invited to complete the HAQL and the Bowel Function Score (BFS). Healthy children participated as controls and completed the HAQL. RESULTS: Seventeen children and 18 mothers completed the HAQL. The children reported impaired function in the physical symptom (PH) fecal continence (FC) and laxative diet (LD) domains compared to controls. Compared with their mothers, they reported impaired physical function and more symptoms in the emotional functioning (EMF) and PH domains. 27 families completed the BFS; 63% reported normal bowel function, 33% moderate outcome and one patient, comprising 4%, poor outcome. Evaluation of the HAQL, FC, EMF and PH domains showed no obvious conflicts. CONCLUSIONS: The children did not differ much regarding their QoL, even though they appeared to have impaired bowel function and worse emotional functioning compared to controls. The mothers underestimated their children's physical symptoms and overestimated their emotional functioning. Evaluated domains in the HAQL appear to work as intended, but the questionnaire needs further development.


Assuntos
Malformações Anorretais/fisiopatologia , Malformações Anorretais/psicologia , Atitude Frente a Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Qualidade de Vida , Adolescente , Criança , Defecação , Emoções , Feminino , Seguimentos , Humanos , Masculino , Mães/psicologia , Inquéritos e Questionários , Suécia
14.
Int J Equity Health ; 18(1): 4, 2019 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621687

RESUMO

BACKGROUND: Population ageing in China has brought increasing attention to the health inequalities of the elderly. The purpose of this paper is to measure income-related health inequality among the elderly in China and decompose its causes. METHODS: The data are from the China Health and Retirement Longitudinal Study (CHARLS) survey in 2013, which contains 6176 individuals aged 60 years and above. A multiple linear regression model was used to analyze the influencing factors of self-rated health (SRH) among the elder people. Furthermore, the corrected concentration index were used to measure income-related health inequality. Wagstaff-type decomposition analysis was employed to explore the cause of inequality. The measurement and decomposition of health inequality was also performed separately in the male and female subgroups. RESULTS: Most elderly declared their health status as "fair" (51.33%) or "poor" (21.88%). Income, gender, residence, region, health insurance and other factors had significant association with SRH (P < 0.05). The corrected concentration index (CCI) was 0.06, indicating pro-rich inequality in health among the elderly. Decomposition analyses revealed that the main contributors to health inequality included income, residence, region, health insurance, and employment. For female elderly, most of the inequality was due to residence (50.78%) and income (49.51%); for male elderly, most of the inequality was due to insurance (38.65%) and income (22.26%); for the total sample, employment had a negative contribution to health inequality (- 25.83%). CONCLUSION: The findings confirm a high proportion of elderly with poor SRH, and health inequality in the Chinese. Some socioeconomic strategies should be conducted to reduce this health inequality among the elderly, such as reducing income disparities, consolidating health insurance schemes, and narrowing urban-rural and regional gaps. Older females with low incomes in rural areas are a vulnerable subgroup and warrant targeted policy attention.


Assuntos
Envelhecimento , Disparidades nos Níveis de Saúde , Nível de Saúde , Inquéritos Epidemiológicos/economia , Renda/estatística & dados numéricos , Seguro Saúde/economia , População Rural/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Seguro Saúde/estatística & dados numéricos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
15.
PLoS Negl Trop Dis ; 13(1): e0007134, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30699107

RESUMO

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.


Assuntos
Cólera/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Cólera/prevenção & controle , Estudos Transversais , Demografia/estatística & dados numéricos , Haiti/epidemiologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Modelos Logísticos , Razão de Chances
16.
PLoS One ; 14(1): e0210091, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30673727

RESUMO

This paper presents a new public-use dataset for community-level life satisfaction in Canada, based on more than 500,000 observations from the Canadian Community Health Surveys and the General Social Surveys. The country is divided into 1216 similarly sampled geographic regions, using natural, built, and administrative boundaries. A cross-validation exercise suggests that our choice of minimum sampling thresholds approximately maximizes the predictive power of our estimates. The resulting dataset reveals robust differences in life satisfaction between and across urban and rural communities. We compare aggregated life satisfaction data with a range of key census variables to illustrate some of the ways in which lives differ in the most and least happy communities.


Assuntos
Felicidade , Inquéritos Epidemiológicos/estatística & dados numéricos , Satisfação Pessoal , Características de Residência/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Canadá , Humanos , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
17.
Psychiatry Res ; 271: 502-509, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30551082

RESUMO

This study examined the psychometric properties of the Danish WEMWBS and its short version (SWEMWBS) in a Danish population sample, and compared scores in Denmark with scores representative of three other European settings. A total of 3,508 Danish men and women aged 16-95 filled out an electronic survey. Face validity was examined by cognitive interviews. Content validity was assessed by examining response distributions and construct validity by confirmatory factor analysis, measurement invariance, and relations to other or similar measures. Overall mental well-being scores were calculated, as well as stratified by sex and age. Support was found for the single-factor hypothesis, yielding good model fits for both versions of the scale. Both scales have high internal consistency. Correlations with mental health measures were largely in line with expectations. The highest mental well-being scores were reported for Catalonia, followed by Denmark, Iceland, and England. The (S)WEMWBS appear to be appropriate instruments to measure mental well-being in the Danish population. The present findings encourage the use of the scales, particularly SWEMWBS, in epidemiological, intervention and evaluation studies in research and practice. Cross-cultural comparisons like the one reported here may be essential to inform international mental health policy.


Assuntos
Comparação Transcultural , Saúde Mental/estatística & dados numéricos , Satisfação Pessoal , Psicometria/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Inglaterra/epidemiologia , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Islândia/epidemiologia , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Espanha/epidemiologia , Adulto Jovem
18.
J Dermatol ; 46(3): 206-212, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30592077

RESUMO

This study aimed to determine the prevalence of vitamin D insufficiency among Thai dermatologists compared with the general working-age population in Bangkok. A cross-sectional study was conducted in healthy Thai physicians who had at least 1 years' experience in dermatology practise and a subsample of the general Thai population from the Fourth National Health Survey. Serum 25-hydroxyvitamin D (25[OH]D), a combination of 25(OH)D2 and 25(OH)D3, levels in both groups were measured using liquid chromatography coupled with mass spectrometry. The majority of dermatologists were of Fitzpatrick skin type III (n = 61, 61.3%) or IV (n = 32, 33.3%). The mean serum 25(OH)D and 25(OH)D3 levels were 18.9 and 18.2 ng/mL, respectively, whereas the corresponding levels in the general population were 26.5 and 25.8 ng/mL. None of the dermatologist had serum 25(OH)D sufficiency (>30 ng/mL), 38 (38.78%) had vitamin D insufficiency (20-30 ng/mL) and 60 (61.22%) had vitamin D deficiency (<20 ng/mL). The frequency of vitamin D deficiency in dermatologists was significantly higher than in the general population (61.2% vs 19.2%, P < 0.001). Ninety percent of dermatologists used sunscreen daily and spent time mostly indoors. Dermatologists used physical sun-protection more than half of the time when outdoors, for example, a book or paper as a sunshade (70.3%), an umbrella (48.4%), a long-sleeved shirt (20.4%) or a hat (9.7%). In conclusion, dermatologists showed a remarkably high prevalence of vitamin D deficiency which may be due to inadequate exposure to sunlight, regular use of sunscreen and practicing various sun-protection activities.


Assuntos
Dermatologistas/estatística & dados numéricos , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Luz Solar , Protetores Solares/administração & dosagem , Tailândia/epidemiologia , Deficiência de Vitamina D/sangue
19.
J Matern Fetal Neonatal Med ; 32(2): 217-224, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28982268

RESUMO

OBJECTIVE: This study aimed to analyze the 2009 Jordan Population and Family Health Survey (JPFHS) data to determine the level, trend, and distribution of neonatal mortality (NNM) in Jordan and determine its associated factors. METHODS: Nationally representative data on NNM were extracted from the JPFHS data. Using multivariate analyses, the strength of associations between 12 clinical/sociodemographic variables and neonatal mortality were quantified after controlling for potential confounders. RESULTS: The weighted NNM rate for 2005-2009 period was 16 deaths per 1000 live births, with the early NNM rate and late NNM rates were 10 deaths per 1000 live births and six deaths per 1000 live births, respectively. Fluctuations of NNM according to year of birth and geographic variations were noted. Risk of NNM increased among male newborns, as mother's education level decreased, in mothers 40-49 years old, in multiple gestations-low birth weight neonates, and as birth interval was <3 years. CONCLUSIONS: The NNR rate for 2005-2009 period of 16 deaths per 1000 live births indicates that there are opportunities to decrease it. Risk factors of neonatal mortality with respect to predictors of death during first days of life and variables related to geographic variations require particular focus to improve the quality of obstetric and neonatal health services and to decrease neonatal mortality.


Assuntos
Mortalidade Infantil , Adolescente , Adulto , Saúde da Família/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Jordânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Gravidez , Resultado da Gravidez/epidemiologia , Fatores de Risco , Adulto Jovem
20.
J Diabetes ; 11(1): 55-64, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29893042

RESUMO

BACKGROUND: Low birth weight (LBW) has been associated with subsequent risks of obesity and certain chronic diseases, but evidence for the associations is limited for the Chinese population. METHODS: In this study we analyzed data from two population-based prospective cohort studies, the Shanghai Women's Health Study and the Shanghai Men's Health Study, to examine the associations between LBW and the risk of obesity and chronic diseases. Birth weight was self-reported at baseline; anthropometric measurements were made at study enrollment. Type 2 diabetes mellitus (T2DM) diagnoses were self-reported, whereas hypertension diagnoses were based on self-report and blood pressure measurements at baseline and follow-up surveys. RESULTS: Birth weight was available for 11 515 men and 13 569 women. Non-linear associations were observed for birth weight with baseline body mass index (BMI), waist circumference (WC), waist: hip ratio (WHR), and waist: height ratio (WHtR; P < 0.05 for non-linearity), and LBW was linked with lower BMI, smaller WC, and larger WHR and WHtR. An excess risk of T2DM was observed for LBW (<2500 g) versus birth weight 2500-3499 g since baseline (hazard ratio [HR] 1.17; 95% confidence interval [CI] 0.92-1.49) and since birth (HR 1.29; 95% CI 1.07-1.54), whereas the HRs for hypertension since baseline and birth were 1.13 (95% CI 1.01-1.27) and 1.20 (95% CI 1.11-1.30), respectively. The risk of the diseases decreased as birth weight increased up to ~4000 g; further increases in birth weight did not convey additional benefits. CONCLUSION: The results suggest that LBW, an index of poor intrauterine nutrition, may affect health risks later in life in the Chinese population.


Assuntos
Peso ao Nascer/fisiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Hipertensão/fisiopatologia , Obesidade/fisiopatologia , Adulto , Grupo com Ancestrais do Continente Asiático , Pressão Sanguínea/fisiologia , Pesos e Medidas Corporais , China , Diabetes Mellitus Tipo 2/etnologia , Feminino , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Hipertensão/etnologia , Masculino , Pessoa de Meia-Idade , Obesidade/etnologia , Estudos Prospectivos , Fatores de Risco
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