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1.
J Med Internet Res ; 22(9): e21319, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32870159

RESUMO

BACKGROUND: Spain has been one of the countries most impacted by the COVID-19 pandemic. Since the first confirmed case was reported on January 31, 2020, there have been over 405,000 cases and 28,000 deaths in Spain. The economic and social impact is without precedent. Thus, it is important to quickly assess the situation and perception of the population. Large-scale online surveys have been shown to be an effective tool for this purpose. OBJECTIVE: We aim to assess the situation and perception of the Spanish population in four key areas related to the COVID-19 pandemic: social contact behavior during confinement, personal economic impact, labor situation, and health status. METHODS: We obtained a large sample using an online survey with 24 questions related to COVID-19 in the week of March 28-April 2, 2020, during the peak of the first wave of COVID-19 in Spain. The self-selection online survey method of nonprobability sampling was used to recruit 156,614 participants via social media posts that targeted the general adult population (age >18 years). Given such a large sample, the 95% CI was ±0.843 for all reported proportions. RESULTS: Regarding social behavior during confinement, participants mainly left their homes to satisfy basic needs. We found several statistically significant differences in social behavior across genders and age groups. The population's willingness to comply with the confinement measures is evident. From the survey answers, we identified a significant adverse economic impact of the pandemic on those working in small businesses and a negative correlation between economic damage and willingness to stay in confinement. The survey revealed that close contacts play an important role in the transmission of the disease, and 28% of the participants lacked the necessary resources to properly isolate themselves. We also identified a significant lack of testing, with only 1% of the population tested and 6% of respondents unable to be tested despite their doctor's recommendation. We developed a generalized linear model to identify the variables that were correlated with a positive SARS-CoV-2 test result. Using this model, we estimated an average of 5% for SARS-CoV-2 prevalence in the Spanish population during the time of the study. A seroprevalence study carried out later by the Spanish Ministry of Health reported a similar level of disease prevalence (5%). CONCLUSIONS: Large-scale online population surveys, distributed via social media and online messaging platforms, can be an effective, cheap, and fast tool to assess the impact and prevalence of an infectious disease in the context of a pandemic, particularly when there is a scarcity of official data and limited testing capacity.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Inquéritos Epidemiológicos/métodos , Pandemias , Pneumonia Viral/epidemiologia , Mídias Sociais , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Autorrelato , Estudos Soroepidemiológicos , Comportamento Social , Espanha/epidemiologia , Adulto Jovem
2.
ACS Chem Neurosci ; 11(17): 2774-2781, 2020 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-32786309

RESUMO

The rapid recovery of smell and taste functions in COVID-19 patients could be attributed to a decrease in interleukin-6 levels rather than central nervous system ischemic injury or viral damage to neuronal cells. To correlate interleukin-6 levels in COVID-19 patients with olfactory or gustatory dysfunctions and to investigate the role of IL-6 in the onset of these disorders, this observational study investigated 67 COVID-19 patients with taste or smell disorders or both, who did not require intensive care admission, admitted at COVID Hospital of Policlinico of Bari from March to May 2020. Interleukin-6 was assayed in COVID-19 patients with taste or smell disturbances at the time of admission and at the time of swab negativization. At the same time, patients have been given a specific survey to evaluate the severity of taste and smell disturbances. Of 125 patients with smell or taste dysfunctions at onset of disease, 67 fulfilled the inclusion criteria, while 58 were excluded because 35 of them required intensive care admission, 5 were unable to answer, 5 died, 7 had finished chemotherapy recently, and 5 refused to participate. The evaluation of taste and smell disorders was carried out using a survey performed at the time of admission and at the time of swab negativization. Sinonasal outcome test 22 (SNOT-22) was used as a reference for olfactory function assessment, and Taste and Smell Questionnaire Section of the US NHANES 2011-2014 protocol (CDC 2013b) was used as reference for gustatory function assessment. A venous blood sample was taken for each patient to measure IL-6 levels upon entry and at swab negativization. Interleukin-6 levels in COVID-19 patients in relation to olfactory or gustatory disorders were correlated from the time of their admission to the time of swab negativization. Statistically significant correlations were obtained between the decrease of interleukin-6 levels and the improvement of smell (p value < 0.05) and taste (p = 0.047) functions at swab negativization. The acquired results demonstrate the key role of interleukin-6 in the pathogenesis of chemosensitive disorders in COVID-19 patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/sangue , Interleucina-6/sangue , Transtornos do Olfato/sangue , Pneumonia Viral/sangue , Distúrbios do Paladar/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Interleucina-6/fisiologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/etiologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Paladar/fisiologia , Distúrbios do Paladar/diagnóstico , Distúrbios do Paladar/etiologia
3.
Rev Bras Epidemiol ; 23: e200058, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32520106

RESUMO

OBJECTIVE: To compare the distribution of chronic non-communicable diseases (CNCD) indicators among adult female beneficiaries and non-beneficiaries of the Bolsa Família Program (BFP) in Brazilian capitals. METHODS: Analysis of Vigitel telephone survey data in 2016 and 2017. Gross and adjusted prevalence ratios (PR) and their respective confidence intervals were estimated using Poisson Regression model. RESULTS: Women with BF have lower schooling, are young people, live more frequently in the Northeast and North of the country. Higher prevalence of risk factors were found in woman receiving BF. The adjusted PR of the BF women were: smokers (PR = 1.98), overweight (PR = 1.21), obesity (PR = 1.63), fruits and vegetables (PR = 0.63), consumption of soft drinks (PR = 1.68), bean consumption (PR = 1.25), physical activity at leisure (PR = 0.65), physical activity at home (PR = 1.35), time watching TV (PR = 1.37), self-assessment of poor health status (PR =2.04), mammography (PR = 0.86), Pap smears (PR = 0.91), hypertension (PR = 1.46) and diabetes (PR = 1,66). When women were compared among strata of the same schooling, these differences were reduced. CONCLUSION: Worst indicators among women receiving BF reflect social inequalities inherent in this most vulnerable group. The study also shows that BF is being targeted at the most vulnerable women.


Assuntos
Doença Crônica , Assistência Pública/estatística & dados numéricos , Adolescente , Adulto , Idoso , Brasil , Doença Crônica/classificação , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Telefone , Adulto Jovem
4.
BMC Med Res Methodol ; 20(1): 159, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32539726

RESUMO

BACKGROUND: We aimed to assess the feasibility of using multiple technologies to recruit and conduct cognitive interviews among young people across the United States to test items measuring sexual and reproductive empowerment. We sought to understand whether these methods could achieve a diverse sample of participants. With more researchers turning to approaches that maintain social distancing in the context of COVID-19, it has become more pressing to refine these remote research methods. METHODS: We used several online sites to recruit for and conduct cognitive testing of survey items. To recruit potential participants we advertised the study on the free online bulletin board, Craigslist, and the free online social network, Reddit. Interested participants completed an online Qualtrics screening form. To maximize diversity, we purposefully selected individuals to invite for participation. We used the video meeting platform, Zoom, to conduct the cognitive interviews. The interviewer opened a document with the items to be tested, shared the screen with the participant, and gave them control of the mouse and keyboard. After the participant self-administered the survey, the interviewer asked about interpretation and comprehension. After completion of the interviews we sent participants a follow-up survey about their impressions of the research methods and technologies used. We describe the processes, the advantages and disadvantages, and offer recommendations for researchers. RESULTS: We recruited and interviewed 30 young people from a range of regions, gender identities, sexual orientations, ages, education, and experiences with sexual activity. These methods allowed us to recruit a purposefully selected diverse sample in terms of race/ethnicity and region. It also may have offered potential participants a feeling of safety and anonymity leading to greater participation from gay, lesbian, and transgender people who would not have agreed to participate in-person. Conducting the interviews using video chat may also have facilitated the inclusion of individuals who would not volunteer for in-person meetings. Disadvantages of video interviewing included participant challenges to finding a private space for the interview and problems with electronic devices. CONCLUSIONS: Online technologies can be used to achieve a diverse sample of research participants, contributing to research findings that better respond to young people's unique identities and situations.


Assuntos
Cognição/fisiologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Entrevistas como Assunto/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Estudos de Viabilidade , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Internet , Entrevistas como Assunto/métodos , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Psicometria/métodos , Reprodutibilidade dos Testes , Estados Unidos/epidemiologia , Adulto Jovem
5.
PLoS One ; 15(6): e0235164, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574206

RESUMO

Inappropriate use of antibacterials is a major public health challenge as it can promote emergence of resistance, wastage of financial resources, morbidity and mortality. In this study, we determined the prevalence and factors associated with antibacterial use in managing symptoms of acute respiratory tract infections (ARIs) in households in rural communities of Gulu district, northern Uganda. A cross-sectional study was conducted among households selected using multi-stage sampling. Data were collected through interviews with care-givers of children under five years, using a structured interviewer administered questionnaire. Out of the 856 children who had symptoms of ARIs, 515 (60.2%; CI: 54.5%-65.6%) were treated with antibacterials. The most commonly used antibacterials were amoxicillin (55.2%, n = 358), cotrimoxazole (15.4%, n = 100) and metronidazole (11.4%, n = 74). The determinants of antibacterial use included; getting treatment from a health facility (AOR: 1.85, CI: 1.34-2.56, P < 0.001), households located in peri-urban area (AOR: 2.54, CI: 1.34-4.84, P = 0.005), and a child having cough (AOR: 7.02, CI: 4.36-11.31, P < 0.001). The prevalence of antibacterial use among children under five years with symptoms of ARIs is high in communities of Gulu district, northern Uganda. Getting treatment from a health facility, if a household was located in a peri-urban area and having a cough are positive predictors of antibacterial use. There is need for targeted education on appropriate antibacterial use in rural communities and hospital settings where over prescription is most likely especially in treating symptoms of ARIs among children under five years.


Assuntos
Antibacterianos/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Serviços de Saúde Rural/estatística & dados numéricos , População Rural/estatística & dados numéricos , Amoxicilina/uso terapêutico , Pré-Escolar , Tosse/complicações , Tosse/diagnóstico , Tosse/tratamento farmacológico , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Lactente , Modelos Logísticos , Masculino , Metronidazol/uso terapêutico , Análise Multivariada , Prevalência , Infecções Respiratórias/complicações , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Fatores de Risco , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Uganda/epidemiologia
6.
PLoS One ; 15(6): e0235088, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574228

RESUMO

Understanding health beliefs is important to facilitate health promotion and disease prevention as they influence health behaviors, outcomes, and disease management. Given the rise of hypertension-related diseases in the Dominican Republic, the purpose of our study was to identify hypertension-related health beliefs of Dominicans in order to inform the development of culturally appropriate interventions for hypertension prevention, care, and treatment. Semi-structured interviews were conducted with 20 Dominicans, 15 of whom were receiving treatment for hypertension. Operating within the interpretative paradigmatic framework, we conducted thematic analyses of interview data to identify hypertension-related health beliefs and practices. Iterative data analysis revealed the following themes: 1) Negative emotions are a primary cause of hypertension, 2) Medication is the best treatment but adherence is challenging, 3) Systemic barriers impede treatment access, 4) Hypertension negatively impacts mental and physical well-being, and 5) Lifestyle changes, relaxation, and social support help manage hypertension. Data gathered from member checking validated these findings. This study enhances understanding of the beliefs and experiences of Dominicans and emphasize the importance of implementing culturally competent health programming and care.


Assuntos
Cultura , Comportamentos Relacionados com a Saúde/fisiologia , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Inquéritos Epidemiológicos/métodos , Hipertensão/prevenção & controle , Hipertensão/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , República Dominicana , Emoções/fisiologia , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Hipertensão/psicologia , Entrevistas como Assunto/métodos , Entrevistas como Assunto/estatística & dados numéricos , Estilo de Vida , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Apoio Social
7.
J Headache Pain ; 21(1): 67, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503410

RESUMO

BACKGROUND: Several previous studies have reported a cross-sectional association between elevated high sensitivity C-reactive protein (hs-CRP) and migraine. The aim of this population-based follow-up study was to investigate the influence of hs-CRP at baseline on the risk of developing migraine 11 years later. METHODS: Data from the Nord-Trøndelag Health Study performed in 2006-2008 (baseline) and 2017-2019 were used. A total of 19,574 participants without migraine at baseline were divided into three groups based on hs-CRP levels (< 3 mg/L, 3-9.99 mg/L and 10.00-20 mg/L). Poisson regression was used to evaluate the associations between hs-CRP levels and risk ratios (RRs) of migraine, and precision of the estimates was assessed by 95% confidence interval (CIs). RESULTS: In the multi-adjusted model, increased risk of migraine (RR 1.46, 95% CI 1.05-2.04) was found in the highest hs-CRP levels group compared to the lowest group. In the group with the highest hs-CRP levels, a nearly three times higher risk of chronic migraine (RR 2.81, 95% CI 1.12-7.06) was found, whereas no evident relationship was found between high hs-CRP level and risk of developing episodic migraine. CONCLUSIONS: The main finding in this 11-year follow-up was that hs-CRP levels between 10.00-20.00 mg/L at baseline was associated with increased risk of chronic migraine.


Assuntos
Proteína C-Reativa/metabolismo , Inquéritos Epidemiológicos/tendências , Transtornos de Enxaqueca/sangue , Transtornos de Enxaqueca/diagnóstico , Adulto , Idoso , Biomarcadores/sangue , Proteína C-Reativa/análise , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Noruega/epidemiologia , Fatores de Risco , Fatores de Tempo
8.
PLoS One ; 15(6): e0235055, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579574

RESUMO

BACKGROUND: Early supported discharge (ESD) models of care for stroke survivors coordinate inpatient and community services, with the aim of reducing length of stay. While there is an established evidence base around the clinical outcomes of ESD), less is known about the implementation of this approach into existing stroke care service. The aim of this case study was to describe staff perceptions of the implementation of an ESD model of care for stroke survivors at a large metropolitan public hospital in Australia. METHODS: This case study utilised a mixed methods design, which was designed in explicit alignment with the Consolidated Framework for Implementation Research (CFIR). Participants included staff that referred patients for ESD, and staff involved in the planning, implementation or delivery of ESD. Survey data was collected at three time points (ESD commencement, 3 months and 6 months), and focus groups were undertaken at the conclusion of the study. All quantitative data was analysed descriptive, while qualitative data was evaluated using thematic analysis. RESULTS: Results from both sources of data identified changes in staff perceptions of ESD implementation over time. While very few changes were statistically significant, they were diverse patterns of change across the CFIR constructs over time. The characteristics of individuals and ESD characteristics attracted consistently positive perceptions, while patient needs and resources was the most prevalent theme within the data. While perceptions of factors related to the inner setting were mixed, there was a steady improvement in perceptions about the process across the later stages of implementation. CONCLUSIONS: The sophistication of knowledge translation and implementation in modern complex healthcare environments is highlighted by the multiple interactions between the CFIR domains and constructs. While the implementation process described was generally positive and effective, using the CFIR as a framework confirmed that it also entailed some challenges and unanticipated outcomes.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Acidente Vascular Cerebral/terapia , Sobreviventes , Austrália , Cidades , Assistência à Saúde/métodos , Assistência à Saúde/normas , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/normas , Inquéritos Epidemiológicos/estatística & dados numéricos , Hospitais Públicos , Humanos , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Alta do Paciente/normas , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa/normas , Projetos de Pesquisa/estatística & dados numéricos
9.
PLoS One ; 15(6): e0235056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579575

RESUMO

Globally, cancer patients obtain much of their disease information online. Online health communities allow patients to share questions and information about diseases. However, there have been few studies on the factors affecting online health community participation behavior in cancer patients. Online social networking is associated with mental health problems, and patients with thyroid cancer experience high levels of distress, anxiety and depression. The purpose of this study was to investigate factors associated with use of online health communities by patients with thyroid cancer to understand the characteristics of patients participating in such online communities. A questionnaire survey was completed by 114 thyroid cancer patients admitted for surgery at a general hospital in Seoul, Korea. General characteristics, clinical characteristics, attitude toward cancer, distress, and anxiety and depression scores of patients who joined an online health community (user group) and patients who did not (non-user group) were compared. The factors affecting online health community participation were education (p = 0.049), tumor size (p = 0.010), attitude toward cancer (p = 0.022), and anxiety and depression (p = 0.021). The average score of satisfaction with the online health community was 4.25 of 5. The user group had larger tumors, a high awareness of the risk of thyroid cancer, and high levels of anxiety and depression. Patients who actively used the online health community have relatively larger cancer size and had higher levels of mental stress. As such patients are often very anxious and depend heavily on the gathered information, the quality of this information is important. Healthcare professionals need to develop appropriate interventions for patients participating in the online health community.


Assuntos
Carcinoma Papilar/psicologia , Participação da Comunidade/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Neoplasias da Glândula Tireoide/psicologia , Adolescente , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/etnologia , Ansiedade/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/etnologia , Depressão/diagnóstico , Depressão/etnologia , Depressão/patologia , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , República da Coreia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/etnologia , Adulto Jovem
10.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32409482

RESUMO

OBJECTIVES: In this study, we present an epidemiological profile of middle childhood (children aged 6-11 years) using the 2016-2017 National Survey of Children's Health. METHODS: We used data from the 2016 and 2017 National Survey of Children's Health, a national cross-sectional, address-based survey administered annually. The study sample included 21 539 children aged 6 to 11 years. Survey items chosen to create this profile of middle childhood described sociodemographic and family characteristics, health status, and behaviors. Weighted descriptive and bivariate analyses were applied to examine the population and differences by subgroups. RESULTS: Most children aged 6 to 11 years were in excellent or very good physical health (89%) and oral health (73%). More than 20% were considered to have special health care needs, and 20% had at least 2 health conditions. Allergies and asthma were the most prevalent physical conditions, whereas attention-deficit/hyperactivity disorder and behavioral or conduct problems were the most prevalent of emotional, behavioral, and/or developmental disorders. More than half of children participated in sports or other activities for at least 60 minutes per day, whereas more than one-third of children had ≥4 hours of parent-reported screen time per day, and nearly two-thirds received ≥9 hours of sleep per night. We found several significant differences in screen time and activity behaviors as children aged and by sex. CONCLUSIONS: The middle-childhood population is generally healthy, yet several patterns observed with respect to age and sex indicate a need to examine the emergence and progression of select health-risk behaviors. In this study, we highlight opportunities to implement targeted interventions at earlier ages and different points along the life course.


Assuntos
Saúde da Criança/tendências , Comportamentos Relacionados com a Saúde/fisiologia , Inquéritos Epidemiológicos/tendências , Fatores Etários , Criança , Estudos Transversais , Feminino , Comportamentos de Risco à Saúde/fisiologia , Inquéritos Epidemiológicos/métodos , Humanos , Masculino
11.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32424076

RESUMO

BACKGROUND AND OBJECTIVES: Previous research has demonstrated associations between maternal experience of intimate partner violence (IPV) and a range of adverse outcomes among women and their young children. However, few studies have examined the associations between maternal experience of IPV and early child development (ECD) outcomes in low- and middle-income countries (LMIC). Our objectives in this study were to examine the association between IPV victimization and ECD and assess whether the association was mediated by maternal and paternal stimulation. METHODS: We combined cross-sectional data from the Demographic and Health Surveys for 15 202 households representing mothers and fathers of children aged 36 to 59 months in 11 LMIC. We used multivariable linear regression models to estimate the association between IPV victimization in the year preceding the survey and ECD, which we measured using the Early Child Development Index. We used path analysis to determine if the association between IPV victimization and ECD was mediated through maternal and paternal stimulation. RESULTS: After adjusting for sociodemographic variables, IPV victimization was negatively associated with ECD (ß = -.11; 95% confidence interval = -.15 to -.07). Path analysis indicated that the direct association between IPV victimization and ECD was partially and independently mediated through maternal and paternal stimulation. CONCLUSIONS: Interventions that include components to prevent IPV may be effective for improving ECD in LMIC.


Assuntos
Desenvolvimento Infantil/fisiologia , Pai/psicologia , Inquéritos Epidemiológicos/métodos , Violência por Parceiro Íntimo/psicologia , Mães/psicologia , Poder Familiar/psicologia , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/tendências , Humanos , Violência por Parceiro Íntimo/tendências , Masculino , Poder Familiar/tendências
12.
PLoS One ; 15(5): e0220164, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32433685

RESUMO

Acute respiratory infection (ARI) and diarrhoea are two major causes of child morbidity and mortality in Bangladesh. National and regional level prevalence of ARI and diarrhoea are calculated from nationwide surveys; however, prevalence at micro-level administrative units (say, district and sub-district) is not possible due to lack of sufficient data at those levels. In such a case, small area estimation (SAE) methods can be applied by combining survey data with census data. Using an SAE method for the dichotomous response variable, this study aims to estimate the proportions of under-5 children experienced with ARI and diarrhoea separately as well as either ARI or diarrhoea within a period of two-week preceding the survey. The ARI and diarrhoea data extracted from Bangladesh Demographic and Health Survey 2011 are used to develop a random effect logistic model for each of the indicators, and then the prevalence is estimated adapting the World Bank SAE approach for the dichotomous response variable using a 5% sample of the Census 2011. The estimated prevalence of each indicator significantly varied by district and sub-district (1.4-11.3% for diarrhoea, 2.2-11.8% for ARI and 4.3-16.5% for ARI/diarrhoea at sub-district level). In many sub-districts, the proportions are found double of the national level. District and sub-district levels spatial distributions of the indicators might help the policymakers to identify the vulnerable disaggregated and remote hotspots. Particularly, aid industries can provide effective interventions at the highly vulnerable spots to overcome the gaps between micro and macro level administrative units.


Assuntos
Diarreia/epidemiologia , Infecções Respiratórias/epidemiologia , Bangladesh/epidemiologia , Censos , Criança , Pré-Escolar , Diarreia/mortalidade , Inquéritos Epidemiológicos/métodos , Humanos , Modelos Logísticos , Prevalência , Infecções Respiratórias/mortalidade
13.
PLoS One ; 15(5): e0232223, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32379769

RESUMO

INTRODUCTION: Measuring health-related quality of life (HRQOL) in patients with chronic low back pain (LBP) is crucial to monitor and improve the patients' health status through effective rehabilitation. While the 12-item short-form health survey (SF-12) was developed as a shorter alternative to the 36-item short-form health survey for assessing HRQOL in large-scale studies, to date, no cross-culturally adapted and validated Hausa version exists. This study aimed to translate and cross-culturally adapt the SF-12 into Hausa language, and test its psychometric properties in mixed urban and rural Nigerian populations with chronic LBP. METHODS: The Hausa version of the SF-12 was developed following the guidelines of the International Quality of Life Assessment project. Fifteen patients with chronic LBP recruited from urban and rural communities of Nigeria pre-tested the Hausa SF-12. A consecutive sample of 200 patients with chronic LBP recruited from urban and rural clinics of Nigeria completed the instrument, among which 100 respondents re-tested the instrument after two weeks. Factorial structure and invariance were assessed using confirmatory factor analysis (CFA) and multi-group CFA respectively. Multi-trait scaling analysis (for convergent and divergent validity) and known-groups validity were performed to assess construct validity. Composite reliability (CR), internal consistency (Cronbach's α), intraclass correlation coefficients (ICC), and Bland-Altman plots were computed to assess reliability. RESULTS: After the CFA of the original conceptual SF-12 model, 2 redundant items were removed and 4 error terms were allowed to covary, thus providing adequate fit to the sample. The refined model demonstrated good fit and evidence of factorial invariance in three demographic groups (age, gender, and habitation). Convergent (11:12; 91% success rate) and divergent (10:12; 83% success rate) validity were satisfactory. Known-groups comparison showed that the instrument discriminated well for those who differed in age (p < 0.05) but in gender and habitation (p > 0.05). The physical component summary and the mental component summary demonstrated acceptable CR (0.69 and 0.79 respectively), internal consistency (α = 0.73 and 0.78 respectively), test-rest reliability (ICC = 0.79 and 0.85 respectively), and good agreement between test-retest values. CONCLUSIONS: The Hausa SF-12 was successfully developed and showed evidence of factorial invariance across age, gender, and habitation. The instrument demonstrated satisfactory construct validity, internal consistency, and test-retest reliability. However, stronger psychometric properties need to be established in general population and other patients groups in future studies. The instrument can be used clinically and for research in Hausa-speaking patients with chronic LBP.


Assuntos
Comparação Transcultural , Inquéritos Epidemiológicos/métodos , Dor Lombar/epidemiologia , Adulto , Feminino , Nível de Saúde , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Psicometria/métodos , Qualidade de Vida , Reprodutibilidade dos Testes , População Rural , Inquéritos e Questionários , Tradução , Traduções , População Urbana
14.
Qual Life Res ; 29(9): 2593-2604, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32436111

RESUMO

PURPOSE: The self-rated health (SRH) item is frequently used in health surveys but variations of its form (wording, response options) may hinder comparisons between versions over time or across surveys. The objectives were to determine (a) whether three SRH forms are equivalent, (b) the form with the best construct validity and (c) the best coding scheme to maximize equivalence across forms. METHODS: We used data from 58,023 respondents of the Swiss Health Survey. Three SRH forms were used. Response options varied across forms and we explored four coding schemes (two considering SRH as continuous, two as dichotomous). Construct validity of the SRH was assessed using 34 health predictors to estimate the explained variance. RESULTS: Distributions of response options were similar across SRH forms, except for the "good" and "very good" options ("good" in form 1: 58.6%, form 2: 65.0% and form 3: 44.1%). Explained variances differed across SRH forms, with form 3 providing the best overall explained variance, regardless of coding schemes. The linear coding scheme maximised the equivalence across SRH forms. CONCLUSION: The three SRH forms were not equivalent in terms of construct validity. Studies examining the evolution of SRH over time with surveys using different forms should use the linear coding scheme to maximise equivalence between SRH forms.


Assuntos
Inquéritos Epidemiológicos/métodos , Qualidade de Vida/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
15.
PLoS One ; 15(5): e0233754, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32470026

RESUMO

BACKGROUND: Obesity is a major public health concern worldwide including Bangladesh. This study aimed to assess the prevalence and associated risk factors of general and abdominal obesity in rural and urban women in Bangladesh. METHODS: A total of 450 adult women aged ≥ 18 years were recruited from rural (n = 210) and urban (n = 240) areas of four administrative regions (Chattagram, Dhaka and Rajshahi and Sylhet) of Bangladesh. Both socio-demographic and anthropometric data were recorded in this study. WHO proposed cut-off values were used for the Asian population for defining general and abdominal obesity. Multinomial logistic regression analysis was applied to evaluate the risk factors of general and abdominal obesity for Bangladeshi women. RESULTS: Overall, the prevalence of general and abdominal obesity was 28% and 49%, respectively. Urban women had a significantly higher prevalence of both general and abdominal obesity (30.9% and 58.6%, respectively) than in the rural women (26.6% and 38.1%, respectively) (p<0.05 and p<0.01, respectively). As region comparison, the prevalence of general obesity was higher in the Dhaka region (39.3%) compared to the Chattragram (23.3%), Rajshahi (23.9%) and Sylhet (3.5%) regions. On the other hand, abdominal obesity was more frequent among participants in Sylhet (72.4%) and Dhaka regions (61.5%), compared to the Chattagram (27.4%) and Rajshahi (37.3%) regions. A wide variation has been observed on the prevalence of general and abdominal obesity in the different age groups of the four regions. In regression analysis, a high socioeconomic status (ref: low socioeconomic level), low education level (ref: higher education), low physical activity (ref: adequate physical activity) and middle age (ref: ≥ 30 years of age) were significant risk factors for general and abdominal obesity. CONCLUSIONS: The prevalence of general and abdominal obesity was higher among participants living in urban areas. Physical inactivity, middle age, high socioeconomic status and low education level were associated with the increased prevalence of general and abdominal obesity. Such a high prevalence of general and abdominal obesity is a health concern for Bangladeshi women; therefore, public awareness and effective health intervention strategies are needed to address these conditions.


Assuntos
Obesidade Abdominal/epidemiologia , Adulto , Antropometria/métodos , Bangladesh/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Pessoa de Meia-Idade , Saúde da População/estatística & dados numéricos , Prevalência , Fatores de Risco , População Rural , Comportamento Sedentário , Fatores Socioeconômicos , População Urbana
16.
Acta Med Port ; 33(4): 237-245, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32238237

RESUMO

INTRODUCTION: In Sao Tome and Principe there are no studies on alcohol and drug use among students, who could be potential allies in preventive interventions. The objectives of the present study are 1) to determine the frequency of alcohol and drug consumption in the school population, and 2) to identify the main characteristics associated with this behaviour. MATERIAL AND METHODS: We applied a biographical, demographic and socioeconomic questionnaire on the use of licit and illicit substances to a sample of 2064 students. Demographic and social characteristics are presented based on observed frequencies and comparisons between groups were made using chi-square tests. Significance was assessed at α = 0.05. RESULTS: More than half of the students reported consumed alcohol at least once in their lifetime, and 32% consumed in the last 30 days. Older students were more likely to consume alcohol (p < 0.0001), but even in students under 16 years, 17% consumed in the last 30 days. We also found that 7% consumed one or more times per week in the last 30 days. The reasons presented for frequent consumption were different for boys ("participation in their group of friends") and girls ("decrease anxiety") (p = 0.005). Less than 1% of respondents admitted to having used marijuana, cocaine, crack or ecstasy. DISCUSSION: Despite some limitations, such as self-reporting, we provide a first overview showing high consumption of alcohol by young people and the existence of illegal drugs circulating in the schools. CONCLUSION: It is urgent to implement preventive interventions, namely in the context of public health communication.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Inquéritos Epidemiológicos/métodos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , São Tomé e Príncipe/epidemiologia , Fatores Sexuais , Fatores Socioeconômicos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
17.
Obesity (Silver Spring) ; 28(5): 857-859, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32320143

RESUMO

OBJECTIVE: Childhood obesity prevention has been identified as a key strategy to address the obesity crisis, with considerable investment by governments internationally. This study modeled the implications of entering adulthood at a lower or higher BMI (a consequence of changes in childhood obesity) and modeled how this would influence future numbers of adults with obesity in Australia. METHODS: In this study, a dynamic population model was used to investigate how obesity prevention in children could impact the future number of adults with obesity in Australia from 2015 to 2040. The base population was a nationally representative data set of 14,256 individuals (representing approximately 17 million adults) from the Australian Health Survey 2014-2015. Each year, a new 20-year-old cohort was added to the simulated population, reflecting the transition to adulthood under scenarios of stable, increasing, or decreasing childhood obesity. RESULTS: Targeting and reducing childhood obesity will have only a small and delayed effect on adult obesity levels, with approximately 280,000 fewer adults with obesity by 2040. CONCLUSIONS: These findings highlight the importance of investing in and implementing obesity prevention programs across all ages, particularly in young adults, to successfully reduce the prevalence of adult obesity in Australia.


Assuntos
Inquéritos Epidemiológicos/métodos , Obesidade Pediátrica/prevenção & controle , Adolescente , Austrália , Criança , Feminino , Humanos , Masculino , Obesidade Pediátrica/epidemiologia , Prevalência
18.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32321779

RESUMO

BACKGROUND: Several studies have investigated the association of breastfeeding status with offspring mortality in Africa, but most studies were from one center only or had limited statistical power to draw robust conclusions. METHODS: Data came from 75 nationally representative cross-sectional Demographic and Health Surveys in 35 countries in sub-Saharan Africa conducted between 2000 and 2016. Our study relied on 217 112 individuals aged 4 days to 23 months for breastfeeding pattern analysis, 161 322 individuals aged 6 to 23 months for breastfeeding history analysis, and 104 427 individuals aged 12 to 23 months for breastfeeding duration analysis. RESULTS: Compared with children aged 4 days to 23 months exclusively breastfed in the first 3 days of life, those not breastfed had a high risk of mortality at <2 years of age (odds ratio [OR] = 13.45; 95% confidence interval [CI] = 11.43-15.83). Young children who were predominantly breastfed or partially breastfed had moderately increased risk of mortality at <2 years of age (OR = 1.11, 95% CI = 1.03-1.21 for predominant pattern; OR = 1.12, 95% CI = 0.99-1.27 for partial pattern). Compared with children aged 6 to 23 months who were breastfed within the first 6 months of life, those not breastfed had a high risk of mortality (OR = 5.65; 95% CI = 4.27-7.47). Compared with children aged 12 to 23 months who were breastfed for ≥6 months, those who were breastfed for shorter periods had a higher risk of mortality (OR = 2.78, 95% CI = 1.45-5.32 for duration of <3 months; OR = 5.28, 95% CI = 3.24-8.61 for those who were not breastfed). CONCLUSIONS: Our findings support exclusive breastfeeding during the first 6 months of life and continued breastfeeding up to 2 years of age recommended by the World Health Organization for reducing mortality of children <2 years old in sub-Saharan Africa.


Assuntos
Aleitamento Materno/tendências , Inquéritos Epidemiológicos/tendências , Mortalidade Infantil/tendências , Adolescente , Adulto , África ao Sul do Saara/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Lactente , Recém-Nascido , Masculino , Mortalidade/tendências , Adulto Jovem
19.
Am J Epidemiol ; 189(7): 717-725, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32285096

RESUMO

Multilevel regression and poststratification (MRP) is a model-based approach for estimating a population parameter of interest, generally from large-scale surveys. It has been shown to be effective in highly selected samples, which is particularly relevant to investigators of large-scale population health and epidemiologic surveys facing increasing difficulties in recruiting representative samples of participants. We aimed to further examine the accuracy and precision of MRP in a context where census data provided reasonable proxies for true population quantities of interest. We considered 2 outcomes from the baseline wave of the Ten to Men study (Australia, 2013-2014) and obtained relevant population data from the 2011 Australian Census. MRP was found to achieve generally superior performance relative to conventional survey weighting methods for the population as a whole and for population subsets of varying sizes. MRP resulted in less variability among estimates across population subsets relative to sample weighting, and there was some evidence of small gains in precision when using MRP, particularly for smaller population subsets. These findings offer further support for MRP as a promising analytical approach for addressing participation bias in the estimation of population descriptive quantities from large-scale health surveys and cohort studies.


Assuntos
Métodos Epidemiológicos , Inquéritos Epidemiológicos/métodos , Saúde da População/estatística & dados numéricos , Estatística como Assunto , Adulto , Austrália/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Seleção de Pacientes , Análise de Regressão , Viés de Seleção
20.
PLoS One ; 15(3): e0230139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155217

RESUMO

The literature on spatial patterns and contextual factors affecting modern contraceptive use is not well-documented in Ghana. This study describes the spatial variations and estimates the socioeconomic determinants of modern contraception among women in reproductive age in Ghana. Using data from the 2014 Ghana Demographic and Health Survey, both global and local Moran's I test were performed to show spatial autocorrelation and Bayesian multilevel models estimated to determine socioeconomic factors affecting modern contraceptive use. The results show evidence of low prevalence and spatial clustering of modern contraception use across the country. There were also notable regional disparities in contraceptive use that favour mostly the southern regions. Modern contraceptive use is significantly associated with socioeconomic factors such as educational attainment, work status, and marital status, as well as age, religious affiliation, and parity. Contextual factors such as the convenient location of health facility and family planning messages exposure also have a considerable positive effect on modern contraceptive use. Uneducated, unemployed and never-married women are considerably disadvantaged in the utilisation of modern contraception in Ghana. Socioeconomic and contextual factors play a key role in modern contraceptive use in Ghana.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Adolescente , Adulto , Teorema de Bayes , Demografia/métodos , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Gana/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos/métodos , Humanos , Estado Civil , Pessoa de Meia-Idade , Análise Multinível , Paridade , Prevalência , Fatores Socioeconômicos
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