Percutaneous injuries correlates in the nursing team of a Brazilian tertiary-care university hospital.

The study aims to identify percutaneous injuries correlates in the nursing team from a Brazilian tertiary-care hospital. A case-control study was conducted from January 2003 to July 2004, including 200 cases and 200 controls. Cases and controls were paired by gender, professional category, and work section. To evaluate the relationship between potential risk/protective factors and the outcome, odds ratios were estimated, using multivariate logistic regression methods. The results shown six predictors of percutaneous injuries: "recapping needles" (OR 9.48; CI(95%): 5.29-16.96); "hours worked per week > 50 hours" (OR 2.47; CI(95%): 1.07-5.67); "years in nursing practice < 5 years" (OR 6.70; CI(95%): 2.42-18.53); "work shift in night" (OR 2.77; CI(95%): 1.35-5.70); "low self evaluation of risk" (OR 10.19; CI(95%): 3.67-28.32) and "previous percutaneous injuries" (OR 3.14; CI(95%): 1.80-5.48). The results support the recommendation of applying effective strategies to prevent percutaneous injuries in the nursing team working on tertiary-care institutions.

Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study.

OBJECTIVE:: to evaluate the association of primary health care and other potential factors in relation to hospitalization due to pneumonia, among children aged under five years. METHOD:: epidemiological study with a case-control, hospital-based design, which included 345 cases and 345 controls, matched according to gender, age and hospital. Data were collected using a pre-coded questionnaire and the Primary Care Assessment Tool, analyzed by means of multivariate logistic regression, following the assumptions of a hierarchical approach. RESULTS:: the protective factors were: family income >US$216.12 (OR=0.68), weight gain during pregnancy ≥10 kg (OR=0.68), quality of Primary Health Care (OR for scores >3.41=0.57; OR for scores >3.17 and ≤3.41=0.50), gastro-esophageal reflux (OR=0.55), overweight (OR=0.37) and birth interval ≥48 months (OR=0.28). The risk factors included: parity (2 childbirths: OR=4.60; ≥3 childbirths: OR=3.25), out-of-date vaccination (OR=2.81), undernutrition (OR=2.53), history of wheezing (≥3 episodes OR=2.37; 1 episode: OR=2.13), attendance at daycare center (OR=1.67), and use of medicines over the past month (OR=1.67). CONCLUSION:: primary health care and its child health care practices, such as nutritional monitoring, immunization, care to prevalent illnesses, prenatal care and family planning need to be prioritized to avoid child hospitalization due to pneumonia.

[Trends in Haemophilus influenzae type b meningitis in Brazil in children under five years of age from 1983 through 2002]. / Tendência das meningites por Haemophilus influenzae tipo b no Brasil, em menores de 5 anos, no período de 1983 a 2002.

The study was based on an ecological design using a historical time series (1983-2002), related to Haemophilus influenzae type b meningitis in Brazil. Incidence, mortality and case-fatality rates, as well as trends in incidence and morbidity-mortality were estimated in children less than 5 years of age. Polynomial regression analysis was used to analyze trends, adopting a significance level of 0.05. 43.9% of confirmed cases occurred in infants less than 1 year old and 38.7% in children 1-4 years old. The observed rates were also highest in these two age strata. The incidence and mortality rates showed an increasing trend, until approximately 1999, when a quick decline was observed. The study results reinforce the effectiveness of the Vaccination Program against HIB in Brazil, which benefited age ranges that did not receive the vaccine (Herd Immunity).

[Prevalence of overweight and obesity, and associated factors in school children from urban area in Chilpancingo, Guerrero, Mexico, 2004]. / Prevalência de sobrepeso e obesidade e fatores associados em escolares de área urbana de Chilpancingo, Guerrero, México, 2004.

This study aimed to investigate the prevalence rates for overweight and obesity among Mexican schoolchildren, identifying factors associated with the outcomes. A cross-sectional study was conducted in a sample consisting of 700 schoolchildren. Prevalence rates were calculated according to age and gender, and odds ratios were estimated by point and intervals, using multivariate logistic regression. Overweight and obesity prevalence were 28.1% and 13.7%, respectively. Risk factors for overweight were: mother's schooling (in years); eating while studying or watching TV; scores for risk food items > or = 12 points; sedentary activities > or = 1.6 hours/day, and birth weight > or = 2,890 grams. Obesity risk factors were similar to those related to overweight. Higher frequency of sport activities was detected as a protective factor in both outcomes. The associated factors for overweight and obesity highlighted the focus for health programs to prevent chronic diseases in this population, for which risk factors can already be identified in childhood.

Social vulnerability effect over obesity anthropometric indexes: results from population-based epidemiological study. / O efeito da vulnerabilidade social sobre indicadores antropométricos de obesidade: resultados de estudo epidemiológico de base populacional.

OBJECTIVES: The study aimed at evaluating the contextual effects of social vulnerability over anthropometric indexes related to global and central obesity in adults living in Ribeirão Preto (SP), Brazil, in 2006. METHODS: In a population-based cross-sectional study using multistage sampling, multilevel linear models were applied considering two levels: ecological and individual. The 81 census tracts drafted for sample composition were considered the ecological level and classified according to Paulista Social Vulnerability Index (IPVS). RESULTS: Individual correlates to body mass index (BMI) were age, familial and personal antecedents of overweight, and total fat consumption (direct relationship), exception to gender and schooling (inverse relationship). Individual correlates to waist circumference were age, familial antecedents of stroke, personal antecedent of overweight, BMI, number of medicines taken, time of smoking, and diet total energy (direct relationship), exception to gender (inverse relationship). Considering both outcomes (BMI and waist circumference), in the final models, the variance of IPVS showed statistical significance (p < 0.05), depicting the contextual effect (rho ≈ 8%) over global and central obesity, even after the adjustment for individual correlates. CONCLUSION: Results showed that interventions to promote healthy behaviors and to prevent obesity might be focused not only on individual factors but also on socioenvironmental context in which people are inserted.

Control of diabetes and fibrinogen levels as well as improvement in health care might delay low cognitive performance in societies aging progressively.

OBJECTIVE: To know the prevalence and factors associated to low cognitive performance in a representative sample of the adult population in a society aging progressively. METHOD: Cross-sectional population-based study carried out in a three-stage sampling: 81 census tracts (primary sampling unity) were randomly selected, followed by 1,672 households and 2,471 participants (weighted sample) corresponding to the second and third stages, respectively. The outcome prevalence was calculated according sociodemographic, behavioral and health related variables. Crude and adjusted prevalence ratios were estimated using Poisson regression. RESULTS: The prevalence of low cognitive performance was high, mainly among females, and indicated linear trends into categories of age, schooling, income, plasma fibrinogen and self-reported health status. In multivariate models, gender, diabetes, fibrinogen and self-reported health status presented positive associations, while schooling, employment and sitting time presented negative associations with the outcome. CONCLUSION: Interventions related to diabetes and fibrinogen levels control as well as improvement in health care might delay low cognitive performance in societies aging progressively as such the study population.

[Low-income senior citizens in the Municipality of São Carlos, São Paulo State, Brazil: an epidemiological survey]. / O perfil do idoso de baixa renda no Município de São Carlos, São Paulo, Brasil: um estudo epidemiológico.

This study focuses on the health profile of the elderly population in Sao Carlos, Sao Paulo State, Brazil, in 2003. The study population consisted of a sample over 60 years of age (n = 523) registered with the Family Health Program and the Unified National Health System. Point and interval prevalence of disabilities and chronic non-communicable diseases and cognitive status were estimated (95%CI). The study population was predominantly female with low education; 24.8% lacked any kind of retirement pension; 43.6% presented a low level of social integration; 46.7% required some form of help for 1 to 3 routine activities; 74.9% presented 1 to 5 chronic non-communicable diseases; and 56.2% scored under 24 on a cognitive test. Some 87.0% had sought health care and 22.4% required some kind of inpatient care. The results confirmed the need for improved professional training, adequacy of health services, and effective public policy to provide qualified health care for the elderly population.

[Dyslipidemia and correlates in adults living in Ribeirão Preto, SP: results of the EPIDCV Project]. / Dislipidemia e fatores associados em adultos residentes em Ribeirão Preto, SP: resultados do Projeto EPIDCV.

OBJECTIVE: To identify the prevalence and correlates of dyslipidemia in adults living in the city of Ribeirão Preto, SP, Brazil, in 2007. MATERIALS AND METHODS: A cross-sectional population-based epidemiological study was carried out using a three-stage cluster sampling. The variability introduced in the third sampling fraction was corrected, resulting in a weighted sample of 2,471 participants. Dyslipidemia prevalence, defined as abnormal values in at least one of four lipid fractions was estimated in both genders, according sociodemographic, behavioral, and health-related variables. To identify correlates, prevalence ratios were estimated using Poisson regression, in crude and adjusted models. All the estimates were calculated taking into account the sampling design effect. RESULTS: High prevalence of dyslipidemia was found (61.9%; CI(95%): 58.5%-65.3%). Income and fiber consumption, in males, and sitting time and saturated fatty acids, in females, were kept in the final models, as well as age and central obesity, which were consistently associated with the outcome, in both genders. CONCLUSIONS: Public intervention policies toward the adoption of healthy food consumption, as well as control central obesity and sedentary behavior might contribute to decrease the prevalence of dyslipidemia and cardiovascular morbidity and mortality in Ribeirão Preto.

[Ischemic heart disease and correlates in adults from Ribeirão Preto, Brazil]. / Doença isquêmica do coração e fatores associados em adultos de Ribeirão Preto, SP.

OBJECTIVE: To identify the prevalence of ischemic heart disease (IHD) and correlates in an adult population. METHODS: Cross-sectional population-based epidemiological study including a weighted sample of 2,471 adults of both sexes and with age 30 years or older residing in Ribeirão Preto, Southeastern Brazil, in 2007. The Rose Questionnaire was administered, and IHD prevalence was calculated with point estimates and 95% confidence intervals. To identify correlates (sociodemographic, cardiovascular risk factors, and those related to access to health services and to physical activity level), crude and adjusted prevalence ratios were estimated using Poisson regression. RESULTS: IHD prevalence was higher in females than males at all age strata. In the final model, the following variables were independently associated with IHD: work status (PR= 0.54 [0.37;0.78]); family history of IHD (PR=1.55 [1.12;2.13]); hypertension (PR= 1.70 [1.18;2.46]); self-reported health status (PR=2.15 [1.40;3.31]); smoking duration (third tertile) (PR= 1.73 [1.08;2.76]); adjusted waist circumference (PR=1.79 [1.21;2.65]) and hypertriglyceridemia (PR=1.48 [1.05;2.10]). Linear trend test of PR across self-reported health status categories was statistically significant (p<0.05). CONCLUSIONS: A high prevalence of IHD was found, and the factors associated with the outcome are almost all modifiable and potentially influenced by public policy interventions.

Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study / Papel da Atenção Primária à Saúde na hospitalização de crianças por pneumonia: um estudo caso-controle / El papel de la Atención Primaria de Salud en la hospitalización de niños debido a neumonía: un estudio caso-control

Objective: to evaluate the association of primary health care and other potential factors in relation to hospitalization due to pneumonia, among children aged under five years. Method: epidemiological study with a case-control, hospital-based design, which included 345 cases and 345 controls, matched according to gender, age and hospital. Data were collected using a pre-coded questionnaire and the Primary Care Assessment Tool, analyzed by means of multivariate logistic regression, following the assumptions of a hierarchical approach. Results: the protective factors were: family income >US$216.12 (OR=0.68), weight gain during pregnancy ≥10 kg (OR=0.68), quality of Primary Health Care (OR for scores >3.41=0.57; OR for scores >3.17 and ≤3.41=0.50), gastro-esophageal reflux (OR=0.55), overweight (OR=0.37) and birth interval ≥48 months (OR=0.28). The risk factors included: parity (2 childbirths: OR=4.60; ≥3 childbirths: OR=3.25), out-of-date vaccination (OR=2.81), undernutrition (OR=2.53), history of wheezing (≥3 episodes OR=2.37; 1 episode: OR=2.13), attendance at daycare center (OR=1.67), and use of medicines over the past month (OR=1.67). Conclusion: primary health care and its child health care practices, such as nutritional monitoring, immunization, care to prevalent illnesses, prenatal care and family planning need to be prioritized to avoid child hospitalization due to pneumonia.

Objetivo: avaliar a associação da atenção primária à saúde e de outros potenciais fatores em relação à hospitalização por pneumonia, em crianças menores de cinco anos de idade. Método: Estudo epidemiológico tipo caso-controle de base hospitalar, que incluiu 345 casos e 345 controles, pareados de acordo com sexo, idade e hospital. Os dados foram coletados através de um questionário pré-codificado e do Instrumento de Avaliação da Atenção Primária à Saúde, sendo analisados por meio da regressão logística multivariada, seguindo os pressupostos da abordagem hierarquizada. Resultados: os fatores de proteção identificados foram: renda familiar >US $ 216,12 (OR=0,68), ganho de peso durante a gravidez ≥10 kg (OR=0,68), qualidade da atenção primária à saúde (OR para escores >3,4 =0,57; e ≤3,41=0,50), refluxo gastro-esofágico (OR=0,55), excesso de peso (OR=0,37) e intervalo interpartal ≥48 meses (OR=0,28). Os fatores de risco consistiram em: paridade (2 partos: OR=4,60; ≥3 partos: OR=3,25), situação vacinal desatualizada (OR=2,81), desnutrição (OR=2,53), história de sibilância (≥3 episódios OR=2,37; 1 episódio: OR=2,13), frequência à creche (OR=1,67) e uso de medicamentos no último mês (OR=1,67). Conclusão: a atenção primária à saúde e suas práticas de cuidado da criança - como seguimento nutricional, imunização, atenção às doenças prevalentes, assistência pré-natal e planejamento familiar - constituem ações prioritárias para evitar hospitalizações de crianças por pneumonia.

Objetivo: evaluar la asociación entre la atención primaria de salud y otros factores potenciales relacionados a la hospitalización debido a neumonía entre niños menores de cinco años. Método: estudio epidemiológico con diseño caso-control hospitalario, abarcando 345 casos y 345 controles, pareados según género, edad y hospital. Para la recolecta de datos fue utilizado un cuestionario pre-codificado y el Primary Care Assessment Tool (PCAT), siendo analisados con regresión logística multivariada, siguiendo las premisas de una aproximación jerárquica. Resultados: los factores de protección fueron: renta familiar >US$216,12 (OR=0,68), gaño de peso durante el embarazo ≥10 kg (OR=0,68), calidad de la Atención Primaria de Salud (OR para puntuaciones >3,41=0,57; OR para puntuaciones >3,17 y ≤3,41=0,50), reflujo gastroesofágico (OR=0,55), sobrepeso (OR=0,37) y intervalo de nacimiento ≥48 meses (OR=0,28). Los factores de riesgo abarcaron: paridad (2 nacimientos: OR=4,60; ≥3 nacimientos: OR=3,25), vacunación expirada (OR=2,81), subnutrición (OR=2,53), historia de sibilancias (≥3 episodios OR=2,37; 1 episodio: OR=2,13), asistencia a jardín maternal (OR=1,67) y uso de medicamentos en el último mes (OR=1,67). Conclusión: la atención primaria de salud y sus prácticas de atención a la salud del niño, tales como el monitoreo nutricional, inmunización, cuidado a las enfermedades prevalentes, atención prenatal y planificación familiar deben ser priorizadas para evitar la hospitalización de niños debido a la neumonía.

[Alcohol addiction and associated factors in adults in Ribeirão Preto, São Paulo State, Brazil, 2006: the OBEDIARP project]. / Dependência de álcool e fatores associados em adultos residentes em Ribeirão Preto, São Paulo, Brasil, 2006: projeto OBEDIARP.

This study aims to estimate the prevalence and severity of alcohol addiction and to identify associated factors. A cross-sectional population-based study was conducted in Ribeirão Preto, São Paulo State, Brazil, in 2006. Prevalence estimates were based on AUDIT (Alcohol Use Disorders Identification Test). Crude and adjusted prevalence ratios (PR) were calculated, and the outcome variable was classified in two levels: (1) scores = 0-7; and (2) scores = 8-40. Overall prevalence of alcohol addiction was 20.18% (43.47% in men and 10.18% in women). In the final model, the following variables were associated with alcohol addiction: gender, age, schooling, marital and work status, smoking, religion, and self-rated health. Prevalence of alcohol addiction was high, especially among men. The results should contribute to the adoption of health promotion and prevention strategies, considering the consequences of alcohol addiction.

O efeito da vulnerabilidade social sobre indicadores antropométricos de obesidade: resultados de estudo epidemiológico de base populacional / Social vulnerability effect over obesity anthropometric indexes: results from population-based epidemiological study

RESUMO: Objetivo: O estudo teve por objetivo avaliar o efeito da vulnerabilidade social sobre os indicadores antropométricos de obesidade global e central em adultos (30 anos ou mais) de Ribeirão Preto (SP), 2006. Métodos: Estudo transversal de base populacional com amostra complexa, desenvolvida em três estágios. Modelos lineares multinível foram construídos em dois níveis: ecológico e individual. Os 81 setores censitários sorteados para a amostra compuseram o nível ecológico e foram classificados segundo o Índice Paulista de Vulnerabilidade Social (IPVS). Resultados: Fatores de nível individual que apresentaram relação direta com o índice de massa corporal (IMC): idade, antecedentes familiares e pessoais de excesso de peso e consumo de lipídios, com exceção de sexo e escolaridade (relação inversa). Fatores de nível individual que apresentaram relação direta com a circunferência da cintura (Ccint): idade, antecedentes familiares de acidente vascular cerebral (AVC), história pessoal de excesso de peso, IMC, número de medicamentos, tempo de tabagismo e energia total da dieta, com exceção da variável sexo (relação inversa). Para ambos os desfechos (IMC e Ccint), a variância do IPVS nos modelos finais apresentou significância estatística (p < 0,05) revelando o efeito contextual (rho ≈ 8%) da vulnerabilidade social sobre os indicadores de obesidade, mesmo após ajustamento para variáveis de nível individual. Conclusão: Os achados apontam para a necessidade de ações de promoção de hábitos saudáveis e de prevenção da obesidade, direcionadas não apenas aos fatores de nível individual, mas ao contexto socioambiental onde os indivíduos estão inseridos.

ABSTRACT: Objectives: The study aimed at evaluating the contextual effects of social vulnerability over anthropometric indexes related to global and central obesity in adults living in Ribeirão Preto (SP), Brazil, in 2006. Methods: In a population-based cross-sectional study using multistage sampling, multilevel linear models were applied considering two levels: ecological and individual. The 81 census tracts drafted for sample composition were considered the ecological level and classified according to Paulista Social Vulnerability Index (IPVS). Results: Individual correlates to body mass index (BMI) were age, familial and personal antecedents of overweight, and total fat consumption (direct relationship), exception to gender and schooling (inverse relationship). Individual correlates to waist circumference were age, familial antecedents of stroke, personal antecedent of overweight, BMI, number of medicines taken, time of smoking, and diet total energy (direct relationship), exception to gender (inverse relationship). Considering both outcomes (BMI and waist circumference), in the final models, the variance of IPVS showed statistical significance (p < 0.05), depicting the contextual effect (rho ≈ 8%) over global and central obesity, even after the adjustment for individual correlates. Conclusion: Results showed that interventions to promote healthy behaviors and to prevent obesity might be focused not only on individual factors but also on socioenvironmental context in which people are inserted.

Physical activity and correlates among adults living in Ribeirão Preto, Southeastern Brazil.

OBJECTIVE: To identify physical activity patterns and associated factors among adults. METHODS: A cross-sectional population-based epidemiological study was conducted in Ribeirão Preto, Southeastern Brazil, in 2006, with a three-stage sampling process. Physical activity patterns were assessed in a weighted sample of 2,197 adults aged 30 years and over, using the International Physical Activity Questionnaire (short version), which has been validated in Brazil. Associated factors were identified using Poisson regression. Prevalence ratios were estimated through points and 95% confidence intervals, in univariate and multiple models. Insufficient versus sufficient practice of physical activity was taken to be the outcome for calculating prevalence ratios. RESULTS: Sufficient practice of physical activity was presented by 37.5% of the men and 32.1% of the women. The prevalence of insufficient practice was higher than the prevalence of sufficient practice in practically all the categories of variables, for both sexes. Different variables remained in the final models when males and females were considered separately. For males, the following remained in the final model: working for more than ten hours/day [PR = 1.30; 95%CI: 1.07;1.57]; three or more medications taken over the last 15 days [PR = 1.56; 95%CI: 1.16;2.08]; and poor/very poor self-reported health [PR = 1.54; 95%CI: 1.01;2.34]. For females, the following remained: education level of one to three years of schooling [PR = 1.20; 95%CI: 1.02;1.41]; not having any income [PR = 0.78; 95%CI: 0.66-0.93]; and income less than R$ 520.00 [PR = 0.74; 95%CI: 0.60;0.90]. CONCLUSIONS: The prevalence of insufficient practice of physical activity was high. The results suggest that there is a need to implement specific programs to promote physical activity, directed towards men who work for more than ten hours/day, take three or more medications and consider that their health is poor or very poor; and towards women of low income and schooling levels.

[Dietary patterns and correlates in adults living in Ribeirão Preto, São Paulo State, Brazil: the OBEDIARP Project]. / Padrões de consumo de alimentos e fatores associados em adultos de Ribeirão Preto, São Paulo, Brasil: Projeto OBEDIARP.

This study aimed to identify and analyze correlates of dietary patterns in residents of Ribeirão Preto, São Paulo State, Brazil. This was a cross-sectional study including both men and women aged > 30 years (n = 930, weighted sample = 2,197). Factor analysis was applied to identify food consumption patterns, using a semi-quantitative questionnaire. Four patterns were identified: (a) obesogenic: associated with more physical activity, more schooling, and age < 40 years; (b) healthy: associated with female gender, individuals without overweight, older adults, central obesity, more physical activity, and higher socioeconomic status; (c) mixed: without overweight, female gender, and younger adults; and (d) popular: associated with absence of hypercholesterolemia and lower family income. The results highlight the need to encourage eating healthy foods in order to prevent chronic non-communicable diseases.

Economic profile of Ribeirão Preto population: application of the National Economic Indicator.

The study aimed to apply the National Economic Indicator on data from a cross-sectional population-based study (nw =2,197) in the city of Ribeirão Preto, Southeastern Brazil, in 2006. Compared to Brazil, the indicator presented a concentration around the last five deciles and was similar to that of the municipality of São Paulo, also in Southeastern Brazil. Differences were observed concerning the gender of the head of the family, showing more unfavourable conditions to families headed by women. Easy calculation and application along with the possibility of comparison with other Brazilian cities confirm that this indicator is a practical tool that can be applied to population-based studies in the evaluation of socioeconomic level.

Control of diabetes and fibrinogen levels as well as improvement in health care might delay low cognitive performance in societies aging progressively / Controle do diabetes e dos níveis de fibrinogênio, bem como melhora no cuidado com a saúde, podem retardar o baixo desempenho cognitivo em sociedades que apresentam envelhecimento progressivo

Objective To know the prevalence and factors associated to low cognitive performance in a representative sample of the adult population in a society aging progressively. Method Cross-sectional population-based study carried out in a three-stage sampling: 81 census tracts (primary sampling unity) were randomly selected, followed by 1,672 households and 2,471 participants (weighted sample) corresponding to the second and third stages, respectively. The outcome prevalence was calculated according sociodemographic, behavioral and health related variables. Crude and adjusted prevalence ratios were estimated using Poisson regression. Results The prevalence of low cognitive performance was high, mainly among females, and indicated linear trends into categories of age, schooling, income, plasma fibrinogen and self-reported health status. In multivariate models, gender, diabetes, fibrinogen and self-reported health status presented positive associations, while schooling, employment and sitting time presented negative associations with the outcome. Conclusion Interventions related to diabetes and fibrinogen levels control as well as improvement in health care might delay low cognitive performance in societies aging progressively as such the study population. .

Objetivo Estimar a prevalência e os fatores associados ao baixo desempenho cognitivo em amostra representativa de adultos pertencentes a uma população com envelhecimento progressivo. Método Estudo transversal, de base populacional, conduzido em amostra selecionada em três estágios: 81 setores censitários (unidade primária de amostragem) foram selecionados aleatoriamente, seguidos por 1.672 domicílios e 2.471 participantes (amostra ponderada), correspondendo ao segundo e terceiro estágios, respectivamente. A prevalência do desfecho foi calculada segundo fatores sociodemográficos, comportamentais e relacionados à saúde. Razões de prevalência brutas e ajustadas foram estimadas pela regressão de Poisson. Resultados A prevalência de baixo desempenho cognitivo foi elevada, principalmente nas mulheres, indicando gradiente linear em relação à idade, à escolaridade, à renda, aos níveis de fibrinogênio e à saúde autorreferida. Nos modelos multivariados, sexo, diabetes, fibrinogênio e saúde autorreferida apresentaram associações positivas, enquanto escolaridade, trabalho e tempo sentado apresentaram associações negativas com o desfecho. Conclusão ...

Avaliação do efeito independente de doenças crônicas, fatores sociodemográficos e comportamentais sobre a incapacidade funcional em idosos residentes em Ribeirão Preto, SP, 2007 - Projeto EPIDCV / The independent effect of chronic diseases, sociodemographic and behavioral factors related to disability in older people living in Ribeirão Preto, SP, 2007 - The EPIDCV Project

RESUMO: Objetivos: Investigar a prevalência e os fatores associados à incapacidade funcional em idosos residentes em Ribeirão Preto, SP, em 2007. Métodos: Estudo transversal de base populacional, com amostra complexa selecionada em três estágios. Para correção do efeito de desenho amostral, utilizou-se amostra ponderada (nw) de 536 idosos. A dependência funcional para atividades da vida diária foi aferida mediante a utilização de questionário estruturado e validado para estudos epidemiológicos de base populacional. Prevalências brutas do desfecho e estratificadas segundo variáveis sociodemográficas, comportamentais, relacionadas à saúde e à morbidade referida foram calculadas por pontos e por intervalos com 95% de confiança. Razões de prevalências brutas e ajustadas foram estimadas por pontos e por intervalos, utilizando-se a regressão de Poisson. Resultados: A prevalência bruta de incapacidade foi 50,31%. Nos modelos multivariados, após ajustamento intragrupos (modelos finais), as seguintes variáveis permaneceram independentemente associadas ao desfecho: sociodemográficas (idade, escolaridade e contribuição com a renda familiar); comportamentais (média diária de tempo sentado); relacionadas à saúde (hipertensão, doença isquêmica do coração, uso de medicamentos e baixo desempenho cognitivo); morbidade referida (número de doenças referidas e baixa acuidade auditiva). Conclusão: A elevada prevalência de incapacidades em idosos de Ribeirão Preto, bem como a presença de associações entre variáveis potencialmente modificáveis e o desfecho, impõe a necessidade de medidas específicas de promoção e prevenção em saúde com vistas à melhora da qualidade de vida desse estrato populacional já bem representado nas últimas pirâmides populacionais do município.

ABSTRACT: Objectives: To investigate the prevalence and correlates of functional disability in elderly people living in Ribeirão Preto, SP. Methods: This is a cross-sectional population-based epidemiological study with multistage sampling. Design effect was corrected using a weighted sample composed by 536 elderly people. Disability based on daily living activities dependence (outcome) was assessed by using a validated questionnaire for population-based epidemiological studies. Points and 95% confidence intervals estimated crude and stratified prevalence rates of the outcome according to sociodemographic, behavioral, health-related, and self-reported morbidity variables. To identify the correlates, the crude and adjusted prevalence ratios were estimated using Poisson regression. Results: The crude prevalence of disability was 50.31%. In the multivariate models, after simultaneous intra-group adjustment (final models), the following variables remained independently associated with the outcome: sociodemographic (age, education, and contribution to familiar income); behavioral (daily mean of sitting time); health-related factors (hypertension, ischemic heart disease, medicines taken, and low cognitive performance); and self-reported morbidity (number of diseases and low hearing performance). Conclusions: The high prevalence of disability among elderly people in Ribeirão Preto and the presence of modifiable variables impose the need for specific health promotion and prevention measures, aiming a better quality of life for this population group, which is already well represented in the city's most recent population pyramids.

O efeito independente da obesidade central sobre a hipertensão arterial em adultos residentes em Ribeirão Preto, SP, 2007. Projeto EPIDCV / The independent effect of central obesity on hypertension in adults living in Ribeirão Preto, SP, 2007. EPIDCV Project

OBJETIVO: Identificar a prevalência de hipertensão arterial e o efeito independente da obesidade central sobre este desfecho, em adultos residentes em Ribeirão Preto, SP. MÉTODOS: Estudo epidemiológico transversal de base populacional, com amostragem desenvolvida em três estágios. A variabilidade introduzida no terceiro estágio foi corrigida pela atribuição de pesos, originando amostra ponderada de 2.471 participantes. A hipertensão foi definida segundo o histórico da doença, uso de medicação anti-hipertensiva ou médias de três medidas consecutivas, em mm/Hg, sendo ≥ 140 para a sistólica e ≥ 90 para a diastólica. Prevalências de hipertensão foram estimadas, segundo variáveis antropométricas, sociodemográficas, comportamentais, dietéticas, dosagens bioquímicas e uso de medicamentos. Razões de prevalências brutas e ajustadas para os indicadores de obesidade central foram obtidas utilizando-se regressão de Poisson. Todas as estimativas foram calculadas levando-se em consideração o efeito de desenho amostral. RESULTADOS: Observou-se elevada prevalência de hipertensão: 32,8 (sexo masculino) e 44,5% (sexo feminino). Nos modelos finais, os indicadores de obesidade central permaneceram consistentemente associados ao desfecho, em ambos os sexos. CONCLUSÃO: Os resultados do estudo impõem a necessidade de planejamento de medidas de promoção e prevenção em saúde, direcionadas para o controle da hipertensão arterial e da obesidade central, com vistas à redução de eventos finais como a doença isquêmica do coração e os acidentes vasculares cerebrais. .

OBJECTIVE: To identify the prevalence of hypertension and evaluate the independent effect of central obesity on this outcome in adults living in the municipality of Ribeirão Preto, São Paulo State, Brazil. METHODS: Cross-sectional population-based epidemiological study using three stage cluster sampling. The variability introduced in the third stage was corrected by attributing probability weights, resulting in a weighted sample of 2,471 participants. Hypertension was defined according to the disease history, the use of anti-hypertensive drugs or the mean of three consecutive measures, in mm/Hg, ≥ 140 for systolic and ≥ 90 for diastolic blood pressure. Prevalence of hypertension was estimated according to anthropometric, sociodemographic, behavioral and dietetic variables, as well as biochemical dosages and medication use. Crude and adjusted prevalence ratios for central obesity indices were estimated using Poisson regression. All the estimates were calculated taking into account the sampling design effect. RESULTS: The results showed high prevalence of hypertension: 32.8 (males) and 44.5% (females). In the final models, central obesity indexes were consistently associated with the outcome, in both genders. CONCLUSION: The results pointed out the need of planning health promotion and prevention, in order to control hypertension and central obesity aiming to reduce end-point events like coronary heart disease and stroke. .

Fruit and vegetable intake by adults in Ribeirão Preto, Southeastern Brazil.

OBJECTIVE: To assess fruit and vegetable intake by adults and identify sociodemographic and life style variables associated with this intake. METHODS: A population-based cross-sectional study was performed in the urban area of the city of Ribeirão Preto, Southeastern Brazil, in 2006. Sample was selected using three-stage cluster sampling, with census tracts as primary units. Sample was comprised of 930 participants aged 30 years and more and the design effect was considered in data analysis. Fruit and vegetable intake was based on a semi-quantitative food frequency questionnaire, using mean scores of frequency of fruit and vegetable intake, daily intake and minimum intake of such foods as indicators. The independent variables analyzed were as follows: age group, marital status, level of education, per capita household income, nutritional status, smoking and physical activity. Mean scores of frequency of intake were estimated by point and 95% confidence intervals. Prevalence ratios were also estimated by point and 95% confidence intervals to analyze association, using Poisson regression. Linear trend tests were applied, adopting a 5% confidence level. RESULTS: Only 24% of men and 38% of women met the minimum recommendation for fruit and vegetable intake; there was a positive association with age and per capita income. Women with a higher level of education and men who lived with a female partner consumed more fruits and vegetables than others. Physical activity, smoking and nutritional status were not associated with the minimum recommended fruit and vegetable intake. CONCLUSIONS: Socioeconomic factors have an important influence on fruit and vegetable intake and, as these are subject to intervention, they can contribute to the adoption of healthy eating habits.

Homicide mortality trends in Belo Horizonte and metropolitan area: 1980- 2005.

OBJECTIVE: To analyze the evolution of homicide mortality rates in Belo Horizonte and its metropolitan area, Southeastern Brazil, from 1980 to 2005. METHODS: Deaths by homicide were obtained from the SIM (Mortality Information System). Population estimates by sex, age group and calendar-years were obtained from the Brazilian Institute of Geography and Statistics (IBGE). The specific mortality rates for sex and age groups were calculated annually for each geographic region. The trends analysis was carried out using polynomial regression models for time series data, with a significance level alpha<0.05. RESULTS: There were high homicide mortality rates in Belo Horizonte and the metropolitan area, principally amongst males. Secular trends showed an accelerated growth of the rate ratios in both sexes and in almost all age groups, most evidently from the beginning of the 1990s in the metropolitan area. CONCLUSIONS: The results show the need to implement organized public policies for the control of violence. Investing in education and guaranteeing access to employment are recommended for the control of the accelerated increase in homicide mortality, principally among male youth residents of the metropolitan area.