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Lyshol H, Gil AP, Tolonen H, Namorado S, Kislaya I, Barreto M, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Dias CM. Local problem solving in the Portuguese health examination survey: a mixed method study. Arch Public Health 2022; 80:198. [PMID: 36002860 PMCID: PMC9400230 DOI: 10.1186/s13690-022-00939-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other similar health examination surveys. The objective of this article is to describe how local teams of survey personnel conducted the survey, describing strategies used to solve practical survey problems and to try to increase the participation rate.
Methods
After a literature search, informal interviews were conducted with 14 public health officials from local health examination teams, regional and central authorities. Forty-one of the local staff members (survey personnel) also filled in a short questionnaire anonymously. The interviews and self-administered questionnaires were analysed using mixed methods, informed by thematic analysis.
Results
The local teams believed that the detailed manual, described as a “cookbook for making a health examination survey”, made it possible to maintain high scientific standards while allowing for improvising solutions to problems in the local context. The quality of the manual, supported by a series of training workshops with the central research and support team, gave the teams the confidence and knowledge to implement local solutions. Motivation and cohesion within the local teams were among the goals of the training process.
Local teams felt empowered by being given large responsibilities and worked hard to incite people to attend the examination through a close and persuasive approach.
Local teams praised their INSA contacts for being available for assistance throughout the survey, and said they were inspired to try harder to reach participants to please their contacts for interpersonal reasons.
Conclusions
The theory of organizational improvisation or bricolage, which means using limited resources to solve problems, was useful to discuss and understand what took place during INSEF.
A detailed manual covering standard procedures, continuous monitoring of the data collection and face-to-face workshops, including role-play, were vital to assure high scientific standards and high participation rates in this health examination survey. Close contacts between the central team and local focal points in all regions and all survey sites were key to accommodating unexpected challenges and innovative solutions.
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Santos AJ, Nunes B, Kislaya I, Gil AP, Ribeiro O. Exploring the Correlates to Depression in Elder Abuse Victims: Abusive Experience or Individual Characteristics? J Interpers Violence 2021; 36:NP115-NP134. [PMID: 29294926 DOI: 10.1177/0886260517732346] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Depression and depressive symptoms have been studied both as risk factors and consequences of elder abuse, even though the most common cross-sectional design of the studies does not allow inferring cause or consequence relationships. This study estimates the proportion of older adults who screened positive for depressive symptoms among those self-reporting elder abuse and examines whether individual characteristics and/or abusive experience aspects are associated with self-reported depressive symptoms. Participants were 510 older adults self-reporting experiences of abuse in family setting enrolled in the cross-sectional victims' survey of the Aging and Violence Study. Depressive symptoms were assessed through the abbreviated version of the Geriatric Depression Scale (GDS-5). Poisson regression was used to determine the prevalence ratio (PR) of screening depressive symptoms according to individual and abusive experience covariates: sex, age group, cohabitation, perceived social support, chronic diseases, functional status, violence type, perpetrator, and number of conducts. Women (PR = 1.18, 95% confidence interval [CI] = [1.04, 1.35]) individuals perceiving low social support level (PR = 1.36, 95% CI = [1.16, 1.60]) and with long-term illness (PR = 1.17, 95% CI = [1.02, 1.33]) were found to be associated with increased risk for screening depressive symptoms. In regard to abusive experience, only the number of abusive conducts increased the PR (PR = 1.07, 95% CI = [1.05, 1.09]). Routine screening for elder abuse should include psychological well-being assessment. Interventions toward risk alleviation for both mental health problems and elder abuse should target women perceiving low social support level and with long-term illness.
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Affiliation(s)
- Ana João Santos
- National Health Institute Doutor Ricardo Jorge, Lisboa, Portugal
- University of Porto, Portugal
| | - Baltazar Nunes
- National Health Institute Doutor Ricardo Jorge, Lisboa, Portugal
- NOVA University of Lisbon, Portugal
| | - Irina Kislaya
- National Health Institute Doutor Ricardo Jorge, Lisboa, Portugal
| | | | - Oscar Ribeiro
- University of Porto, Portugal
- University of Aveiro, Portugal
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Rodrigues AP, Gaio V, Kislaya I, Graff-Iversen S, Cordeiro E, Silva AC, Namorado S, Barreto M, Gil AP, Antunes L, Santos A, Miguel JP, Nunes B, Dias CM. Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey. Rev Port Cardiol 2019; 38:547-555. [PMID: 31708247 DOI: 10.1016/j.repc.2018.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 05/29/2018] [Accepted: 10/28/2018] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese population in 2015. METHODS A national survey using a representative sample of 4911 individuals residing in Portugal and aged between 25 and 74 years was implemented. Trained nurses performed a health interview and a physical examination, including blood pressure measurement (right arm, three measurements at 1-min intervals). The prevalence of hypertension was stratified by gender, age group, marital status, education, occupation and type of residential area. Associations between hypertension prevalence and sociodemographic factors were assessed using bivariate and multivariate Poisson regression. RESULTS The overall hypertension prevalence was 36.0%. The highest rates were observed in males (39.6%), in individuals aged between 65 and 74 years (71.3%), and in those with low levels of education (62.6%) and with no formal occupation (64.5%). Among hypertensive individuals, 69.8% were aware of their condition and 69.4% were under treatment, of whom 71.3% were controlled. Rates of awareness and medical treatment were significantly higher among women and older individuals. CONCLUSIONS A large majority of the adult Portuguese population are likely to reach blood pressure levels defined as hypertension in adulthood. Significant differences in hypertension prevalence were found according to gender, age and socioeconomic status, which highlights the importance of population strategies in public health policies.
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Affiliation(s)
- Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal.
| | - Vânia Gaio
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | | | - Eugénio Cordeiro
- Departamento de Saúde Pública, Administração Regional de Saúde do Centro, Coimbra, Portugal
| | - Ana Clara Silva
- Instituto de Administração da Saúde e Assuntos Sociais, Secretaria Regional de Saúde da Região Autónoma da Madeira, Funchal, Portugal
| | - Sónia Namorado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Marta Barreto
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; Escola Nacional de Saúde Pública (ENSP), Centro de Investigação em Saúde Pública (CISP/NOVA), Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana Paula Gil
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; Centro Interdisciplinar de Ciências Sociais, Faculdade de Ciências Sociais e Humanas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Liliana Antunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Ana Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - José Pereira Miguel
- Instituto de Medicina Preventiva, Faculdade de Medicina de Lisboa, Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; Escola Nacional de Saúde Pública (ENSP), Centro de Investigação em Saúde Pública (CISP/NOVA), Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; Escola Nacional de Saúde Pública (ENSP), Centro de Investigação em Saúde Pública (CISP/NOVA), Universidade NOVA de Lisboa, Lisboa, Portugal
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Kislaya I, Tolonen H, Rodrigues AP, Barreto M, Gil AP, Gaio V, Namorado S, Santos AJ, Dias CM, Nunes B. Differential self-report error by socioeconomic status in hypertension and hypercholesterolemia: INSEF 2015 study. Eur J Public Health 2019; 29:273-278. [PMID: 30380048 DOI: 10.1093/eurpub/cky228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to compare self-reported and examination-based prevalence of hypertension and hypercholesterolemia in Portugal in 2015 and to identify factors associated with the measurement error in self-reports. METHODS We used data from the Portuguese National Health Examination Survey (n = 4911), that combines personal interview, blood collection and, physical examination. Sensitivity and specificity of self-reported hypertension and hypercholesterolemia were calculated. Poisson regression was used to estimate prevalence ratios (PRs) of underreport of hypertension and hypercholesterolemia according to sex, age, socioeconomic status (education and income) and general practitioner (GP) consultation in the past year. RESULTS Sensitivity of self-reports was 69.8% for hypertension and 38.2% for hypercholesterolemia. Underreport of hypertension was associated with male gender (PR = 1.54), lack of GP consultation (PR = 1.70) and being 25-44 years old (PR = 2.45) or 45-54 years old (PR = 2.37). Underreport of hypercholesterolemia was associated with lack of GP consultation (PR = 1.15), younger age (PR = 1.83 for 25-44 age group and PR = 1.52 for 45-54 age group), secondary (PR = 1.30) and higher (PR = 1.27) education. CONCLUSION Self-reported data underestimate prevalence of hypertension and hypercholesterolemia. Magnitude of measurement error in self-reports varies by health conditions and population characteristics. Adding objective measurements to self-reported questionnaires improve data accuracy allowing better understanding of socioeconomic inequalities in health.
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Affiliation(s)
- Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Hanna Tolonen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal
| | - Marta Barreto
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana Paula Gil
- Interdisciplinary Centre of Social Sciences (CICS.NOVA) NOVA School of Social Sciences and Humanities, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Vânia Gaio
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Sónia Namorado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana João Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
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Rodrigues AP, Gaio V, Kislaya I, Graff-Iversen S, Cordeiro E, Silva AC, Namorado S, Barreto M, Gil AP, Antunes L, Santos A, Miguel JP, Nunes B, Dias CM. Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey. Revista Portuguesa de Cardiologia (English Edition) 2019. [DOI: 10.1016/j.repce.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Santos AJ, Gil AP, Ribeiro O. The ageing process in older adults’ narratives of family violence. QAOA 2019. [DOI: 10.1108/qaoa-10-2018-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine, through a qualitative lens, how community elder abuse and the ageing process are represented in the older adults’ narratives reporting abuse perpetrated by family members.
Design/methodology/approach
A qualitative study of a convenience sample of 22 interviews from 24 older adults (two couples) aged 60 years or older who had experienced one or more types of abuse and had sought help about the victimisation experience. A general inductive approach of thematic content analysis was employed.
Findings
The four main emergent themes related to the passage of time or the perception of becoming old within the process of abuse were: abuse grown old, abuse after entering later life, vulnerability to abuse and responses to abuse. Ageing was found to be associated with an increase vulnerability to abuse and an important element in shaping how older adults experience, report and cope with victimization. The social and contextual issues of being older also influenced the decision of ending (or not) the abuse and the victims’ repertoire of responses.
Originality/value
Despite the little suitability of chronological age to define and delimit elder abuse, understanding the phenomenon demands the recognition of ageing (both as a process and as a product) in order to more accurately identify aetiology processes and develop interventions.
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Santos AJ, Nunes B, Kislaya I, Gil AP, Ribeiro O. Older adults' emotional reactions to elder abuse: Individual and victimisation determinants. Health Soc Care Community 2019; 27:609-620. [PMID: 30334593 DOI: 10.1111/hsc.12673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
Elder abuse has been gaining public, state, and scientific attention for the past 40 years, but research focusing on emotional reactions of older adults to victimisation is still scarce. The study describes the emotions and feelings of older adults who experienced abuse in a community setting, and the association between these emotions and individual or abuse characteristics. The cross-sectional study comprises 510 older adults who were identified and referred by four institutions. Participants answered a questionnaire on elder abuse experiences, including the emotion or feeling brought out by the act of abuse that was perceived to be the most serious. Fear and sadness comprised 67.1% of all provided responses. Emotional reactions were associated with functional status, the presence of depressive symptoms, relationship with the perpetrator and, to a limited degree, to the experience of multiple types of abuse. The most significant and meaningful variable was the relationship with the perpetrator. This study demonstrates that older adults present very similar patterns of emotional reactions, but individual characteristics and the established relationship with the perpetrator might mediate the emotional response. Implications for prevention and intervention of elder abuse are discussed.
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Affiliation(s)
- Ana João Santos
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Baltazar Nunes
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- CISP - Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Lisboa, Portugal
| | - Irina Kislaya
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Ana Paula Gil
- CICS.NOVA - Centro Interdisciplinar de Ciências Sociais, Faculdade de Ciências Sociais e, Humanas da Universidade Nova de Lisboa, Lisboa, Portugal
| | - Oscar Ribeiro
- Departamento de Educação e Psicologia, Universidade de Aveiro, Porto, Portugal
- CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Universidade do Porto, Porto, Portugal
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Santos AJ, Nunes B, Kislaya I, Gil AP, Ribeiro O. Elder abuse victimization patterns: latent class analysis using perpetrators and abusive behaviours. BMC Geriatr 2019; 19:117. [PMID: 31014265 PMCID: PMC6480599 DOI: 10.1186/s12877-019-1111-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/21/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Research on elder abuse has defined it as a multidimensional construct that encompasses a set of different abusive behaviours, victims, perpetrators and settings. The array of possible elder abuse configurations is difficult to capture. This study sought to identify victimization patterns that represent distinct elder abuse configurations based on specific abusive behaviours and on the relationship with the perpetrator; it also sought to determine the association between these latent classes with victims' characteristics. METHOD Data comes from two elder abuse surveys: a representative sample of community-dwelling adults and a convenience sample of older adults reporting elder abuse to four state and NGOs institutions. Latent Class Analysis (LCA) was used to categorize victimization in the population-based (N = 245) and in the victims' sample (N = 510) using 7 items measuring physical, psychological and financial abuse, and appointed perpetrators. Association tests were conducted to determine differences and similarities of victims' characteristics between the different obtained classes. RESULTS The LCA procedure identified six different latent classes of victimization experiences in each of the samples, which were statistically and plausibly distinct. In the population-based survey: verbal abuse by others (29%); psychological abuse from children/grandchildren (18%); overlooked by others (18%); stolen by others (15%); verbal Intimate Partner Violence (IPV) (14%) and physical and psychological IPV (6%). In the victims' survey: physical abuse by children/grandchildren (29%); physical IPV (26%); psychological abuse by children/grandchildren (18%); polyvictimization by others (16%); physical abuse by others (6%) and physical and psychological IPV (4%). In the victims survey the 6 groups significantly differ in age, gender, civil status, living arrangements, perceived social support and functional status. CONCLUSIONS The results support the possibility of the multidimensionality of elder abuse not being accounted by the "classical" abuse typologies. Elder abuse victims seeking help may represent a distinct group from that included in population-based prevalence studies. The appointed perpetrators may be the most meaningful and relevant aspect in distinguishing victimization experiences. Further research is needed to develop tailored interventions to specific elder abuse cases and enhance successful outcomes.
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Affiliation(s)
- Ana João Santos
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
- CISP - Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Lisboa, Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana Paula Gil
- CICS.NOVA - Centro Interdisciplinar de Ciências Sociais, Faculdade de Ciências Sociais e Humanas da Universidade Nova de Lisboa, Av. de Berna, 26-C, 1069-061 Lisboa, Portugal
| | - Oscar Ribeiro
- Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal
- CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Universidade do Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
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Machado A, Kislaya I, Santos AJ, Gaio V, Gil AP, Barreto M, Namorado S, Antunes L, Matias Dias C, Nunes B. Factors associated to repeated influenza vaccination in the Portuguese adults with chronic conditions. Vaccine 2018; 36:5265-5272. [DOI: 10.1016/j.vaccine.2018.07.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022]
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Barreto M, Kislaya I, Gaio V, Rodrigues AP, Santos AJ, Namorado S, Antunes L, Gil AP, Boavida JM, Ribeiro RT, Silva AC, Vargas P, Prokopenko T, Nunes B, Matias Dias C. Prevalence, awareness, treatment and control of diabetes in Portugal: Results from the first National Health examination Survey (INSEF 2015). Diabetes Res Clin Pract 2018; 140:271-278. [PMID: 29626582 DOI: 10.1016/j.diabres.2018.03.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/20/2018] [Accepted: 03/29/2018] [Indexed: 12/14/2022]
Abstract
AIMS Diabetes Mellitus is a major public health threat worldwide and continues to increase in numbers and significance. Estimates of diabetes prevalence, awareness, treatment and control are essential to effectively monitor its trends, plan and evaluate interventions. METHODS We conducted a nationwide health examination survey in the population residing in Portugal aged between 25 and 74 years old in 2015. It consisted in a cross sectional prevalence study which included the measurement of HbA1c, a physical examination and a general health interview of a probabilistic sample of 4911 individuals (Authorization n°9348/2010 of the National Committee for Data Protection). RESULTS The overall prevalence of diabetes was 9.9% (95%CI: 8.4; 11.5). It was higher in males than in females (12.1% vs 7.8%). Diabetes was more prevalent among individuals of lower education and without any professional activity. The majority of persons with diabetes was aware of their condition (87.1%) and was taking antidiabetic medication (79.7%). Of these, 63.2% had glycated hemoglobin levels lower than 7.0% (53 mmol/mol), but the majority failed to comply with the LDL and blood pressure recommended clinical targets (71.9% and 59.0%). Similarly, the prevalence of prediabetes was 16%, higher among women than men (17.5% vs 14.4%). CONCLUSION The prevalence of diabetes and prediabetes remains higher than the global and European estimates, although there is increasing awareness of this disorder.
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Affiliation(s)
- Marta Barreto
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1649-560 Lisboa, Portugal.
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Vânia Gaio
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana João Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Sónia Namorado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Liliana Antunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana Paula Gil
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - José Manuel Boavida
- Associação Protetora dos Diabéticos de Portugal, Rua Rodrigo da Fonseca n°1, 1250-189 Lisboa, Portugal
| | - Rogério Tavares Ribeiro
- Associação Protetora dos Diabéticos de Portugal, Rua Rodrigo da Fonseca n°1, 1250-189 Lisboa, Portugal
| | - Ana Clara Silva
- Instituto de Administração da Saúde e Assuntos Sociais, IP-RAM, Secretaria Regional da Saúde da Região Autónoma da Madeira, Rua das Pretas n°1, 9050-000 Funchal, Madeira, Portugal
| | - Patrícia Vargas
- Direção de Serviços de Cuidados de Saúde, Secretaria Regional da Saúde da Região Autónoma dos Açores, Solar dos Remédios, 9701-855 Angra do Heroísmo, Açores, Portugal
| | - Tamara Prokopenko
- Unidade de Saúde Pública Alentejo Litoral, Núcleo de Alcácer do Sal, Avenida José Saramago n°14, 7580-206 Alcácer do Sal, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1649-560 Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1649-560 Lisboa, Portugal
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Nunes B, Barreto M, Gil AP, Kislaya I, Namorado S, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Santos J, Alves-Alves C, Castilho E, Cordeiro E, Dinis A, Prokopenko T, Silva AC, Vargas P, Lyshol H, Dias CM. The first Portuguese National Health Examination Survey (2015): design, planning and implementation. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rodrigues AP, Kislaya I, Antunes L, Gaio V, Barreto M, Santos AJ, Gil AP, Namorado S, Lyshol H, Nunes B, Dias CM. Prevalence of Elevated Cholesterol in Portugal: National Health Examination Survey Results (2015). Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Namorado S, Kislaya I, Gaio V, Santos AJ, Gil AP, Barreto M, Santos J, Lyshol H, Nunes B, Matias Dias C. Participants’ recruitment: preliminary results of Portuguese National Health Examination Survey. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gil AP, Santos AJ, Santos J, Kislaya I, Rodrigues AP, NamoradoV S, Gaio, Barreto M, Lyshol H, Nunes B, Matias Dias C. Population's adherence to the Portuguese Health Examination Survey:the perspective of fieldwork teams. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kislaya I, Rodrigues AP, Santos J, Gaio V, Gil AP, Santos AJ, Namorado S, Barreto M, Lyshol H, Nunes B, Matias Dias C. Portuguese National Health Examination Survey: Lessons from data collection monitoring. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gil AP, Santos AJ, Kislaya I, Santos C, Mascoli L, Ferreira AI, Vieira DN. Estudo sobre pessoas idosas vítimas de violência em Portugal: sociografia da ocorrência. CAD SAUDE PUBLICA 2015. [DOI: 10.1590/0102-311x00084614] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O presente artigo apresenta dados sobre violência contra pessoas com 60 e mais anos residentes em Portugal há mais de 12 meses. O estudo transversal e descritivo recolheu dados por meio de um questionário aplicado presencialmente a vítimas que recorreram a três entidades governamentais e a uma instituição não-governamental de apoio a vítimas. A amostra não probabilística foi constituída por 510 vítimas de violência em contexto familiar. A violência física e a psicológica foram os tipos mais reportados, afetando 87,8% e 69,6% das pessoas estudadas, seguindo-se a violência financeira (47,5%), sexual (7,5%) e a negligência (6,5%). A maioria (74,1%) dos respondentes indicou mais de um tipo de violência. As vítimas, na maioria mulheres, tinham uma média de idade de 70,7 anos. A maioria dos agressores pertencia à família nuclear, nomeadamente, cônjuges ou companheiros, filhos/enteados e filhas/enteadas. Contudo, observaram-se diferenças no agressor consoante o gênero da vítima. Os resultados indicam que a violência não é um fenômeno uniforme, apresentando-se sob diferentes configurações.
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Affiliation(s)
- Ana Paula Gil
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
| | | | - Irina Kislaya
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
| | - César Santos
- Instituto Nacional de Medicina Legal e Ciências Forenses, Portugal
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Gaio V, Picanço I, Nunes B, Fernandes A, Mendonça F, Horta Correia F, Beleza Á, Gil AP, Bourbon M, Vicente A, Matias Dias C, Barreto da Silva M. Pharmacogenetic Profile of a South Portuguese Population: Results from the Pilot Study of the European Health Examination Survey in Portugal. Public Health Genomics 2015; 18:139-50. [DOI: 10.1159/000373920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/08/2015] [Indexed: 01/19/2023] Open
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Gaio V, Nunes B, Fernandes A, Mendonça F, Horta Correia F, Beleza Á, Gil AP, Bourbon M, Vicente A, Dias CM, Barreto da Silva M. Genetic variation at the CYP2C19 gene associated with metabolic syndrome susceptibility in a South Portuguese population: results from the pilot study of the European Health Examination Survey in Portugal. Diabetol Metab Syndr 2014; 6:23. [PMID: 24548628 PMCID: PMC3932792 DOI: 10.1186/1758-5996-6-23] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a cluster of conditions that occur together, increasing the risk of heart disease, stroke and diabetes. Since pathways implicated in different diseases reveal surprising insights into shared genetic bases underlying apparently unrelated traits, we hypothesize that there are common genetic components involved in the clustering of MetS traits. With the aim of identifying these common genetic components, we have performed a genetic association study by integrating MetS traits in a continuous MetS score. METHODS A cross-sectional study developed in the context of the Portuguese Component of the European Health Examination Survey (EHES) was used. Data was collected through a detailed questionnaire and physical examination. Blood samples were collected and biochemical analyses were performed. Waist circumference, blood pressure, glucose, triglycerides and high density lipoprotein cholesterol (HDL) levels were used to compute a continuous MetS score, obtained by Principal Component Analysis. A total of 37 single nucleotide polymorphisms (SNPs) were genotyped and individually tested for association with the score, adjusting for confounding variables. RESULTS A total of 206 individuals were studied. Calculated MetS score increased progressively with increasing number of risk factors (P < 0.001). We found a significant association between CYP2C19 rs4244285 and the MetS score not detected using the MetS dichotomic approach. Individuals with the A allelic variant seem to be protected against MetS, displaying a lower MetS score (Mean difference: 0.847; 95%CI: 0.163-1.531; P = 0.015), after adjustment for age, gender, smoking status, excessive alcohol consumption and physical inactivity. An additive genetic effect of GABRA2 rs279871, NPY rs16147 and TPMT rs1142345 in the MetS score variation was also found. CONCLUSIONS This is the first report of a genetic association study using a continuous MetS score. The significant association found between the CYP2C19 polymorphism and the MetS score but not with the individual associated traits, emphasizes the importance of lipid metabolism in a MetS common etiological pathway and consequently on the clustering of different cardiovascular risk factors. Despite the sample size limitation of our study, this strategy can be useful to find genetic factors involved in the etiology of other disorders that are defined in a dichotomized way.
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Affiliation(s)
- Vânia Gaio
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Aida Fernandes
- Laboratório de Saúde Pública Dra. Laura Ayres, Faro, Portugal
| | | | | | - Álvaro Beleza
- Laboratório de Saúde Pública Dra. Laura Ayres, Faro, Portugal
| | - Ana Paula Gil
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Mafalda Bourbon
- Departamento de Promoção da Saúde e Prevenção das Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Astrid Vicente
- Departamento de Promoção da Saúde e Prevenção das Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Marta Barreto da Silva
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
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Kislaya I, Santos AJ, Nicolau R, Gil AP. Violence against older adults in Portugal: findings from the first national prevalence study. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fonseca R, Gomes I, Lobato Faria P, Paula Gil A. Perspetivas atuais sobre a proteção jurídica da pessoa idosa vítima de violência familiar: contributo para uma investigação em saúde pública. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.rpsp.2012.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Storchová Z, Gil AP, Janderová B, Vlasák J, Vondrejs V. Accumulation of Ade+ reversions in isoauxotrophic stains of Saccharomyces cerevisiae allelic in RAD6 during adenine starvation. Folia Microbiol (Praha) 1997; 42:47-51. [PMID: 9161002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A comparative method based on an analysis of accumulation of starvation-induced Ade+ reversions and cell death during adenine starvation was developed and exploited for estimating the role of RAD6 in the starvation-induced reversions. It was shown that inactivation of RAD6 function in Saccharomyces cerevisiae markedly enhances the accumulation of Ade+ reversions, and therefore it is likely that this gene is taking part in maintaining the low level of starvation-induced mutations in yeast cells.
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Affiliation(s)
- Z Storchová
- Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czech Republic
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