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Figueira RS, Xavier MO, Tomasi E, Demarco FF, Gonzalez MC, Bielemann RM. Validation of dysphagia perception to predict the risk for dysphagia in non-institutionalized older adults. Clin Nutr ESPEN 2023; 57:358-363. [PMID: 37739679 DOI: 10.1016/j.clnesp.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/08/2023] [Accepted: 07/11/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND AIMS Dysphagia is a swallowing disorder that affects mainly the older adults and can compromise quality of life, and increase the risk for malnutrition and aspiration. Early diagnosis is, therefore, essential to prevent adversities. We aimed to evaluate the validity of self-perceived dysphagia in community-dwelling older adults (60 years or older) from Pelotas, Brazil, participants in the "COMO VAI?" STUDY METHODS The Eating Assessment Tool (EAT-10) was used as the reference tool to identify the risk for dysphagia and the self-perception of dysphagia was assessed using the following question: "Do you have swallowing difficulties?" (Yes/No). The parameters of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were described with 95% confidence intervals (95% CI) and according to independent variables (sex, age, economic level, and education). RESULTS The prevalence of dysphagia risk according to EAT-10 and self-perception was 12.9% (95% CI 10.2-16.1) and 8.8% (95% CI 6.6-11.6), respectively. Sensitivity was 34.8% (95% CI 23.5-47.6) and the highest values were observed in women and the older individuals (80 years or older). Specificity was 95.1% (95% CI 92.6-96.9). PPV was 51.1% (95% CI 35.8-66.3), NPV 90.8% (95% CI 87.8-93.2) and accuracy 87.3%. CONCLUSIONS Considering the low sensitivity and PPV, the self-perception of dysphagia analyzed with a single question should be used with caution, as an individual at risk for dysphagia may not realize their condition.
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Affiliation(s)
| | - Mariana Otero Xavier
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Flávio Fernando Demarco
- Post-Graduate Program in Epidemiology and Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.
| | - Renata Moraes Bielemann
- Nutrition College and Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
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Xavier MO, Amouzou A, Maïga A, Akseer N, Huicho L, Matijasevich A. The impact of the COVID-19 pandemic on trends in stillbirths, under-5 and maternal mortality in Brazil: Excess deaths and regional inequalities. J Glob Health 2023; 13:06040. [PMID: 37772786 PMCID: PMC10540663 DOI: 10.7189/jogh.13.06040] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Background Despite the proliferation of studies on the impact of the coronavirus disease 2019 (COVID-19) pandemic, there is less evidence on the indirect death toll compared to the health system and service provision disruptions. We assessed the impact of the COVID-19 pandemic on national and regional trends and differences in stillbirths, under-5 and maternal deaths in Brazil. Methods We used the nationwide routine health information system data from January 2017 to December 2021, to which we applied descriptive and advanced mixed effects ordinary least squared regression models to measure the percent change in mortality levels during the COVID-19 pandemic (March 2020 to December 2021). We carried out counterfactual analyses comparing the observed and expected mortality levels for each type of mortality at national and regional levels. Results Stillbirths increased 4.8% (3.1% in 2020 and 6.2% in 2021) and most noticeably maternal deaths increased 71.6% (35.3% in 2020 and 103.3% in 2021) over the COVID-19 period. An opposite pattern was observed in under-5 mortality, which dropped -10.2% (-12.5% in 2020 and -8.1% in 2021). We identified regional disparities, with a higher percent increase in stillbirths observed in the Central-West region and in maternal deaths in the South region. Discussion Based on pre-pandemic trends and expected number of deaths in the absence of the COVID-19, we observed increases in stillbirths and maternal deaths and reductions in under-5 deaths during the pandemic. The months with the highest number of deaths (stillbirths and maternal deaths) coincided with the months with the highest mortality from COVID-19. The increase in deaths may also have resulted from indirect effects of the pandemic, such as unavailability of health services or even reluctance to go to the hospital when necessary due to fear of contagion. Conclusions In Brazil, the COVID-19 outbreak and subsequent restrictions had a detrimental impact on stillbirths and maternal deaths. Even before the pandemic, mortality trends highlighted pre-existing regional inequalities in the country's health care system. Although there were some variations, increases were observed in all regions, indicating potential weaknesses in the health system and inadequate management during the pandemic, particularly concerning pregnant and postpartum women.
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Affiliation(s)
- Mariana Otero Xavier
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Agbessi Amouzou
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abdoulaye Maïga
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nadia Akseer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil, Centro de Investigación para el Desarrollo Integral y Sostenible and Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
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Berrutti B, Otero Xavier M, S. Santos I, Matijasevich A, Tovo-Rodrigues L. Sleep Duration in Adolescence and Its Prenatal, Perinatal, and Health Determinants in a Large Population-based Cohort Followed from Birth. Sleep Sci 2023; 16:148-158. [PMID: 37583372 PMCID: PMC10424492 DOI: 10.1055/s-0043-1770807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Objective To investigate sleep duration and its associated factors in adolescents aged 11 years from the 2004 Pelotas (Brazil) Birth Cohort Study. Methods Sleep duration was assessed using a self-report sleep habits. Independent variables included perinatal, sociodemographic, behavioral, and health characteristics. The associations were estimated using multiple linear regression. Results The mean sleep duration of 3,179 adolescents was 9.3 hour (SD =1.7 hour). Longer sleep duration was associated with lower socioeconomic status at birth (β: 0.37, 95% CI: 0.12; 0.61), lower mother's education level ( p < 0.001), and being female (β: 0.19, 95% CI: 0.06; 0.33). Shorter sleep duration was associated with cesarean section delivery (β: -0.16, 95% CI: -0.31; -0.02); having classes in the morning shift (β: -1.38, 95% CI: -1.51; -1.26), and lower terciles of physical activity ( p = 0.04). Conclusions The mean sleep duration observed in this study was consistent with the international recommendations for this age range. Adolescents from lower income families, who are more active, study in shifts other than morning, girls, and those born through vaginal delivery presented higher sleep duration than their counterparts.
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Affiliation(s)
- Barbara Berrutti
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Mariana Otero Xavier
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Iná S. Santos
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- School of Medicine, Graduate Program in Pediatrics and Child Health, Pontifical
Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul,
Brazil
| | - Alicia Matijasevich
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Department of Preventive Medicine, Faculty of Medicine FMUSP, Universidade de
São Paulo, SP, Brazil
| | - Luciana Tovo-Rodrigues
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Donalisio MR, Boing AC, Sato APS, Martinez EZ, Xavier MO, Almeida RLFD, Moreira RDS, Queiroz RCDS, Matijasevich A. Vaccination against poliomyelitis in Brazil from 2011 to 2021: successes, setbacks, and challenges ahead. Cien Saude Colet 2023; 28:337. [PMID: 36651390 DOI: 10.1590/1413-81232023282.17842022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 01/17/2023] Open
Abstract
The drop in childhood vaccination coverage (VC), including poliomyelitis, has become a health concern. The objective was to analyze the temporal trend of coverage of the three doses of the polio vaccine in the first 12 months of life between 2011 and 2021, in addition to mapping vaccination coverage in Brazil, including the COVID-19 pandemic period. An ecological study was carried out using interrupted time series (STI) techniques and spatial analysis, with data from the National Immunization Program Information System. The VC trend was adjusted by the Newey-West variance estimator according to the federated units and the Brazilian Deprivation Index. The VC distribution was estimated by Bayesian models and the spatial clusters by the global and local Moran index, identifying areas of lower coverage in the health regions. There was a reduction in the VC over the period in all regions, being more pronounced in the North and Northeast regions and during the Covid-19 pandemic. The biggest drops were identified in states and health regions with greater social vulnerability after 2019. The drop in VC shows that the risk of reintroduction of the wild virus is imminent and the challenges need to be faced with the strengthening of the Brazilian Health System (SUS).
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Affiliation(s)
- Maria Rita Donalisio
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Alexandra Crispim Boing
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina. Florianópolis SC Brasil
| | | | - Edson Zangiacomi Martinez
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto SP Brasil
| | - Mariana Otero Xavier
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
| | | | - Rafael da Silveira Moreira
- Departamento de Medicina Social, Centro de Biociências, Universidade Federal de Pernambuco Centro. Recife PE Brasil
| | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
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Sato APS, Boing AC, Almeida RLFD, Xavier MO, Moreira RDS, Martinez EZ, Matijasevich A, Donalisio MR. Measles vaccination in Brazil: where have we been and where are we headed? Ciênc saúde coletiva 2023. [DOI: 10.1590/1413-81232023282.19172022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Abstract The re-emergence of vaccine-preventable diseases due to the decline in vaccine coverage (VC) has been documented in several countries. The objective was to analyze the VC, the homogeneity of VC, and measles cases in Brazil from 2011 to 2021, focusing on the period of the COVID-19 pandemic, its temporal trend, space-time distribution, and factors associated with clusters of lower VC. This is an ecological study on measles VC (dose 1), with methods of interrupted time series and evaluation of spatio-temporal disposition, through the sweep test to identify clusters of VC. Starting in 2015, we observe a progressive decline in VC and homogeneity, with an accentuation after 2020, in all regions, particularly in the North and Northeast. Low VC clusters were associated with worse human development indicators, social inequality, and less access to the Family Health Strategy. In Brazil, the pandemic intensified health inequalities with low VC of measles in socially more vulnerable and unequal municipalities. There is a risk of virus circulation, however, the challenge of strengthening primary care, improving health communication and guaranteeing access to the vaccine, reducing missed opportunities for vaccination and vaccine hesitancy, is highlighted.
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Sato APS, Boing AC, Almeida RLFD, Xavier MO, Moreira RDS, Martinez EZ, Matijasevich A, Donalisio MR. Measles vaccination in Brazil: where have we been and where are we headed? Cien Saude Colet 2023; 28:351-362. [PMID: 36651391 DOI: 10.1590/1413-81232023282.19172022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023] Open
Abstract
The re-emergence of vaccine-preventable diseases due to the decline in vaccine coverage (VC) has been documented in several countries. The objective was to analyze the VC, the homogeneity of VC, and measles cases in Brazil from 2011 to 2021, focusing on the period of the COVID-19 pandemic, its temporal trend, space-time distribution, and factors associated with clusters of lower VC. This is an ecological study on measles VC (dose 1), with methods of interrupted time series and evaluation of spatio-temporal disposition, through the sweep test to identify clusters of VC. Starting in 2015, we observe a progressive decline in VC and homogeneity, with an accentuation after 2020, in all regions, particularly in the North and Northeast. Low VC clusters were associated with worse human development indicators, social inequality, and less access to the Family Health Strategy. In Brazil, the pandemic intensified health inequalities with low VC of measles in socially more vulnerable and unequal municipalities. There is a risk of virus circulation, however, the challenge of strengthening primary care, improving health communication and guaranteeing access to the vaccine, reducing missed opportunities for vaccination and vaccine hesitancy, is highlighted.
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Affiliation(s)
- Ana Paula Sayuri Sato
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715. 01246-904 São Paulo SP Brasil.
| | - Alexandra Crispim Boing
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina. Florianópolis SC Brasil
| | | | - Mariana Otero Xavier
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
| | - Rafael da Silveira Moreira
- Departamento de Saúde Coletiva, Fundação Oswaldo Cruz - Instituto Aggeu Magalhães. Centro de Ciências Médicas, Universidade Federal de Pernambuco. Recife PE Brasil
| | - Edson Zangiacomi Martinez
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto SP Brasil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
| | - Maria Rita Donalisio
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. Campinas SP Brasil
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Donalisio MR, Boing AC, Sato APS, Martinez EZ, Xavier MO, Almeida RLFD, Moreira RDS, Queiroz RCDS, Matijasevich A. Vaccination against poliomyelitis in Brazil from 2011 to 2021: successes, setbacks, and challenges ahead. Ciênc saúde coletiva 2023. [DOI: 10.1590/1413-81232023282.17842022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract The drop in childhood vaccination coverage (VC), including poliomyelitis, has become a health concern. The objective was to analyze the temporal trend of coverage of the three doses of the polio vaccine in the first 12 months of life between 2011 and 2021, in addition to mapping vaccination coverage in Brazil, including the COVID-19 pandemic period. An ecological study was carried out using interrupted time series (STI) techniques and spatial analysis, with data from the National Immunization Program Information System. The VC trend was adjusted by the Newey-West variance estimator according to the federated units and the Brazilian Deprivation Index. The VC distribution was estimated by Bayesian models and the spatial clusters by the global and local Moran index, identifying areas of lower coverage in the health regions. There was a reduction in the VC over the period in all regions, being more pronounced in the North and Northeast regions and during the Covid-19 pandemic. The biggest drops were identified in states and health regions with greater social vulnerability after 2019. The drop in VC shows that the risk of reintroduction of the wild virus is imminent and the challenges need to be faced with the strengthening of the Brazilian Health System (SUS).
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Mello RP, Xavier MO, Tomasi E, Gonzalez MC, Demarco FF, Bielemann RM. Dysphagia Perception Among Community-Dwelling Older Adults from a Municipality in Southern Brazil. Dysphagia 2021; 37:879-888. [PMID: 34319457 DOI: 10.1007/s00455-021-10347-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/09/2020] [Accepted: 07/19/2021] [Indexed: 11/25/2022]
Abstract
To analyse the prevalence of dysphagia perception and associated factors among community-dwelling older adults in Pelotas, Brazil. A total of 1447 community-dwelling individuals aged 60 and older participated in a cross-sectional population-based study carried out in 2014. Dysphagia perception was assessed using the following question: "Do you have swallowing difficulties? (Yes/No)". Independent variables included sociodemographic, behavioural and health characteristics. Poisson regression was used to obtain prevalence ratios. Dysphagia perception prevalence was 8.1%, higher among women (PR 1.63, 95% CI 1.07; 2.46) and in subjects older than 80 years (PR 1.88, 95% CI 1.16; 3.03). Older adults with 1-7 years of schooling were more likely to present dysphagia (PR 1.62; 95% CI 1.09; 2.40). Those who did not use dental prosthesis (PR 1.85; 95% CI 1.08; 3.16), who presented dry mouth sensation (PR 4.10; 95% CI 2.59; 6.51) and multimorbidity (PR 30.0; 95% CI 4.09; 219.45) were more likely to present dysphagia perception. The participants who consumed alcohol were 60% less likely to report dysphagia perception (PR 0.43; 95% CI 0.22; 0.86). One out of twelve older adults presented dysphagia perception, and associations with sociodemographic characteristics and other health problems were found. Early identification of dysphagia should be a public health and clinical concern.
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Affiliation(s)
| | - Mariana Otero Xavier
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil.
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Flávio Fernando Demarco
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil.,Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Renata Moraes Bielemann
- Nutrition College, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil
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Bertoldi AD, Silveira MPT, Machado AKF, Xavier MO, Martins RC. Sources of access to medication and its use in the rural area of Pelotas, Rio Grande do Sul, Brazil, in 2016: a cross-sectional population-based study. ACTA ACUST UNITED AC 2021; 30:e2020089. [PMID: 33605375 DOI: 10.1590/s1679-49742021000100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/04/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyze the prevalence of medication use, sources of access, and associated factors among rural residents in Pelotas, RS, Brazil. METHODS This was a cross-sectional study conducted in 2016 with adults ≥18 years old. Participants reported on medication use and sources of access to medication in the month prior to the interview. Poisson regression was used. RESULTS Among the 1,519 respondents, 54.7% (95%CI 48.7;60.5) used some form of medication and 3.3% (95%CI 2.4;4.5) stopped taking necessary medication. Higher prevalence of use occurred in: women (PR=1.23 - 95%CI 1.12;1.34), the elderly (PR=2.36 - 95%CI 2.05;2.73), people with poorer self-perceived health (PR=1.29 - 95%CI 1.14;1.46) and people with a higher number of diseases (PR=2.37 - 95%CI 2.03;2.77). A total of 14.0% (95%CI 11.2;17.4) obtained medication exclusively from the Brazilian National Health System, prevalence of which was higher among those who self-reported themselves to be non-white and from lower economic classification. CONCLUSION A low number stopped taking medication they needed to take. Use of free-of-charge medication was greater in groups with lower income.
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Affiliation(s)
- Andrea Dâmaso Bertoldi
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | | | | | - Mariana Otero Xavier
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | - Rafaela Costa Martins
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
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Cardoso AS, Xavier MO, Dos Santos Costa C, Tomasi E, Cesar JA, Gonzalez MC, Domingues MR, Barbosa-Silva TG, Bielemann RM. Body mass index and mortality among community-dwelling elderly of Southern Brazil. Prev Med 2020; 139:106173. [PMID: 32592797 DOI: 10.1016/j.ypmed.2020.106173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/08/2019] [Revised: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 01/27/2023]
Abstract
This study aims to measure the association between body mass index (BMI), comparing two different classifications, and mortality among community-dwelling elderly considering myopenia in Pelotas, Brazil. This is a longitudinal study started in 2014, we followed 1451 elderly people (≥ 60 years) enrolled in the "COMO VAI?" study. BMI was classified according to the World Health Organization (WHO) and the classification with specific cutoff points for older adults. Myopenia was measured by calf circumference (≤33 cm for women and ≤34 cm for men). Cox proportional-hazards models were used to test associations controlling for sociodemographic and behavioral characteristics and number of morbidities. Nearly 10% (N = 145) of the elderly died during almost three years of follow-up. We observed a L-shaped relation between BMI and mortality. Elderly with underweight had a higher mortality risk compared to those with adequate BMI in both classifications. According to the WHO classification, overweight elderly presented protection for mortality (HR: 0.58; 95% CI 0.38-0.87) when compared to those with adequate BMI. Among elderly with myopenia, overweight by WHO continued to protect against mortality, although not significantly, while those with the specific classification underweight presented a higher risk of death compared to those with normal weight (HR: 2.09; 95% CI 1.06-4.14). In conclusion the underweight increased the risk of death in community-dwelling elderly people during a follow-up of three years. The specific classification seemed to be more adequate to indicate risk of mortality in this population. Higher BMI protect against mortality when muscle mass was not considered.
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Affiliation(s)
| | | | | | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Juraci Almeida Cesar
- Post-Graduate Program in Public Health, Federal University of Rio Grande, Brazil
| | - Maria Cristina Gonzalez
- School of Nutrition, Federal University of Pelotas, Brazil; Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil; Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Brazil
| | | | | | - Renata Moraes Bielemann
- School of Nutrition, Federal University of Pelotas, Brazil; Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil; School of Physical Education, Federal University of Pelotas, Brazil
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da Silva LB, Bock D, Klafke GB, Sanchotene KO, Basso RP, Benelli JL, Poester VR, da Silva FA, Trilles L, Severo CB, Stevens DA, Xavier MO. Cryptococcosis in HIV-AIDS patients from Southern Brazil: Still a major problem. J Mycol Med 2020; 30:101044. [PMID: 33046394 DOI: 10.1016/j.mycmed.2020.101044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/26/2019] [Revised: 06/23/2020] [Accepted: 09/10/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Cryptococcus neoformans is an opportunistic pathogen that causes ∼15% mortality in AIDS patients. Rio Grande City, Rio Grande do Sul (RS), Brazil, has the highest national rate of HIV/AIDS, considering cities with population more than 100,000 habitants. OBJECTIVE We aimed to evaluate the clinical and epidemiological profile of cryptococcosis in a reference service for HIV-AIDS patients in the South region of Brazil, over seven years. Material and methods A retrospective study was performed including all cryptococcosis cases diagnosed at the University Hospital, Federal University of Rio Grande (UH-FURG) between January 2010 and December 2016. RESULTS Seventy cases of cryptococcosis were diagnosis from 2010 to 2016 in the UH-FURG in the seven years of the study. These numbers were responsible for 2.1% to 8.1% of the hospitalizations/year for HIV patients. All were caused by C. neoformans infection (95% C. neoformans var. grubii VNI and 5% C. neoformans var. grubii VNII). Neurocryptococcosis was the major clinical manifestation and cryptococcosis was the HIV- defining condition in 40% of patients. The period of hospitalization was an average of 39.3 days (SD=31.3), and more than half of patients (53%; 37/70) died after a mean of 82 days. DISCUSSION The present study showed the importance of cryptococcosis as an AIDS-defining disease in HIV-AIDS patients in a tertiary hospital from Southern Brazil. More investment is necessary to reduce the impact of this opportunistic mycosis in HIV-AIDS patients from southern Brazil.
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Affiliation(s)
- L B da Silva
- Mycology Laboratory of Faculty of Medicine (FAMED), Federal University of Rio Grande (FURG), Rio Grande do Sul, Brazil; Program Post-Graduation in Health Sciences (PPGCS - FAMED-FURG), Rio Grande do Sul, Brazil
| | - D Bock
- Mycology Laboratory of Faculty of Medicine (FAMED), Federal University of Rio Grande (FURG), Rio Grande do Sul, Brazil
| | - G B Klafke
- Mycology Laboratory of Faculty of Medicine (FAMED), Federal University of Rio Grande (FURG), Rio Grande do Sul, Brazil
| | - K O Sanchotene
- Mycology Laboratory of Faculty of Medicine (FAMED), Federal University of Rio Grande (FURG), Rio Grande do Sul, Brazil; Program Post-Graduation in Health Sciences (PPGCS - FAMED-FURG), Rio Grande do Sul, Brazil
| | - R P Basso
- Program Post-Graduation in Health Sciences (PPGCS - FAMED-FURG), Rio Grande do Sul, Brazil
| | - J L Benelli
- Program Post-Graduation in Health Sciences (PPGCS - FAMED-FURG), Rio Grande do Sul, Brazil
| | - V R Poester
- Mycology Laboratory of Faculty of Medicine (FAMED), Federal University of Rio Grande (FURG), Rio Grande do Sul, Brazil; Program Post-Graduation in Health Sciences (PPGCS - FAMED-FURG), Rio Grande do Sul, Brazil
| | - F A da Silva
- Mycology Laboratory of National Institute of Infectology, Foundation Oswaldo Cruz (INI-FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - L Trilles
- Mycology Laboratory of National Institute of Infectology, Foundation Oswaldo Cruz (INI-FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - C B Severo
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - D A Stevens
- California Institute for Medical Research, San Jose, California, USA and Div. of Infectious Diseases and Geographic Medicine, Stanford University Medical School, Stanford, California, USA
| | - M O Xavier
- Mycology Laboratory of Faculty of Medicine (FAMED), Federal University of Rio Grande (FURG), Rio Grande do Sul, Brazil; Program Post-Graduation in Health Sciences (PPGCS - FAMED-FURG), Rio Grande do Sul, Brazil.
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Hirschmann R, Bortolotto CC, Martins-Silva T, Machado AKF, Xavier MO, Fernandes MP, Martins RC, Bielemann RM, Tovo-Rodrigues L, Wehrmeister FC. Simultaneity of risk factors for chronic non-communicable diseases in a rural population of a Southern Brazilian city. Rev Bras Epidemiol 2020; 23:e200066. [PMID: 32667466 DOI: 10.1590/1980-549720200066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/24/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To describe the occurrence of simultaneous risk factors for chronic noncommunicable diseases, and factors associated with these prevalences in rural adults of a Southern Brazilian city. METHODS The design of this study was cross-sectional with a sample of 1,445 adults from the rural area of Pelotas, RS. Four risk factors were considered: smoking, alcohol consumption, physical inactivity and inadequate consumption of vegetables. To verify the simultaneous occurrence of the outcomes, a cluster analysis was used. The association was tested by ordinal regression resulting in odds ratios. RESULTS Among the four risk factors evaluated, three were the most prevalent among men, and only physical inactivity was greater among women. In the cluster analysis, only the combination of alcohol consumption + smoking + inadequate vegetable consumption presented an observed prevalence that was significantly higher than the expected (O/E = 2.67, 95%CI 1.30, 5.48), and higher than another study in the south of the country. This can be justified because that study included an evaluation of urban dwellers and the consumption of fruits. After adjustment, men, single individuals, non-white people, those with less schooling, those with a worse socioeconomic status, those who reported poor perception of health, and those who do not work in specifically rural activities had a greater probability of having the simultaneity of risk factors. CONCLUSION The results show the importance of developing priority actions regarding the health of rural populations with special attention to the subgroups with an identified higher risk.
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Affiliation(s)
- Roberta Hirschmann
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Thais Martins-Silva
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Mariana Otero Xavier
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Mayra Pacheco Fernandes
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Rafaela Costa Martins
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Renata Moraes Bielemann
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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13
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Karpinski C, Xavier MO, Gomes AP, Bielemann RM. [Adequacy of the frequency and types of meals consumed by community-dwelling elderly folk in the south of Brazil]. Cien Saude Colet 2020; 26:3161-3173. [PMID: 34378706 DOI: 10.1590/1413-81232021268.03712020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/01/2020] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to describe the frequency and types of meals consumed by the elderly in Pelotas (Brazil) and factors associated with the adequacy of meal frequency. A cross-sectional study was carried out with ≥60 years of age individuals. They were asked about daily meals during the week prior to the interview. The adequacy of meals was defined as recommended by the Ministry of Health (at least three main meals and two small snacks per day). The independent variables were sociodemographic, health and food routine characteristics. Prevalence ratios and 95% confidence intervals were calculated using Poisson regression. Of the 1,438 elderly individuals interviewed, about 40% reported consuming four meals a day. Lunch was the most reported meal, followed by breakfast. A total of 30.6% of men and 38.6% of women had adequate frequency of meals (p=0.002). Men with edentulism (total tooth loss) were 35% more likely to eat adequately, while this probability was about 30% lower among non-white women, those without schooling and those who reported a lack of money to buy food. One in each three elderly people met the recommendation of adequate frequency of meals and some sociodemographic characteristics were negatively associated with this habit.
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Affiliation(s)
- Caroline Karpinski
- Faculdade de Nutrição, Universidade Federal de Pelotas (UFPel). R. Gomes Carneiro 01, Campus Anglo. 96010-610 Pelotas RS Brasil.
| | | | | | - Renata Moraes Bielemann
- Faculdade de Nutrição, Universidade Federal de Pelotas (UFPel). R. Gomes Carneiro 01, Campus Anglo. 96010-610 Pelotas RS Brasil. .,Programa de Pós-Graduação em Epidemiologia, UFPel. Pelotas RS Brasil
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14
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Carpena MX, Munhoz TN, Xavier MO, Rohde LA, Santos IS, Del-Ponte B, Barros FC, Matijasevich A, Tovo-Rodrigues L. The Role of Sleep Duration and Sleep Problems During Childhood in the Development of ADHD in Adolescence: Findings From a Population-Based Birth Cohort. J Atten Disord 2020; 24:590-600. [PMID: 31617436 DOI: 10.1177/1087054719879500] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: We aimed to investigate the association between sleep in early life and ADHD in adolescence. As a secondary analysis, we tested whether the associations may be specific to ADHD. Method: Data from 3,467 participants of the 2004 Pelotas Birth Cohort were used. Information on their sleep duration and problems was collected at 12, 24, and 48 months of age. ADHD diagnosis and hyperactivity/inattention problems were assessed with the Development and Well-Being Assessment (DAWBA) and the Strengths and Difficulties Questionnaire (SDQ) among participants at 11 years of age. Results: Difficulty going to sleep at 24 months, nightmares at 24 months and at 48 months, and restless sleep at 48 months were consistently associated with ADHD as well as with other mental disorders. Conclusion: The results suggest that sleep disturbances may be more important ADHD predictors than sleep duration or sleep duration trajectories. However, it may also be considered early markers of other mental disorders.
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Affiliation(s)
- Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Mariana Otero Xavier
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Postgraduate Program Pediatrics Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Del-Ponte
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Xavier MO, Bielemann RM, Carpena MX, Barros FC, Matijasevich A, Santos IS. Sleep duration trajectories from age 3 to 48 months in The Pelotas (Brazil) 2004 Birth Cohort Study. Paediatr Perinat Epidemiol 2020; 34:60-69. [PMID: 31960475 DOI: 10.1111/ppe.12628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/16/2019] [Accepted: 11/03/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Optimal sleep is essential for child growth, development, and immune function. Few studies have evaluated factors associated with sleep duration in childhood from a longitudinal perspective. OBJECTIVES This study aimed to identify trajectories of sleep duration in childhood and associated maternal and child characteristics. METHODS Sleep duration was assessed by maternal report at 3, 12, 24, and 48 months among children from the Pelotas (Brazil) 2004 Birth Cohort. Independent variables included family income, maternal and child demographics, and clinical characteristics. Trajectory analysis was carried out using a semi-parametric, group-based modelling approach. Multinomial logistic regression provided odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between independent variables and sleep duration trajectory groups. RESULTS A total of 3824 participants were included in the analyses. Three trajectories of sleep duration were identified: "short sleepers" (9.1%), "typical sleepers" (72.1%), and "initially longer sleepers" (18.8%). When compared to typical sleepers, children from less schooled mothers (OR 1.82, 95% CI 1.26, 2.62) and those whose mothers reported depressive symptoms during pregnancy (OR 1.31, 95% CI 1.02, 1.68) and consumed alcohol beverages at 3 months post-partum (OR 1.60, 95% CI 1.03, 2.50) were more likely to be short sleepers. Children who shared the bedroom with another child were about 40% (OR 1.41, 95% CI 1.07, 1.87) more likely to be short sleepers. None of the investigated maternal and child characteristics remained associated with the "initially longer sleeper" group. CONCLUSIONS Among the identified trajectories, the group with short sleep duration trajectory deserves special attention given the importance of adequate sleep duration in the first years of life for the child's growth and development and the high concomitance of other risk factors, such as less schooled mothers, and mothers who reported depressive symptoms during pregnancy and consumed alcohol at 3 months post-partum.
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Affiliation(s)
- Mariana Otero Xavier
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Renata Moraes Bielemann
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, Brazil
| | - Marina Xavier Carpena
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Department of Preventive Medicine, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-graduate Program in Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Abstract
OBJECTIVE To estimate the prevalence of smoking and associated factors among rural residents. METHODS This is a population-based, cross-sectional study of 1,519 individuals carried out in 2016. We randomly selected 24 of the 50 census tracts that make up the eight rural districts of the city of Pelotas, State of Rio Grande do Sul, Brazil. All individuals aged 18 years or more living in the randomly selected households were eligible. Smokers were all those who smoked ≥ 1 cigarette/day for at least one month or declared that they had stopped smoking for less than one month. The independent variables included socioeconomic, demographic, behavioral, and health characteristics. We investigated age of onset, duration of addiction, number of cigarettes smoked/day, pack-years, and types of cigarettes consumed. Poisson regression was performed to calculate the adjusted prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS The prevalence of smoking was 16.6% (95%CI 13.6-20.0), and it was twice as high in men in relation to women (PR = 1.99, 95%CI 1.44-2.74), in socioeconomic class D or E in relation to class A or B (PR = 2.23, 95%CI 1.37-3.62), and in those who considered their health poor or very poor in relation those with good or very good health (PR = 2.02, 95%CI 1.33-3.08). It was also higher in persons aged 30-59 years (compared to those aged < 30 years), with 5-8 years of education level (compared to those with ≥ 9 years), and with positive screening for alcohol-related disorder. Prevalence was lower among individuals who were overweight or obese than in those with normal weight. Smoking began on average at 16.9 years, with an average consumption of approximately 14 cigarettes/day and mean pack-years of 22 packs/year. The paper hand-rolled cigarette was the most consumed (57.6%). CONCLUSIONS Approximately one in six adults in rural Pelotas is a current smoker. The findings show the existence of social inequalities related to smoking addiction. Actions to prevent and control smoking should continue to be stimulated, especially in the most vulnerable subgroups.
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Affiliation(s)
- Mariana Otero Xavier
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Bianca Del-Ponte
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Iná S Santos
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Departamento de Medicina Social. Pelotas, RS, Brasil
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Gonçalves H, Tomasi E, Tovo-Rodrigues L, Bielemann RM, Machado AKF, Ruivo ACO, Bortolotto CC, Jaeger GP, Xavier MO, Fernandes MP, Martins RC, Hirschmann R, da Silva TM, Assunção MCF. Population-based study in a rural area: methodology and challenges. Rev Saude Publica 2018; 52:3s. [PMID: 30234883 PMCID: PMC6254958 DOI: 10.11606/s1518-8787.2018052000270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 06/01/2017] [Accepted: 10/31/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the planning, sampling, operational aspects of the field, and the sample obtained during a research conducted in a rural area, specifying and discussing the main logistical difficulties unique to these places and the solutions adopted. METHODS We carried out a population-based, cross-sectional survey between January and June 2016, with a representative sample of the population aged 18 years or over living in the rural area of Pelotas (approximately 22,000 individuals), State of Rio Grande do Sul, Brazil. We collected demographic, socioeconomic, and health-related information, such as alcohol consumption, cigarette consumption, depressive symptoms, quality of diet, quality of life, physical activity, satisfaction with the health unit, overweight or obesity, and sleep problems. RESULTS In the 720 domiciles sampled, 1,697 individuals were identified and 1,519 were interviewed (89.5%). The study initially drew 24 census tracts and proposed the visit to 42 households per tract; however, we need to adjust the method, such as decreasing the number of households per census tract (from 42 to 30) and identifying housing centers in each tract. The main reasons for these changes were difficulty accessing the area, large distances between households, misconceptions in the satellite data available (which did not fit the reality), and high cost of the field work. CONCLUSIONS The previous detailed recognition of the research environment was crucial for decision making as the maps and territory had geographical inconsistencies. The strategies and techniques used in studies for the urban area are not applicable to the rural area given the outcomes observed in Pelotas. The decisions taken, keeping the methodological rigor, were essential to ensure the timely execution of the study with the financial resources available.
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Affiliation(s)
- Helen Gonçalves
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Elaine Tomasi
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Luciana Tovo-Rodrigues
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Renata Moraes Bielemann
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
- Universidade Federal de Pelotas . Faculdade de Nutrição . Pelotas , RS , Brasil
| | - Adriana Kramer Fiala Machado
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Ana Carolina Oliveira Ruivo
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Caroline Cardozo Bortolotto
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Gustavo Pêgas Jaeger
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Mariana Otero Xavier
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Mayra Pacheco Fernandes
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Rafaela Costa Martins
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Roberta Hirschmann
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Thais Martins da Silva
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
| | - Maria Cecília Formoso Assunção
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia. Pelotas , RS , Brasil
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Cabana AL, Xavier MO, Mendes JF, Teles AJ, Martins AM, Silva-Filho RP, Meireles MCA. Applicability of the Platelia EIA® Aspergillus test for the diagnosis of aspergilosis in penguins. BRAZ J BIOL 2018; 79:169-173. [PMID: 30133554 DOI: 10.1590/1519-6984.171140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 11/13/2017] [Indexed: 11/22/2022] Open
Abstract
Even today, an effective diagnostic test for aspergillosis in penguins is unknown, being the gold standard post-mortem examinations. The fungal antigen galactomannan (GM) has been used as a biomarker of disease in humans and is detected by the Platelia Aspergillus EIA (BioRad)®, a commercial kit based on the sandwich ELISA technique. It is standardized for use in neutropenic patients, however studies have demonstrated its usefulness also possible for birds. The aim of our study was to evaluate the effectiveness of Platelia Aspergillus EIA® test (BioRad-US) in the diagnosis of aspergillosis in Magellanic penguins, determining sensitivity, specificity, and positive and negative predictive values for different cut-off points. Were included in the study, blood serum samples (n = 29) Magellanic penguins in captivity that died by aspergillosis. Detection of GM was performed following manufacturer's instructions and the GM index was obtained by dividing the average value of OD of the duplicate of the clinical sample by duplicate OD of the average value of the cut-off sample provided by the kit. Through information database results were obtained for the presence of anti-Aspergillus fumigatus antibodies detected by agar gel immunodiffusion (AGID) for all serum samples. Results were analyzed using chi-square test and Kruskal-Wallis from SPSS 20.0, IBM®. ROC curve was obtained and from this, rates of sensitivity, specificity, positive and negative predictive values were also calculated based on four different cutoff points (0.5, 1.0, 1.5 and 2.0). The serum GM index did not differ between animals of the case and control group (pkw =0.097). In determining the ROC curve for serum GM detection the value of area under the curve was 0.635. From the values determined by the coordinate of the curve, four different cut points (0.5, 1.0, 1.5 and 2.0) were analyzed, resulting in sensitivity rates ranging from 86.2 to 34.5% % and specificity between 87% and 26.1%. By comparing the serum GM index in group case as the presence or absence of antibodies detected by AGID was found p=0.503. The detection of GM the Platelia Aspergillus EIA® test seems is not be useful for the diagnosis of aspergillosis in naturally infected penguins.
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Affiliation(s)
- A L Cabana
- Programa de Pós-graduação em Veterinária, Centro de Pesquisa e Diagnóstico em Micologia Veterinária - MICVET, Universidade Federal de Pelotas - UFPel, Av. Eliseu Maciel, s/n, Campus Universitário, CEP 96010-900, Capão do Leão, RS, Brasil
| | - M O Xavier
- Faculdade de Medicina - FAMED, Departamento de Parasitologia e Micologia, Área de Ciências da Saúde, Universidade Federal do Rio Grande - FURG, Rua Visconde de Paranaguá, 102, CEP 96200-190, Rio Grande, RS, Brasil
| | - J F Mendes
- Programa de Pós-graduação em Veterinária, Centro de Pesquisa e Diagnóstico em Micologia Veterinária - MICVET, Universidade Federal de Pelotas - UFPel, Av. Eliseu Maciel, s/n, Campus Universitário, CEP 96010-900, Capão do Leão, RS, Brasil
| | - A J Teles
- Programa de Residência em Saúde Animal, Universidade Federal de Pelotas - UFPel, Av. Eliseu Maciel, s/n, Campus Universitário, CEP 96010-900, Capão do Leão, RS, Brasil
| | - A M Martins
- Programa de Pós-graduação em Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Av. Eliseu Maciel, s/n, Campus Universitário, CEP 96010-900, Capão do Leão, RS, Brasil.,Centro de Recuperação de Animais Marinhos - CRAM, Universidade Federal do Rio Grande - FURG, Rua Tenente Capitão Heitor Perdigão, 10, Centro, CEP 96200-190, Rio Grande, RS, Brasil
| | - R P Silva-Filho
- Centro de Recuperação de Animais Marinhos - CRAM, Universidade Federal do Rio Grande - FURG, Rua Tenente Capitão Heitor Perdigão, 10, Centro, CEP 96200-190, Rio Grande, RS, Brasil
| | - M C A Meireles
- Programa de Pós-graduação em Veterinária, Centro de Pesquisa e Diagnóstico em Micologia Veterinária - MICVET, Universidade Federal de Pelotas - UFPel, Av. Eliseu Maciel, s/n, Campus Universitário, CEP 96010-900, Capão do Leão, RS, Brasil
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Farías-Antúnez S, Xavier MO, Santos IS. Effect of maternal postpartum depression on offspring's growth. J Affect Disord 2018; 228:143-152. [PMID: 29248820 DOI: 10.1016/j.jad.2017.12.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 11/16/2017] [Accepted: 12/06/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous studies have linked maternal depression to different child offspring's growth outcomes. However, its effect has not been well established. The aim of this review was to evaluate the available evidence on the effect of maternal postpartum depression on offspring weight and height growth outcomes. METHODS A systematic review of longitudinal studies that evaluated the effect of maternal depression on child's growth outcomes was conducted in PubMed, LILACs, Web of Science, Science Direct and PsyInfo databases, using maternal postpartum depression related keywords, according to each database searching tool. RESULTS A total of 9608 articles were screened and 20 met the final inclusion criteria. The child's first-year growth was the most affected by the exposure to maternal depression. Children of depressed mothers had a higher chance of being underweight and stunted in the first year of life. Maternal depression was also associated with child's linear growth impairment after the first year. LIMITATIONS As a literature review, a publication bias could not be ruled out. The diversity of the published data made it unfeasible for a pooled effect to be estimated. CONCLUSIONS Considering the results observed on child's first year of life growth, physicians should engage in assessing maternal depression, as it is a treatable and manageable disease, thus avoiding unnecessary harm on child's physical development.
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Affiliation(s)
| | | | - Iná Silva Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
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20
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Murray J, Lima NP, Ruivo ACO, Ramírez Varela A, Bortolotto CC, Magalhães EIDS, Leite FMC, Xavier MO, Pingault JB, Fazel S, Mielke GI, Anselmi L, Wehrmeister FC, Gonçalves H, Menezes AMB. Lifelong robbery victimisation and mental disorders at age 18 years: Brazilian population-based study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:487-496. [PMID: 29453749 PMCID: PMC5908817 DOI: 10.1007/s00127-018-1488-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 01/21/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Urban violence is a major problem in Brazil and may contribute to mental disorders among victims. The aim of this study was to assess the association between robbery victimisation and mental health disorders in late adolescence. METHODS At age 18 years, 4106 participants in the 1993 Pelotas Birth Cohort Study were assessed. A questionnaire about history of robbery victimisation was administered, the Self-Report Questionnaire was used to screen for common mental disorders, and the Mini International Neuropsychiatric Interview was used to assess major depressive disorder and generalised anxiety disorder. Cross-sectional prevalence ratios between lifetime robbery victimisation and mental disorders were estimated using Poisson regression with robust standard errors, adjusting for socioeconomic variables measured at birth and violence in the home and maltreatment measured at age 15. RESULTS There was a dose-response relationship between frequency of lifetime robberies and risk of mental disorders. Adolescents who had been robbed three or more times had twice the risk (PR 2.04; 95% CI 1.64-2.56) for common mental disorders, over four times the risk for depression (PR 4.59; 95% CI 2.60-8.12), and twice the risk for anxiety (PR 1.93; 95% CI 1.06-3.50), compared with non-victims, adjusting for covariates. Experiencing frequent robberies had greater impact on common mental disorders than experiencing an armed robbery. Population attributable fractions with regard to robbery were 9% for common mental disorders, 13% for depression, and 8% for anxiety. CONCLUSIONS Robberies are associated with common mental disorders in late adolescence, independently of violence between family members. Reducing urban violence could significantly help in preventing common mental illnesses.
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Affiliation(s)
- Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil.
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | - Andrea Ramírez Varela
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | | | | | - Mariana Otero Xavier
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Jean-Baptiste Pingault
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Gregore Iven Mielke
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Luciana Anselmi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
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Bielemann RM, Silva BGCD, Coll CDVN, Xavier MO, Silva SGD. Burden of physical inactivity and hospitalization costs due to chronic diseases. Rev Saude Publica 2015; 49:S0034-89102015000100307. [PMID: 26487291 PMCID: PMC4603264 DOI: 10.1590/s0034-8910.2015049005650] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 12/05/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the physical inactivity-related inpatient costs of chronic non-communicable diseases. METHODS This study used data from 2013, from Brazilian Unified Health System, regarding inpatient numbers and costs due to malignant colon and breast neoplasms, cerebrovascular diseases, ischemic heart diseases, hypertension, diabetes, and osteoporosis. In order to calculate the share physical inactivity represents in that, the physical inactivity-related risks, which apply to each disease, were considered, and physical inactivity prevalence during leisure activities was obtained from Pesquisa Nacional por Amostra de Domicílio (Brazil’s National Household Sample Survey). The analysis was stratified by genders and residing country regions of subjects who were 40 years or older. The physical inactivity-related hospitalization cost regarding each cause was multiplied by the respective share it regarded to. RESULTS In 2013, 974,641 patients were admitted due to seven different causes in Brazil, which represented a high cost. South region was found to have the highest patient admission rate in most studied causes. The highest prevalences for physical inactivity were observed in North and Northeast regions. The highest inactivity-related share in men was found for osteoporosis in all regions (≈ 35.0%), whereas diabetes was found to have a higher share regarding inactivity in women (33.0% to 37.0% variation in the regions). Ischemic heart diseases accounted for the highest total costs that could be linked to physical inactivity in all regions and for both genders, being followed by cerebrovascular diseases. Approximately 15.0% of inpatient costs from Brazilian Unified Health System were connected to physical inactivity. CONCLUSIONS Physical inactivity significantly impacts the number of patient admissions due to the evaluated causes and through their resulting costs, with different genders and country regions representing different shares.
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Bielemann RM, Xavier MO, Gigante DP. Preferência por comportamentos favoráveis à prática de atividade física e nível de atividade física de crianças de uma cidade do sul do Brasil. Ciênc saúde coletiva 2014; 19:2287-96. [PMID: 25014307 DOI: 10.1590/1413-81232014197.11202013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/08/2013] [Indexed: 11/21/2022] Open
Abstract
O artigo objetiva descrever preferências por comportamentos favoráveis à prática de atividade física (AF) e avaliar sua influência sobre o nível de AF de crianças da cidade de Pelotas, RS. Estudo transversal de base populacional com crianças de 4 a 11 anos. Comportamentos favoráveis à prática de AF foram avaliados pelo Netherlands Physical Activity Questionnaire (NPAQ). O tempo de AF moderada ou vigorosa (AFMV) foi medido por acelerometria. Análise de variância e regressão linear foram usadas para avaliar associações entre as perguntas do NPAQ e variáveis independentes e entre cada comportamento e o tempo de AFMV, respectivamente. Crianças de maior nível econômico gostaram mais de desenhar e preferiram menos brincadeiras agitadas e brincar na rua do que crianças de menor nível econômico. Crianças de maior idade foram menos extrovertidas e gostaram menos de desenhar do que crianças mais novas. Gostar de esportes, ter falta de interesse por desenhar e preferir brincar na rua foram positivamente associados ao tempo diário de AFMV. Algumas das características estudadas mostraram-se associadas a comportamentos favoráveis à prática de AF, sendo a maior influência observada para o nível econômico. Preferências como gostar de esportes influenciaram positivamente o tempo gasto em AFMV.
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