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Castro SS, Bassichetto KC, Lima MG, Cesar CLG, Goldbaum M, Barros MBDA. Impairments and related social inequalities among adults: a population-based study in São Paulo city, Brazil. Cien Saude Colet 2024; 29:e16962022. [PMID: 38655955 DOI: 10.1590/1413-81232024294.16962022] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/23/2023] [Indexed: 04/26/2024] Open
Abstract
The study of the association of social variables with the prevalence of impairments can provide subsidies for more adequate care and health policies for the most needy people by incorporating social aspects. This article aims to estimate the prevalence of diverse types of impairments, the degree of difficulty, limitations, and the need for help they cause and attest whether this prevalence differ by educational attainment in individuals aged 20 years or older. This is a populational cross-sectional study (2015 Health Survey of São Paulo-ISA Capital). Data from 3184 individuals were analyzed via educational attainment as exposure variable and outcome variables related to visual, hearing, intellectual, and mobility impairments. 19.9% of participants had visual, 7.8%, hearing, 2.7%, intellectual, and 7.4%, mobility impairments. Mobility and intellectual impairments limited participants' daily activities the most, 70.3% and 63.3%, respectively; who, thus, needed the most help: 48.9% and 48.5%, respectively. Lower schooling was associated with a higher prevalence of impairments, greater need for help due to visual and intellectual impairments, and greater limitations due to hearing and visual impairments.
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Affiliation(s)
- Shamyr Sulyvan Castro
- Departamento de Fisioterapia, Universidade Federal do Ceará. R. Doutor José Lourenço 816 apto 2101. 60115-281 Fortaleza CE Brasil.
| | | | | | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Universidade de São Paulo. São Paulo SP Brasil
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Ferreira BH, de Aguiar RG, Santos EFDS, Cesar CLG, Goldbaum M, Monteiro CN. Physical activity among older adults with multimorbidity: Evidence from a population-based health survey. PLoS One 2024; 19:e0296460. [PMID: 38166094 PMCID: PMC10760873 DOI: 10.1371/journal.pone.0296460] [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] [Received: 07/13/2023] [Accepted: 12/13/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION The promotion of physical activity has been recognized as an important component in the management and prevention of multimorbidity, a condition that is increasing prevalent worldwide, including in Brazil. However, there is a scarcity of studies exploring the disparity in physical activity levels between individuals with and without multimorbidity. Therefore, the study aimed to estimate the prevalence of multimorbidity and physical activity among older adults, as well as analyze the relationship of a sufficient level of physical activity and multimorbidity, while considering sociodemographic characteristics of residents in São Paulo, Brazil. MATERIALS AND METHODS Data from 1.019 participants aged 60 years or older (59.7% female; mean age 69.7±7.7) were collected from the Health Survey (ISA-Capital, 2015) conducted in the city of São Paulo, Brazil. We defined multimorbidity as the presence of two or more chronic conditions, and for physical activity, classified a sufficient level (≥150 min/week). Prevalence Ratios (PR) with 95% Confidence Intervals (95%CI) were estimated using univariate and multivariate Poisson regression to examine the relationship between multimorbidity and sufficient level of physical activity. RESULTS 67.7% of the participants lived with multimorbidity, while 30.1% had achieved a sufficient level of physical activity. There was a higher prevalence of sufficient level of physical activity among older adults with two (PR = 1.38; 95%CI 1.02-1.88) and four (PR = 1.37; 95%CI 1.00-1.87) chronic conditions. Older adults with multimorbidity who were 70 years or older (PR = 1.77; 95%IC 1.13-2.77), female (PR = 1.65; 95%CI 1.16-2.36), without a partner (PR = 1.43; 95%IC 1.03-1.99), and had a per capita income of 1 to 2.5 (PR = 1.83; 95%IC 1.00-3.33) were more likely to achieve a sufficient level of physical activity compared to their peers without multimorbidity. CONCLUSIONS The study highlights sociodemographic disparities in the sufficient level of physical activity among multimorbidity, suggesting the importance of considering these factors when planning public policies aimed at promoting physical activity.
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Affiliation(s)
- Bruno Holanda Ferreira
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
| | - Ricardo Goes de Aguiar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo (SP), Brazil
| | | | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo (SP), Brazil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
| | - Camila Nascimento Monteiro
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
- Hospital Sírio-Libanês, São Paulo (SP), Brazil
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Santos EFDS, Louvison MCP, Oliveira ECT, Monteiro CN, Barros MBDA, Goldbaum M, Cesar CLG. Analysis of education level in access and use of health care services, ISA-Capital, São Paulo, Brazil, 2003 and 2015. CAD SAUDE PUBLICA 2023; 39:e00249122. [PMID: 37820229 PMCID: PMC10566551 DOI: 10.1590/0102-311xen249122] [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: 12/30/2022] [Revised: 04/03/2023] [Accepted: 06/02/2023] [Indexed: 10/13/2023] Open
Abstract
The great socioeconomic inequality that prevails in Brazil and the existence of a national health system with universal coverage places the need to monitor the evolution and social inequities regarding access to these services. This study aims to analyze the changes in the prevalence of health care use and the extent of social inequality in the demand, use and, access, resolution of health problems, satisfaction, and health care use of Brazilian Unified National Health System (SUS) according to education levels in the population living in the urban area of the Municipality of São Paulo, in 2003 and 2015. We analyzed data from two population-based household health surveys (Health Survey in São Paulo City - ISA-Capital) from 2003 and 2015. Dependent variables related to health care use in the two weeks preceding the survey and due to diseases included demand, access, satisfaction, problem resolution, and the public or private nature of the service. Prevalence was estimated using level of education and prevalence ratios (PR) by the Poisson regression. In the period, the demand for health care, access, resolution, and use of public health care increased from 2003 to 2015. Inequities in public health care use changed from 2003 to 2015 according to level of education. We found no social inequities in health care use in the municipality of São Paulo regarding demand, access, satisfaction, and resolution according to levels of education. Results show progress in the use and resolution of health care services, as well as the strong concentration of the use of SUS by the population with lower education. Results indicate the progress that SUS has made, but also show persistent challenges in the use and access to services.
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Affiliation(s)
| | | | - Elaine Cristina Tôrres Oliveira
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil
- Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brasil
| | | | | | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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Moura RF, Cesar CLG, Goldbaum M, Okamura MN, Antunes JLF. [Factors associated with inequalities in social conditions in the health of elderly white, brown and black people in the city of São Paulo, Brazil]. Cien Saude Colet 2023; 28:897-907. [PMID: 36888872 DOI: 10.1590/1413-81232023283.08582022] [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: 10/21/2021] [Accepted: 09/02/2022] [Indexed: 03/08/2023] Open
Abstract
The scope of this study is to identify determining factors of disparities in social conditions in the health of non-institutionalized elderly people in the city of São Paulo, from the standpoint of self-declaration of skin color. It is a cross-sectional study with a representative sample of 1,017 elderly participants in the "2015 Health Survey of the Municipality of São Paulo". The analysis used crude and adjusted Poisson regression models, reporting the prevalence ratio and 95% confidence intervals as a measure of association between the variables. In the adjusted analysis, brown and black skin color was positively associated with worse schooling, negative self-assessment of health status, health insurance and access to public health services. On the one hand, black skin color was no longer associated with the lowest income, however, it was associated with arterial hypertension. On the other hand, brown skin color was associated with low income, but not with arterial hypertension. Elderly black and brown people had worse health conditions, less access to private health services and socioeconomic resources. These results are compatible with the hypothesis of structural racism in São Paulo's society and may inform social health policies aimed at promoting health and social justice.
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Affiliation(s)
- Roudom Ferreira Moura
- Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Centro de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo. Av. Dr. Enéas Carvalho de Aguiar 188, Cerqueira César. 05403-000 São Paulo SP Brasil.
| | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
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Santos EFDS, Monteiro CN, Vale DB, Louvison M, Goldbaum M, Cesar CLG, Barros MBDA. Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil. Clinics (Sao Paulo) 2023; 78:100160. [PMID: 36681068 PMCID: PMC9868844 DOI: 10.1016/j.clinsp.2022.100160] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level. METHOD This is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. RESULTS The proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003‒2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003‒2015. CONCLUSIONS The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.
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Affiliation(s)
| | | | | | - Marília Louvison
- Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Barata RB, Costa MFFLE, Goldbaum M. The Brazilian congresses of epidemiology. Rev Bras Epidemiol 2022; 25:e220008. [PMID: 35475904 DOI: 10.1590/1980-549720220008] [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: 09/30/2021] [Accepted: 02/01/2022] [Indexed: 11/22/2022] Open
Abstract
This paper deals with the first ten epidemiology conferences held by ABRASCO between 1990 and 2017. OBJECTIVE To provide historical records of these events, highlighting the context in which they were conceived, the chosen themes and their role in the national and international epidemiological landscape, the venues, and the presidents of the different editions. METHODS Data were extracted from printed and electronic proceedings, with some data gaps that could not be filled. RESULTS The numbers and characteristics of different activities are also presented, with emphasis on conferences and roundtables, lectures, panels and debates, and the collaboration of the academic and professional community for coordinated communications and posters outlining a wide range of themes and approaches. This paper keeps record of most of the activities carried out. CONCLUSIONS The authors are aware that the record presented is a pale picture of the real meaning of these meetings in which the development of epidemiology was being built, in an articulation between scholars and health services and as a cooperation between national researchers and our companions and friends who work in foreign institutions all around the world.
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Affiliation(s)
- Rita Barradas Barata
- School of Medical Sciences, Santa Casa de São Paulo, Department of Collective Health - São Paulo (SP), Brazil
| | | | - Moisés Goldbaum
- Medical School of Universidade de São Paulo, Department of Preventive Medicine - São Paulo (SP), Brazil
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Pereira JL, de Castro MA, Leite JMRS, Rogero MM, Sarti FM, César CLG, Goldbaum M, Fisberg RM. Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015. International Journal of Cardiovascular Sciences 2021. [DOI: 10.36660/ijcs.20210076] [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: 11/18/2022] Open
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Guimarães R, Morel CM, Aragão É, Paranhos J, Palácios M, Goldbaum M, Gadelha P, Kropf S. Health Science, Technology and Innovation Policy (ST&I/H): an update for debate. Cien Saude Colet 2021; 26:6105-6116. [PMID: 34910002 DOI: 10.1590/1413-812320212612.18632021] [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: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 11/22/2022] Open
Abstract
The text presents an updated proposal for a Health Science, Technology and Innovation Policy in Brazil, following the huge political turmoil in the country since 2019 and the COVID-19 pandemic since 2020. The proposal is presented in five sections: Scientific Research; Productive Innovation; Health Technology Assessment and Incorporation; Intellectual Property in Health; New challenges posed by the Pandemic. The authors take part in the Advisory Committee in Science, Technology and Innovation of the Brazilian Association of Collective Health.
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Affiliation(s)
- Reinaldo Guimarães
- Núcleo de Bioética e Ética Aplicada, Universidade Federal do Rio de Janeiro (UFRJ). R. Venceslau Brás 71, Campus Praia Vermelha, Botafogo. 22290-140 Rio de Janeiro RJ Brasil.
| | - Carlos Medicis Morel
- Centro de Desenvolvimento Tecnológico em Saúde, Fundação Oswaldo Cruz (Fiocruz). Rio de Janeiro RJ Brasil
| | - Érika Aragão
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | | | - Marisa Palácios
- Núcleo de Bioética e Ética Aplicada, Universidade Federal do Rio de Janeiro (UFRJ). R. Venceslau Brás 71, Campus Praia Vermelha, Botafogo. 22290-140 Rio de Janeiro RJ Brasil.
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
| | - Paulo Gadelha
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Rio de Janeiro RJ Brasil
| | - Simone Kropf
- Casa de Oswaldo Cruz. Fiocruz. Rio de Janeiro RJ Brasil
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Figueiredo TKF, Aguiar RGD, Florindo AA, Alves MCGP, Barros MBDA, Goldbaum M, Ferrari G, Fisberg RM, Cesar CLG. Changes in total physical activity, leisure and commuting in the largest city in Latin America, 2003-2015. Rev Bras Epidemiol 2021; 24:e210030. [PMID: 34076092 DOI: 10.1590/1980-549720210030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/22/2021] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To analyze the prevalence of physical inactivity and the average time of practice of total physical activity and by domains (leisure and commuting), according to gender, age group and schooling, between 2003 and 2015, in residents of the urban area of the city of São Paulo. METHODS Data from Household Health Surveys in the Municipality of São Paulo (2003: n = 2,514; 2015: n = 4,043). The International Physical Activity Questionnaire was used to measure total, leisure, and commuting physical activity. Results were presented in < 10 minute/week periods, physical inactivity and minutes/week, according to evaluation period, sex, age and schooling. RESULTS Prevalence of < 10 minutes/week periods in 2003 and 2015 were: 22.5 and 28.9% for the total; 56.7 and 58.3% for leisure; and 35.2 and 39.9% for commuting, with significant change only in the total item, among adolescents (10.3 to 18.8%). For physical inactivity, prevalence rates were: 54.9 and 61.6% (total); 78.2 and 78.9% (leisure); and 72 and 79.9% (commuting), with significant changes only for commuting among adults (67.8 to 77.4%). For the average in minutes per week, in total, there was a significant decrease for female adolescents (138.2 minute/week) and adults with 0-8 (122.6 minutes/week) and 9-11 years (96.7 minutes/week) years of schooling; in commuting, there was a reduction for female adolescents (95 minutes/week); and male adults (95 minutes/week) and female adults (82 minutes/week). CONCLUSIONS There were no reductions in the prevalence of < 10 min/week periods or leisure physical inactivity. Commuting physical inactivity has become even more common.
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Affiliation(s)
| | | | - Alex Antonio Florindo
- School of Arts, Sciences and Humanities, Universidade de São Paulo - São Paulo (SP), Brazil
| | | | | | - Moisés Goldbaum
- Medical School, Universidade de São Paulo - São Paulo (SP), Brazil
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile - Santiago, Chile
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Garcez MR, de Castro MA, César CLG, Goldbaum M, Fisberg RM. A chrononutrition perspective of diet quality and eating behaviors of Brazilian adolescents in associated with sleep duration. Chronobiol Int 2021; 38:387-399. [PMID: 33441036 DOI: 10.1080/07420528.2020.1851704] [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] [Indexed: 10/22/2022]
Abstract
It is well recognized that sleep and food intake exhibit 24-h patterns and disturbances of these patterns can lead to health problems. Cross-sectional and prospective studies suggest that diet quality and eating behaviors are negatively affected by short sleep duration. Adolescence is a particularly vulnerable period for the emergence of inadequate sleep and diet patterns. The aim of the study was to investigate associations, from a chrononutrition perspective, of diet quality, nutrients intake, and eating behaviors (eating frequency, eating period, and time-interval between eating occasions) in relation to sleep duration among a multi-ethnic cohort of Brazilian adolescents. Data were collected by the 2015 ISA-Capital survey, a population-based cross-sectional study comprising 419 adolescents of both sexes (12-19 years old) of São Paulo, Brazil. Demographic, socioeconomic, anthropometric, and lifestyle, including sleep duration, data were obtained from an interviewer-administered structured questionnaire. Dietary data were obtained by 24-h dietary recall (24-HDR), and diet quality was assessed by the Brazilian Healthy Eating Index - Revised (BHEI-R), validated for the Brazilian population. The independent associations between sleep duration categories (i.e., <8 h as short sleep and 8-10 h as adequate sleep), and dietary variables were assessed after adjustments for covariates. Multiple linear, logistic, and Poison regression models were used, depending on the variable. Diet quality, nutrients intake, and eating behaviors differed according to adolescents' sleep duration. Approximately 36% of adolescents were sleep deprived. They presented poorer diet quality (53 points, p = .034) and eating behaviors characterized by lower probability of having lunch (88%, p < .001) and dinner (71%, p < .001) and higher probabilities of eating breakfast (87%, p < .001) and morning snack (26%, p = .001). These adolescents compared to those with adequate sleep duration also had, from snacks and in the 24-h cycle, higher contribution of available carbohydrates (8%, p < .001; 50%, p = .024) and total sugar (6%, p < .001; 21%, p < .001) and added sugar (3%, p < .001; 15%, p < .001). The chrononutrition characteristics of sleep-deprived adolescents were marked by longer eating periods (12 h, p < .001) and time-interval between eating occasions (3 h, p < .001) than adolescents with adequate sleep duration. These differences point to the relevance of the interrelation between sleep and diet, i.e., disruption of circadian cycles and consequent metabolic health problems, to inform public health policies and clinical interventions.
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Affiliation(s)
| | | | | | - Moisés Goldbaum
- Department of Preventive Medicine, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Monteiro CN, Santos FTC, Costa KS, Barros MBDA, Cesar CLG, Goldbaum M. Use of medicines in São Paulo, Brazil, and State Health Care Coverage, 2003 and 2015. Clinics (Sao Paulo) 2021; 76:e2781. [PMID: 34287478 PMCID: PMC8266172 DOI: 10.6061/clinics/2021/e2781] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/31/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To analyze the use and acquisition of medicines in São Paulo, Brazil, in 2003 and 2015, according to sociodemographic factors, socioeconomic status, and health conditions of the population. METHODS Data were obtained from population health surveys "ISA-Capital". Descriptive analysis, bivariate analysis, and logistic regression models were used to evaluate the use of medicines and coverage by the Brazilian Unified Health System (SUS) according to socioeconomic status and health conditions in two periods: 2003 and 2015. RESULTS From 2003 to 2015, the surveys showed an increase in the income and education level of the study population. There was no increase in the prevalence of chronic diseases and use of medicines from 2003 to 2015. The provision of medicines by SUS was higher in 2015 than in 2003, and the coverage by SUS was higher in the population with lower education level and income in both 2003 and 2015. CONCLUSIONS The use of medicines, mainly for chronic disease control, did not change over the years, and there was an increase in SUS coverage for medicines during 2003-2015 in all population groups, with a greater impact on the lower socioeconomic status population. The programs of the provision of medicines implanted since 2003 had influenced the greater SUS coverage for medicines and in the reduction of inequalities in access to medicines.
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Affiliation(s)
- Camila Nascimento Monteiro
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Nucleo de Indicadores e Sistemas de Informacao, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | | | - Karen Sarmento Costa
- Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, BR
| | | | | | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Okamura MN, Goldbaum M, Madeira W, Cesar CLG. Prevalence of headache and associated factors among adolescents: results of a population-based study. Rev Bras Epidemiol 2020; 23:e200067. [PMID: 32667464 DOI: 10.1590/1980-549720200067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/25/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Cephalalgia is one of the most common somatic complaints related to health problems in childhood and adolescence. OBJECTIVE To measure the cephalalgia prevalence in adolescents from the city of São Paulo, Brazil, and associated factors. METHODS This is a cross-sectional population-based study, carried out in 2015, with 539 adolescents of both sexes, aged between 15 and 19 years. The information was collected in a household survey, and the participants were selected from probabilistic sampling. Frequencies, χ2 test and logistic regression analysis were used in the study, and significance level was 5%. RESULTS the estimated prevalence of cephalalgia was 38.2% (95%CI 33.8 - 42.7), and 7.8% (95%CI 5.6 - 10.7), migraine. The associated factors for cephalalgia were: female sex (OR = 2.2; 95%CI 1.4 - 3.4), Common Mental Disorder (OR = 2.8; 95%CI 1.7 - 4.9), vision impairment (OR = 2.6; 95%CI 1.6 - 4.2), besides back pain (OR = 2.2; 95%CI 1.3 - 3.5), sinusitis (OR = 2.0; 95%CI 1.2 - 3.4) and incomplete elementary education (OR = 3.0; 95%CI 1.6 - 5.6). CONCLUSION The prevalence of headache among adolescents in the city of São Paulo represented more than 1/3 (one third) of this population. The main associated factors were sex, low schooling and the following comorbidities: common mental disorder and vision impairment.
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Affiliation(s)
- Mirna Namie Okamura
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Dos Santos GDBV, Goldbaum M, César CLG, Gianini RJ. Care seeking behavior of people with common mental disorders in São Paulo-Brazil. Int J Ment Health Syst 2020; 14:36. [PMID: 32489421 PMCID: PMC7247186 DOI: 10.1186/s13033-020-00369-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mental health in developing countries is a keen area for improvements. Epidemiological research in this field helps to reinforce information, generate hypothesis and guide police makers. This study intends to analyze patterns of care seeking among cases of common mental disorders (CMD) in São Paulo city in 2015. Methods The data is from the population-based survey ISA-Capital 2015 and the screening for common mental disorders follows the Self-reporting questionnaire (SRQ-20). The study analyses care seeking according to sociodemographic and health conditions. Results The prevalence of CMD was 19.7% (95% CI 18.2–21.4%). There was a higher prevalence of CMD among who sought care in last 30 days (25.4%). Among CMD cases, care seeking presented significant different prevalence ratio (PR) for: women (PR 1.13; 95% CI 1.05–1.2); age 60 years or more (PR 1.13; 95% CI 1.05–1.22) and 30–44 years (PR 1.10; 95% CI 1.01–1.2); brown skin (PR 0.92; 95% CI 0.86–0.97); single or divorced (PR 0.93; 95% CI 0.89–0.99); unemployed (PR 1.06; 95% CI 1.01–1.12); last 15 days referred morbidity (PR 1.3; 95% CI 1.2–1.34); physical disability (PR 1.11; 95% CI 1.06–1.18); and chronic disease (PR 1.15; 95% CI 1.07–1.24). Conclusion Identifying vulnerable groups and developing proper public health actions is important to promote equity accessibility. Analysing care seeking behavior among people with CMD is a strong contribution.
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Affiliation(s)
| | - Moisés Goldbaum
- Department of Preventive Medicine, University of São Paulo, Medicine School, São Paulo, Brazil
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Fontes AS, Pallottini AC, Vieira DADS, Fontanelli MDM, Marchioni DM, Cesar CLG, Alves MCGP, Goldbaum M, Fisberg RM. Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study. Rev bras epidemiol 2020; 23:e200003. [DOI: 10.1590/1980-549720200003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT: Introduction: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. Objective: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. Methods: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. Results: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. Conclusion: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.
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Fiório CE, Cesar CLG, Alves MCGP, Goldbaum M. Prevalência de hipertensão arterial em adultos no município de São Paulo e fatores associados. Rev bras epidemiol 2020; 23:e200052. [DOI: 10.1590/1980-549720200052] [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: 10/16/2018] [Accepted: 04/09/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Analisar o comportamento da prevalência de hipertensão arterial no município de São Paulo e seus fatores associados. Métodos: O presente trabalho utilizou os dados do Inquérito de Saúde no Município de São Paulo (ISA Capital), estudo transversal de base populacional executado no município de São Paulo. Foram utilizados dados de 1.667 e de 3.184 indivíduos em 2003 e 2015, respectivamente, com idade de 20 anos e mais. Fizeram-se análises descritivas das prevalências de hipertensão arterial com respectivos intervalos de 95% de confiança. Análises simples e múltiplas foram realizadas para analisar possíveis associações com as variáveis socioeconômicas, demográficas e de estilo de vida por meio de regressão de Poisson. Resultados: A prevalência de hipertensão arterial passou de 17,2% em 2003 para 23,2% em 2015. Os fatores associados à hipertensão foram: sexo feminino; idade (60 anos e mais); situação conjugal (casados, separados e viúvos); ter religião; baixa escolaridade; ter nascido no estado de São Paulo (exceto capital); estado nutricional (baixo peso, sobrepeso e obesidade); e ex-fumantes. Conclusão: A prevalência de hipertensão autorreferida aumentou significativamente no período estudado em São Paulo. Considerando o impacto dessa doença na sociedade, conhecendo sua atual prevalência e identificando seus principais fatores associados, evidencia-se a necessidade de intensificar atividades que contribuam para a prevenção desse agravo, atenuando os danos aos indivíduos e gastos públicos.
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Rocha BMC, Goldbaum M, César CLG, Stopa SR. Sedentary behavior in the city of São Paulo, Brazil: ISA-Capital 2015. Rev Bras Epidemiol 2019; 22:e190050. [PMID: 31460665 DOI: 10.1590/1980-549720190050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 07/12/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The excessive sitting time involved in activities of low energy expenditure (sedentary behavior) can contribute to the development of chronic diseases. Assessing factors related to this behavior in a population is important to identify its most vulnerable segments. OBJECTIVE To describe sitting time distribution in the adult population of São Paulo City according to sociodemographic and environmental characteristics and health conditions. METHODS This is a cross-sectional study involving 2,512 individuals, aged 20 to 65 years, who participated in the Health Survey in the City of São Paulo (Inquérito de Saúde no Município de São Paulo - ISA-Capital) 2015. Data relating to sitting time were collected using the International Physical Activity Questionnaire (IPAQ), initially analyzed continuously, and, afterward, dichotomized by the median to analyze categorical variables. RESULTS The total sitting time median in the sample was 180 min/day. The variables that, after adjustments, remained related to sedentary behavior were: schooling (prevalence ratio - PR = 1.41; 95% confidence interval - 95%CI 1.35 - 1.48); marital status (PR = 1.05; 95%CI 1.02 - 1.08); neighborhood safety (PR = 0.96; 95%CI 0.93 - 0.99); age (PR = 0.91; 95%CI 0.87 - 0.95); income (PR = 1.07; 95%CI 1.00 - 1.15); self-rated health (PR = 1.03; 95%CI 1.01 - 1.07), and gender (PR = 0.96; 95%CI 0.94 - 0.99). CONCLUSION The most vulnerable groups to sedentary behavior in this population are: younger males, with higher schooling and income, who live in neighborhoods considered safe, unmarried, and with negative self-rated health.
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Affiliation(s)
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Chester Luiz Galvão César
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Sheila Rizzato Stopa
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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Goldbaum M, Antunes JLF, Camargo Júnior KR. [The relevance of Public Health Journals in informing research, education, health services, and citizenship]. Cien Saude Colet 2019; 26:1401-1405. [PMID: 33886768 DOI: 10.1590/1413-81232021264.33992018] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 07/14/2019] [Indexed: 11/22/2022] Open
Abstract
This text presents in a synthetic manner the discussions of the working group of the same name, held during the international conference commemorating the twenty years of the SciELO Program. The objective is to inform the Public Health professional field about chronic problems affecting scientific periodicals in Brazil - financing, classification of journals, the impact of published works, among others.
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Affiliation(s)
- Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo (USP). Av. Dr. Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
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Stopa SR, Cesar CLG, Alves MCGP, Barros MBDA, Goldbaum M. Uso de serviços de saúde para controle da hipertensão arterial e do diabetes mellitus no município de São Paulo. Rev bras epidemiol 2019; 22:e190057. [DOI: 10.1590/1980-549720190057] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 10/05/2018] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Descrever as prevalências do uso de serviços de saúde para controle da hipertensão arterial (HA) e do diabetes mellitus (DM) no município de São Paulo nos anos de 2003, 2008 e 2015 e analisar os fatores associados a esse uso no ano de 2015. Métodos: Foram analisados dados de população adulta provenientes dos inquéritos de saúde no município de São Paulo em 2003, 2008 e 2015. Foram estimadas as prevalências e seus intervalos de confiança de 95% nos 3 anos para descrever as prevalências do uso de serviços de saúde para controle da HA e do DM. Para 2015, foram estimadas as prevalências para as mesmas variáveis segundo características sociodemográficas, geográficas e de saúde. Utilizou-se regressão logística multinomial para estimar modelos de análise para HA e DM. Resultados: Observou-se aumento significativo no percentual de pessoas que referiram ir ao serviço de saúde de rotina por causa da HA e do DM no período 2003 a 2015. Em 2015, maior uso de serviços de saúde de rotina para controle da HA foi observado entre os idosos e as pessoas que referiram possuir plano de saúde. No caso do DM, houve associação entre o uso de serviços e baixa escolaridade. Ser idoso diminui o risco de não ir ao serviço de saúde para o controle da HA, enquanto ser do sexo masculino e não possuir plano de saúde aumentam esse risco significativamente. Conclusões: Identificar como os indivíduos com HA e DM utilizam os serviços de saúde para controle das doenças é de extrema relevância para reduzir barreiras no acesso e, ainda, orientar políticas de saúde no intuito de reduzir desigualdades.
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Pereira JL, Vieira DADS, Alves MCGP, César CLG, Goldbaum M, Fisberg RM. Excess body weight in the city of São Paulo: panorama from 2003 to 2015, associated factors and projection for the next years. BMC Public Health 2018; 18:1332. [PMID: 30509223 PMCID: PMC6276135 DOI: 10.1186/s12889-018-6225-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 11/16/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Excess body weight (EBW: overweight and obesity) has high and rising prevalence in Brazil. Up-to-date information about the distribution and changes in the prevalence of EBW and their associated factors are essential to determine target groups and to identify priority actions. The aim of this study was to investigate the associated factors and to determine the prevalence of overweight and obesity in the adolescent and adult population of the city of São Paulo in the years of 2003, 2008, and 2015, as well as to estimate the prediction for the next years. METHODS Individuals aged 12 years and older from three editions of the Health Survey of São Paulo (ISA-Capital), a cross-sectional population-based survey, carried out in 2003 (n = 2144), 2008 (n = 2599), and 2015 (n = 3939), had their socioeconomic, anthropometric, and lifestyle data collected at households. Individuals were classified according to their age and BMI as: without excess body weight, overweight, or obese. Differences were evaluated through Pearson's Chi-square test and comparison of 95% CI. Generalized ordered logit models were used to evaluate factors associated to overweight/obesity and logistic regression models were used to predict their prevalence for the next years. RESULTS The prevalence (95% CI) of obesity in total population doubled: from 10% (8.0, 12.5) in 2003 to 19.2% (17.8, 20.6) in 2015. The main increase occurred in female adolescents from 2.5% (1.2, 5.3) to 11.2% (8.4, 14.7) and adults, from 9.2% (6.4, 13.1) to 22.3% (20.0, 24.8). Those with higher chance of having EBW were adults, those with higher income, and former smokers. The prevalence of EBW increased 31% from 2003 to 2008, and 126% from 2003 to 2015, when half of the population had EBW. If this pattern does not change, 77% of the population is expected to have EBW by 2030. CONCLUSIONS Our findings present up-to-date information about the distribution of EBW, which increased substantially over a short time and more prominently in specific groups. The factors associated with EBW may provide important information for decision makers and researchers to create or review the existing programs and interventions in order to decrease the trend for the next years.
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Affiliation(s)
- Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Moisés Goldbaum
- Department of Preventive Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Fontanelli MDM, Nogueira LR, Garcez MR, Sales CH, Corrente JE, César CLG, Goldbaum M, Fisberg RM. [Validity of self-reported high cholesterol in the city of São Paulo, Brazil, and factors associated with this information's sensitivity]. CAD SAUDE PUBLICA 2018; 34:e00034718. [PMID: 30517313 DOI: 10.1590/0102-311x00034718] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Abstract
The study aimed to validate self-report of high cholesterol in São Paulo, Brazil, and verify factors associated with this information's sensitivity. Data were used from the Health Survey of the City of São Paulo 2015, a cross-sectional population-based study with a probabilistic sample of the city's residents. The sample included 886 individuals with information from the structured questionnaire, blood measurements of total cholesterol and fractions or who reported being on medication for high cholesterol. The validity of self-reported information on high cholesterol was measured according to sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa index, considering total cholesterol and LDL-c and pharmacological treatment as the gold standard. Logistic regression models were developed to investigate factors associated with the sensitivity of this information. The sensitivity of information on high cholesterol using total cholesterol as the reference was 50.6%, specificity 90.19%, PPV 51.64%, NPV 89.82%, and kappa 0.41. Taking LDL-c as the gold standard, sensitivity was 53.52%, specificity 89.93%, PPV 49.22%, NPV 91.39%, and kappa 0.43. Using total cholesterol as the reference, age (OR = 1.69; 95%CI: 1.24-2.29) and having a private health plan (OR = 2.91; 95%CI: 1.06-7.99) were associated with the information's sensitivity. With LDL-c as the gold standard, age (OR = 1.71; 95%CI: 1.13-2.57), smoking (OR = 3.33; 95%CI: 1.08-10.27), and having a private health plan (OR = 3.64; 95%CI: 1.10-12.08) were associated with the information's sensitivity. The results suggest low sensitivity and low PPV of self-reported high cholesterol in residents of São Paulo.
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Affiliation(s)
| | | | | | | | | | | | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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Estancial Fernandes CS, de Azevedo RCS, Goldbaum M, Barros MBDA. Psychotropic use patterns: Are there differences between men and women? PLoS One 2018; 13:e0207921. [PMID: 30475871 PMCID: PMC6257918 DOI: 10.1371/journal.pone.0207921] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 11/08/2018] [Indexed: 01/08/2023] Open
Abstract
This study analyzed differences between men and women regarding the use of psychotropic drugs and associated factors in a population of adults and seniors in the city of Campinas, Brazil. A population-based, cross-sectional study was conducted using data from the ISACamp 2014/2015 health survey in the city of Campinas. The sample was composed of 1999 individuals aged 20 years or older. For each sex, prevalence rates and prevalence ratios were estimated for the use of psychotropic drugs according to demographic characteristics, socioeconomic characteristics, health problems, degree of limitation and type of emotional/mental problem. The most used classes of medications were also determined. The prevalence of the use of psychotropic drugs was 11.7% (7.3% among men and 15.8% among women). The most common therapeutic classes were antidepressants (38.2%) and benzodiazepines (24.0%). The frequency of antidepressant use was higher among women (44.3%) than men (25.5%). Regarding associated factors, reports of emotional/mental problems were associated with the greater use of this type of drug in both sexes. Among the men, white skin color, a lack of an occupational activity, a greater number of complaints of health problems and the occurrence of insomnia were associated with the use psychotropic drugs. Among the women, a significant increase in the use of these drugs was found with the increase in age and higher prevalence rates were found among those with a higher level of schooling, those with a greater number of diagnosed chronic diseases and those with a common mental disorder. The present results confirm the greater use of psychotropic agents, especially antidepressants, in the female sex and reveal that the pattern of associated factors differs between sexes. It is therefore necessary to understand the peculiarities of each sex that exert an influence on the perception of health problems and the desire to seek care, which, in turn, affect the use of psychotropic agents.
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Affiliation(s)
| | - Renata Cruz Soares de Azevedo
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, State University of Campinas, Campinas, Sao Paulo, Brazil
| | - Moisés Goldbaum
- Department of Preventive Medicine, Medical School, University of Sao Paulo, Sao Paulo, Brazil
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Affiliation(s)
| | - Moisés Goldbaum
- Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil
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Stopa SR, Cesar CLG, Segri NJ, Alves MCGP, Barros MBDA, Goldbaum M. [Prevalence of arterial hypertension, diabetes mellitus, and adherence to behavioral measures in the city of São Paulo, Brazil, 2003-2015]. CAD SAUDE PUBLICA 2018; 34:e00198717. [PMID: 30365748 DOI: 10.1590/0102-311x00198717] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 06/14/2018] [Indexed: 11/22/2022] Open
Abstract
The objective was to compare the estimates for prevalence of diabetes, hypertension, and behavioral measures to control these diseases. Data were analyzed for the adult population from Health Surveys in the city of São Paulo, Brazil, in 2003, 2008, and 2015. Prevalence rates and 95% confidence intervals (95%CI) were calculated for the following: hypertension, diabetes, and practices to control these diseases (diet, physical activity, oral medication, insulin, nothing). Estimates were compared by age and sex-adjusted Poisson regression and analyzed according to the 20-59-years and 60-and-older age brackets. The data were presented comparing 2008 to 2003 and 2015 to 2003. Among persons 20 to 59 years of age, there was an increase in the prevalence rates for: hypertension in 2003-2015 (PR = 1.27; 95%CI: 1.03-1.60) and diet for both periods (2003-2008, PR = 2.04; 95%CI: 1.42-2.91; and 2003-2015, PR = 1.51; 95%CI: 1.05-2.15). Among persons 60 years and older: diabetes (PR = 1.29; 95%CI: 1.08-1.56) and oral medication to control diabetes (PR = 1.38; 95%CI: 1.17-1.63), both in 2003-2015; hypertension in 2003-2015 (PR = 1.19; 95%CI:1.05-1.39); and diet and oral medication to control hypertension in 2003-2008 (PR = 1.20; 95%CI: 0.95-1.51 and PR = 1.02; 95%CI: 0.95-1.09, respectively). The results are important for surveillance and monitoring of the target indicators and provide backing for planning health care activities in the city of São Paulo. Linking and aligning effective and integrated interventions is indispensable for reducing and controlling these chronic noncommunicable diseases.
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Affiliation(s)
| | | | | | | | | | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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Ribeiro MKP, Gianini RJ, Goldbaum M, Cesar CLG. Equidade na cobertura dos gastos com saúde pelo Sistema Único de Saúde de pessoas com indicativos de transtornos mentais comuns no município de São Paulo. Rev bras epidemiol 2018; 21:e180011. [DOI: 10.1590/1980-549720180011] [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: 01/20/2017] [Accepted: 02/05/2018] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Introdução: O objetivo deste trabalho foi verificar a equidade na cobertura/complementação dos gastos com saúde pelo Sistema Único de Saúde (SUS) de pessoas com indicativos de transtornos mentais comuns (TMC), no ano de 2008, no município de São Paulo. Métodos: Foi realizado um estudo de corte transversal a partir dos dados do Inquérito de Saúde no Município de São Paulo de 2008 (ISA-Capital 2008). Os sujeitos incluídos na pesquisa tinham 16 anos de idade ou mais e indicativos de TMC, avaliados por meio do instrumento Self-Reporting Questionnaire (SRQ-20). Foram analisados: a procura pelo SUS, a cobertura dos gastos com saúde pelo SUS e os gastos com saúde no último mês, correlacionando-os com aspectos sociodemográficos e de condições de saúde. Resultados: A procura pelo SUS foi menor entre as pessoas de cor branca, renda per capita elevada, com união estável e Ensino Superior. A cobertura pelo SUS foi menor entre as faixas etárias de 45 a 59 anos e de 60 anos ou mais, com renda per capita elevada, Ensino Médio ou Técnico e Ensino Superior. As pessoas que gastaram mais com a saúde da família foram aquelas com idade igual ou superior a 60 anos, de cor branca, renda per capita mais elevada, com união estável e Ensino Superior. Conclusões: Foi observado que o SUS atende e cobre os gastos majoritariamente daqueles com renda per capita e escolaridade mais baixas, denotando uma cobertura desigual que favorece os mais necessitados. Porém, considerando o fator idade, ficou explícita uma situação de iniquidade, pois foi constatada maior cobertura dos gastos em saúde pelo SUS para a população mais jovem.
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Mello AVD, Sarti FM, Pereira JL, Goldbaum M, Cesar CLG, Alves MCGP, Fisberg RM. Determinants of inequalities in the quality of Brazilian diet: trends in 12-year population-based study (2003-2015). Int J Equity Health 2018; 17:72. [PMID: 29879999 PMCID: PMC5992855 DOI: 10.1186/s12939-018-0784-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/28/2018] [Indexed: 11/30/2022] Open
Abstract
Background Recent studies have explored the influence of socioeconomic inequalities on the diet quality. However, there is lack of evidence regarding the level of inequalities in dietary quality and its main contributing factors from population-based follow-up studies. The primary objective of this study was to investigate the level and the determinants of inequalities in diet quality in a representative sample of adolescents, adults and older adults resident in São Paulo, Brazil. Methods Data from the Health Survey of São Paulo (ISA-Capital) were analyzed for 2003 (n = 2398), 2008 (n = 1662) and 2015 (n = 1742) surveys. Information on food consumption was obtained through 24-h dietary recall, and diet quality was assessed based on the Revised Brazilian Healthy Eating Index (BHEI-R). The descriptive variables were compared using 95% confidence interval. The scores of BHEI-R and its components were compared across age groups and year. The association between socioeconomic inequalities and diet quality was based on the estimation of concentration index. Results We observed that the BHEI-R scores gradually improved over 12-years, with older adults showing the greatest improvement. The increase in overall population score was observed for total fruits, whole fruits, whole grains, oils and sodium. The main contributor to socioeconomic inequality in diet quality in 2003 was ethnic group, and in 2008 and 2015, it was per capita household income; age was a persistent factor of inequality in the population over the years. Concentration indices indicated that lower income individuals had higher BHEI-R scores in 2003; however, there was a shift in favor of higher income individuals in 2008 and 2015. Conclusions Changes in the patterns of determination of inequalities according to age, ethnic group or income during the period analyzed show the existence of ongoing process of contribution of demographic and socioeconomic factors in the diet quality of individuals in a large urban center.
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Affiliation(s)
- Aline Veroneze de Mello
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Moisés Goldbaum
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715 - Cerqueira Cesar, São Paulo, SP, 01246-904, Brazil.
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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Monteiro CN, Gianini RJ, Stopa SR, Segri NJ, Barros MBDA, Cesar CLG, Goldbaum M. Cobertura vacinal e utilização do SUS para vacinação contra gripe e pneumonia em adultos e idosos com diabetes autorreferida, no município de São Paulo, 2003, 2008 e 2015*. Epidemiologia e Serviços de Saúde 2018; 27:e2017272. [DOI: 10.5123/s1679-49742018000200006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/22/2018] [Indexed: 11/02/2022] Open
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Costa KS, Goldbaum M, Guayta-Escolies R, Modamio P, Mariño EL, Tolsá JLS. Coordinación entre servicios farmacéuticos para una farmacoterapia integrada: el caso de Cataluña. Ciênc saúde coletiva 2017; 22:2595-2608. [DOI: 10.1590/1413-81232017228.02232017] [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: 10/26/2016] [Accepted: 05/15/2017] [Indexed: 11/22/2022] Open
Abstract
Resumen Las políticas farmacéuticas han sido consideradas como estratégicas para contribuir con la garantía de la coordinación asistencial y la integración clínica. El presente estudio tiene como objetivo describir los servicios farmacéuticos desarrollados en diferentes niveles asistenciales en la red de salud de Cataluña, así como identificar y analizar los mecanismos e instrumentos que actúan como facilitadores y/o barreras para la coordinación de la farmacoterapia. Se trata de un estudio descriptivo de 12 casos de los servicios farmacéuticos hospitalarios, atención primaria y oficinas de farmacia comunitarias. Se identifica avances que relacionan la percepción, formalización y la coordinación asistencial y clínica de los servicios farmacéuticos. Sin embargo, se identifican también fragilidades y situaciones mejorables en cuanto a la coordinación. Se concluyó que las diferentes herramientas e instrumentos implantados, parece facilitar una mayor posibilidad de integración entre servicios farmacéuticos y de éstos con la red de salud para contribuir con una farmacoterapia integrada.
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29
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Costa DF, Goldbaum M. Contaminação química, precarização, adoecimento e morte no trabalho: benzeno no Brasil. Ciênc saúde coletiva 2017; 22:2681-2692. [DOI: 10.1590/1413-81232017228.31042016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 02/20/2017] [Indexed: 11/22/2022] Open
Abstract
Resumo A toxicidade do benzeno é conhecida e os tipos de doenças a ele ligadas vêm se ampliando. Foi recuperada a trajetória e as descobertas relacionadas às doenças combinadas com o deslocamento das atividades dos países centrais para os periféricos. Neste processo há correlações na prevenção da exposição ao benzeno. No Brasil foram analisadas as aplicações das regulações para identificar seu impacto, pois as informações sobre contaminação ambiental e doenças é bastante precária. Prevaleceram legislações formais sem registro de sua aplicação. Somente quando houve mobilização de trabalhadores e técnicos ocorreram avanços.
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30
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Stopa SR, Malta DC, Monteiro CN, Szwarcwald CL, Goldbaum M, Cesar CLG. Use of and access to health services in Brazil, 2013 National Health Survey. Rev Saude Publica 2017; 51:3s. [PMID: 28591351 PMCID: PMC5676359 DOI: 10.1590/s1518-8787.2017051000074] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [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: 06/14/2016] [Accepted: 09/01/2016] [Indexed: 11/13/2023] Open
Abstract
OBJECTIVE To analyze the use of health services in the Brazilian population by sociodemographic factors, according to data from the 2013 Brazilian National Health Survey. METHODS The study analyzed data from 205,000 Brazilian citizens in all age groups who participated in the Brazilian National Health Survey, a cross-sectional study carried out in 2013. Prevalence and confidence intervals were estimated for indicators related to access to and use of health services according to age group, level of education of head of household, and Brazilian macroregions. RESULTS Among individuals who sought health services in the two weeks prior to the survey, 95.3% (95%CI 94.9-95.8) received care in their first visit. Percentages were higher in the following groups: 60 years of age and over; head of household with complete tertiary education; living in the South and Southeast regions. In addition, 82.5% (95%CI 81.2-83.7) of individuals who received health care and prescriptions were able to obtain all the necessary medicines, 1/3 of them from SUS. Less than half the Brazilian population (44.4%; 95%CI 43.8-45.1) visited a dentist in the 12 months prior to the survey, with smaller percentages among the following groups: 60 years of age or older; head of household with no education or up to incomplete elementary; living in the North region of Brazil. CONCLUSIONS People living in the South and Southeast regions still have greater access to health services, as do those whose head of household has a higher level of education. The (re)formulation of health policies to reduce disparities should consider differences encountered between regions and social levels. OBJETIVO Descrever o uso de serviços de saúde na população brasileira segundo fatores sociodemográficos, de acordo com dados da Pesquisa Nacional de Saúde, 2013. MÉTODOS Foram analisados dados referentes a 205 mil brasileiros, de todas as faixas etárias, que participaram da Pesquisa Nacional de Saúde, estudo transversal conduzido em 2013. Calcularam-se as prevalências e seus intervalos de confiança para indicadores referentes ao acesso e a utilização dos serviços de saúde, segundo grupos de idade, nível de instrução do chefe da família e macrorregiões do país. RESULTADOS Dentre os indivíduos que procuraram o serviço de saúde nas duas semanas prévias à pesquisa, 95,3% (IC95% 94,9-95,8) conseguiu usá-lo na primeira vez que procurou. As proporções foram maiores: no grupo de 60 anos ou mais; cujo chefe da família tinha nível superior completo; e nas regiões Sul e Sudeste. Ainda, dos indivíduos atendidos e que tiveram medicamentos receitados, 82,5% (IC95% 81,2-83,7) conseguiram obter todos os medicamentos, sendo 1/3 pelo SUS. Menos da metade da população brasileira (44,4%; IC95% 43,8-45,1) consultou um dentista nos 12 meses anteriores à pesquisa, com proporções menores entre: indivíduos com 60 anos ou mais; cujo chefe da família não possuía nível de instrução ou tinha até o fundamental incompleto; e indivíduos que residiam na região Norte do país. CONCLUSÕES Pessoas que residem nas regiões Sul e Sudeste ainda possuem maior acesso aos serviços de saúde, bem como aquelas cujo chefe da família tem maior nível de instrução. A (re)formulação de políticas de saúde no intuito de reduzir disparidades deve considerar as diferenças regionais e entre níveis sociais encontradas.
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Affiliation(s)
- Sheila Rizzato Stopa
- Programa de Pós-Graduação em Saúde Pública. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública. Escola de Enfermagem. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
| | - Camila Nascimento Monteiro
- Núcleo de Indicadores e Sistemas de Informação. Hospital Israelita Albert Einstein. São Paulo, SP, Brasil
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
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31
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Affiliation(s)
- Euclides Ayres de Castilho
- Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
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32
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Florindo AA, Barrozo LV, Cabral-Miranda W, Rodrigues EQ, Turrell G, Goldbaum M, Cesar CLG, Giles-Corti B. Public Open Spaces and Leisure-Time Walking in Brazilian Adults. Int J Environ Res Public Health 2017; 14:ijerph14060553. [PMID: 28545242 PMCID: PMC5486239 DOI: 10.3390/ijerph14060553] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 12/04/2022]
Abstract
Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults’ residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants’ homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09–2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.
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Affiliation(s)
- Alex Antonio Florindo
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo 03828-000, Brazil.
- Graduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil.
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of Sao Paulo, Sao Paulo 05508-080, Brazil.
| | - William Cabral-Miranda
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of Sao Paulo, Sao Paulo 05508-080, Brazil.
| | - Eduardo Quieroti Rodrigues
- Graduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil.
| | - Gavin Turrell
- Institute for Health and Ageing, Australian Catholic University, Melbourne 3065, Australia.
| | - Moisés Goldbaum
- Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paulo 01246-903, Brazil.
| | - Chester Luiz Galvão Cesar
- Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil.
| | - Billie Giles-Corti
- Centre for Urban Research, Royal Melbourne Institute of Technology University, Melbourne 3000, Australia.
- Adjunct, School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia.
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33
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Monteiro CN, Beenackers MA, Goldbaum M, Barros MBDA, Gianini RJ, Cesar CLG, Mackenbach JP. Use, access, and equity in health care services in São Paulo, Brazil. CAD SAUDE PUBLICA 2017; 33:e00078015. [PMID: 28538789 DOI: 10.1590/0102-311x00078015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/06/2016] [Indexed: 11/22/2022] Open
Abstract
The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).
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Affiliation(s)
- Camila Nascimento Monteiro
- Universidade de São Paulo, São Paulo, Brasil.,Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
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Fontanelli MDM, Teixeira JA, Sales CH, de Castro MA, Cesar CLG, Alves MCGP, Goldbaum M, Marchioni DM, Fisberg RM. Validation of self-reported diabetes in a representative sample of São Paulo city. Rev Saude Publica 2017; 51:20. [PMID: 28355348 PMCID: PMC5344074 DOI: 10.1590/s1518-8787.2017051006378] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 05/04/2015] [Accepted: 02/14/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To validate the self-reported diabetes mellitus in adults and older adults living in the city of São Paulo, Brazil. METHODS We have used data of 569 subjects (284 adults and 285 older adults), participants of the population-based cross-sectional study Inquérito de Saúde do Município de São Paulo (Health Survey of São Paulo). Fasting glucose ≥ 7.0 mmol/L (126 mg/dL) and/or use of drugs (oral hypoglycemic and/or insulin) defined the diagnosis of diabetes mellitus. We have validated the self-reported diabetes mellitus by calculating the sensitivity, specificity, positive predictive values, and negative predictive values. We have used Poisson regression with robust variance to verify the factors associated with the sensitivity of the self-reported datum. For all analyses, we have considered the sample design of the study. RESULTS The sensitivity of self-reported diabetes mellitus was 63.8% (95%CI 49.2-76.3), specificity was 99.7% (95%CI 99.1-99.9), positive predictive value was 95.5% (95%CI 84.4-98.8), and negative predictive value was 96.9% (95%CI 94.9-98.2). The correct reporting of diabetes mellitus was more prevalent among older adults (PR = 2.0; 95%CI 1.2-3.5) than among adults. CONCLUSIONS The use of the datum of self-reported diabetes mellitus is valid, especially among older adults living in the city of São Paulo. The results highlight the need to track diabetes mellitus in asymptomatic subjects who have one or more risk factors for it, mainly in the adult population of this city.
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Affiliation(s)
| | - Juliana Araújo Teixeira
- Programa de Pós-Graduação de Nutrição em Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Cristiane Hermes Sales
- Programa de Pós-Graduação de Nutrição em Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | | | - Chester Luiz Galvão Cesar
- Departamento do Epidemiologia. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | | | - Moisés Goldbaum
- Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Dirce Maria Marchioni
- Departamento de Nutrição. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Regina Mara Fisberg
- Departamento de Nutrição. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
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Ferrari TK, Cesar CLG, Alves MCGP, Barros MBDA, Goldbaum M, Fisberg RM. Estilo de vida saudável em São Paulo, Brasil. CAD SAUDE PUBLICA 2017; 33:e00188015. [DOI: 10.1590/0102-311x00188015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 04/06/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo: O objetivo foi analisar o estilo de vida das populações adolescente, adulta e idosa do Município de São Paulo, Brasil, de acordo com variáveis demográficas e socioeconômicas. Foi realizado estudo transversal, de base populacional, com dados do Inquérito de Saúde no Município de São Paulo (ISA-Capital 2008). O estilo de vida foi definido pela avaliação da atividade física, consumo alimentar, tabagismo, consumo abusivo e dependência de álcool, de acordo com as respectivas recomendações. A prevalência de estilo de vida saudável foi de 36,9% entre idosos, 15,4% entre adultos e 9,8% entre adolescentes, sendo maior no sexo feminino entre idosos e adultos. Dentre aqueles com estilo de vida não saudável, 51,5% dos idosos, 32,2% dos adultos e 57,9% dos adolescentes não atingiram a recomendação para uma dieta adequada. A prevalência de estilo de vida saudável foi maior entre idosos, seguida pelos adultos e adolescentes. O consumo alimentar foi o principal responsável pelo estilo de vida não saudável, evidenciando a importância de intervenções para a promoção do estilo de vida saudável e, principalmente, da dieta adequada.
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Monteiro CN, Beenackers MA, Goldbaum M, de Azevedo Barros MB, Gianini RJ, Cesar CLG, Mackenbach JP. Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003-2008. BMC Health Serv Res 2016; 16:683. [PMID: 27927241 PMCID: PMC5142432 DOI: 10.1186/s12913-016-1928-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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] [Received: 08/20/2015] [Accepted: 11/30/2016] [Indexed: 12/02/2022] Open
Abstract
Background Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the “Smiling Brazil” Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003. Method Data was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored. Results Overall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups. Conclusions The Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1928-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Camila Nascimento Monteiro
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. .,Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - Mariëlle A Beenackers
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Moisés Goldbaum
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Researcher 1C of National Council for Scientific and Technological Development-CNPq, São Paulo, Brazil
| | - Marilisa Berti de Azevedo Barros
- Department of Public Health, School of Medical Sciences, University of Campinas, Campinas, Brazil.,Researcher 1D of National Council for Scientific and Technological Development-CNPq, São Paulo, Brazil
| | - Reinaldo José Gianini
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Catholic University of São Paulo, Sorocaba, São Paulo, Brazil
| | - Chester Luiz Galvão Cesar
- Researcher 1C of National Council for Scientific and Technological Development-CNPq, São Paulo, Brazil.,Department of Epidemiology, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Monteiro CN, Gianini RJ, Segri NJ, Goldbaum M, Barros MBDA, Cesar CLG. Use of generic drugs in São Paulo city, Brazil, in 2003: a population-based study. Epidemiol Serv Saude 2016; 25:251-258. [PMID: 27869943 DOI: 10.5123/s1679-49742016000200004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 02/05/2016] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to analyze the use and perception of generic drugs by people with diabetes and hypertension in São Paulo City, Brazil, considering the Brazilian Generic Drug Policy. METHODS this was a cross-sectional study using data from a household health survey (ISA-Capital) in 2003; analysis was performed on knowledge regarding generic drugs and on the association between their use and sociodemographic and socio-economic characteristics. RESULTS 603 people with hypertension and diabetes were included in the study, low use of generic drugs was found (33.3% and 26.3, respectively) and low cost was the major reported advantage of generic drugs (71.0% and 71.1%, respectively); there was no statistically significant difference between the use of generic medication and age, sex or schooling. CONCLUSION low cost and there being no difference between generic drug use and education level strengthen the importance of generic drugs for promoting equity and universal access to medication.
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Affiliation(s)
| | | | - Neuber José Segri
- Universidade Federal do Mato Grosso, Departamento de Estatística, Cuiabá-MT, Brasil
| | - Moisés Goldbaum
- Universidade de São Paulo, Faculdade de Medicina, São Paulo-SP, Brasil
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Dainesi SM, Goldbaum M. Reasons behind the participation in biomedical research: a brief review. Rev Bras Epidemiol 2016; 17:842-51. [PMID: 25388485 DOI: 10.1590/1809-4503201400040004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/18/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Clinical research is essential for the advancement of Medicine, especially regarding the development of new drugs. Understanding the reasons behind patients' decision of participating in these studies is critical for the recruitment and retention in the research. OBJECTIVES To examine the decision-making of participants in biomedical research, taking into account different settings and environments where clinical research is performed. METHODS A critical review of the literature was performed through several databases using the keywords: "motivation", "decision", "reason", "biomedical research", "clinical research", "recruitment", "enrollment", "participation", "benefits", "altruism", "decline", "vulnerability" and "ethics", between August and November 2013, in English and in Portuguese. RESULTS The review pointed out that the reasons can be different according to some characteristics such as the disease being treated, study phase, prognoses and socioeconomic and cultural environment. Access to better health care, personal benefits, financial rewards and altruism are mentioned depending on the circumstances. CONCLUSION Finding out more about individuals' reasons for taking part in the research will allow clinical investigators to design studies of greater benefit for the community and will probably help to remove undesirable barriers imposed to participation. Improving the information to health care professionals and patients on the benefits and risks of clinical trials is certainly a good start.
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Affiliation(s)
| | - Moisés Goldbaum
- School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
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Monteiro CN, Gianini RJ, Barros MBDA, Cesar CLG, Goldbaum M. Access to medication in the Public Health System and equity: populational health surveys in São Paulo, Brazil. Rev bras epidemiol 2016; 19:26-37. [DOI: 10.1590/1980-5497201600010003] [Citation(s) in RCA: 11] [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] [Received: 08/21/2015] [Accepted: 12/14/2015] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT: Introduction: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.
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Affiliation(s)
| | - Reinaldo José Gianini
- Universidade de São Paulo, Brazil; Pontifícia Universidade Católica de São Paulo, Brazil
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Goldbaum M. Professor Frederico Simões Barbosa e sua contribuição à epidemiologia brasileira. CAD SAUDE PUBLICA 2016; 32 Suppl 1:eES04S116. [DOI: 10.1590/0102-311xes04s116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 05/19/2016] [Indexed: 11/21/2022] Open
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Almeida MFD, Goldbaum M. Tributo a Mervyn Susser e Ruy Laurenti. Rev bras epidemiol 2015; 18:727. [DOI: 10.1590/1980-5497201500040002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Almeida MFD, Goldbaum M. A Revista Brasileira de Epidemiologia no alvorecer do 19 o ano de existência. Rev bras epidemiol 2015; 18:725-6. [DOI: 10.1590/1980-5497201500040001] [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: 11/22/2022] Open
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Segri N, Cesar C, Francisco P, Alves C, Barros M, Goldbaum M. Social Inequalities and Preventive Practices among Women in Sao Paulo/Brazil. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.014] [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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Stopa SR, Cesar C, Segri N, Goldbaum M, Guimarães V, Barros M. Self-Reported Diabetes in Elderly: Comparison of Prevalences, Control Measures and Health Promotion Practices, São Paulo-Brazil. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.549] [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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Monteiro C, Stopa SR, Segri N, Gianini R, Barros M, Cesar C, Goldbaum M. Health Services Utilization to Immunization against Influenza and Pneumonia in Diabetic Population, São Paulo-Brazil. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.015] [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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Stopa SR, Monteiro C, Segri N, Gianini R, Goldbaum M, Barros M, Cesar C. Hospitalization Trends among Adults with Hypertension and Diabetes: Population-Based Health Surveys—São Paulo, Brazil. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.445] [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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Nunes APDOB, Luiz ODC, Barros MBA, Cesar CLG, Goldbaum M. [Domains of physical activity and education in São Paulo, Brazil: a serial cross-sectional study in 2003 and 2008]. CAD SAUDE PUBLICA 2015; 31:1743-55. [PMID: 26375652 DOI: 10.1590/0102-311x00130814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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
This study aimed to estimate the prevalence of physical activity in different domains and the association with schooling, using a serial cross-sectional population-based design comparing data from two editions of a health survey in the city of São Paulo, Brazil. Participation included 1,667 adults in 2003 and 2,086 in 2008. Probabilistic sampling was performed by two-stage clusters. The long version of International Physical Activity Questionnaire (IPAQ) allowed evaluating multiple domains of physical activity. Poisson regression was used. Men were more active in their leisure time and at work and women in the home. Schooling was associated directly with leisure-time activity (2003 and 2008) and inversely with work-related physical activity (2003) for men and for women in housework. The studies showed that Brazilians with less schooling are becoming less active, so that intervention strategies should consider different educational levels. Interventions in the urban space and transportation can increase the opportunities for physical activity and broaden access by the population.
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Affiliation(s)
| | | | | | | | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR
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de Almeida MF, Goldbaum M, Carvalheiro JDR. The Brazilian Journal of Epidemiology: 18 years of contributing to knowledge dissemination. Cien Saude Colet 2015; 20:2031-9. [PMID: 26132242 DOI: 10.1590/1413-81232015207.06012015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/18/2015] [Indexed: 11/22/2022] Open
Abstract
The Revista Brasileira de Epidemiologia (RBE - Brazilian Journal of Epidemiology) is completing 18 years as a vehicle for the dissemination of knowledge in the area of health. This knowledge relates to theoretical perspectives, the analysis of the reality of existing health conditions, as well as practices within health services. Fitting within all the disciplines of the field of public health, the origins of this journal, and the concepts that it covers, reflect movements within the health sector and also shadow the areas of operation proposed in the "Master Plans for the Development of Epidemiology in Brazil". Over time, there has been increasing demand for the publication of articles within the journal, a fact that has favored its growing impact factor. The RBE adopted an editorial policy designed to disseminate its production in a bilingual form in order to attain greater international visibility and to meet the needs of both researchers and professionals in the field. Like all Brazilian scientific journals, it has suffered from the absence of national scien-tific and technological policies designed to provide more effective assistive in ensuring its sustainability. Looking towards the future, it is hoped that the RBE will achieve even greater impact within academia, in relation to health service professionals, and, not least, that it will achieve a high impact within society at large.
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Affiliation(s)
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, USP, Brasil
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Goldbaum M. Guilherme Rodrigues da Silva: the development of the field of collective health in Brazil. Cien Saude Colet 2015; 20:2129-34. [PMID: 26132252 DOI: 10.1590/1413-81232015207.07552015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 05/08/2015] [Indexed: 11/22/2022] Open
Abstract
This article describes the academic trajectory of Professor Guilherme Rodrigues da Silva and his contribution in the formation of Collective Health in Brazil. Three key aspects are covered: active participation in medical education, both undergraduate and graduate level; its application in scientific research for the study of neglected diseases and the development of epidemiological methodology; his contribution in establishing health policy with emphasis on the Unique Health System (Sistema Único de Saúde - SUS).
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Affiliation(s)
- Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, USP, São Paulo, SP, Brasil,
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Monteiro CN, Gianini RJ, Goldbaum M, Cesar CLG, Barros MBA. Coverage by the public health services of medication and vaccines for the population with diabetes mellitus. Cien Saude Colet 2015; 20:557-64. [PMID: 25715149 DOI: 10.1590/1413-81232015202.02112014] [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: 03/20/2014] [Accepted: 07/28/2014] [Indexed: 11/22/2022] Open
Abstract
This study analyzed the coverage by the public health service of expenses with medication and vaccines for the adult population of São Paulo with self-reported diabetes mellitus in 2003 and the implications for access to medicines and vaccination campaigns programs. Data were collected by the Multicenter Health Survey of São Paulo. The Unified Health System (SUS) was widely used by the population for vaccination against influenza and pneumonia and there was significant private sector participation for coverage of expenses with medication, with an estimated coverage of 38% by SUS. There were no significant differences in the prevalence of use of public services for vaccination among the categories of variables studied, suggesting a universal distribution of vaccination by the public health service. Unlike vaccinations, in 2003 the coverage of medication expenses by the public health service was recent in Brazil, which may explain the low level of coverage. An analysis of coverage of vaccination and medication expenses in diabetes mellitus population since 2003 may contribute to be the basis for policies to broaden access of the population to health services.
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Affiliation(s)
- Camila Nascimento Monteiro
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,
| | - Reinaldo José Gianini
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,
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