ORCID Profile
0000-0002-7153-2878
Current Organisation
University of Adelaide
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Publisher: FapUNIFESP (SciELO)
Date: 09-2013
Publisher: Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)
Date: 26-02-2018
DOI: 10.11606/S1518-8787.2018052000123
Abstract: OBJECTIVE: To test whether there is an association between socioeconomic status in childhood and measures of body mass index, waist circumference and the presence of overall and abdominal obesity in adult life. METHODS: A cross-sectional analysis of a population-based cohort study, including a s le of adults (22–63 years old) living in Florianópolis, Southern Brazil. The socioeconomic status in childhood was analyzed through the education level of the participant’s parents. Height, weight and waist circumference were measured by previously trained interviewers. Linear and logistic regressions with adjustment for confounding factors and stratification of data according to gender were used. RESULTS: Of the 1,222 adults evaluated, 20.4% (95%CI 18.1–22.8) presented overall obesity and 24.8% (95%CI 22.4–27.4), abdominal obesity. The body mass index and waist circumference averages among women were, respectively, 1.2 kg/m2 (95%CI -2.3– -0.04) and 2.8 cm (95%CI -5.3– -0.2) lower among those with higher socioeconomic status in childhood. Among men, waist circumference was 3.9 cm (95%CI 1.0–6.8) higher in in iduals with higher socioeconomic status in childhood. Regarding obesity, women of higher socioeconomic status in childhood had lower odds of abdominal obesity (OR = 0.56, 95%CI 0.34–0.90), and no such association was observed among men. CONCLUSIONS: The socioeconomic status in childhood influences body mass index, waist circumference and obesity in adults, with a difference in the direction of association according to gender. The higher socioeconomic status among men and the lower socioeconomic status among women were associated with higher adiposity indicators.
Publisher: Elsevier BV
Date: 09-2015
Publisher: FapUNIFESP (SciELO)
Date: 06-2012
DOI: 10.1590/S1519-38292012000200007
Abstract: OBJETIVOS: medir a prevalência e identificar fatores associados à automedicação em crianças menores de cinco anos nos municípios de Caracol no Estado do Piauí, e Garrafão do Norte no Pará. MÉTODOS: utilizando-se de delineamento transversal, amostragem sistemática e utilização de questionário padrão por meio de visita domiciliar, foram investigadas ersas características das mães, das famílias e das crianças. Utilizou-se teste do qui-quadrado para comparar proporções e regressão de Poisson com ajuste robusto da variância na análise multivariável. RESULTADOS: dentre as 590 crianças estudadas em Caracol e 1081 em Garrafão, 30% e 25% haviam sido automedicadas nos últimos 15 dias, respectivamente. Após análise ajustada para ersas variáveis confundidoras, o fato de não conseguir atendimento para o filho doente nos últimos 15 dias nos dois municípios, assim como de residir há mais de 1 km dos serviços de saúde em Caracol e de a mãe exercer trabalho remunerado nos últimos 12 meses em Garrafão mostraram-se significativamente associadas à automedicação entre menores de cinco anos. CONCLUSÕES: a prevalência de automedicação por parte das mães para menores de cinco anos nos municípios estudados, apesar de inferior à observada em outras localidades brasileiras, decorreu, sobretudo, da dificuldade de realização de consulta médica.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.JOCD.2015.06.001
Abstract: Children and adolescents living with HIV have low bone mass for age. There are reliable and accurate methods for evaluation of bone mass, however, alternative methods are necessary, especially, for application in limited-resource scenarios. Anthropometry is a noninvasive and low cost method that can predict bone mass in healthy youths. The aim of the study was to develop predictive equations for bone mineral content and bone mineral density in children and adolescents living with HIV based on anthropometric variables. Forty-eight children and adolescents of both sexes (24 females) from 7 to 17 years, living in greater Florianopolis area, Santa Catarina, Brazil, who were under clinical follow-up at "Hospital Infantil Joana de Gusmão", participated in the study. Dual-energy X-ray absorptiometry was used to evaluate whole-body bone mineral content (BMC) and areal bone mineral density (aBMD). Height, body weight, bone diameters, arm circumference, and triceps skinfold were measured and the body mass index and arm muscle area were calculated. Multiple regression models were fitted to predict BMC and aBMD, using backward selection (p ≥ 0.05). Two predictive models with high R
Publisher: Wiley
Date: 24-06-2020
DOI: 10.1111/IRV.12774
Publisher: Informa UK Limited
Date: 28-05-2021
Publisher: FapUNIFESP (SciELO)
Date: 12-2011
DOI: 10.1590/S1519-38292011000400004
Abstract: OBJETIVOS: avaliar a iniquidade na assistência à gestação e ao parto para menores de cinco anos residentes no município de Caracol, Piauí, Brasil. MÉTODOS: usando delineamento transversal, amostragem sistemática e aplicação de questionário domiciliar foram coletadas informações sobre características demográficas de mães e crianças, assistência à gestação e ao parto e nível socioeconômico. Por meio da técnica de componentes principais, criou-se um escore em tercis. As associações deste escore com as variáveis relativas à assistência à gestação e ao parto foram avaliadas pelos testes qui-quadrado e Kruskal- Wallis. RESULTADOS: todas as 405 crianças incluídas no estudo eram provenientes de famílias com renda inferior a um salário mínimo mensal 65% residiam em área rural. Mães pertencentes ao maior tercil socioeconômico realizaram um maior número de consultas de pré-natal realizaram maior número de exames de urina, hemograma, citopatológico de colo uterino e ultrassonografia, tiveram o parto realizado por médico e foram mais frequentemente submetidas à cesariana. CONCLUSÕES: mesmo entre os mais pobres, há enormes iniquidades em saúde. Combater os determinantes desta pobreza com programas sociais mais agressivos é imperativo, assim como priorizar o atendimento aos mais pobres dentre os pobres.
Publisher: SAGE Publications
Date: 02-12-2019
Abstract: The success of integrated prevention initiatives for eating disorders and obesity is h ered by a lack of shared risk factor research. Bullying and sexual abuse are potentially potent shared risk factors for the spectrum of eating and weight disorders. A representative s le of N = 3005 South Australian males and females ≥15 years was interviewed about their height, weight, eating disorder symptoms, lifetime experiences of bullying and sexual abuse and mental and physical health-related quality of life. Participants who were currently obese (25.2%) or underweight (2.7%) or who reported current eating disorder symptoms (32.7%) were between 10% and 27% more likely to have experienced bullying, and obese and eating disordered participants were also 47% and 56% more likely to have experienced sexual abuse, respectively. In regard to specific symptoms, a lifetime history of bullying was associated with increased risk of obesity, extreme dieting, purging and overvaluation of body weight and/or shape, whereas a lifetime history of sexual abuse was associated with increased risk of obesity, binge eating and extreme dieting and decreased risk of underweight. Lifetime histories of bullying and sexual abuse were associated with health-related quality of life impairment however, lifetime bullying was associated with a greater adverse impact among participants with current eating disorder symptoms. Self-reported bullying and sexual abuse victimisation have shared associations with eating and weight spectrum problems. Differences in the symptoms associated with bullying versus sexual abuse are discussed, as well as the clinical and public health implications.
Publisher: FapUNIFESP (SciELO)
Date: 12-2014
DOI: 10.1590/ABD1806-4841.20143884
Abstract: The selection of instruments that will be used to collect data is a crucial step in the research process. Validity and reliability of the collected data and, above all, their potential comparability with data from previous investigations must be prioritized during this phase. We present a decision tree, which is intended to guide the selection of the instruments employed in research projects. Studies conducted along these lines have greater potential to broaden the knowledge on the studied subject and contribute to addressing truly socially relevant needs.
Publisher: Springer Science and Business Media LLC
Date: 18-01-2018
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2020-046425
Abstract: This study aimed to explore the relationship (presence and severity) between chronic breathlessness and sleep problems, independently of diagnoses and health service contact by surveying a large, representative s le of the general population. Analysis of the 2017 South Australian Health Omnibus Survey, an annual, cross-sectional, face-to-face, multistage, clustered area systematic s ling survey carried out in Spring 2017. Chronic breathlessness was self-reported using the ordinal modified Medical Research Council (mMRC scores 0 (none) to 4 (housebound)) where breathlessness has been present for more than 3 of the previous 6 months. ‘Sleep problems—ever’ and ‘sleep problem—current’ were assessed dichotomously. Regression models were adjusted for age sex and body mass index (BMI). 2900 responses were available (mean age 48.2 years (SD=18.6) 51% were female mean BMI 27. 1 (SD=5.9)). Prevalence was: 2.7% (n=78) sleep problems—past 6.8% (n=198) sleep problems—current and breathlessness (mMRC 1–4) was 8.8% (n=254). Respondents with sleep problemspast were more likely to be breathless, older with a higher BMI and sleep problems—present also included a higher likelihood of being female. After adjusting for age, sex and BMI, respondents with chronic breathlessness had 1.9 (95% CI=1.0 to 3.5) times the odds of sleep problems—past and sleep problems—current (adjusted OR=2.3 95% CI=1.6 to 3.3). There is a strong association between the two prevalent conditions. Future work will seek to understand if there is a causal relationship using validated sleep assessment tools and whether better managing one condition improves the other.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.YPMED.2017.02.007
Abstract: This study investigated the achievement of lifestyle recommendations and use of preventive medication in people who 1) are obese, 2) or have metabolic risk factors (hypertension, dyslipidaemia, and/or diabetes), 3) or have cardiovascular disease (CVD), 4) or are healthy, and the impact this preventive health care had on their 'Health-Related Quality of Life' (HRQoL). Cross-sectional survey conducted in 2015 with 2379 South Australian adults (57.1±14years 51.7% females). Physical (PCS) and mental components scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Although adequate fruit/vegetable intake was lower among in iduals with CVD (29.8% p=0.049), this behaviour was associated with a better MCS. Adequate physical activity level was lower among those with metabolic risk factors (29.5%) or CVD (31.0% p=0.008), but independent of their clinical condition, this behaviour was associated with a higher PCS. In iduals with CVD were less likely to have adequate alcohol consumption (63.4% p=0.026), but those achieving this recommendation had poorer PCS. Non-smoking was similar in all groups (85% p=0.768) and was associated with a better MCS only among healthy in iduals and those with CVD. In all the groups, in iduals achieving all the lifestyle recommendations had a better PCS. Only 48.2% of in iduals with CVD reported combined use of antithrombotic, antihypertensive, and antilipidemic drugs, but the use of these medications was not associated with HRQoL. In conclusion, the vast majority of in iduals at risk of or with CVD did not achieve preventive recommendations, and only the adequacy of uptake of all recommended lifestyle behaviours showed consistent benefits for PCS and MCS.
Publisher: Frontiers Media SA
Date: 08-01-2019
Publisher: Oxford University Press (OUP)
Date: 21-02-2012
DOI: 10.1093/IJE/DYS002
Publisher: Vigilancia Sanitaria em Debate: Sociedade, Ciencia y Tecnologia
Date: 27-11-2014
DOI: 10.3395/VD.V2I4.445
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12875-019-1066-9
Abstract: Little is known about whether a more comprehensive health assessment, performed by a general practitioner (GP) during a clinical encounter, could influence patients’ lifestyle. We aimed to investigate whether health assessments, performed by GPs, are more important than the presence of cardiovascular disease (CVD) or cardiometabolic risk factors (obesity, diabetes, hypertension, dyslipidaemia) for engagement in lifestyle change. Cross-sectional, population-based survey conducted in South Australia (September–December 2017) using face-to-face interviews and self-reported data of 2977 in iduals aged 15+ years. The main outcome was engagement in four lifestyle changes: 1) increasing fruit/vegetable intake, 2) increasing physical activity level, 3) reducing alcohol consumption, and 4) attempts to stop smoking. Health assessments performed by a GP in the last 12 months included clinical/laboratory investigations (weight/waist circumference, blood pressure, glucose levels, lipid levels) and questions about lifestyle/wellbeing (current diet, physical activity, smoking status, alcohol intake, mental health, sleeping problems). Results were restricted to in iduals aged 35+ years because of the low prevalence of CVD or their risk factors among younger participants. Logistic regression was used in all associations, adjusted for sociodemographic, lifestyle, mental health, and clinical variables. Of the 2384 investigated adults (mean age 57.3 ± 13.9 years 51.9% females), 10.2% had CVD and 49.1% at least one cardiometabolic risk factor. Clinical/laboratory assessments performed by the GP were 2–3 times more frequent than assessments of lifestyle, mental health status, or sleeping problems, especially among those with CVD. In iduals with CVD or a cardiometabolic risk factor were no more likely to be increasing their fruit/vegetable consumption (33.6%), physical activity level (40.9%), reducing alcohol consumption (31.1%), or trying to quit smoking (34.0%) than ‘healthy’ participants. However, lifestyle changes were between 30 and 100% more likely when GPs performed three or more health assessments (either clinical/laboratory or questions about lifestyle/wellbeing) than when in iduals did not visit the GP or when GPs performed no any assessment during these clinical encounters ( p 0.05 in all cases). More frequent and comprehensive CVD-related assessments by GPs were more important in promoting a healthier lifestyle than the presence of CVD or cardiometabolic risk factors by themselves.
Publisher: Springer Science and Business Media LLC
Date: 03-07-2017
Publisher: BMJ
Date: 2020
DOI: 10.1136/BMJOPEN-2019-034400
Abstract: The health workforce is an integral component of the healthcare system. Comprehensive, high-quality data on the health workforce are essential to identifying gaps in health service provision, as well as informing future health workforce and health services planning, and health policy. While many data sources are used in Australia for these purposes, the quality of the data sources with respect to relevance, accessibility and accuracy is not clear. This scoping review aims to identify and appraise publicly available data sources describing the Australian health workforce. The review will include any data source (eg, registry, administrative database and survey) or document reporting a data source (eg, journal article, report) on the Australian health workforce, which is publicly available and describes the characteristics of the workforce. The search will be conducted in 10 bibliographic databases and the grey literature using an iterative process. Screening of titles and abstracts will be undertaken by two investigators, independently, using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Documents/data sources identified as potentially eligible will be retrieved in full text and reviewed following the same process. Data will be extracted using a customised data extraction tool. A customised appraisal tool will be used to assess the relevance, accessibility and accuracy of included data sources. The scoping review is a secondary analysis of existing, publicly available data sources and does not require ethics approval. The findings of this scoping review will further our understanding of the quality and availability of data sources used for health workforce and health services planning in Australia. The results will be submitted for publication in peer-reviewed journals and presented at conferences targeted at health workforce and public health topics.
Publisher: Oxford University Press (OUP)
Date: 05-07-2021
DOI: 10.1111/BJD.20494
Publisher: FapUNIFESP (SciELO)
Date: 06-2013
DOI: 10.1590/S1415-790X2013000200017
Abstract: Objetivo: Investigar o efeito de fatores demográficos, socioeconômicos, educacionais e familiares sobre o conhecimento acerca do HIV/AIDS em adolescentes com 11 anos de idade. Métodos: Foram estudados 3.949 adolescentes de Pelotas/RS. O conhecimento acerca do HIV/AIDS foi avaliado por meio de um questionário autoaplicado e mensurado através de cinco perguntas sobre relação heterossexual, relação homossexual, compartilhamento de seringas, beijo na boca e abraçar alguém com AIDS. As análises foram ajustadas com base em um modelo hierárquico, usando regressão de Poisson com ajuste robusto da variância. Resultados: Os percentuais de respostas erradas para as questões examinadas foram: 17,2% para transmissão em relações heterossexuais 44,1% para relações homossexuais 34,9% para compartilhar seringas 25,6% para beijo na boca e 16,2% para abraçar pessoa com AIDS. Na análise ajustada, menor grau de conhecimento foi demonstrado pelos meninos, por adolescentes de menor nível econômico, cujas mães possuíam menor escolaridade, para os adolescentes que não haviam conversado sobre sexo com a mãe e entre os que não tiveram aula sobre educação sexual na escola. O grau de conhecimento não esteve associado com o tipo de escola, cor da pele, t ouco com a conversação com o pai sobre sexo. Conclusão: Fornecer informações aos adolescentes é fundamental para melhorar o conhecimento sobre o risco de transmissão de HIV e de outras infecções sexualmente transmissíveis, principalmente entre jovens do sexo masculino e de menor nível socioeconômico. As políticas públicas devem considerar o rol que a mãe e a escola desempenham no conhecimento sobre este tema por parte dos adolescentes.
Publisher: Informa UK Limited
Date: 23-12-2020
DOI: 10.1080/00913847.2020.1862633
Abstract: We investigated the independent and joint association between muscle strength and health variables according to in idual health status among adults. Cross-sectional population-based study comprising 643 adults (39.6 ± 11.1 years, 44.9% men) from Florianópolis, Southern Brazil. Muscle strength was assessed by handgrip strength. Health variables included were systolic (SBP) and diastolic blood pressure (DBP), waist circumference (WC), carotid intima-media thickness (IMT), high-sensitivity C-reactive protein (CRP), total cholesterol (CHOL), HDL cholesterol (HDL-C), triglycerides (TRG), glycated hemoglobin (HbA1c), and insulin resistance index (HOMA-IR). Participants were grouped into three health status categories: 1) healthy (without CVD and risk for CVD) 2) at risk for CVD (obesity, high blood pressure, and hyperglycemia) 3) with CVD. Multiple linear regression adjusted for confounding factors was used. Muscle strength was inversely associated with IMT (β = -0.02, SE: 0.03), CHOL (β = -0.14, SE: 0.02) and HbA1c (β = -0.01, SE: 0.10), and directly associated with SBP (β = 0.16, SE: 0.06) and WC (β = 0.02, SE: 0.03). Among adults with CVD, muscle strength was inversely associated with IMT (p < 0.05). Higher muscle strength was directly associated with SBP among healthy adults (p < 0.05). The main finding of the present study indicated that among in iduals with CVD, muscle strength was associated with lower IMT values.
Publisher: Springer Science and Business Media LLC
Date: 20-06-2016
DOI: 10.1007/S11136-016-1330-6
Abstract: To analyze the effects of anthropometric measures change on quality of life (QoL) in elderly, using measured anthropometric data on body mass index (BMI) and waist circumference (WC). Population-based cohort study investigating a s le of elderly (≥60) assessed in 2009 (n = 1705) and followed up in 2013 (n = 1197). QoL was evaluated in 2013 using the CASP-19. Variables evaluated as exposure including BMI and WC in 2009 (both standardized), categories of anthropometric measures change from 2009 to 2013 (excess weight = BMI ≥ 25.0 kg/m Both BMI and WC at baseline were associated with lower QoL scores, even after adjustment for confounding variables (β Having excess weight and large WC in both waves was associated with lower QoL scores in elderly, but changing the anthropometric measures did not affect this outcome. Maintaining weight and WC within normal limits during aging can help to preserve QoL.
Publisher: Public Library of Science (PLoS)
Date: 07-06-2018
Publisher: FapUNIFESP (SciELO)
Date: 04-2013
Publisher: Informa UK Limited
Date: 02-04-2021
DOI: 10.1080/17461391.2021.1902571
Abstract: The aim of the present study was to investigate the independent and joint associations among muscle strength (MS) and obesity with blood pressure, atherosclerosis, and laboratory markers. This was a cross-sectional study comprising a representative s le of 642 adults (men: 44.9%, 39.9 ± 11.2 years women: 55.1%, 39.3 ± 11.1 years) from Florianópolis, Brazil. MS was assessed by handgrip strength. Obesity was defined as a Body Mass Index (BMI) ≥30.0 kg/m² and a waist circumference ≥80.0 cm in women and ≥90.0 cm in men. Clinical variables included systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein (CRP), lipids, glucose metabolism markers and carotid intima-media thickness (IMT). Linear regression models stratified by sex and adjusted for confounders were used. Higher MS levels were related to lower CRP (up to 0.59 times lower), triglycerides (up to 0.33 times lower), HOMA-IR (up to 0.35 times lower), and higher HDL cholesterol (up to 5.2 mg/dL) levels among men. Among women, higher MS levels were related to lower SBP and DBP (up to -10.2 mmHg), CRP (up to 0.56 times lower), HOMA-IR (up to 0.27 times lower) and IMT (up to -4.8 × 10
Publisher: BMJ
Date: 03-2019
DOI: 10.1136/BMJOPEN-2018-024797
Abstract: To assess changes in the frequency of vitamin D testing and detection of moderate/severe vitamin D deficiency ( nmol/L) among adults after the introduction of new Medicare Benefits Schedule (MBS) rebate criteria (November 2014), and their relationship to sociodemographic and clinical characteristics. Dynamic (open) cohort study Primary care About 1.5 million ‘active’ patients aged 18+ years visiting a general practitioner and included in the National Prescribing Service MedicineInsight database. The frequency of vitamin D testing (per 1000 consultations) and moderate/severe vitamin D deficiency (%) recorded between October 2013 and March 2016, stratified by the release of the new MBS criteria for rebate. More patients were female (57.7%) and 30.2% were aged 60+ years. Vitamin D testing decreased 47% (from 40.3 to 21.4 tests per 1000 consultations) after the new MBS criteria, while the proportion of tests with no indication for being performed increased from 71.3% to 76.5%. The proportion of patients identified as moderate/severe vitamin D deficient among those tested increased from 5.4% to 6.5%. Practices located in high socioeconomic areas continued to have the highest rates of testing, but moderate/severe vitamin D deficiency detection remained 90% more frequent in practices from low socioeconomic areas after the rebate change. Furthermore, the frequency of in iduals being tested was reduced independent of the patients’ sociodemographic or clinical condition, and the gap in the prevalence of vitamin D deficiency detection between those meeting or not meeting the criteria for being tested remained the same. Moderate/severe vitamin D deficiency detection decreased slightly among patients with hyperparathyroidism or chronic renal failure. Although the new criteria for rebate almost halved the frequency of vitamin D testing, it also lessened the frequency of testing among those at higher risk of deficiency, with only a small improvement in vitamin D deficiency detection.
Publisher: Wiley
Date: 10-10-2023
DOI: 10.1111/DAR.13561
Abstract: We aimed to explore trends and sociodemographic patterns in benzodiazepine (BZD) (by half-life) and Z-drugs prescribing in Australian general practice. This open cohort study used de-identified electronic health records of 1.4 million patients (50,812,413 consultations) from 402 Australian practices (MedicineInsight 2011-2018). Annual prescribing frequency and changes over time were estimated according to sex, age, socioeconomic position and rurality. Between 2011 and 2018, the prescribing of very short-acting BZD increased from 0.10 to 0.29 per 1000 consultations (average annual change +17.2% [95% CI 9.6 25.3]), while it declined for short-intermediate (from 38.5 to 26.6 per 1000 consultations annual change -5.1% [95% CI -5.6 -4.5]), long-acting BZD (from 24.1 to 21.6 per 1000 consultation annual change -1.5% [95% CI -2.2 -0.8]) and Z-drugs (from 4.6 to 4.0 per 1000 consultations annual change -1.9% [95% CI -3.0 -0.7]). Short-intermediate-acting BZD prescribing was three times more frequent among women aged 65+ years than younger women, and long-acting BZD three-to-four times more likely among younger than older men. Z-drugs prescribing was higher among women aged 45-64 years than younger or older females. Short-intermediate- and long-acting BZD were more likely prescribed for patients from more disadvantaged areas, and Z-drugs in more advantaged areas. There were no disparities by rurality. Although most BZD and Z-drugs prescriptions declined over time, short-intermediate BZD prescriptions remained higher among older women and long-acting BZD more frequent among younger men, especially for those living in more disadvantaged areas. Targeted interventions could reduce the prescribing of BZD and Z-drugs in these groups.
Publisher: FapUNIFESP (SciELO)
Date: 06-2014
DOI: 10.1590/1809-4503201400020021
Abstract: Objetivo: Descrever a metodologia e desafios de estudos de saúde bucal, inseridos em uma coorte prospectiva de adultos. Métodos: Foi obtida uma amostra de 2.016 adultos residentes em Florianópolis em 2009. Visitas domiciliares foram realizadas para a aplicação de um questionário sobre condições socioeconômicas e demográficas, de saúde geral, uso de serviços e de medicamentos, doação de sangue, violência doméstica e uma seção relativa à saúde da mulher. Informações sobre saúde bucal incluíram autoavaliação de seu estado, número de dentes, uso de serviços, percepção de necessidade de tratamento, ocorrência, intensidade e impacto nas atividades diárias da dor dentária, sintomas de xerostomia e dificuldade de alimentação em virtude de problemas bucais. Adicionalmente, aferiram-se a pressão arterial e medidas antropométricas. Em 2012, ocorreu a segunda onda do estudo, na qual foi aplicado um questionário sobre questões socioeconômicas, qualidade de vida, experiências discriminatórias, recordatório alimentar de 24 horas e de saúde bucal. Além disso, foi aferida a pressão arterial, medidas antropométricas, e foram realizados exames bucais (cárie, perdas dentárias e condições periodontais). Resultados: A taxa de participação foi de 85,3% (n = 1.720) em 2009 e, destes, 1.222 (71,1%) foram investigados em 2012. Conclusões: A continuidade do estudo poderá contribuir para a elucidação da causalidade de associações entre condições de saude bucal e agravos e doencas cronicas.
Publisher: Hogrefe Publishing Group
Date: 06-2020
DOI: 10.1024/0300-9831/A000535
Abstract: Abstract. Introduction: According to the literature, education and income are determinants factors of diet quality and consequently of micronutrient intake. However, this association is still little known among adults who live in middle-income countries. Objective: To estimate energy and micronutrients intake by men and women living in a capital city in southern Brazil, according to education and income levels, and to identify prevalence of inadequate micronutrient intake according also to education and income levels. Method: This is a second wave cross-sectional analysis of a population-based longitudinal study, the EpiFloripa Adultos, including 1,222 in iduals of 22–63 years. Data on food consumption were obtained through applying two 24-hour dietary recalls, and the prevalence of inadequate micronutrient intake, following the recommendations of the Institute of Medicine and from the National Research Council. Results: A tendency of increased intake with an increase in income (calcium, vitamins C, E) and education levels (calcium, vitamins A, C, D) was observed for most of the micronutrients analyzed (p .05 in all cases) still, a prevalence of inadequacy according to Estimated Average Requirement (EAR) between 85.5–100% in intake of vitamins A, D and E were found for the whole s le. Iron inadequate intake was associated with education level and among women less than 50 years of age (p=0.018). Conclusion: The results showed an influence of the education and income levels on micronutrient intake, point to the need of daily food consumption, of minimally processed and in natura foods (as fruits, vegetables, whole grains, milk and its derivatives) as a means to reduce the encountered inadequacies.
Publisher: Cambridge University Press (CUP)
Date: 28-08-2014
DOI: 10.1017/S1368980014001736
Abstract: To analyse the Na content and labelling of processed and ultra-processed food products marketed in Brazil. Cross-sectional study. A large supermarket in Florianopolis, southern Brazil. Ingredient lists and Na information on nutrition labels of all processed and ultra-processed pre-prepared meals and prepared ingredients, used in lunch or dinner, available for sale in the supermarket. The study analysed 1416 products, distributed into seven groups and forty-one subgroups. Five products did not have Na information. Most products (58·8 % 95 % CI 55·4, 62·2 %) had high Na content ( mg/100 g). In 78·0 % of the subgroups, variation in Na content was at least twofold between similar products with high and low Na levels, reaching 634-fold difference in the ‘garnishes and others’ subgroup. More than half of the products (52·0 % 95 % CI 48·2, 55·6 %) had at least one Na-containing food additive. There was no relationship between the appearance of salt on the ingredients list (first to third position on the list) and a product’s Na content (high, medium or low P =0·08). Most food products had high Na content, with great variation between similar products, which presents new evidence for reformulation opportunities. There were inconsistencies in Na labelling, such as lack of nutritional information and incomplete ingredient descriptions. The position of salt on the ingredients list did not facilitate the identification of high-Na foods. We therefore recommend a reduction in Na in these products and a review of Brazilian legislation.
Publisher: Cambridge University Press (CUP)
Date: 12-10-2015
DOI: 10.1017/S0033291715001956
Abstract: Episodes of depression and anxiety (D& A) during the transition from late adolescence to adulthood, particularly when persistent, are predictive of long-term disorders and associated public health burden. Understanding risk factors at this time is important to guide intervention. The current objective was to investigate the associations between maternal symptoms of D& A with offspring symptoms during their transition to adulthood. Data from a large population-based birth cohort study, in South Brazil, were used. Prospective associations between maternal D& A and offspring risk of these symptoms during the transition to adulthood (18/19, 24 and 30 years) were estimated. Maternal D& A in adolescence was associated with offspring symptoms across the transition to adulthood, associations were consistently stronger for females than for males. Daughters whose mothers reported D& A were 4.6 times (95% confidence interval 2.71–7.84) as likely to report D& A at all three time-points, than daughters of symptom-free mothers. Maternal D& A is associated with persistent D& A during the daughter's transition to adulthood. Intervention strategies should consider the mother's mental health.
Publisher: Springer Science and Business Media LLC
Date: 31-05-2019
Publisher: FapUNIFESP (SciELO)
Date: 06-2016
Publisher: Emerald
Date: 04-07-2016
Abstract: – The purpose of this paper is to compare the sodium content displayed on the labels of conventional processed food products (C) and of those with nutrition claims suggesting the absence or reduced levels of nutrients (AR). – Cross-sectional study analyzing the ingredients list, nutrition facts and nutrition claims on food labels. Subjects: all processed food products with added salt or additives containing sodium that were for sale in a large supermarket in Brazil from October to December 2011. – All 3,449 products were analyzed and categorized into 66 groups according to Brazilian legislation. The median of sodium content in the AR was 42.7 percent higher than in the C ( p =0.007). In 33.3 percent of the groups there was difference in sodium content between AR and C ( p 0.05) and in 68.2 percent of these the sodium content was higher in AR. The variation range of sodium in products from the same group reached 2,905.0 mg in C and 1,712.0 mg in AR. Even when the median of sodium was lower in the AR, the minimum sodium values were lower in the C. – Comparisons of sodium content of conventional and AR processed food are scarce in the literature, especially covering all food for sale in a large supermarket. To the best of the knowledge, this is the first census making this comparisons in Latin America.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/RJ16004
Abstract: The importance of plants and other natural reserves as sources for biologically important compounds, particularly for application in food and medicine, is undeniable. Herein we provide a historical context of the major scientific research programs conducted in Australia that have been aimed at discovering novel bioactive natural products from terrestrial plants. Generally speaking, the main approaches used to guide the discovery of novel bioactive compounds from natural resources have included random, ethnobotanical and chemotaxonomic strategies. Previous Australian plant natural product research c aigns appear to have lacked the use of a fourth strategy with equally high potential, namely the ecologically guided approach. In addition, many large studies have s led plant material predominantly from tropical regions of Australia, even though arid and semi-arid zones make up 70% of mainland Australia. Therefore, plants growing in arid zone environments, which are exposed to different external stressors (e.g. low rainfall, high ultraviolet exposure) compared with tropical flora, remain an untapped reservoir of potentially novel bioactive compounds. Research of Australian arid zone plants that is ecologically guided creates a new opportunity for the discovery of novel bioactive compounds from plants (and potentially other biota) for application in health care, food and agricultural industries.
Publisher: Springer Science and Business Media LLC
Date: 11-02-2017
DOI: 10.1007/S11136-017-1503-Y
Abstract: To investigate if sociodemographic characteristics increase the adverse effects of cardiovascular diseases (CVD) and cardiometabolic risk factors (CMRF) on health-related quality of life (HRQoL). Cross-sectional, face-to-face survey investigating 2379 adults living in South Australia in 2015 (57.1 ± 14 years 51.7% females). Questions included diagnosis of CMRF (obesity, diabetes, hypertension, dyslipidaemia) and CVD. Physical and mental HRQoL were assessed using the SF-12v1 questionnaire. Multiple linear regression models including confounders (sociodemographic, lifestyle, use of preventive medication) and interaction terms between sociodemographic variables and cardiometabolic conditions were used in adjusted analysis. The prevalence of CMRF (one or more) was 54.6% and CVD was 13.0%. The physical HRQoL reduced from 50.8 (95%CI 50.2-51.4) in healthy in iduals to 45.1 (95%CI 44.4-45.9) and 39.1 (95%CI 37.7-40.5) among those with CMRF and CVD, respectively. Adjustment for sociodemographic variables reduced these differences in 33%, remaining stable after controlling for lifestyle and use of preventive medications (p < 0.001). Differences in physical HRQoL according to cardiometabolic conditions were twice as high among those with lower educational level, or if they were not working. Among unemployed, having a CMRF or a CVD had the same impact on the physical HRQoL (9.7 lower score than healthy in iduals). The inverse association between cardiometabolic conditions and mental HRQoL was subtle (p = 0.030), with no evidence of disparities due to sociodemographic variables. A lower educational level and unemployment increase the adverse effects of cardiometabolic conditions on the physical HRQoL. Targeted interventions for reducing CMRF and/or CVD in these groups are necessary to improve HRQoL.
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: Wiley
Date: 05-04-2022
DOI: 10.1111/AJR.12866
Abstract: To understand how contemporary socio‐cultural factors may impact medical students' rural career intent. Cross‐sectional study using data from the national Federation of Rural Australian Medical Educators survey. Medical students across 18 Australian universities who completed a full academic year of clinical training in rural areas in 2019. Preferred location of practice post‐training reported to be either: (i) a major city (ii) a regional area or large town or (iii) a small rural location. In total, 626 students completed the survey (70.1% response rate). A small rural location was the most preferred location of practice after graduation for 28.3% of the students (95% CI 21.6–36.0). Four socio‐cultural factors were positively associated with a preference for a rural career location: poor health status of rural people, motor vehicle traffic congestion in cities, rural generalist training opportunities in the state and the Royal Flying Doctor Service. Other socio‐cultural factors, including specialists’ under‐employment, Medicare freeze effect on doctors' income, bullying/sexual harassment in hospitals, climate change/natural disasters or recognised rural health personalities did not influence the investigated outcome. Our findings indicate a novel association between contemporary socio‐cultural factors and rural career intention in a cohort of Australian rural clinical school students. These findings advocate for further consideration of research exploring socio‐cultural factors shaping rural career intent and workforce outcomes.
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.CLNESP.2022.03.025
Abstract: Diabetes mellitus (DM) and cardiovascular disease (CVD) are among the biggest causes of death and health expenses worldwide. A higher dietary acid load (DAL) is associated with chronic low-grade metabolic acidosis, and may increase the risk of insulin resistance (IR), DM, hypertension, and CVD mortality. However, the association between DAL and IR still lacks population-based studies to confirm laboratory findings. This is a population-based observational study including a s le of 545 in iduals aged 25-64 years from Florianópolis (Southern Brazil) who participated in the EpiFloripa cohort study. All diet variables were obtained through two 24-h Food Recalls adjusted to obtain an estimate of habitual food consumption. DAL was measured by Potential Renal Acid Load (PRAL) and Net Endogenous Acid production (NEAP). Fasting blood s les were obtained from all participants. The primary outcome was IR, which was estimated by HOMA-IR. Secondary outcomes included HOMA-β, glycosylated hemoglobin, and fasting blood glucose and insulin. Multiple linear regression models adjusted for sociodemographics, lifestyle, and clinical variables were used for analysis, with exposure and outcome variables standardized as Z-scores to allow comparability of the results. The mean PRAL and NEAP in the s le were 16.9 ± 4.8 and 66.1 ± 7.1 mEq/day, respectively. The average HOMA-IR score was 2.4 ± 1.6. In adjusted analyses, PRAL was positively associated with HOMA-IR, fasting insulin, and fasting blood glucose (p-value <0.05 in all cases), but not with HOMA-β or glycated hemoglobin. NEAP also showed a direct-trend relationship with HOMA-IR and fasting insulin, but not with fasting blood glucose or the other outcomes. The strongest association was between PRAL and HOMA-IR (β, 0.20 95% CI, 0.06-0.35). A higher DAL was consistently associated with higher IR and insulin levels but not with other glycaemic parameters. Apparently, β-pancreatic cells function is not affected by DAL in this population. This is the first study that describes the DAL in a population-based s le of adults in Latin America and in a middle-income country population. Further longitudinal and interventional studies are required to establish a better causal effect between DAL and IR.
Publisher: FapUNIFESP (SciELO)
Date: 09-2013
DOI: 10.1590/S0103-05822013000300007
Abstract: OBJECTIVE To evaluate the National Program of Iron Supplementation (PNSF) coverage, the compliance with the directions for of using of this supplementation and the association with sociodemographic factors in children aged six to 18 months old and registered in 35 public health centers of Florinópolis (Southern Brazil). METHODS Cross-sectional study using secondary data obtained from the health information system of the Health Department of Florianópolis, Santa Catarina, Brazil (Infosaúde). Data on ferrous sulfate supplementation and sociodemographic variables were obtained of all children registered in PNSF in Florianópolis in 2010. STATA 11.0 software was used in the analyses. RESULTS The PNSF covered 6.3% (95%CI 5.9-6.7) of the children the compliance with the directions regarding age at the onset of supplementation and its frequency was adequate only in 2.4% of the cases (95%CI 1.5-3.7). There was no association with the child's gender, maternal education level and ethnicity or the distance from home to the health center. CONCLUSIONS This study showed low coverage and inadequate compliance with the PNSF directions. Measures to improve this strategy are urgent.
Publisher: FapUNIFESP (SciELO)
Date: 12-2013
DOI: 10.1590/S1413-81232013001200030
Abstract: Estudo transversal de base escolar que avaliou a prevalência e fatores associados ao consumo diário de refrigerantes, doces e frituras em adolescentes (15-20 anos) da rede pública estadual de Caruaru (PE), em 2007. Para avaliar os fatores associados ao consumo diário de refrigerantes, doces e frituras, realizou-se análise multivariável e hierarquizada, por regressão de Poisson, com variáveis sociodemográficas no primeiro nível hierárquico, comportamentais no segundo e relacionadas ao padrão alimentar no terceiro. O consumo de refrigerantes, doces ou frituras em pelo menos uma vez por semana foi referido por 90,9%, 95,4% e 89,6% dos adolescentes, respectivamente. As prevalências correspondentes ao consumo diário destes alimentos foram 30,2%, 42,0% e 28,3%. O consumo diário de doces foi 21% maior entre as meninas e 25% maior entre adolescentes que consumiram arroz e feijão diariamente. Em relação às frituras, as meninas referiram um consumo 37% maior do que os meninos. Adolescentes que consumiram carnes diariamente, apresentaram um consumo diário de frituras 43% maior. O consumo de refrigerantes, doces e frituras entre os adolescentes caruaruenses mostrou-se elevado e apresentou um padrão de consumo homogêneo para a maioria das variáveis analisadas.
Publisher: Cambridge University Press (CUP)
Date: 12-03-2014
DOI: 10.1017/S1368980013000529
Abstract: To evaluate the adequacy and accuracy of cut-off values currently recommended by the WHO for assessment of cardiovascular risk in southern Brazil. Population-based study aimed at determining the predictive ability of waist circumference for cardiovascular risk based on the use of previous medical diagnosis for hypertension, diabetes mellitus and/or dyslipidaemia. Descriptive analysis was used for the adequacy of current cut-off values of waist circumference, receiver operating characteristic curves were constructed and the most accurate criteria according to the Youden index and points of optimal sensitivity and specificity were identified. Pelotas, southern Brazil. In iduals ( n 2112) aged ≥20 years living in the city were selected by multistage s ling, since these in iduals did not report the presence of previous myocardial infarction, angina pectoris or stroke. The cut-off values currently recommended by WHO were more appropriate in men than women, with overestimation of cardiovascular risk in women. The area under the receiver operating characteristic curve showed moderate predictive ability of waist circumference in men (0·74, 95 % CI 0·71, 0·76) and women (0·75, 95 % CI 0·73, 0·77). The method of optimal sensitivity and specificity showed better performance in assessing the accuracy, identifying the values of 95 cm in men and 87 cm in women as the best cut-off values of waist circumference to assess cardiovascular risk. The cut-off values currently recommended for waist circumference are not suitable for women. Longitudinal studies should be conducted to evaluate the consistency of the findings.
Publisher: FapUNIFESP (SciELO)
Date: 12-2017
Publisher: FapUNIFESP (SciELO)
Date: 08-2013
DOI: 10.1590/S1415-52732013000400003
Abstract: OBJETIVO: Identificar o perfil dos cozinheiros escolares e avaliar a utilização, os benefícios e os possíveis fatores limitantes da introdução de alimentos orgânicos na alimentação escolar. MÉTODOS: Estudo transversal e exploratório incluindo os cozinheiros chefes de 242 escolas públicas municipais dos 52 municípios do estado de Santa Catarina que compraram alimentos orgânicos para a alimentação escolar em 2010. Os entrevistados foram questionados sobre a utilização de alimentos orgânicos, seus benefícios, as dificuldades e a capacitação recebida sobre esse tema. As prevalências e os IC95% foram calculados no software Stata 11.0. RESULTADOS: Dos 242 cozinheiros entrevistados, 97,4% eram do sexo feminino, 86,6% apresentavam 30 ou mais anos de idade e 47,9% não cursaram o ensino médio ou superior. Entre esses, 9,4% (IC95% 6,1-13,9) desconheciam que a escola estava recebendo alimentos orgânicos. Entre aqueles que referiram usar alimentos orgânicos (n=219), 42,7% (IC95% 34,3-51,5) referiram presença diária desses alimentos no cardápio escolar. A qualidade dos alimentos no momento da entrega na escola foi considerada ótima/boa em 93,7% dos casos. Quase 10,0% relataram dificuldades no uso desses alimentos, especialmente por problemas no recebimento/ armazenamento e baixa aceitação pelos alunos. A maioria percebeu benefícios no uso de orgânicos na alimentação escolar, tanto para os alunos (99,8%) quanto para a comunidade (100,0%). CONCLUSÃO: O percentual de dificuldades encontrado pelos cozinheiros no uso dos alimentos orgânicos foi baixo, sendo positiva a avaliação quanto ao rendimento, a durabilidade, a quantidade de trabalho e a qualidade desses produtos em comparação aos não orgânicos. Os possíveis fatores limitantes poderiam ser corrigidos mediante melhoria na estrutura física das escolas, na logística de recebimento/estocagem desses alimentos, na capacitação direcionada dos cozinheiros e na sua maior integração nas políticas de alimentação escolar.
Publisher: Springer Science and Business Media LLC
Date: 05-2019
Publisher: Cambridge University Press (CUP)
Date: 09-06-2015
DOI: 10.1017/S1368980015001718
Abstract: To assess the Na content reported on the labels of processed foods sold in Brazil that are usually consumed as snacks by children and adolescents. Cross-sectional study that assessed Na content and serving size reporting on processed food labels. A supermarket that is part of a large chain in Brazil. All foods available for sale at the study’s location and reported in the literature as snacks present in the diets of Brazilian children and adolescents. Of the 2945 processed foods, 87 % complied with the reference serving sizes, although variability in reporting was observed in most of the food subgroups. In addition, 21 % of the processed foods had high Na levels ( mg/100 g) and 35 % had medium Na levels ( and ≤600 mg/100 g). The meats, oils, fats and seeds groups as well as the prepared dishes had higher percentages of foods classified as high Na (81 %, 58 % and 53 %, respectively). Most of the processed foods had high or medium Na content. We emphasize the importance of revising Brazilian nutrition labelling legislation to standardize reference serving sizes to avoid variation. Besides, we point out the potential for reducing Na levels in most processed foods, as evidenced by the variability in Na content within subgroups. Finally, we have identified the need to develop a method to classify Na levels in processed foods with specific parameters for children and adolescents.
Publisher: FapUNIFESP (SciELO)
Date: 12-2018
DOI: 10.1590/1413-812320182311.28012016
Abstract: Resumo A integração entre a agricultura familiar e a alimentação escolar têm o potencial de melhorar a variedade dos cardápios escolares aproximando produção e consumo de alimentos. Este estudo caracterizou os municípios brasileiros quanto à compra de alimentos da agricultura familiar pelo Programa Nacional de Alimentação Escolar. Trata-se de estudo transversal realizado por meio de questionário eletrônico enviado aos 5.565 municípios do país. Participaram da pesquisa 93,2% dos municípios (n = 5.184). Destes, 78,5% adquiriram alimentos da agricultura familiar, destacando-se a região Sul, com a maior frequência de municípios realizando a compra (95,5%), e a região Centro-Oeste com a menor (67,9%). Os municípios de grande porte, com gestão da alimentação escolar do tipo mista, descentralizada ou terceirizada e sem nutricionista como responsável técnico, apresentaram menor frequência de compra de alimentos da agricultura familiar. Conclui-se que, apesar da la efetivação da aquisição de alimentos da agricultura familiar pelo programa em todo país, 50% dos municípios não investiram o mínimo exigido em lei, demandando ações educativas e de assistência técnica direcionadas para o cumprimento da legislação, em especial nos estados e regiões que apresentaram maiores dificuldades.
Publisher: Wiley
Date: 04-2020
DOI: 10.1111/AJR.12621
Publisher: Wiley
Date: 25-08-2023
DOI: 10.1111/AJR.13032
Abstract: Type 2 diabetes is more prevalent among Aboriginal and Torres Strait Islander Peoples, especially those living in rural than urban areas. However, little is known about how diabetes is managed in different settings. To investigate differences in the prevalence of diabetes and the prescription of antidiabetic medications for Aboriginal and/or Torres Strait Islander Peoples living in urban or rural Australia. Cross‐sectional study using de‐identified electronic medical records of 29,429 Aboriginal and/or Torres Strait Islander adults (60.4% females mean age 45.2 ± 17.3 years) regularly attending 528 ‘mainstream’ Australian general practices (MedicineInsight) in 2018. The prevalence of diabetes was 16.0%, and it was more frequent among those living in rural areas (22.0 95% CI 19.3–24.4) than inner regional (17.6% 95% CI 16.0–19.2) or major cities (15.8% 95% CI 14.7–17.0 p 0.001). The highest prevalence of diabetes was for males living in rural settings (25.0%). Of those with diabetes, 71.6% (95% CI 69.0–74.0) were prescribed antidiabetics, with a similar frequency in urban and rural areas ( p = 0.291). After adjustment for sociodemographics, the only difference in diabetes management was a higher prescription of sulfonylureas in rural areas than in major cities (OR 1.39 1.07–1.80). The prevalence of diabetes was similar to other national data, although we found it was more frequent amongst Aboriginal and/or Torres Strait Islander males, especially those from rural areas. Despite current recommendations, one‐in‐four Indigenous Australians with diabetes were not prescribed antidiabetics. The clinical significance of more frequent prescriptions of sulfonylureas in rural locations remains unclear.
Publisher: Wiley
Date: 10-04-2023
DOI: 10.1111/AJR.12981
Abstract: To evaluate the contribution of the Adelaide Rural Clinical School (ARCS) longitudinal integrated clerkship to the rural medical workforce. Design : Retrospective cohort study. Setting : Practice location data were sourced from the Australian Health Practitioner Regulation Agency (AHPRA, January 2021) and matched using university records. Participants : University of Adelaide medical school alumni graduating between 2004 and 2019 (ARCS alumni who completed a full year of rural training [ n = 423], metropolitan‐trained peers [ n = 1655]). Main outcome measures : The proportions of medical graduates working in a rural location (Modified Monash Model [MMM3‐7] or Australian Statistical Geography Standard [ASGS‐RA2‐5] classifications). Logistic regression was used to examine the association between ARCS training and working rurally, and the influence of rural background and sociodemographic factors. Working in a rural location was almost three times more frequent among ARCS alumni than their metropolitan‐trained peers, using the MMM3‐7 (14.7% vs. 5.3%) classification for ASGS‐RA2‐5 classification (21.3% vs. 8.9%). In adjusted analysis, working rurally (MMM3‐7) was associated with having a rural/remote residence on enrolment (OR 8.29, 95% CI 4.22–16.26) and was 3.1 times more likely for ARCS alumni (OR 3.06, 95% CI 2.06–4.53) than their peers. The magnitude of the effects of ARCS training on whether they are working rurally was similar among those with metropolitan or rural background ( p ‐value for interaction 0.873). Similar associations were observed using ASGS‐RA2‐5 classifications. Extended rural placements through the Adelaide Rural Clinical School increased the rural medical workforce, with a similar impact among those with a rural or metropolitan background.
Publisher: Wiley
Date: 31-08-2023
DOI: 10.1111/AJR.13035
Abstract: To report self‐perceived readiness for work as a junior doctor in a national cohort of rural clinical school students. Cross‐sectional study using a self‐report questionnaire. Independent variables included 14 in idual readiness items related to clinical and professional tasks, sociodemographic data and reported experience of rural clinical school (RCS) training. Participants were 668 medical students (55.3% females) completing a full academic year in rural Australia. Multivariable analysis explored factors associated with overall readiness for work as a junior doctor. 86% agreed that RCS experience prepared them to undertake the roles and responsibilities of a junior doctor. Self‐ratings for specific clinical and professional tasks varied from a mean score of 5.9–8.0 out of 10, and 13 of the 14 items were associated with the outcome ( p ‐value .001, except for performing spirometry). Lowest readiness scores were seen for some aspects including raising concerns about a colleague (mean score 6.1) or responding to workplace bullying (mean score 6.0). Aspects of the RCS experience that were strongly associated with overall readiness included: feeling a valued team‐member (OR 9.28, 95%CI 2.43–35.39), feeling well‐supported academically (OR 6.64, 95%CI 3.39–13.00), having opportunity for unsupervised but supported clinical practice (OR 4.67, 95%CI 1.45–15.00), having a rural mentor (OR 3.38, 95%CI 1.89–6.06) and having a previous health professional qualification (OR 2.7, 95%CI 1.32–5.54). Most RCS students felt ready for work as a junior doctor. Important aspects of RCS experience are likely to include students feeling integrated within the clinical team and having opportunities for authentic clinical roles. There remains a significant challenge for medical school curricula to address professional areas where graduates felt less prepared.
Publisher: FapUNIFESP (SciELO)
Date: 2016
DOI: 10.1590/0102-311X00164015
Abstract: Resumo: O objetivo do estudo foi estimar a ingestão dietética de micronutrientes por adultos em um município do Sul do Brasil segundo sexo e idade, assim como identificar a prevalência de ingestão inadequada de micronutrientes segundo sexo. Trata-se de um estudo transversal, de base populacional, com 1.222 adultos de 22 a 63 anos, residentes em Florianópolis, Santa Catarina, Brasil. Os dados sobre a ingestão alimentar foram obtidos pela aplicação de dois recordatórios de 24 horas (um no total da amostra e outro em subamostra de 40% dos entrevistados), sendo a ingestão de micronutrientes e as prevalências de inadequação na ingestão estimadas conforme recomendações do National Research Council e do Institute of Medicine. Prevalências elevadas de inadequação para toda a amostra foram vistas para as vitaminas A, C, D e E (variação de 52%-100%). A ingestão de cálcio e ferro foi a mais inadequada entre as mulheres (87,3% e 13,7%, respectivamente), e a de zinco entre os homens (25,1%). Adultos de Florianópolis apresentaram prevalências elevadas de inadequação na ingestão de micronutrientes essenciais.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2019
Publisher: Archives of Endocrinology and Metabolism
Date: 19-06-2020
Publisher: Informa UK Limited
Date: 05-07-2021
Publisher: Springer Science and Business Media LLC
Date: 10-05-2015
Publisher: FapUNIFESP (SciELO)
Date: 10-2011
DOI: 10.1590/S0102-311X2011001000004
Abstract: Este estudo teve por objetivo identificar fatores associados à ocorrência de gravidez não planejada em Rio Grande, Rio Grande do Sul, Brasil. Em 2007, aplicou-se questionário padronizado a todas as parturientes residentes neste município, investigando sobre características demográficas e reprodutivas maternas, nível socioeconômico da família e assistência recebida na gestação e parto. A análise ajustada foi realizada utilizando-se regressão de Poisson com ajuste robusto da variância. Dentre as 2.557 gestantes incluídas no estudo, 65% não planejaram a gravidez. Após ajuste para confundimento, as seguintes variáveis mostraram-se significativamente associadas à gravidez não planejada: cor da pele parda reta, idade inferior a 20 anos, sem companheiro, baixa renda familiar, aglomeração familiar, tabagismo e mais de um parto. Abortamento prévio mostrou-se protetor para a gravidez não planejada. A elevada ocorrência de gravidez não planejada, sobretudo entre aquelas com maiores riscos de complicações durante a gestação e o parto, indica a necessidade de se estabelecerem programas de saúde à atenção desta população.
Publisher: BMJ
Date: 04-2019
DOI: 10.1136/BMJOPEN-2018-026396
Abstract: To investigate the epidemiology of influenza-like illness (ILI) by general practice and patient characteristics, and explore whether sociodemographic variables or comorbidities affect antiviral or antibiotic prescribing. Open cohort study. A representative s le of 550 Australian general practices contributing data to the MedicineInsight programme. 4 228 149 patients of all age groups who had at least one consultation between 2015 and 2017. Median age was 37 years (Interquartile range: 21–57), 54.4% women, 16.4% aged ≥65 years, 2.2% Aboriginal or Torres Strait Islander, 17.6% had a chronic disease and 18.1% a mental health condition. ILI consultation rates (per 1000 consultations) were calculated using all ILI diagnoses for all clinical encounters with a general practitioner between 2015 and 2017. Antiviral and antibiotic prescribing for ILI cases were investigated and logistic regression models adjusted for practice and patient characteristics used to analyse associations. ILI consultation rates in 2017 were higher than in previous years. Antiviral prescribing increased from 20.6% in 2015, to 23.7 in 2016 and 29.7% in 2017, while antibiotic prescribing decreased from 30.3% to 28.0% and 26.7%, respectively (p .05 in both cases). Practices located in high socioeconomic areas had higher ILI consultation rates (4.3 vs 2.5 per 1000 consultations, p .05), antibiotic (30.7% vs 23.4%, p .05) and antiviral (34.2% vs 13.5%, p .05) prescribing than those in lower socioeconomic areas. The coexistence of chronic or mental health conditions was associated with lower ILI consultation rates, higher antibiotic use, but not with antiviral prescribing. However, those with chronic respiratory conditions had a higher frequency of antibiotic and antiviral prescribing in 2017 than in iduals with other comorbidities. Although the apparent decline in antibiotic prescribing for ILI is welcome, the increase in antiviral use may not be targeting those at high risk of complications from infection.
Publisher: FapUNIFESP (SciELO)
Date: 02-2013
DOI: 10.1590/S1413-81232013000200011
Abstract: Trata-se de um estudo transversal de base escolar que avaliou a prevalência e fatores associados ao consumo diário de frutas, legumes e verduras (FLV) entre adolescentes de escolas públicas de Caruaru (PE). Para avaliar os fatores associados ao consumo diário de FLV, realizou-se análise multivariável e hierarquizada, por regressão de Poisson, com variáveis sociodemográficas no primeiro nível, comportamentais no segundo e alimentares no terceiro. Os resultados mostraram que, dos 600 adolescentes entrevistados, 10% informaram não consumir frutas e 30,7% não consomem legumes/verduras. A prevalência de consumo diário de frutas foi 32,9% e de legumes/verduras 29%. Apenas 6,5% dos adolescentes consomem ambos os alimentos diariamente. Somente o consumo diário de legumes/verduras apresentou diferença segundo sexo (maior nas meninas). O consumo diário de frutas foi 63% maior entre residentes da zona urbana. Não ingerir álcool esteve associado com maior consumo de frutas, mas não com o de legumes/verduras. O consumo diário de frutas e legumes/verduras foi 2,4 vezes maior entre adolescentes que consomem arroz e feijão diariamente. O consumo diário de FLV entre adolescentes caruaruenses é inferior ao recomendado, estando associado ao sexo, zona de residência, consumo de álcool e de arroz e feijão.
Publisher: Hindawi Limited
Date: 23-03-2022
DOI: 10.1155/2022/1566408
Abstract: Aims. To investigate the epidemiology of diabetes diagnosis and screening in Australian general practice. Methods. Cross-sectional study using electronic health records of 1,522,622 patients aged 18+ years attending 544 Australian general practices (MedicineInsight database). The prevalence of diagnosed diabetes and diabetes screening was explored using all recorded diagnoses, laboratory results, and prescriptions between 2016 and 2018. Their relationship with patient sociodemographic and clinical characteristics was also investigated. Results. Overall, 7.5% (95% CI 7.3, 7.8) of adults had diabetes diagnosis, 0.7% (95% CI 0.6, 0.7) prediabetes, and 0.3% (95% CI 0.3, 0.3) unrecorded diabetes rediabetes (elevated glucose levels without a recorded diagnosis). Patients with unrecorded diabetes rediabetes had clinical characteristics similar to those with recorded diabetes, except for a lower prevalence of overweight/obesity (55.5% and 69.9%, respectively). Dyslipidaemia was 1.8 times higher (36.2% vs. 19.7%), and hypertension was 15% more likely (38.6% vs. 33.8%) among patients with prediabetes than with diabetes. Diabetes screening (last three years) among people at high risk of diabetes was 55.2% (95% CI 52.7, 57.7), with lower rates among young or elderly males. Conclusions. Unrecorded diabetes rediabetes is infrequent in Australian general practice, but prediabetes diagnosis was also lower than expected. Diabetes screening among high-risk in iduals can be improved, especially in men, to enhance earlier diabetes diagnosis and management.
Publisher: Wiley
Date: 31-05-2017
DOI: 10.1111/OBR.12564
Abstract: While the impact of interpersonal discrimination on mental health is well established, its effects on physical health outcomes have not been fully elucidated. This study systematically reviewed the literature on the prospective association between interpersonal discrimination and markers of adiposity. Medline, Web of Science, Scopus, PsycInfo, SciELO, LILACS, Google Scholar, Capes/Brazil and ProQuest databases were used to retrieve relevant information in November 2016. The results from the 10 studies that met the inclusion criteria support an association between interpersonal self-reported discrimination and the outcomes. In general, the most consistent findings were for weight and body mass index (BMI) among women, i.e. high levels of self-reported discrimination were related to increased weight and BMI. Waist circumference (WC) showed a similar pattern of association with discrimination, in a positive direction, but an inverted U-shaped association was also found. Despite a few inverse associations between discrimination and markers of adiposity, none of the associations were statistically significant. Overall, markers of adiposity were consistently associated with discrimination, mainly through direct and nonlinear associations. This review provides evidence that self-reported discrimination can play an important role in weight, BMI and WC changes.
Publisher: BMJ
Date: 06-2019
DOI: 10.1136/BMJOPEN-2018-026035
Abstract: To assess the relationship between gastrointestinal conditions, restrictive diets, mental health and health-related quality of life (HRQoL). Cross-sectional population-based face-to-face survey. South Australia. A representative s le of 2912 consenting adults (48.9±18.1 years 50.9% females) investigated in 2015. Participants self-reported diagnosis of gastrointestinal conditions, mental health and current use of restrictive diets. The physical component score (PCS) and mental component score (MCS) of HRQoL were investigated (Study Short Form 12 V.1 questionnaire). Linear regression models were used to test the associations, adjusting for (1) sociodemographic variables, (2) mental health status and (3) lifestyle and body mass index. The prevalence of restrictive diets (36.1% 95% CI 33.9 to 38.3) was higher among those with any self-reported gastrointestinal condition (60.7% vs 31.3% for those without these conditions p .001). PCS was lower among those with a gastrointestinal condition (mean difference=−3.4 95% CI −4.5 to −2.4) or on a restrictive diet (mean difference=−1.9 95% CI −2.7 to −1.1), with a similar pattern, but with a smaller effect, observed for MCS. Being on a restrictive diet did not modify the relationship between having a gastrointestinal condition and reduced HRQoL. However, having a gastrointestinal condition was associated with a 2.4 points lower PCS (95% CI −3.5 to −1.3) among those without a mental health problem, while for those affected by a mental health condition this reduction was greater (mean difference=−5.9 95% CI −8.7 to −3.1). For MCS, there was no evidence of interaction between mental health and gastrointestinal conditions. One-third of Australian adults are restricting their diet, and this is associated with lower HRQoL. Being on a restrictive diet was not associated with a better HRQoL among in iduals with a gastrointestinal condition. Mental health problems were associated with a stronger adverse relationship between gastrointestinal diseases and physical HRQoL. Health professionals should be alert to these associations when trying to improve health outcomes for patients.
Publisher: FapUNIFESP (SciELO)
Date: 09-2011
DOI: 10.1590/S0102-311X2011000900010
Abstract: Este estudo transversal de base populacional teve por objetivo investigar a prevalência de tabagismo materno durante a gestação e seu impacto sobre as medidas antropométricas do recém-nascido. Aplicou-se questionário padronizado a todas as parturientes nas maternidades do Município de Rio Grande, Rio Grande do Sul, Brasil, em 2007. Foram obtidas medidas de peso, comprimento e perímetros cefálico dos recém-nascidos. A prevalência do tabagismo materno na gestação foi de 23%, enquanto a prevalência da exposição passiva ao fumo foi de 29%. Após ajuste para possíveis fatores de confusão, comparados aos recém-nascidos de mães que nunca fumaram, aqueles nascidos de mães fumantes durante toda a gestação tiveram ao nascer, em média, redução de 223,4g (IC95%: 156,7 290,0) no peso, de 0,94cm (IC95%: 0,60 1,28) no comprimento e de 0,69cm (IC95%: 0,42 0,95) no perímetro cefálico. Concluiu-se que a prevalência de tabagismo materno na gestação é alta no Município de Rio Grande. Tabagismo materno durante toda a gestação teve impacto negativo nas medidas antropométricas do recém-nascido.
Publisher: Elsevier BV
Date: 08-2013
Publisher: Wiley
Date: 10-05-2017
DOI: 10.1111/GGI.13024
Abstract: To assess the influence of sociodemographic, behavioral and health status variables on longitudinal changes in height, weight, and waist circumference in older adults. This is a population-based cohort study in Southern Brazil (EpiFloripa Study) investigating 1702 in iduals aged 70.6 ± 8.0 years (62.5% women). Height, weight and waist circumference were measured in 2009/10 and 2013/14 (n = 1197). Linear mixed regression models were used to estimate age-related changes in anthropometric measurements according to the explanatory variables. Unmarried in iduals, with higher education level or household income, with excessive alcohol consumption, former smokers and positives for some chronic disease were heavier than their counterparts. Similar associations were observed for waist circumference in terms of marital status, smoking and the presence of chronic diseases. Height was higher among the wealthiest, in former smokers and those physically active. Only in men were a lower education level and being unmarried associated with higher weight loss after the age of 75 years, but not with waist circumference reduction. Despite their association with current height, weight and waist circumference, neither behavioral variables nor the presence of chronic diseases influenced the anthropometric changes. Less educated and unmarried men lose weight at a higher rate, showing a higher risk of sarcopenia. Geriatr Gerontol Int 2017 17: 2074-2082.
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.JNEB.2014.09.005
Abstract: To assess the effect of a nutrition education intervention on nutritional factors and oxidative stress during treatment of breast cancer. Nonrandomized clinical trial conducted in 2010-2011, including an evaluation at baseline and after 12 months. Women from Brazil who had breast cancer, ided into an intervention group (IG) (n = 18) and comparison group (n = 75). To increase intake of fruits and vegetables and reduce red and processed meats, via telephone and printed materials. Food intake, anthropometry, and levels of lipid hydroperoxide, carbonyl proteins, reduced glutathione, and ferric reducing antioxidant power. Chi-square, Mann-Whitney or t tests for baseline data Wilcoxon or paired t tests for intra-group outcomes, linear regression models, and Bonferroni multiplicity adjustment. The researchers observed an increase in fruit and vegetable intake, reduction in red and processed meat intake, no change in body weight, and an increase in glutathione in the IG over the comparison group. However, after Bonferroni adjustment, only the consumption of fruits and vegetables and fruit was significantly higher in IG. This study presents improved dietary changes after a theory-driven nutrition education intervention. Although the s le size is small, it has proven to be clinically relevant.
Publisher: FapUNIFESP (SciELO)
Date: 06-2014
DOI: 10.1590/1809-4503201400020014ENG
Abstract: Objective: It was to investigate the cluster of four main risk behaviors (smoking, alcohol, physical inactivity and low consumption of fruits and vegetables) related to chronic diseases from Northeastern Brazil. Methods: Cross-sectional study with a representative s le (n = 600) of high school students from public schools in Caruaru, Pernambuco, Brazil. The cluster was evaluated by comparing the observed prevalence expected in all the possibilities of coupling between the behaviors. The logistic regression analysis was performed by grouping three or four behaviors, after adjusting for independent variables. Results: With the exception of smoking, other risk behaviors had prevalence rates above 20%. Only 0.3% (95%CI 0.1 - 1.3) of the students presented the four risk behaviors simultaneously, while 15.3% (95%CI 12.3 - 18.2) did not present anyone. Risk behaviors tended to cluster, particularly smoking and alcohol consumption, being more pronounced among boys, and physical inactivity and low consumption of fruits and vegetables among girls (p 0.05). Regression analysis indicated that, among the independent variables, those students who do not have physical education classes were 2.1 times more likely to have three or more risk behaviors added. Conclusions: The results of this study allow us to establish the prevalence of risk behaviors in cluster, which may have important implications for health policies and practices. It is suggested that educational and health actions are tested in schools, and physical education classes can be an important context for intervention.
Publisher: Informa UK Limited
Date: 25-11-2013
DOI: 10.3109/03014460.2013.854832
Abstract: The negative health consequences of childhood overweight/obesity (OW/OB) are well known. Therefore, an accurate monitoring of the OW/OB prevalence is essential. Anthropometry is the most practical and cost-effective method for nutritional status evaluation. To describe trends in the nutritional status among 7-10-year-old children by investigating changes in the prevalence of stunting, thinness, overweight, obesity, risk and excess abdominal adiposity, and to study changes in height-for-age, body mass index (BMI) and waist circumference (WC). A school-based s le of 7-10-year-old children participated in two cross-sectional studies in 2002 (n = 2936) and 2007 (n = 1232) in Florianopolis, southern Brazil. Prevalence of stunting, risk and excess abdominal adiposity and changes in the distribution of height-for-age, BMI-for-age, WC-for-age z-scores were evaluated. Three BMI-based references were used to define the prevalence of thinness, overweight and obesity. Between 2002-2007, the prevalence of stunting, thinness, obesity and excess abdominal adiposity remained stable, whereas overweight (including obesity) increased 10-23% in boys and 18-21% in girls, depending on the BMI reference used. The risk of abdominal adiposity increased in boys, but not in girls. No significant change was observed in mean height, BMI, WC-for-age z-scores. This study identified a potential levelling off in the prevalence of obesity and excess abdominal adiposity, but a continuing increase in the prevalence of overweight.
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJOPEN-2020-045418
Abstract: Describe trends and patterns in long-term opioid prescriptions among adults with musculoskeletal conditions (MSK). Interrupted time-series analysis based on an open cohort study. A representative s le of 402 Australian general practices contributing data to the MedicineInsight database. 811 174 patients aged 18+ years with an MSK diagnosis and three or more consultations in any two consecutive years between 2012 and 2018. Males represented 44.5% of the s le, 28.4% were 65+ years and 1.9% were Aboriginal or Torres Strait Islanders. Annual prevalence and cumulative incidence (%) of long-term opioid prescribing (3+ prescriptions in 90 days) among patients with an MSK. Average duration of these episodes in each year between 2012 and 2018. The prevalence of long-term opioid prescribing increased from 5.5% (95% CI 5.2 to 5.8) in 2012 to 9.1% (95% CI 8.8 to 9.7) in 2018 (annual change OR 1.09, 95% CI 1.08 to 1.09), but a slightly lower incidence was observed in 2018 (3.0% vs 3.6%–3.8% in other years annual change OR 0.99, 95% CI 0.98 to 0.99). The incidence was between 37% and 52% higher among practices located in rural Australia or lower socioeconomic areas. In idual risk factors included increasing age (3.4 times higher among those aged 80+ years than the 18–34 years group in 2012, increasing to 4.8 times higher in 2018), identifying as Aboriginal or Torres Strait Islander (1.7–1.9 higher incidence than their peers), or living in disadvantaged areas (36%–57% more likely than among those living in wealthiest areas). Long-term opioid prescriptions lasted in average 287–301 days between 2012 and 2016, reducing to 229 days in 2017 and 140 days in 2018. A longer duration was observed in practices from more disadvantaged areas and females in all years, except in 2018. The continued rise in the prevalence of long-term opioid prescribing is of concern, despite a recent reduction in the incidence and duration of opioid management.
Publisher: Wiley
Date: 06-2021
DOI: 10.1111/AJR.12750
Abstract: To investigate whether perceived opinions of primary care are associated with student career preferences after graduation among a rural clinical school cohort and whether the preferred location of practice moderates these relationships. Cross‐sectional study using data from the national Federation of Rural Australian Medical Educators survey. Medical students across 18 Australian universities who completed a clinical year in a rural setting in 2019. Career preference in primary care after graduation. The survey was completed by 624 students (response rate = 69.9%). A preference for primary care was reported by 35.5% (95% CI: 29.4‐42.0) of students and was more likely among those age 30+ years, with a rural background, or preferring to practise rurally after graduation. Students reported that primary care was more commonly respected by medical academics (66.8%) than peers (24.0%) or junior/hospital doctors (24.0%). In adjusted analysis, none of the perceived opinions were associated with student career preferences. However, among students aiming to work in small rural locations, a career in primary care was associated with more frequent reports that peers had poor opinions of primary care ( P = .004). Rural clinical school students perceive negative opinions of primary care, particularly among peers and junior/hospital doctors. Students aiming to work in small towns after graduation are more likely to report negative opinions among their peers, suggesting they may be more attuned to negative attitudes. This points to the need for a community of practice of like‐minded peers and clinicians to preserve the career interest of these students.
Publisher: Wiley
Date: 08-05-2023
DOI: 10.1111/AJR.12992
Abstract: To assess awareness, needs and use of Australian Government‐funded home aged care services among Aboriginal and Torres Strait Islander Peoples from rural and remote South Australia. Mixed‐method study. Four rural and remote communities with a higher proportion of Aboriginal populations (Ceduna, Port Augusta, Port Lincoln and Whyalla). Fifty Aboriginal peoples aged 50–89 years (68% females) interviewed between August 2020 and October 2021. Participant awareness, needs and unmet needs. 88% of the participants indicated they needed home care support with daily activities (median number of needs = 3 interquartile range 2–6 needs), especially housework (86%) and transportation (59%). However, only 41% of those reporting current needs were receiving home care services. The most prevalent unmet needs were allied health (87%), housework (79%), help with meals/meals preparation (76%), shopping (73%) and personal care (73%). Overall, 62% of the participants were unaware of the Commonwealth Home Support Programme, and 54% were unaware of the Home Care Packages program. Qualitative data showed participants felt there is insufficient information and public consultation about these services for older Aboriginal adults. Regular communication in group activities was the preferable approach to becoming aware of these services rather than websites, posted materials or phone calls. Further work is needed to increase home aged care service access for Aboriginal and Torres Strait Islander Peoples living in rural and remote settings. Promotion of these programmes through local group activities could facilitate access to these services and facilitate community engagement in decision‐making.
Publisher: FapUNIFESP (SciELO)
Date: 06-2014
DOI: 10.1590/1415-52732014000300007
Abstract: OBJECTIVE: To compare serving sizes reported on processed food labels with reference serving sizes according to nutrition labeling legislation and the "Food Guide for the Brazilian Population". METHODS: This cross-sectional study analyzed the labels of 2,072 processed foods in a supermarket of Florianópolis, Santa Caratina, Brazil. The foods were classified according to the Brazilian food labeling legislation. Central tendency and variability values were calculated for the serving sizes and energy values reported on the labels, as well as the ratio between the reported and reference energy value. The Spearman correlation test was performed between the reference serving size and the reference energy density, and also between the reference serving size and energy density of each study food. RESULTS: Nutrition labeling and the Food Guide presented reference servings with different sizes and energy values. The serving sizes reported on the labels did not follow either of the references and presented heterogeneous values, with a maximum range of 55-240 g among ready and semi-ready pre-prepared dishes. The reported energy values were between 0.1 times smaller and 2.4 times larger than the reference values. The reference serving sizes presented a highly inverse correlation with the reference energy density (Spearman coefficient= 0.9) and a very low inverse correlation with the energy density of the foods analyzed (Spearman coefficient= 0.2). CONCLUSION: This study showed the need for standardizing reference serving size information for the Brazilian population as well as reviewing nutrition labeling legislation in order to standardize the serving sizes reported on labels and to update the reference energy density used to calculate serving sizes.
Publisher: Science and Education Publishing Co., Ltd.
Date: 07-11-2014
DOI: 10.12691/JFNR-2-12-8
Publisher: Oxford University Press (OUP)
Date: 25-12-2017
Abstract: To evaluate the association between sociodemographic conditions and the quality of life (QoL) in adults and investigate whether these inequalities are greater among in iduals with long-lasting chronic health conditions. Cross-sectional analysis of the second wave (2012) of the EpiFloripa Study, a population-based cohort of 1720 adults living in Southern Brazil. QoL domains (physical, psychological, social relationships and environmental) were evaluated using the WHOQoL-BREF. Unadjusted and adjusted means of QoL according to socioeconomic and demographic variables were estimated and stratified by the presence of long-lasting chronic conditions (heart disease, stroke, diabetes, hypertension, chronic kidney disease, cirrhosis, tendinitis, arthritis, rheumatism and/or fibromyalgia) were peformed in 2016. Among 1222 interviewed adults (56.6% females, mean age 41.7 ± 11.4 years follow-up rate 71.1%), the prevalence of 1+ long-lasting chronic disease was 37.3% (95%CI: 34.4-40.3). Their effect on the QoL was four times higher on the physical component (-9.6 95%CI -12.1 -7.1) than on the other domains. Adults aged 40+ years with black skin colour or lower educational level had a lower physical QoL score only when any chronic disease was present. Among those with some chronic illness, the psychological domain was also lower among those aged 40+ years and with a lower family income. No interaction between sociodemographic variables and chronic diseases was observed for the other QoL domains. The occurrence of long-lasting chronic diseases is associated with inequalities in QoL (physical and psychological domains), with stronger adverse effects among older adults, blacks and in iduals with lower income or educational levels.
Publisher: Public Library of Science (PLoS)
Date: 04-03-2016
Publisher: FapUNIFESP (SciELO)
Date: 2020
DOI: 10.1590/1980-549720200070
Abstract: RESUMO: Objetivo: Analisar as associações entre mudanças do nível de atividade física de lazer em adultos com a prevalência de síndrome metabólica. Métodos: Estudo de base populacional realizado com 818 adultos de 20 anos ou mais em Florianópolis, Santa Catarina, entre 2009 e 2014. Testou-se a associação da manutenção e/ou mudança do nível de atividade física com a prevalência de síndrome metabólica, ajustada por variáveis sociodemográficas (sexo, idade, escolaridade, renda, estado civil e cor da pele) e tabagismo. Empregou-se regressão logística, estimando-se as razões de chance (OR) e os respectivos intervalos de confiança (IC95%). Resultados: A prevalência geral de síndrome metabólica foi de 30,9% (IC95% 27,2 - 34,7). Independentemente das variáveis de ajuste, os adultos que deixaram de ser ativos e/ou se mantiveram fisicamente inativos no lazer no período apresentaram, respectivamente, 108 e 124% maiores chances para a síndrome metabólica (OR = 2,08 IC95% 1,30 - 3,33) e (OR = 2,24 IC95% 1,38 - 3,65). As mulheres e os in íduos com idade inferior a 45 anos apresentaram menores chances para a síndrome metabólica. Conclusões: Nesta amostra, manter-se inativo ou passar a sê-lo associou-se, significativamente, com maiores chances para a síndrome metabólica.
Publisher: FapUNIFESP (SciELO)
Date: 12-2013
DOI: 10.1590/S1415-52732013000600010
Abstract: OBJETIVO: Caracterizar o Programa Nacional de Alimentação Escolar no Estado de Santa Catarina. MÉTODOS: Pesquisa quantitativa exploratória e transversal. A coleta de dados foi realizada de fevereiro a maio de 2010 por meio de questionário online com 293 municípios catarinenses. As variáveis descritivas foram analisadas conforme distribuição absoluta e relativa. Na análise estatística foi realizado o teste de Qui-quadrado (p ,05) utilizando software Stata 11.0. RESULTADOS: A taxa de adesão foi de 74,4%. A maioria dos municípios possuía: gestão do Programa Nacional de Alimentação Escolar centralizada (97,7%) até 10 escolas (58,7%) até mil alunos matriculados (55,1%), apenas um nutricionista (91,7%) e até 10 merendeiras no município (49,5%) fornecendo até 2 mil refeições ao dia (61,9%). Destaca-se que 2,8% dos municípios não possuíam responsável técnico e dois terços afirmaram que o custo médio por refeição servida variava entre R$0,31 e R$0,90, enquanto 21,6% informaram que o custo médio da refeição foi ≤R$0,30. Não foi detectada diferença estatística significante em relação ao número de refeições por merendeira ao dia e ao custo médio da refeição entre os diferentes portes dos municípios ou índice de desenvolvimento humano (p=0,584). Detectou-se adequação no número de nutricionistas por aluno matriculado estatisticamente maior nos municípios de pequeno porte (p ,001), assim com nos municípios de médio índice de desenvolvimento humano (p ,001). CONCLUSÃO: Verifica-se inadequação da maioria dos municípios quanto ao número de nutricionistas. Percebeu-se a necessidade do estabelecimento de parâmetros mínimos de adequação entre número de merendeiras e refeições servidas, da necessidade de incentivos financeiros relacionados à mão de obra e custo das refeições.
Publisher: BMJ
Date: 04-2023
DOI: 10.1136/BMJOPEN-2022-069875
Abstract: This study investigated whether the monitoring and control of clinical parameters are better among patients with newly compared with past recorded diabetes diagnosis. Retrospective cohort study. MedicineInsight, a national general practice database in Australia. 101 875 ‘regular’ adults aged 18+ years with past recorded (2015–2016) and 9236 with newly recorded (2017) diabetes diagnosis. Two different groups of outcomes were assessed in 2018. The first group of outcomes was the proportion of patients with clinical parameters (ie, glycated haemoglobin A1c (HbA1c), blood pressure (BP), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, estimated glomerular filtration rate and albumin-to-creatinine ratio) monitored at least once in 2018. The second group of outcomes were those related to diabetes control in 2018 (HbA1c ≤7.0%, (BP) ≤140/90 mm Hg, total cholesterol .0 mmol/L and LDL-C .0 mmol/L). Adjusted ORs (OR adj ) and adjusted probabilities (%) were obtained based on logistic regression models adjusted for practice variables and patients’ socio-demographic and clinical characteristics. The study included 111 111 patients (51.7% men mean age 65.3±15.0 years) with recorded diabetes diagnosis (11.0% of all 1 007 714 adults in the database). HbA1c was monitored in 39.2% (95% CI 36.9% to 41.6%) of patients with newly recorded and 45.2% (95% CI 42.6% to 47.8%) with past recorded diabetes (OR adj 0.78, 95% CI 0.73 to 0.82). HbA1c control was achieved by 78.4% (95% CI 76.7% to 80.0%) and 54.4% (95% CI 53.4% to 55.4%) of monitored patients with newly or past recorded diabetes, respectively (OR adj 3.11, 95% CI 2.82 to 3.39). Less than 20% of patients with newly or past recorded diabetes had their HbA1c, BP and total cholesterol levels controlled (OR adj 1.08, 95% CI 0.97 to 1.21). The monitoring of clinical parameters was lower among patients with newly than past recorded diabetes. However, diabetes control was similarly low in both groups, with only one in five monitored patients achieving control of all clinical parameters.
Publisher: Wiley
Date: 16-04-2017
DOI: 10.1111/ACPS.12735
Abstract: Although findings suggest that binge eating is becoming increasingly normative, the 'clinical significance' of this behaviour at a population level remains uncertain. We aimed to assess the time trends in binge-eating prevalence and burden over 18 years. Six cross-sectional face-to-face surveys of the Australian adult population were conducted in 1998, 2005, 2008, 2009, 2014, and 2015 (N The prevalence of OBE increased six-fold from 1998 (2.7%) to 2015 (13.0%). Health-related quality of life associated with OBE improved from 1998 to 2015, where it more closely approximated population norms. Days out of role remained higher among participants who reported OBE, although decreased over time. Half of participants who reported weekly (56.6%) and twice-weekly (47.1%) OBE reported that they were not distressed by this behaviour. However, the presence of distress related to OBE in 2015 was associated with greater health-related quality-of-life impairment. As the prevalence of binge eating increases over time, associated disability has been decreasing. Implications for the diagnosis of disorders associated with binge eating are discussed.
Publisher: FapUNIFESP (SciELO)
Date: 18-12-2017
DOI: 10.1590/0102-311X00136616
Abstract: Resumo: O objetivo do estudo foi investigar a associação entre o consumo alimentar inadequado de micronutrientes e indicadores de obesidade geral e abdominal. Análise transversal, da segunda onda do estudo longitudinal EpiFloripa Adultos, incluindo 1.222 in íduos de 22-63 anos, residentes em Florianópolis, Santa Catarina, Sul do Brasil. Os dados de consumo alimentar foram obtidos mediante aplicação de dois recordatórios de 24 horas, sendo o consumo habitual e as prevalências de inadequação no consumo de cálcio, ferro, zinco, e das vitaminas A, C, D e E estimadas conforme as recomendações do Instituto de Medicina e do Conselho Nacional de Pesquisa dos Estados Unidos. O estado nutricional de obesidade geral foi determinado considerando-se valores do índice de massa corporal (IMC), e a obesidade abdominal, considerando-se valores da circunferência da cintura (CC). Para a maioria dos micronutrientes investigados (cálcio, vitaminas A, C, D e E), as médias de consumo mostraram-se aquém dos valores recomendados, com prevalências elevadas de inadequação para toda a amostra. Somente a inadequação no consumo de vitamina C foi maior entre in íduos obesos (geral ou abdominal). Além disso, associação inversa foi observada entre o menor consumo de cálcio e ferro com valores maiores do IMC e da CC, e entre o menor consumo das vitaminas A e D com valores maiores da CC (β = -0,92cm IC95%: -1,76 -0,08 e β = -0,69cm IC95%: -1,32 -0,06, respectivamente), principalmente entre adultos jovens. Foi possível identificar a existência de associação inversa entre o consumo alimentar inadequado de micronutrientes e o estado nutricional de obesidade geral e abdominal também em uma amostra de adultos residentes no Sul do Brasil.
Publisher: Elsevier BV
Date: 12-2014
Publisher: FapUNIFESP (SciELO)
Date: 08-05-2014
Publisher: FapUNIFESP (SciELO)
Date: 12-2009
DOI: 10.1590/S0102-311X2009001200017
Abstract: Este estudo teve por objetivo medir a prevalência e identificar fatores associados à percepção de corrimento vaginal patológico por gestantes residentes em Rio Grande, Rio Grande do Sul, Brasil. Aplicou-se questionário padronizado a todas as parturientes nas maternidades do município em 2007. Utilizou-se teste do qui-quadrado para comparar proporções e análise multivariável por regressão de Poisson. A prevalência de corrimento vaginal foi de 40%. Análise ajustada mostrou as seguintes razões de prevalência: 1,6 (1,4-1,8) para adolescentes 1,3 (1,1-1,6) para aquelas com até oito anos de escolaridade 1,3 (1,1-1,5) para aquelas que ingeriram álcool 2,0 (1,8-2,2) para aquelas que referiram corrimento vaginal em gestação anterior 1,4 (1,3-1,6) para infecção urinária na gestação atual prematuridade em gestação anterior mostrou-se protetor com RP = 0,8 (0,7-0,9). Os serviços de saúde deveriam priorizar diagnóstico e tratamento de corrimento vaginal entre gestantes adolescentes, de baixa renda familiar e escolaridade, com história prévia de corrimento em gravidez anterior e infecção urinária na gravidez atual.
Publisher: Wiley
Date: 2017
Abstract: The aim of this study is to investigate the effects of abdominal and general obesity on periodontal outcomes in a population-based cohort of Brazilian adults. Abdominal and general obesity were assessed in the years 2009 (n = 1,720) and 2012 (n = 1,222). For abdominal obesity, a dichotomous variable was created: 1) eutrophic/lost weight or 2) obese/gained weight. For general obesity, a categorical variable was created: 1) eutrophic/lost weight 2) gained weight or 3) obese. Periodontal outcomes were percentage of teeth with bleeding on probing (BOP) and combination of BOP and attachment loss (AL). Hypertension was set as the mediator. Marginal structural models (MSMs) were used to estimate the controlled direct effect of obesity on periodontal outcomes. Periodontal data were presented from 1,066 participants. The total effect model showed those with general obesity in the cohort period presented higher risk of unfavorable periodontal outcomes (rate ratio [RR]: 1.45 for AL and BOP in different teeth RR: 1.84 for AL and BOP in the same tooth). Estimates from MSMs revealed an effect of general obesity on AL and BOP in different teeth (RR: 1.44). No effect of general obesity was noted on the percentage of BOP. Total effect of abdominal obesity increased risk of AL and BOP in different teeth (RR: 1.47), AL and BOP in the same tooth (RR: 2.77), and percentage of BOP (RR: 1.49). In a MSM, those with abdominal obesity presented greater risk of AL and BOP in the same tooth (RR: 2.16) and percentage of BOP (RR: 1.37). Abdominal obesity has a direct effect on unfavorable periodontal outcomes in MSMs.
Publisher: SAGE Publications
Date: 28-12-2021
DOI: 10.1177/00048674211067720
Abstract: To examine trends in prescribing psychotropic medications to children and adolescents in Australian primary care from 2011 to 2018. A retrospective cohort study examined prescriptions written by general practitioners using MedicineInsight, a large Australian primary care database, covering approximately 9% of all general practitioner practices. Numbers of patients receiving prescriptions for five main classes of psychotropics (antipsychotics, antidepressants, attention deficit hyperactivity disorder medications, anxiolytics, and hypnotics/sedatives [including benzodiazepines and Z-drugs, but excluding melatonin]) were examined annually by age-group (0–4, 5–9, 10–14, 15–18 years). Melatonin was analysed separately. The number of patients prescribed any psychotropic increased from 25.6 to 36.2 per 1000 in iduals from 2011 to 2018 (average annual increase +4.5%, 95% confidence interval [4.1%, 4.9%] overall +41.4%). Among the five main classes, the largest annual increase was for attention deficit hyperactivity disorder medications (+9.6%, 95% confidence interval [8.8%, 10.5%] overall +95.8%), followed by antipsychotics (+6.2%, 95% confidence interval [5.0%, 7.3%] overall +62.8%) and antidepressants (+4.5%, 95% confidence interval [4.0%, 5.0%] overall +42.8%). Hypnotic/sedative prescribing decreased on average 6.5% per year (95% confidence interval [–8.0%, –5.0%] overall −40.2%). Anxiolytic prescribing remained steady. Melatonin prescriptions showed the highest increase of all (+24.7%, 95% confidence interval [23.7%, 25.8%] overall +606.7%). The largest annual increase in antipsychotic, antidepressant or attention deficit hyperactivity disorder medication prescribing occurred in 10- to 14-year-olds (+7.5%, +6.5% and +10.4%, respectively). The largest point prevalence occurred in 2018 among 15- to 18-year-olds, with 98.5 per 1000 prescribed antidepressants. Antidepressants were more frequently prescribed to females antipsychotics, attention deficit hyperactivity disorder medications and melatonin more often to males. The most prescribed antipsychotics were risperidone ( years) and quetiapine (15- to 18-year-olds). Fluoxetine was the most prescribed antidepressant in those aged 5+ years and amitriptyline in 0- to 4-year-olds. General practitioner prescribing of melatonin, antipsychotics, antidepressants and attention deficit hyperactivity disorder medications to under-19-year-olds increased markedly from 2011 to 2018. Although benzodiazepine and Z-drug prescriptions declined, this was offset by a substantial increase in melatonin prescribing.
Publisher: American Chemical Society (ACS)
Date: 18-03-2016
DOI: 10.1021/ACS.BIOCHEM.5B01384
Abstract: Cellulose synthase-like F6 (CslF6) genes encode polysaccharide synthases responsible for (1,3 ,4)-β-glucan biosynthesis in cereal grains. However, it is not clear how both (1,3)- and (1,4)-linkages are incorporated into a single polysaccharide chain and how the frequency and arrangement of the two linkage types that define the fine structure of the polysaccharide are controlled. Through transient expression in Nicotiana benthamiana leaves, two CSLF6 orthologs from different cereal species were shown to mediate the synthesis of (1,3 ,4)-β-glucans with very different fine structures. Chimeric cDNA constructs with interchanged sections of the barley and sorghum CslF6 genes were developed to identify regions of the synthase enzyme responsible for these differences. A single amino acid residue upstream of the TED motif in the catalytic region was shown to dramatically change the fine structure of the polysaccharide produced. The structural basis of this effect can be rationalized by reference to a homology model of the enzyme and appears to be related to the position and flexibility of the TED motif in the active site of the enzyme. The region and amino acid residue identified provide opportunities to manipulate the solubility of (1,3 ,4)-β-glucan in grains and vegetative tissues of the grasses and, in particular, to enhance the solubility of dietary fibers that are beneficial to human health.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.VACCINE.2019.06.057
Abstract: To assess influenza immunisation rates and coverage in adult patients from Australian general practice and identify whether practice or patients' characteristics are associated with vaccination uptake. Open cohort study. 550 Australian general practices included in the MedicineInsight database. Patients aged 18+ years who had at least one consultation during influenza season between 2015 and 2017. Two s les were considered: (1) 'active' patients (at least three consultations in any two consecutive years) and (2) 'every year' patients (at least one consultation per year). Influenza vaccination rates per 1,000 consultations and coverage (% vaccinated among those who consulted) from 2015 to 2017. Between 2015 and 2017 the influenza vaccine rate changed from 57.4 to 51.7 and 67.0 per 1,000 consultations, while correspondent values for coverage were 29.3%, 25.2% and 27.6% (in 'active' patients). Vaccine coverage was at least 30% higher in inner regional areas, among patients aged 65+ years or those with comorbidities. Similar associations were found among 'every year' patients, but average coverage across the three years was higher (41% vs 27%). Aboriginal and Torres Strait Islander people, either with or without comorbidity, showed a vaccine coverage 10-30% higher than non-Indigenous people for those aged less than 65 years (p-value for interaction < 0.001). MedicineInsight data is a useful and low-cost method to monitor influenza immunisation coverage. Independent of the s le used, vaccination coverage among Indigenous people or patients with comorbidities could be improved. Targeted strategies for high-risk groups need to be developed.
Publisher: Springer Science and Business Media LLC
Date: 04-03-2023
Publisher: FapUNIFESP (SciELO)
Date: 07-2014
Publisher: FapUNIFESP (SciELO)
Date: 09-2015
Publisher: FapUNIFESP (SciELO)
Date: 05-2011
DOI: 10.1590/S0102-311X2011000500016
Abstract: Este estudo teve por objetivo comparar a assistência à gestação e ao parto entre mães adolescentes e não adolescentes residentes no Município de Rio Grande, Rio Grande do Sul, Brasil. Entre 1º de janeiro e 31 de dezembro de 2007 aplicou-se questionário padronizado a todas as mães destes recém-nascidos buscando informações sobre cuidados recebidos do inicio da gravidez até momento do parto. Utilizou-se teste do qui-quadrado para comparar proporções. Um quarto (516) dos recém-nascidos era filho de mães adolescentes. Em relação às demais mães, uma menor proporção de adolescentes completou seis ou mais consultas de pré-natal (61% x 75%), iniciou o pré-natal no primeiro trimestre de gravidez (58% x 77%), recebeu vacina antitetânica (81% x 85%) e fez todo o pré-natal com o mesmo profissional (70% x 78%) no entanto, foram mais comumente suplementadas com sulfato ferroso (66% x 57%), submetidas a fórcipe (11% x 6%), à episiotomia (86% x 66%), e atendidas no SUS (92% x 76%). Estes dados mostram que a assistência recebida pelas mães adolescentes foi sistematicamente pior àquela recebida pelas demais mães.
Publisher: FapUNIFESP (SciELO)
Date: 04-2014
Publisher: Elsevier BV
Date: 03-2018
Publisher: Springer Science and Business Media LLC
Date: 02-05-2022
DOI: 10.1038/S41371-022-00691-Z
Abstract: Hypertension guidelines recommend that absolute cardiovascular disease (CVD) risk guide the management of hypertensive patients. This study aimed to assess the proportion of patients with diagnosed hypertension with sufficient data to calculate absolute CVD risk and determine whether CVD risk is associated with prescribing of antihypertensive therapies. This was a cross-sectional study using a large national database of electronic medical records of patients attending general practice in 2018 (MedicineInsight). Of 571,492 patients aged 45–74 years without a history of CVD, 251,733 [40.6% (95% CI: 39.8–41.2)] had a recorded hypertension diagnosis. The proportion of patients with sufficient recorded data available to calculate CVD risk was higher for patients diagnosed with hypertension [51.0% (95% CI: 48.0–53.9)] than for patients without a diagnosis of hypertension [38.7% (95% CI: 36.5–41.0)]. Of those patients with sufficient data to calculate CVD risk, 29.3% (95% CI: 28.1–30.6) were at high risk clinically, 6.0% (95% CI: 5.8–6.3) were at high risk based on their CVD risk score, 12.8% (95% CI: 12.5–13.2) at moderate risk and 51.8% (95% CI: 50.8–52.9) at low risk. The overall prevalence of antihypertensive therapy was 60.9% (95% CI: 59.3–62.5). Prescribing was slightly lower in patients at high risk based on their CVD risk score [57.4% (95% CI: 55.4–59.4)] compared with those at low [63.3% (95% CI: 61.9–64.8)] or moderate risk [61.8% (95% CI: 60.2–63.4)] or at high risk clinically [64.1% (95% CI: 61.9–66.3)]. Guideline adherence is suboptimal, and many patients miss out on treatments that may prevent future CVD events.
Publisher: Springer Science and Business Media LLC
Date: 08-11-2018
Publisher: Springer Science and Business Media LLC
Date: 11-07-2018
Publisher: BMJ
Date: 25-10-2012
Publisher: FapUNIFESP (SciELO)
Date: 11-2018
DOI: 10.1590/1413-812320182311.27792016
Abstract: Resumo A força muscular é necessária para realização de atividades diárias, sendo considerada marcador de saúde global. O objetivo deste estudo foi identificar os fatores sociodemográficos e do estilo de vida correlatos à força de preensão manual (FPM) em adultos e idosos jovens. Estudo de base populacional com delineamento transversal, realizado com 705 in íduos, de 25 a 65 anos de idade, da cidade de Florianópolis, SC, Brasil. Analisou-se a FPM por meio do instrumento de dinamometria manual. Os dados sociodemográficos e do estilo de vida foram levantados por entrevista. Utilizou-se regressão linear múltipla para a identificação das variáveis preditoras da FPM. Mulheres e in íduos mais velhos foram os fatores associados a menores valores de FPM. Além disso, ser ativo no lazer foi associado a maiores valores de FPM. Intervenções objetivando a manutenção dos níveis de FPM nos in íduos devem considerar o envelhecimento e aqueles inativos e insuficientemente ativos fisicamente no lazer.
Publisher: FapUNIFESP (SciELO)
Date: 2012
DOI: 10.1590/S0102-311X2012000100008
Abstract: Analisou-se a validade do peso e altura autorreferidos para determinação do estado nutricional, e as implicações do seu uso em análises de associação com desfechos em saúde. Baseando-se em um estudo transversal de base populacional realizado em Pelotas, Rio Grande do Sul, Brasil, em 2007 (n = 2.986), sorteou-se uma subamostra de 276 in íduos com idade 20 anos. Em média, o peso autorreferido foi similar ao medido a altura medida foi superestimada nos homens (1,4cm) e nas mulheres (2,5cm) o índice de massa corporal (IMC) real foi subestimado em quase 1kg/m². Mesmo com diferenças médias pequenas, a variabilidade dos dados foi grande. Sexo, idade e escolaridade influenciaram nos resultados. O uso de medidas autorreferidas gerou subestimativas de sobrepeso e obesidade, assim como erros imprevisíveis em análises de associação com desfechos em saúde (subestimativa, superestimativa e inversão nas medidas reais de efeito). Equações de correção reduziram a média das diferenças com os valores medidos, mas não reduziram a variabilidade das diferenças e nem solucionaram erros de classificação ou vieses nas associações.
Publisher: Informa UK Limited
Date: 11-04-2022
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.YPMED.2012.10.022
Abstract: The purpose of this study was to investigate the prevalence and identify factors associated with simultaneous risk behaviors for chronic noncommunicable diseases in adults in a southern capital in Brazil. A cross-sectional, population-based study was carried out with 1720 adults in Florianópolis, Brazil. The simultaneous occurrence of tobacco smoking, abusive drinking, inadequate or unhealthy diet, and physical inactivity during leisure was assessed. The independent variables were demographic and socioeconomic characteristics. Only 8.3% of the respondents did not have any of these factors, whereas the simultaneous occurrence of two or more risk behaviors was 59.4%. The simultaneous presence of four risk behaviors (3.4%) was 220% higher of what would be expected by combining the in idual prevalence of these factors (1.5%). The likelihood of in iduals having two or more risk behaviors simultaneously was greater in young men, with black skin color, living without a partner, with lower household per capita income, and lower education. It is necessary to implement programs that reduce the risk behaviors for chronic noncommunicable diseases among adults in Brazil, especially between young men with low education and income.
Publisher: Cambridge University Press (CUP)
Date: 18-12-2014
DOI: 10.1017/S1368980014002857
Abstract: To describe changes in total and central adiposity and body fat distribution in children over a 5-year period by investigating variations in BMI, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold thicknesses (SFT). A school-based s le of children from 2nd to 5th grades of elementary schools participated in two cross-sectional studies in 2002 ( n 2936) and 2007 ( n 1232). Public and private schools of Florianopolis, Brazil. Schoolchildren aged 7–10 years had their weight, height, WC and SFT measured according to standard procedures. Body fat distribution was assessed by triceps, subscapular, suprailiac and medial calf skinfold measurements. Changes in BMI, WC, WHtR and SFT were analysed, adjusting for type of school and monthly family income. Adjusted mean differences between 2002 and 2007 for BMI and WC were always positive and of similar magnitude between boys and girls. However, a statistically significant increase was observed only for BMI (raw and Z -score values) in boys. WHtR remained stable in both sexes. Adjusted median values for SFT also increased in boys and girls, except for triceps skinfold. BMI, WC and SFT tended to increase across age classes in both sexes. The relative change observed for the median central skinfolds (subscapular and suprailiac) was greater than that of peripheral skinfolds (triceps and medial calf). The subcutaneous adipose tissue (SFT) appeared to increase at a faster rate than total adiposity (BMI). The increase in central SFT indicates that the relative change is due primarily to a rise in central adiposity.
Publisher: Elsevier BV
Date: 09-2014
Publisher: Informa UK Limited
Date: 17-01-2020
Publisher: Universidade de Estado do Rio de Janeiro
Date: 24-01-2015
Publisher: Emerald
Date: 02-02-2015
Abstract: – The purpose of this paper is to relate average serving size intake by the Brazilian population and declared serving size, the presence of trans fat and household measure fractioning declared on labels of processed, and ultra-processed food products. – Cross-sectional study that analyzed the food labelling of all processed and ultra-processed food products sold in a supermarket in southern Brazil. – A total of 1,071 processed and ultra-processed food products were analyzed. In 88 per cent of food groups, the average serving size consumed was larger than what was declared on labels. Consumed serving size was up to 9.2 times larger than the declared ones in food products with trans fat among their ingredients list and in false negatives and up to 9.9 times larger in foods with fractioned household measure ( p .001). The Brazilian population consumes, on average, larger serving sizes than those declared on labels, which may represent a significant intake of trans fats without the consumers’ noticing. – This study has been performed with the use of a national database on food consumption, as well as the information from a large number of processed and ultra-processed food labels marketed in Brazil. This study is also proven to be important and novel, contributing with information as to the manner in which nutrition labelling has been presented to Brazilian consumers, discussing its possible consequences for food choices, intake, and the guarantee of consumer rights.
Publisher: Informa UK Limited
Date: 07-10-2020
Publisher: Cambridge University Press (CUP)
Date: 06-02-2017
DOI: 10.1017/S1041610216002246
Abstract: The relation between body weight status and depressive symptoms in the elderly differs according to age and country of origin. The goal of this study was to analyze the cross-sectional and longitudinal relationship between body mass index (BMI), waist circumference (WC) and depressive symptoms in the elderly. A population-based cohort study of 1,702 elderly in iduals (70.6+8.0 years) in Southern Brazil evaluated in 2009/10 and 2013/14 was accessed. The body weight status was assessed using measured data of BMI and WC. The Geriatric Depression Scale (GDS-15) was used to determine depressive symptoms. Logistic regression analysis adjusted for sociodemographic and behavioral variables was performed. The prevalence of depressive symptoms in 2009/10 was 23.3% (95% CI 20.3–26.6) and the cumulative incidence in the 4-years period was 10.9% (95% CI 8.7–13.6). Elderly people with obesity class II–III and WC in the highest quartile had higher prevalence odds ratio of being depressed than in iduals with normal weight or WC in the lower quartile (OR 2.34 95% CI 1.42–3.87 and OR 1.73 95% CI 1.13–2.65, respectively). Meanwhile, intermediary values of BMI and WC were associated with a lower prevalence. When evaluating the incidence of depressive symptoms, overweight in iduals and those in the second quartile of WC had a lower risk (58% and 57%, respectively), but severely obese in iduals had the same risk compared to those with normal BMI/WC. Severely obese in iduals presented a similar incidence of depressive symptoms compared to those with normal BMI/WC, but higher prevalence. Intermediary values of body weight status decrease the risk of depressive symptoms.
Publisher: FapUNIFESP (SciELO)
Date: 10-2014
DOI: 10.1590/1415-52732014000500002
Abstract: OBJECTIVE: This study describes educational actions concerning organic foods conducted in Brazilian public schools and investigates how these actions are associated with the weekly workload and duration of employment of the dietician responsible for school meals. METHODS: In 2012 this cross-sectional, census-type study used an electronic questionnaire to collect data from dieticians or others responsible for school meals in all 5,565 Brazilian municipalities. The software Stata 11.0 was used for the statistical analyses. RESULTS: Although all Brazilian municipalities were contacted, 93.1% (n=5,184) replied. Of these, 94.2% had dieticians in charge of the school meals. Organic food-related educational actions were provided in the schools of 37.9% of the municipalities. The main actions were school gardening (67.1%) and development of educational material (50.7%). Having a dietician responsible for school meals was not associated with the existence of educational actions at school (p=0.372). However, municipalities with dieticians in charge of school meals for at least twelve months were 22.0% and 20.0%, respectively, more likely to provide educational actions at school and include the subject 'organic foods' in the municipal school curriculum (p .05 for both). Dieticians' weekly work hours was directly related to the performance of school gardening-related activities (p=0.016). CONCLUSION: The percentage of Brazilian municipalities that provide organic food-related educational actions at school is low. Additionally, the availability of such actions relates to the dietician's duration of employment and weekly work hours.
Publisher: Cambridge University Press (CUP)
Date: 07-02-2013
DOI: 10.1017/S1368980013000050
Abstract: The present study investigated how trans -fat is reported on the packaging of foods sold in a Brazilian supermarket. The present descriptive, cross-sectional study analysed the ingredient list, nutrition facts label and claims of no trans -fat on the packaging. A large supermarket in Florianópolis, Brazil. All food products available at the supermarket. Of the 2327 study products, more than half had components containing trans -fat in the ingredient list, especially hydrogenated vegetable fat and its alternative names. A small percentage of food products reported some trans -fat content on the nutrition facts label and roughly a quarter of the food products claimed to contain no trans -fat on the front of the packaging. There was very low agreement among the trans -fat content reported in the nutrition facts label, claims of no trans -fat made on the packaging and the ingredient list. There was low agreement among the different ways of reporting trans -fat, suggesting that it is not possible to rely on the nutrition facts label or no trans -fat claims printed on the packaging of Brazilian food products. Hence, the Brazilian legislation on food labels needs to change to improve the reliability of food labels and to help control the trans -fat intake of the population.
Location: Brazil
No related grants have been discovered for David Gonzalez-Chica.