RESUMEN
DEFINICIÓN DEL PROBLEMA: El suicidio es un fenómeno que ha estado presente en todo tipo de culturas a lo largo de la historia de la humanidad (1). Es definido por la Organización Mundial de la Salud (OMS), como el acto de quitarse la vida deliberadamente (2) y constituye un grave problema de salud pública mundial. Se estima que a nivel mundial mueren anualmente cerca de 700.000 personas por esta causa, lo que representó cerca del 1,3% de las muertes globales en 2019 (3). En ese sentido, muere más gente por suicidio que por malaria, VIH, cáncer de mama, guerra u homicidio (3). En relación con factores de riesgo, se observa que durante el periodo 2010-2019, la mortalidad por suicidio fue mayor en hombres que en mujeres, en una relación cercana 4 es a 1, mientras que el grupo etario que presenta la mayor cantidad de defunciones fue el ubicado entre los 25 a 29 años (4). Respecto al año 2023, un informe de epidemiología del MINSAL realizado a mayo del presente año, informa que se presentaron 677 defunciones por esta causa lo que significa un aumento de 1,2% respecto al mismo periodo del año pasado. Observándose una tasa cruda de 3,6 por 100.000 habitantes, significando una disminución de un 1,2% respecto al año anterior en el mismo periodo(6). IDENTIFICACIÓN Y SELECCIÓN DE OPCIONES DE S
Asunto(s)
Humanos , Demografía/normas , Encuestas Epidemiológicas/normas , Prevención del Suicidio/métodos , Evaluación en Salud/economía , Análisis Costo-Beneficio/economíaRESUMEN
BACKGROUND: To verify the validity of the 2016-revised Fibromyalgia Survey Questionnaire (FSQ) by telephone interview compared to self-administration and to produce a valid version of FSQ in Brazilian Portuguese language. METHODS: The Brazilian version of FSQ was produced following the recommendations for cross-cultural adaptation. Validity of Brazilian FSQ self-administration was assessed by checking agreement of its results with fibromyalgia diagnosis according the 1990 American College of Rheumatology (ACR) criteria. Reproducibility and validity of FSQ by telephone were assessed by comparing its results with the previous FSQ self-administration. RESULTS: A Brazilian Portuguese version (FSQ-Brazil) was produced. FSQ-Brazil had good internal consistency (Cronbach's alpha between 0.73 and 0.94). Agreement between the results obtained by self-administration of FSQ-Brazil and by telephone interview was substantial or almost perfect for almost all questions about pain sites and all questions about other somatic symptoms (Cohen's kappa higher than 0.6). There were small but significant bias toward higher scores of widespread pain index and fibromyalgia severity scale in the telephone interview compared to self-administration. Fibromyalgia definition by self-administration and telephone interview with FSQ-Brazil both revealed substantial agreement with the diagnosis based on ACR 1990 criteria (Cohen's kappa 0.62 and 0.65; respectively). CONCLUSIONS: FSQ-Brazil demonstrated good internal consistency, reproducibility and validity both by self-administration and by telephone interview. However, caution must be taken with the interpretation of quantitative scores of widespread pain index and symptoms severity scale, which slightly differed according the method (self-administration or interview) in our study.
Asunto(s)
Fibromialgia/diagnóstico , Encuestas Epidemiológicas/normas , Adulto , Sesgo , Brasil , Comparación Transcultural , Escolaridad , Femenino , Encuestas Epidemiológicas/métodos , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Autoadministración , Autoinforme , Índice de Severidad de la Enfermedad , Evaluación de Síntomas , Teléfono , TraduccionesRESUMEN
OBJECTIVE: To describe reference values for blood counts obtained from laboratory tests in the Brazilian adult population according to laboratory results from the National Health Survey (Pesquisa Nacional de Saúde - PNS), by gender, age group and skin color. METHODS: The initial sample consisted of 8,952 adults. To determine the reference values, individuals with prior diseases and outliers were excluded. Mean values, standard deviation and limits were stratified by gender, age group and skin color. RESULTS: For red blood cells, men presented a mean value of 5.0 million per mm3 (limits: 4.3-5.8) and women, 4.5 million per mm3 (limits: 3.9-5.1). Hemoglobin levels were higher among men with a mean of 14.9 g/dL (13.0-16.9), and in women, 13.2 g/dL (11.5-14.9). The mean number of white blood cells among men was 6.142/mm3 (2.843-9.440) and 6.426/mm3 (2.883-9.969) for women. Other parameters showed close values between the genders. Regarding age groups and skin color, mean values, standard deviation and limits of the exams presented small variations. CONCLUSION: Hematological reference values based on the national survey allow for the establishment of specific reference limits for gender, age and skin color. The results presented here may contribute to the establishment of better evidence and criteria for the care, diagnosis and treatment of diseases.
OBJETIVO: Descrever valores de referência para exames laboratoriais de hemograma da população adulta brasileira segundo os resultados laboratoriais da Pesquisa Nacional de Saúde (PNS) estratificados por sexo, faixa etária e cor da pele. MÉTODOS: A amostra foi constituída inicialmente de 8.952 adultos. Para determinar os valores de referência, excluíram-se indivíduos com doenças prévias e os outliers. Valores médios, desvio padrão e limites foram estratificados por sexo, faixa etária e cor da pele. RESULTADOS: Para glóbulos vermelhos, os homens apresentaram valor médio de 5,0 milhões por mm3 (limites: 4,3-5,8) e as mulheres 4,5 milhões por mm3 (limites: 3,9-5,1). Valores de hemoglobina entre homens exibiram média de 14,9 g/dL (13,0-16,9) e entre mulheres de 13,2 g/dL (11,5-14,9). A média dos glóbulos brancos entre os homens foi de 6.142/mm3 (2.843-9.440) e entre as mulheres de 6.426/mm3 (2.883-9.969). Outros parâmetros mostraram valores próximos entre os sexos. Com relação a faixas etárias e cor da pele, valores médios, desvio padrão e limites dos exames apontaram pequenas variações. CONCLUSÃO: Os valores de referência hematológicos com base em inquérito nacional permitem a definição de limites de referência específicos por sexo, idade e cor da pele. Os resultados aqui expostos podem contribuir para o estabelecimento de melhores evidências e critérios para o cuidado, diagnóstico e tratamento de doenças.
Asunto(s)
Recuento de Células Sanguíneas/normas , Técnicas de Laboratorio Clínico/normas , Encuestas Epidemiológicas/normas , Adolescente , Adulto , Factores de Edad , Brasil/etnología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , Adulto JovenRESUMEN
RESUMO: Objetivo: Descrever valores de referência para exames laboratoriais de hemograma da população adulta brasileira segundo os resultados laboratoriais da Pesquisa Nacional de Saúde (PNS) estratificados por sexo, faixa etária e cor da pele. Métodos: A amostra foi constituída inicialmente de 8.952 adultos. Para determinar os valores de referência, excluíram-se indivíduos com doenças prévias e os outliers. Valores médios, desvio padrão e limites foram estratificados por sexo, faixa etária e cor da pele. Resultados: Para glóbulos vermelhos, os homens apresentaram valor médio de 5,0 milhões por mm3 (limites: 4,3-5,8) e as mulheres 4,5 milhões por mm3 (limites: 3,9-5,1). Valores de hemoglobina entre homens exibiram média de 14,9 g/dL (13,0-16,9) e entre mulheres de 13,2 g/dL (11,5-14,9). A média dos glóbulos brancos entre os homens foi de 6.142/mm3 (2.843-9.440) e entre as mulheres de 6.426/mm3 (2.883-9.969). Outros parâmetros mostraram valores próximos entre os sexos. Com relação a faixas etárias e cor da pele, valores médios, desvio padrão e limites dos exames apontaram pequenas variações. Conclusão: Os valores de referência hematológicos com base em inquérito nacional permitem a definição de limites de referência específicos por sexo, idade e cor da pele. Os resultados aqui expostos podem contribuir para o estabelecimento de melhores evidências e critérios para o cuidado, diagnóstico e tratamento de doenças.
ABSTRACT: Objective: To describe reference values for blood counts obtained from laboratory tests in the Brazilian adult population according to laboratory results from the National Health Survey (Pesquisa Nacional de Saúde - PNS), by gender, age group and skin color. Methods: The initial sample consisted of 8,952 adults. To determine the reference values, individuals with prior diseases and outliers were excluded. Mean values, standard deviation and limits were stratified by gender, age group and skin color. Results: For red blood cells, men presented a mean value of 5.0 million per mm3 (limits: 4.3-5.8) and women, 4.5 million per mm3 (limits: 3.9-5.1). Hemoglobin levels were higher among men with a mean of 14.9 g/dL (13.0-16.9), and in women, 13.2 g/dL (11.5-14.9). The mean number of white blood cells among men was 6.142/mm3 (2.843-9.440) and 6.426/mm3 (2.883-9.969) for women. Other parameters showed close values between the genders. Regarding age groups and skin color, mean values, standard deviation and limits of the exams presented small variations. Conclusion: Hematological reference values based on the national survey allow for the establishment of specific reference limits for gender, age and skin color. The results presented here may contribute to the establishment of better evidence and criteria for the care, diagnosis and treatment of diseases.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Recuento de Células Sanguíneas/normas , Encuestas Epidemiológicas/normas , Técnicas de Laboratorio Clínico/normas , Valores de Referencia , Brasil/epidemiología , Factores Sexuales , Estudios Transversales , Factores de Edad , Persona de Mediana EdadRESUMEN
INTRODUCTION: Land transport accidents (LTA) are the second cause of death in schoolchildren aged 13 to 17 years. The study aims to describe the risk factors for LTA in schoolchildren from the National School Health Survey (PeNSE) of 2015 and to evaluate the trend of selected indicators in the last three editions of PeNSE. METHODOLOGY: A descriptive study on risk factors for LTA in 2015, with PeNSE data and time series trends analysis, with age-adjusted regression tests of the 2009, 2012 and 2015 editions, in Brazilian capitals. RESULTS: In 2015, 26.3% of ninth grade schoolchildren, mostly between 13 and 15 years of age, reported having been in a motor vehicle driven by someone who consumed alcohol and 32.4% had driven a motor vehicle; 30.7% of adolescents did not use seat belts in the back seat; and 16.8% of schoolchildren who ride motorcycles did not wear helmets. There was also a worsening of the indicators between 2009 and 2015, regarding driving a motor vehicle (1.0 percentage points) and having been driven by vehicle for consumption of alcoholic beverages (1.1 percentage points). DISCUSSION: The LTA occurrence results from the interaction between roads, vehicles and users, and has a strong correlation with behavior. CONCLUSIONS: The results show the need to invest in educational measures, associated with supervision, the improvement of road infrastructure, research and improvement of legislation. The monitoring of risk factors in schoolchildren substantially contributes to support intersectoral public policies interventions to reduce morbidity and mortality in traffic.
INTRODUÇÃO: Os acidentes de transporte terrestre (ATT) são a segunda causa de morte em escolares de 13 a 17 anos. O presente estudo visou descrever os fatores de risco para ATT em escolares da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015 e avaliar a tendência de indicadores selecionados nas três últimas edições da PeNSE. METODOLOGIA: Estudo descritivo sobre fatores de risco para ATT no ano de 2015, com dados da PeNSE e análise de tendência das séries temporais, com testes de regressão ajustados por idade, das edições de 2009, 2012 e 2015, nas capitais brasileiras. RESULTADOS: Em 2015, 26,3% dos escolares do nono ano, na maioria entre 13 e 15 anos, relataram terem sido conduzidos em veículo motorizado dirigido por alguém que consumiu bebida alcoólica e 32,4% relataram terem dirigido veículo motorizado; 30,7% dos adolescentes não usaram cinto de segurança no banco de trás; e 16,8% dos escolares usuários de motocicleta não usaram capacetes. Observou-se ainda tendência de piora dos indicadores entre 2009 e 2015, referentes a dirigir veículo motorizado (1,0 pontos percentuais) e ter sido conduzido em veículo por alguém que consumiu bebida alcoólica (1,1 pontos percentuais). DISCUSSÃO: A ocorrência de ATT resulta da interação entre vias, veículos e usuários, tendo forte correlação com o comportamento. CONCLUSÕES: Os resultados apontam a necessidade de investir em medidas educativas, associadas a fiscalização, a melhoria das vias, pesquisas e aprimoramento da legislação. O monitoramento dos fatores de risco em escolares contribui substancialmente para apoiar intervenções das políticas públicas intersetoriais para a redução de morbimortalidade por trânsito.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Conducta del Adolescente/psicología , Encuestas Epidemiológicas/normas , Accidentes de Tránsito/tendencias , Adolescente , Conducción de Automóvil/psicología , Conducción de Automóvil/estadística & datos numéricos , Brasil , Conducir bajo la Influencia/psicología , Conducir bajo la Influencia/estadística & datos numéricos , Femenino , Dispositivos de Protección de la Cabeza/estadística & datos numéricos , Encuestas Epidemiológicas/tendencias , Humanos , Masculino , Motocicletas/estadística & datos numéricos , Factores de Riesgo , Cinturones de Seguridad/estadística & datos numéricos , Distribución por Sexo , Factores SocioeconómicosRESUMEN
Objective: To test the psychometric properties of the EUROHIS-QOL 8-item index in a Brazilian sample. Methods: The sample consisted of 151 patients and 174 healthy controls (n=325). Several psychometric properties were tested. Results: Reliability showed good internal consistency (Cronbach's alpha = 0.81). The measure showed good discriminant validity between patients and healthy controls (mean1 = 3.32, SD1 = 0.70; mean2 = 3.77, SD2 = 0.63, t = 6.12, p < 0.001). Convergent validity showed significant correlations (p < 0.001) between the EUROHIS-QOL 8-item index and all domains of the WHOQOL-Bref (overall r = 0.47; general health r = 0.54; physical r = 0.69; psychological r = 0.62; social relationship r = 0.55; environment r = 0.55) and between the EUROHIS-QOL 8-item index and the domains of the SF-36, except for the social domain (p = 0.38). On Rasch analysis of unidimensionality, general fit measures showed adequate performance. The EUROHIS-QOL 8-item index also showed good fit on confirmatory factor analysis (CFA) (chi-square = 18.46, degrees of freedom [df] = 15; comparative fit index [CFI] = 0.99; root mean square error of approximation [RMSEA] = 0.03; goodness of fit index [gfi] = 0.99; root mean square residual [RMR] = 0.03; p = 24). Conclusion: The EUROHIS-QOL 8-item index showed good psychometric properties. It is a reliable quality of life measure that can be used in Brazilian populations.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Encuestas Epidemiológicas/normas , Ansiedad/psicología , Psicometría , Factores Socioeconómicos , Brasil , Estudios de Casos y Controles , Análisis Discriminante , Reproducibilidad de los Resultados , Depresión/psicología , LenguajeRESUMEN
OBJECTIVE: To test the psychometric properties of the EUROHIS-QOL 8-item index in a Brazilian sample. METHODS: The sample consisted of 151 patients and 174 healthy controls (n=325). Several psychometric properties were tested. RESULTS: Reliability showed good internal consistency (Cronbach's alpha = 0.81). The measure showed good discriminant validity between patients and healthy controls (mean1 = 3.32, SD1 = 0.70; mean2 = 3.77, SD2 = 0.63, t = 6.12, p < 0.001). Convergent validity showed significant correlations (p < 0.001) between the EUROHIS-QOL 8-item index and all domains of the WHOQOL-Bref (overall r = 0.47; general health r = 0.54; physical r = 0.69; psychological r = 0.62; social relationship r = 0.55; environment r = 0.55) and between the EUROHIS-QOL 8-item index and the domains of the SF-36, except for the social domain (p = 0.38). On Rasch analysis of unidimensionality, general fit measures showed adequate performance. The EUROHIS-QOL 8-item index also showed good fit on confirmatory factor analysis (CFA) (chi-square = 18.46, degrees of freedom [df] = 15; comparative fit index [CFI] = 0.99; root mean square error of approximation [RMSEA] = 0.03; goodness of fit index [gfi] = 0.99; root mean square residual [RMR] = 0.03; p = 24). CONCLUSION: The EUROHIS-QOL 8-item index showed good psychometric properties. It is a reliable quality of life measure that can be used in Brazilian populations.
Asunto(s)
Encuestas Epidemiológicas/normas , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Adolescente , Adulto , Ansiedad/psicología , Brasil , Estudios de Casos y Controles , Depresión/psicología , Análisis Discriminante , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Factores Socioeconómicos , Adulto JovenRESUMEN
RESUMO: Introdução: Os acidentes de transporte terrestre (ATT) são a segunda causa de morte em escolares de 13 a 17 anos. O presente estudo visou descrever os fatores de risco para ATT em escolares da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015 e avaliar a tendência de indicadores selecionados nas três últimas edições da PeNSE. Metodologia: Estudo descritivo sobre fatores de risco para ATT no ano de 2015, com dados da PeNSE e análise de tendência das séries temporais, com testes de regressão ajustados por idade, das edições de 2009, 2012 e 2015, nas capitais brasileiras. Resultados: Em 2015, 26,3% dos escolares do nono ano, na maioria entre 13 e 15 anos, relataram terem sido conduzidos em veículo motorizado dirigido por alguém que consumiu bebida alcoólica e 32,4% relataram terem dirigido veículo motorizado; 30,7% dos adolescentes não usaram cinto de segurança no banco de trás; e 16,8% dos escolares usuários de motocicleta não usaram capacetes. Observou-se ainda tendência de piora dos indicadores entre 2009 e 2015, referentes a dirigir veículo motorizado (1,0 pontos percentuais) e ter sido conduzido em veículo por alguém que consumiu bebida alcoólica (1,1 pontos percentuais). Discussão: A ocorrência de ATT resulta da interação entre vias, veículos e usuários, tendo forte correlação com o comportamento. Conclusões: Os resultados apontam a necessidade de investir em medidas educativas, associadas a fiscalização, a melhoria das vias, pesquisas e aprimoramento da legislação. O monitoramento dos fatores de risco em escolares contribui substancialmente para apoiar intervenções das políticas públicas intersetoriais para a redução de morbimortalidade por trânsito.
ABSTRACT: Introduction: Land transport accidents (LTA) are the second cause of death in schoolchildren aged 13 to 17 years. The study aims to describe the risk factors for LTA in schoolchildren from the National School Health Survey (PeNSE) of 2015 and to evaluate the trend of selected indicators in the last three editions of PeNSE. Methodology: A descriptive study on risk factors for LTA in 2015, with PeNSE data and time series trends analysis, with age-adjusted regression tests of the 2009, 2012 and 2015 editions, in Brazilian capitals. Results: In 2015, 26.3% of ninth grade schoolchildren, mostly between 13 and 15 years of age, reported having been in a motor vehicle driven by someone who consumed alcohol and 32.4% had driven a motor vehicle; 30.7% of adolescents did not use seat belts in the back seat; and 16.8% of schoolchildren who ride motorcycles did not wear helmets. There was also a worsening of the indicators between 2009 and 2015, regarding driving a motor vehicle (1.0 percentage points) and having been driven by vehicle for consumption of alcoholic beverages (1.1 percentage points). Discussion: The LTA occurrence results from the interaction between roads, vehicles and users, and has a strong correlation with behavior. Conclusions: The results show the need to invest in educational measures, associated with supervision, the improvement of road infrastructure, research and improvement of legislation. The monitoring of risk factors in schoolchildren substantially contributes to support intersectoral public policies interventions to reduce morbidity and mortality in traffic.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Accidentes de Tránsito/estadística & datos numéricos , Encuestas Epidemiológicas/normas , Conducta del Adolescente/psicología , Cinturones de Seguridad/estadística & datos numéricos , Factores Socioeconómicos , Conducción de Automóvil/psicología , Conducción de Automóvil/estadística & datos numéricos , Motocicletas/estadística & datos numéricos , Brasil , Accidentes de Tránsito/tendencias , Factores de Riesgo , Encuestas Epidemiológicas/tendencias , Distribución por Sexo , Conducir bajo la Influencia/psicología , Conducir bajo la Influencia/estadística & datos numéricos , Dispositivos de Protección de la Cabeza/estadística & datos numéricosRESUMEN
To improve the health and well-being of the medically underserved in a free clinic in Pittsburgh, Pennsylvania, a multidisciplinary team representing several health information management and information technology (IT) professionals, including faculty, students, researchers, and clinicians, created a novel IT system called imHealthy. The imHealthy system includes four critical components: a multidomain well-being questionnaire, a mobile app for data collection and tracking, a customization of an open-source electronic health record (EHR), and a data integration and well-being evaluation program leading to recommendations for personalized interventions to caregivers serving the medically underserved. This multidisciplinary team has worked closely on this project and finished critical components of the imHealthy system. Evaluations of these components will be conducted, and factors facilitating the design and adoption of the imHealthy system will be presented. The results from this research can serve as a model for free clinics with similar needs that identified by the research team in Cleveland, Indianapolis, Minnesota, Motor City, Orange County, San Diego, and St. Louis.
Asunto(s)
Sistemas de Información en Salud/organización & administración , Estado de Salud , Encuestas Epidemiológicas/métodos , Encuestas Epidemiológicas/normas , Relaciones Interprofesionales , Poblaciones Vulnerables , Algoritmos , Conducta Cooperativa , Registros Electrónicos de Salud/organización & administración , Gestión de la Información en Salud/organización & administración , Humanos , Aplicaciones Móviles , Reproducibilidad de los Resultados , Proveedores de Redes de Seguridad , Estados UnidosRESUMEN
OBJECTIVE: Research methods are described for developing a food and physical activity behaviors questionnaire for the Expanded Food and Nutrition Education Program (EFNEP), a US Department of Agriculture nutrition education program serving low-income families. DESIGN: Mixed-methods observational study. The questionnaire will include 5 domains: (1) diet quality, (2) physical activity, (3) food safety, (4) food security, and (5) food resource management. A 5-stage process will be used to assess the questionnaire's test-retest reliability and content, face, and construct validity. SETTING: Research teams across the US will coordinate questionnaire development and testing nationally. PARTICIPANTS: Convenience samples of low-income EFNEP, or EFNEP-eligible, adult participants across the US. INTERVENTIONS: A 5-stage process: (1) prioritize domain concepts to evaluate (2) question generation and content analysis panel, (3) question pretesting using cognitive interviews, (4) test-retest reliability assessment, and (5) construct validity testing. MAIN OUTCOME MEASURE: A nationally tested valid and reliable food and physical activity behaviors questionnaire for low-income adults to evaluate EFNEP's effectiveness. ANALYSIS: Cognitive interviews will be summarized to identify themes and dominant trends. Paired t tests (P ≤ .05) and Spearman and intra-class correlation coefficients (r > .5) will be conducted to assess reliability. Construct validity will be assessed using Wilcoxon t test (P ≤ .05), Spearman correlations, and Bland-Altman plots.
Asunto(s)
Ejercicio Físico , Educación en Salud , Encuestas Epidemiológicas/normas , Encuestas Nutricionales/normas , Encuestas y Cuestionarios/normas , Conducta Alimentaria , Conductas Relacionadas con la Salud , Humanos , Reproducibilidad de los ResultadosAsunto(s)
Encuestas Epidemiológicas , Vigilancia en Salud Pública/métodos , Minorías Sexuales y de Género/estadística & datos numéricos , Encuestas Epidemiológicas/métodos , Encuestas Epidemiológicas/normas , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Mala Praxis , Salud Pública , Estados UnidosRESUMEN
BACKGROUND: The nationwide dementia prevalence is usually calculated by applying the results of local surveys to countries' populations. To evaluate the reliability of such estimations in developing countries, we chose Brazil as an example. We carried out a systematic review of dementia surveys, ascertained their risk of bias, and present the best estimate of occurrence of dementia in Brazil. METHODS AND FINDINGS: We carried out an electronic search of PubMed, Latin-American databases, and a Brazilian thesis database for surveys focusing on dementia prevalence in Brazil. The systematic review was registered at PROSPERO (CRD42014008815). Among the 35 studies found, 15 analyzed population-based random samples. However, most of them utilized inadequate criteria for diagnostics. Six studies without these limitations were further analyzed to assess the risk of selection, attrition, outcome and population bias as well as several statistical issues. All the studies presented moderate or high risk of bias in at least two domains due to the following features: high non-response, inaccurate cut-offs, and doubtful accuracy of the examiners. Two studies had limited external validity due to high rates of illiteracy or low income. The three studies with adequate generalizability and the lowest risk of bias presented a prevalence of dementia between 7.1% and 8.3% among subjects aged 65 years and older. However, after adjustment for accuracy of screening, the best available evidence points towards a figure between 15.2% and 16.3%. CONCLUSIONS: The risk of bias may strongly limit the generalizability of dementia prevalence estimates in developing countries. Extrapolations that have already been made for Brazil and Latin America were based on a prevalence that should have been adjusted for screening accuracy or not used at all due to severe bias. Similar evaluations regarding other developing countries are needed in order to verify the scope of these limitations.
Asunto(s)
Demencia/epidemiología , Encuestas Epidemiológicas/normas , Adulto , Anciano , Anciano de 80 o más Años , Sesgo , Brasil , Femenino , Humanos , Masculino , Factores SocioeconómicosRESUMEN
BACKGROUND: This study assessed the construct validity of a measure of nicotine dependence that was used in the Global Youth Tobacco Survey (GYTS). METHODS: Using 2007-2009 data from the GYTS, subjects from 6 countries were used to assess current smokers' odds of reporting time to first cigarette or craving positive (TTFC/C+) by the number of cigarette smoking days per month (DPM) and the number of cigarettes smoked per day (CPD). RESULTS: The percentage of GYTS smokers who reported TTFC/C+ ranged from 58.0% to 69.7%. Compared with students who smoked on 1-2 DPM, those who smoked on 3-9 DPM had 3 times the adjusted odds of reporting TTFC/C+. The adjusted odds of reporting TTFC/C+ were 3 to 7 times higher among those who smoked 10-29 DPM and 6 to 20 times higher among daily smokers. Similarly, the adjusted odds of TTFC/C+ were 3-6 times higher among those who smoked 2-5 CPD and 6 to 20 times higher among those who smoked >6 CPD, compared to those who smoked <1 CPD. CONCLUSION: Associations of TTFC/C+ prevalence with both frequency and intensity of cigarette smoking provide a construct validation of the GYTS question used to assess respondents' TTFC/C status.
Asunto(s)
Encuestas Epidemiológicas/normas , Fumar/epidemiología , Adolescente , Conducta del Adolescente , Distribución por Edad , Argentina/epidemiología , Femenino , Humanos , Jordania/epidemiología , Modelos Logísticos , Malasia/epidemiología , Masculino , Prevalencia , Reproducibilidad de los Resultados , Instituciones Académicas , Distribución por Sexo , Eslovaquia/epidemiología , Cese del Hábito de Fumar/estadística & datos numéricos , Sudáfrica/epidemiología , Encuestas y Cuestionarios/normas , Tailandia/epidemiología , Nicotiana , Organización Mundial de la SaludRESUMEN
OBJECTIVE: To determine the presence of bias on the estimation of the consumption sometime in life of alcohol, tobacco or illegal drugs and inhalable substances, and to propose a correction for this in the case it is present. MATERIALS AND METHODS: Mexican National Addictions Surveys (NAS) 2002, 2008, and 2011 were analyzed to compare population estimations of consumption sometime in life of tobacco, alcohol or illegal drugs and inhalable substances. A couple of alternative approaches for bias correction were developed. RESULTS: Estimated national prevalences of consumption sometime in life of alcohol and tobacco in the NAS 2008 are not plausible. There was no evidence of bias on the consumption sometime in life of illegal drugs and inhalable substances. New estimations for tobacco and alcohol consumption sometime in life were made, which resulted in plausible values when compared to other data available. CONCLUSION: Future analyses regarding tobacco and alcohol using NAS 2008 data will have to rely on these newly generated data weights, that are able to reproduce the new (plausible) estimations.
Asunto(s)
Encuestas Epidemiológicas/estadística & datos numéricos , Encuestas Epidemiológicas/normas , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Anciano , Sesgo , Niño , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Prevalencia , Análisis de Regresión , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJETIVO: Investigar la existencia de sesgo en la estimación de las prevalencias de consumo "alguna vez" en la vida de alcohol, tabaco y drogas ilegales e inhalables, para luego proponer una corrección al mismo, si existiera. MATERIAL Y MÉTODOS: Se analizaron las Encuestas Nacionales de Adicciones (ENA) 2002, 2008 y 2011 para comparar estimaciones de parámetros poblacionales sobre el consumo "alguna vez" en la vida de tabaco, alcohol y drogas ilegales e inhalables. Se desarrollaron dos métodos para corregir el sesgo. RESULTADOS: Las prevalencias nacionales estimadas de consumo "alguna vez" de alcohol y tabaco de la ENA 2008 no son plausibles. En contraste, no se encontró evidencia que apoyara un subregistro o sobrerregistro del consumo "alguna vez" de drogas ilegales e inhalables. Se obtuvieron nuevas estimaciones de las prevalencias de consumo "alguna vez" de alcohol y tabaco; las nuevas estimaciones resultaron ser plausibles al contrastarse con otras fuentes de información disponibles. CONCLUSIONES: Los nuevos análisis sobre alcohol y tabaco que se realicen deberán usar los factores de expansión corregidos de la ENA 2008 para poder incorporar las nuevas estimaciones de consumo "alguna vez" de alcohol y tabaco obtenidas en este trabajo.
OBJECTIVE: To determine the presence of bias on the estimation of the consumption sometime in life of alcohol, tobacco or illegal drugs and inhalable substances, and to propose a correction for this in the case it is present. MATERIALS AND METHODS: Mexican National Addictions Surveys (NAS) 2002, 2008, and 2011 were analyzed to compare population estimations of consumption sometime in life of tobacco, alcohol or illegal drugs and inhalable substances. A couple of alternative approaches for bias correction were developed. RESULTS: Estimated national prevalences of consumption sometime in life of alcohol and tobacco in the NAS 2008 are not plausible. There was no evidence of bias on the consumption sometime in life of illegal drugs and inhalable substances. New estimations for tobacco and alcohol consumption sometime in life were made, which resulted in plausible values when compared to other data available. CONCLUSION: Future analyses regarding tobacco and alcohol using NAS 2008 data will have to rely on these newly generated data weights, that are able to reproduce the new (plausible) estimations.
Asunto(s)
Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Encuestas Epidemiológicas/normas , Encuestas Epidemiológicas/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Sesgo , México/epidemiología , Prevalencia , Análisis de Regresión , Estudios RetrospectivosRESUMEN
OBJECTIVE: The present study analysed the impact of using the 2006 WHO Child Growth Standards ('the WHO standards') compared with the 1977 National Center for Health Statistics (NCHS) international growth reference ('the NCHS reference') on the calculated prevalence of chronic malnutrition in children aged 6·0-59·9 months. DESIGN: Anthropometric data were collected as part of a cross-sectional study exploring the association between household environments and nutritional status of children. Z-scores were computed for height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) using each reference/standard. Results were compared using Bland-Altman plots, percentage agreement, kappa statistics, line graphs and proportion of children in Z-score categories. SETTING: The study was conducted in thirteen rural villages within Honduras's department of Intibucá. SUBJECTS: Children aged 6·0-59·9 months were the focus of the analysis, and households with children in this age range served as the sampling unit for the study. RESULTS: The WHO standards yielded lower means for HAZ and higher means for WAZ and WHZ compared with the NCHS reference. The WHO standards and NCHS reference showed good agreement between Z-score categories, except for HAZ among males aged 24·0-35·9 months and WHZ among males aged >24·0 months. Using the WHO standards resulted in higher proportions of stunting (low HAZ) and overweight (high WHZ) and lower proportions of underweight (low WAZ). The degree of difference among these measures varied by age and gender. CONCLUSIONS: The choice of growth reference/standard employed in nutritional surveys may have important methodological and policy implications. While ostensibly comparable, data on nutritional indicators derived with different growth references/standards must be interpreted cautiously.