RESUMO
Aim: To identify psychosocial predictors of the intention to get a booster COVID-19 vaccine in a low-income country, given that increasing booster vaccination rates against COVID-19 remains a global challenge, especially among low- and middle-income countries (LMIC). Subject and methods: We used an online survey to collect responses from a non-probabilistic sample of 720 Bolivians regarding vaccine uptake, motives, perceived confidence, information sources, attitudes favouring COVID-19 vaccines, biosafety behaviour, and sociodemographic characteristics. Descriptive, bivariate, and multivariate analyses were performed to identify significant associations and predictors. Results: We found that having already received the third dose, obtaining recommendations from family or friends, recommendation from the government, perceived confidence in the previously received dose, and higher attitudes in favour of COVID-19 vaccines significantly predicted the intention to get a booster dose. The associations were significant even when adjusting the model for sociodemographic variables. Conclusion: Including certain psychosocial factors could enhance the promotion of voluntary booster doses among residents of low- and middle-income countries such as Bolivia, where cultural, social, political, and contextual variables may influence health behaviour and increase health-associated risk factors. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01937-x.
RESUMO
BACKGROUND: The role of universities in health promotion has been strengthened by institutional policies and the Health Promoting Universities movement. Together they seek to identify behaviours that are harmful to the health of university students and implement programs or interventions to promote the health of students within the physical environment of universities. However, the COVID-19 pandemic rapidly increased the number of students learning by distance. Under these circumstances, there is an increased need to assess the knowledge, attitudes and health practices of students in distance learning. OBJECTIVE: To develop a KAP (knowledge, attitude and practice) questionnaire on the health of distance learning students. METHODS: Development was carried out in four stages: 1) literature review to identify existing health programs in universities; 2) formulation of questions based on WHO theoretical frameworks, National Health Promotion Policy and the literature review; 3) selection of interdisciplinary expert judges and submission of the KAP-Health questionnaire for analysis of appearance, efficiency/consistency, clarity/understanding, pertinence of content and sequence of items; and 4) content validation by applying the content validity coefficient (CVC). RESULTS: The mean CVCs obtained were all equal to or greater than 0.96, 0.95 and 0.93 for the Knowledge, Attitudes and Practices domains, respectively; all comfortably above the cut-off score of 80% (CVCt = 0.80). CONCLUSIONS: At this stage of the study, the judges consider the content of the KAP-Health questionnaire adequate to identify issues related to the health of students in distance learning. However, it is important to note that the next step is to test the usefulness of this questionnaire. We believe that our KAP-Health instrument is both original and useful for planning institutional policies in order to implement assertive strategies to promote the health of remote-learning students in Brazil and in other parts of the world.
Assuntos
COVID-19 , Educação a Distância , Humanos , Brasil , Conhecimentos, Atitudes e Prática em Saúde , Pandemias , COVID-19/epidemiologia , Estudantes , Inquéritos e Questionários , UniversidadesRESUMO
OBJECTIVES: Oral health behaviour is a learning process that begins in the early years of an individual's life. The aim of this study was to evaluate the associations between demographic, socioeconomic, and psychosocial factors and oral health behaviours during the transition period from childhood to adolescence. METHODS: This was a cohort study with a follow-up of 7 years. The baseline assessment occurred in 2010 with a random sample of 639 preschool children from southern Brazil. Demographic, socioeconomic and psychosocial oral health conditions were assessed at baseline. Oral health habit variables were collected at follow-up and included questions regarding dental care and oral hygiene behaviours. Structural equation modelling was performed to assess the direct and indirect relationships between predictors at baseline in oral health behaviours at follow-up. RESULTS: A total of 449 children were re-examined at follow-up (70.3% cohort retention rate). Factors directly related to poorer oral health behaviours (lower use of dental services, dental visits for emergency reasons and lower frequency of toothbrushing) were lower household income, lower maternal education, lower frequency of visits to neighbours or friends, and male sex. Considering indirect pathways, the household income and maternal education at baseline influenced oral health behaviours at follow-up via visits to neighbours or friends. CONCLUSIONS: Our findings suggest that household income, maternal education and social capital play an important role in the development of oral health behaviours during the transition from childhood to adolescence. Acquisition of healthy oral behaviours is an important factor to consider in childhood. With this knowledge, public health policies can be developed to intervene in specific causal factors and improve oral health during this transitional period.
Assuntos
Cárie Dentária , Saúde Bucal , Humanos , Pré-Escolar , Masculino , Adolescente , Estudos de Coortes , Análise de Classes Latentes , Escovação Dentária , Comportamentos Relacionados com a Saúde , Cárie Dentária/etiologiaRESUMO
The aim of this research is to describe the evolution of the pandemic in a school context, following the introduction of school nurses into the educational setting. BACKGROUND: The first wave of COVID-19 in Spain prevented social interaction by imposing lockdowns on the population. All non-essential activities, including face-to-face education, were interrupted, affecting the school-aged population during the second and third trimester of the 2019/2020 school year. Schools are places where prevention, identification and case management measures should be rapidly implemented. METHODS: This is a prospective and descriptive study using a quantitative method to study the school population of Granada and its province during the school year 2020/2021, from September 2020 to May 2021. The study participants were all schools under the jurisdiction of the Territorial Delegation of Education of Granada, whether public, private, state-subsidised or charter schools, including all educational stages. RESULTS: The confirmation rate in Granada city (11.2%), in contrast to the Andalusian average (6.9%), places Granada as the province with the highest incidence rate. The infection rates among teachers show the same confirmation rate as the general population of Granada (9%); however, among students this rate is lower (7%). There is a higher incidence of outbreaks taking place outside school and a lower incidence of outbreaks occurring within the school environment. Both partial and total outbreaks are more frequent in early childhood education. CONCLUSION: The early identification and management of reported suspected cases of COVID-19 in schools is proving effective in preventing infection in the school population, achieving good pandemic control in schools, and reducing the number of outbreaks and people affected. Schools have been confirmed to be safe. Establishing screening for asymptomatic schoolchildren could be a tool to improve control in schools.
RESUMO
BACKGROUND: This study aims to identify the relationships between health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being among older adults with a Surinamese background. METHODS: Community-dwelling older adults (≥ 70 years) with a Surinamese background living in Rotterdam, the Netherlands, were identified by the municipal register. A survey study was conducted to assess background information, health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being. Multiple regression analyses were performed to assess the relationships of health behaviours with well-being while controlling for background characteristics. RESULTS: Average age of participants was 76.2 (4.9) years, slightly more than half of them were female (54.2%). Almost half of the participants had a low-income level (49.6%). More than half of the participants met the Dutch guidelines of fruit intake (63.0%) and vegetable intake (62.8%). Less than half of the participants met the guidelines of fish intake (40.9%) and physical activity (39.8%). The majority of the participants were non-smokers (87.9%). Most of the participants had daily contact with family/friends (90.9%) and slightly more than half of the participants visited family/friends often (53.6%). Looking at the health behaviours, a positive relationship was found between eating enough fruit (ß = .109; p ≤ 0.05) and vegetables (ß = .135; p ≤ 0.01), physical activity (ß = .164; p ≤ 0.001) and often visiting family/friends (ß = .158; p ≤ 0.001) with well-being. CONCLUSION: This study suggests that next to traditional health behaviours also social activity is an essential health behaviour for the well-being of older Surinamese adults. Research about health promotion should expand its focus by including social activity as health behaviour.
Assuntos
Frutas , Verduras , Feminino , Humanos , Masculino , Países Baixos , Comportamentos Relacionados com a Saúde , Exercício Físico , DietaRESUMO
Vaccination hesitancy has become a central concern and is a barrier to overcoming the coronavirus disease (COVID-19) crisis. Studies have indicated that mis/disinformation plays a role on the attitudes and behaviours towards vaccination. However, further formal statistical models are required to investigate how fake news relates to vaccination intent and how they mediate the relationship between socioeconomic/political factors and vaccination intent. We studied a sample of 500 Brazilians and found that people were mostly not susceptible to vaccine mis/disinformation. In addition, we found that their vaccination intent was high. However, suspicions that fake news could be true raised doubts over the vaccination intention. Although age and political orientation directly influenced vaccination intent, we found that the relationship between socioeconomic/political factors and vaccination intent was strongly mediated by belief in fake news. Our results raise the need to create multiple strategies to combat the dissemination and acceptance of such content.
Assuntos
COVID-19 , Humanos , Brasil , COVID-19/prevenção & controle , Intenção , Desinformação , VacinaçãoRESUMO
BACKGROUND & AIMS: Only a few studies have assessed the association between a proinflammatory diet and the risk of depression in older adults, and they have rendered weak results. The present study analysed the association between the Dietary Inflammatory Index (DII) and incident self-reported diagnosis or symptoms of depression in two cohorts of community-dwelling older adults in Spain. METHODS: We used data from the Seniors-ENRICA-I (SE-I) and Seniors-ENRICA-II (SE-II) cohorts. In both cohorts, the baseline DII was calculated from habitual food consumption estimated with a validated computer-based diet history. The incidence of both physician self-reported diagnosis of depression and mild-to-major depressive symptoms (≥3 on the 10-item Geriatric Depression Scale) was analysed. Logistic regression models were adjusted for the main potential confounders, such as sociodemographics, lifestyles, and comorbidities. The results of both cohorts were pooled using a random effects model. RESULTS: Among the 1627 participants in SE-I (mean age 71.5 ± 5.5 y, 53.1% women) and the 1579 in SE-II (mean age 71.4 ± 4.2, 46.7% women), 86 (5.3%) and 140 (8.9%) incident cases of depression were identified after a mean 3.2-y and 2.3-y follow-up, respectively. The fully adjusted odds ratio (95% confidence interval) of incident depression for the highest (the highest proinflammatory diet) versus the lowest quartile of DII was 2.76 (1.25-6.08, p-for-trend = 0.005) in the SE-I, 1.90 (1.04-3.40, p-for-trend = 0.005) in the SE-II and 2.07 (1.01-3.13) in the pooled cohorts. The results were consistent across strata defined by sex, age, physical activity, loneliness/poor social network, and morbidity. CONCLUSIONS: A proinflammatory dietary pattern is associated with depression risk in older adults. Future research should evaluate whether reducing the inflammatory component of diet leads to reduced depression symptoms in this population.
Assuntos
Depressão , Transtorno Depressivo Maior , Humanos , Feminino , Idoso , Masculino , Estudos Prospectivos , Depressão/epidemiologia , Depressão/etiologia , Dieta , Exercício Físico , Inflamação/complicaçõesRESUMO
In Colombia, the uptake rate of the HPV vaccine dropped from 96.7% after its introduction in 2013 to 9% in 2020. To identify the behavioural components of HPV-vaccine hesitancy in females aged 15 and under and their families, we conducted a convergent mixed-methods study in which 196 parents/caregivers responded to an online questionnaire and 10 focus groups were held with 13 of these parents/caregivers, and 50 age-eligible girls. The study is novel as it is the first to explore the factors influencing HPV-vaccine hesitancy alongside the COVID vaccine within an integrative model of behaviour change, the capability-opportunity-motivation-behaviour (COM-B) model. We found that COVID-19 has had an impact on the awareness of HPV and HPV vaccination. Lack of information about the vaccination programs, concerns about vaccine safety and the relationship between HPV and sexuality could be related to vaccine hesitancy. Trust in medical recommendations and campaigns focused on the idea that vaccination is a way of protecting daughters from cervical cancer could improve HPV vaccine uptake.
RESUMO
OBJECTIVE/BACKGROUND: Consumption of added sugar and excessive screen-time is increasing worldwide and is associated with sleeping and behavior disorders, which are related with possible Sleep Bruxism (SB) in children. Therefore, the objective of this investigation was to examine the relationship between screen-time and sugar-consumption and possible SB in children. PATIENTS/METHODS: A cross-sectional study, including parents of 460 4- to 8-year-old children, was performed. Frequency of possible SB was assessed with the Children's Sleep Habits Questionnaire; sugar consumption with the Health Behaviour in School-Aged Children Food-Frequency Questionnaire. Comprehensive measures of screen-time (including cell phones, computers, electronic devices, electronic games, and TV) were taken. The time was recorded in hour/day. All data were analyzed with STATA© data analysis and statistical software version 13.0 (Copyright 1996-2016; Stata-Corp LP, College Station, TX, USA). Spearman correlation test and ordinal-multiple-variable regression analyses were used. RESULTS: Data of 440 subjects Mean age 6.2 years (S.D. 1.8) were analyzed. Prevalence of possible SB was 35% and screen-time was available for 92.9% of the children. Mean screen-time was 2.1 h/day. Parents reported 73% of the children (n = 319) to consume added sugar once a day every day and 20% more than once every day. Correlations of possible SB were statistically significant with screen-time (Rho = 0.8; p = 0.002) and sugar-consumption (Rho = 0.7; p = 0.03). Associations were found between possible SB and increase-to-increase screen-time and sugar-consumption (OR > 2). CONCLUSION: The results of this study demonstrated that as screen-time and sugar consumption increased, the frequency of bruxism in children increased.
RESUMO
BACKGROUND: Ideal cardiovascular health behaviour (CVHB) measures four ideal health behaviours (non-smoking, body mass index <85th Percentile, healthy diet, and physical activity). This study aimed to determine the prevalence, distribution, and correlates of ideal CVHB among adolescents in the Caribbean. METHODS: Nationally representative cross-sectional data of 2016 or 2017 with complete CVHB measurements were analysed from 7556 school adolescents from four Caribbean countries. RESULTS: The prevalence of 0-1 ideal metrics CVHB was 20.4%, 2 ideal metrics 48.7%, and 3-4 ideal metrics 30.8%. Only 5.0% had all 4 ideal CVHB metrics, 41.0% intermediate CVH (≥1 metric in the intermediate category and none in the poor category), and 54.0% had poor CVH (≥1 metric in poor category). In adjusted logistic regression analysis, compared to students from Dominican Republic, students from Jamaica (Adjusted Odds Ratio-AOR: 1.36, 95% confidence interval-CI: 1.01-1.85), students from Trinidad and Tobago (AOR: 1.46, 95% CI: 1.17-1.82) and male sex (AOR: 1.35, 95% CI: 1.11-1.64) were positively associated with meeting 3-4 ideal CVHB metrics. In addition, in unadjusted analysis, rarely or sometimes experiencing hunger was negatively and high peer and parent support were positively associated with meeting 3-4 ideal CVHB metrics. CONCLUSION: The proportion of meeting 3-4 ideal CVHB metrics was low among adolescents in four Caribbean countries. Both high-risk and school-wide intervention programmes should be implemented in aiding to improve CVHB in Caribbean countries. Several factors associated with ideal CVHB were identified, which can be targeted in school health interventions.
Assuntos
Comportamento do Adolescente , Doenças Cardiovasculares/prevenção & controle , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Comportamento de Redução do Risco , Adolescente , Fatores Etários , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Dieta Saudável , República Dominicana/epidemiologia , Exercício Físico , Feminino , Inquéritos Epidemiológicos , Fatores de Risco de Doenças Cardíacas , Humanos , Jamaica/epidemiologia , Masculino , não Fumantes , Medição de Risco , Suriname/epidemiologia , Trinidad e Tobago/epidemiologiaRESUMO
OBJECTIVE: Our aim was to analyse the association of change patterns on TV-viewing and computer/tablet use and incidence of elevated consumption of ultra-processed food consumption and lower consumption of fruits and vegetables during the COVID-19 pandemic. DESIGN: Data of 39 208 Brazilian adults from a Behaviour Web Survey were used. Unhealthy nutrition habits were eating fruits or vegetables for <5 d/week and ultra-processed food (sugary foods, snacks, ready-to-eat frozen foods and embedded foods) for ≥5 d/week. For incidence indicators, we only considered participants without unhealthy behaviour before the quarantine. We created four categories of change in TV-viewing and computer/tablet use, considering a cut-off point of 4 h/d for each behaviour (1 - consistently low, 2 - become low during the quarantine, 3 - become high during the quarantine or 4 - consistently high). Analyses were adjusted for sex, age group, highest academic achievement, per capita income, working status during the quarantine, skin colour and adherence to the quarantine. SETTING: Brazil. PARTICIPANTS: Brazilian adults (nationally representative). RESULTS: Logistic regression models revealed that high TV-viewing and computer/tablet use incidence were associated with higher odds for elevated frequency of ultra-processed food consumption (TV-viewing: OR 1·70; 95 % CI 1·37, 2·12; computer/tablet: OR 1·73; 95 % CI 1·31, 2·27) and low consumption of fruit and vegetables (TV-viewing: OR 1·70; 95 % CI 1·29, 2·23; computer/tablet: OR 1·53; 95 % CI 1·08, 2·17) incidence. Consistent high computer/tablet use also presented higher odds for incidence of elevated frequency of ultra-processed food consumption. CONCLUSIONS: Participants with incidence of sedentary behaviours were also more likely to present incidence of unhealthy diet during the COVID-19 pandemic quarantine.
Assuntos
COVID-19/epidemiologia , Dieta/estatística & dados numéricos , Comportamento Alimentar , Comportamento Sedentário , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Computadores , Estudos Transversais , Dieta/métodos , Fast Foods/estatística & dados numéricos , Feminino , Frutas , Comportamentos Relacionados com a Saúde , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pandemias , Quarentena , Estudos Retrospectivos , SARS-CoV-2 , Inquéritos e Questionários , Televisão , Verduras , Adulto JovemRESUMO
Parental practices can affect children's weight and BMI and may even be related to a high prevalence of obesity. Therefore, the aim of this study was to evaluate the relationship between parents' practices related to feeding their children and excess weight in preschoolers in Bucaramanga, Colombia, using artificial intelligence. A cross-sectional study was carried out between September and December 2017. The sample included preschoolers who attended child development institutions belonging to the Colombian Institute for Family Wellbeing in Bucaramanga and the metropolitan area (n 384). The outcome variable was excess weight and the main independent variable was parental feeding practices. Confounding variables analysed included sociodemographic characteristics, food consumption, and children's physical activity. All equipment for the anthropometric measurements was calibrated. Logistic regression was used to predict the effect of parental practices on the excess weight of the children, and the AUC was used to measure performance. The parental practices with the greatest association with excess weight in the children involved using food to control their behaviour and restricting the amount of food they offered (use of food to control emotions (OR 1·77; 95 % CI 1·45, 1·83; P = 0·034) and encouraging children to eat less (OR 1·22; 95 % CI 1·14, 1·89; P = 0·045)). Childrearing practices related to feeding were found to be an important predictor of excess weight in children. The results of this study represent implications for public health considering this as a baseline for the design of nutrition education interventions focused on parents of preschoolers.
Assuntos
Inteligência Artificial , Comportamento Alimentar , Sobrepeso/epidemiologia , Poder Familiar , Obesidade Infantil/epidemiologia , Índice de Massa Corporal , Peso Corporal , Pré-Escolar , Colômbia , Estudos Transversais , Humanos , Pais , Inquéritos e Questionários , Aumento de PesoRESUMO
This paper estimates the short-term impact of a twofold increase of the tobacco excise tax on consumption of illicit cigarette trade in Colombia. Using data collected before and after the tax increase from a novel smoker survey (DEICS-Col), the impact is estimated as the change in the probability that a smoker has illicit cigarettes. The methodology follows a difference-in-differences strategy, measuring the year-to-year variation of the proportion of illicit cigarettes between smokers who report buying low-priced cigarettes (the highest treatment intensity) and those who bought high-priced cigarettes (lowest treatment intensity). Estimations of the impact show an average increase of 4-5 percentage points on the proportion of illicit cigarettes relative to an initial penetration of low-priced illicit cigarettes of nearly 5.1 %.
Assuntos
Crime/estatística & dados numéricos , Impostos/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Colômbia , Comércio/estatística & dados numéricos , Humanos , Inquéritos e QuestionáriosRESUMO
Resumen Introducción: El espectro evitativo/restrictivo de la conducta alimentaria, incluye el trastorno evitativo/restrictivo de la ingestión de alimentos (TERIA), y otros desórdenes que implican a veces traslapes, entrecruzamientos y virajes con otros trastornos alimentarios. Objetivo: Se realiza un análisis descriptivo del TERIA, y de otros trastornos alimentarios, en relación a sus aspectos epidemiológicos, etiopatogénicos, clínicos y terapéuticos. Se incluyen viñetas clínicas ilustrativas. Método: Se efectuó una búsqueda bibliográfica sobre el TERIA y otros trastornos alimentarios mediante las bases de datos Medline/PubMed, SciELO y textos especializados. Resultados: El TERIA, que en el DSM-5 adquiere la categoría de un trastorno alimentario bien definido, puede ser precedido por el comer selectivo/exigente. Los pacientes son principalmente hombres jóvenes con evolución prolongada del desorden. Otros trastornos alimentarios incluidos en el abanico evitativo/restrictivo son: anorexia nerviosa, alergia e intolerancia alimentaria y ortorexia nerviosa, como un concepto sindromático relativamente reciente. Existe controversia si la ortorexia nerviosa es un trastorno alimentario único o una consecuencia del desenlace de éste o un proceso obsesivo-compulsivo. El antecedente de trastorno alimentario es un factor predictivo significativo para ortorexia nerviosa. Todos estos desórdenes pueden producir diversos niveles de desnutrición e interferencia en el desempeño psicosocial. El manejo terapéutico requiere un equipo multidisciplinario que incluya médicos, psicoterapeutas, nutricionistas, psicoeducación, psicoterapia cognitivo-conductual, asesoría nutricional, y en ocasiones terapia farmacológica anti-serotoninérgica. Conclusiones: Se necesita una mayor evidencia en la investigación de estos nuevos fenotipos de trastornos alimentarios para determinar su impacto en aspectos demográficos, nosológicos, clínicos y terapéuticos.
Background: The avoidant/restrictive spectrum of eating behaviour includes the avoidant/restrictive of food intake disorder (ARFID), sometimes involving overlapping, crossing and turning with other eating disorders. Objective: A descriptive analysis of ARFID and other eating disorders is performed in relation to its epidemiological, etiopathogenic, clinical and therapeutic aspects. Illustrative clinical vignettes are included. Method: A review of specialised textbooks and the available literature in Medline/PubMed and SciELO on ARFID and other eating disorders was carried out. Results: ARFID, which in the DSM-5 acquires the category of a well-defined eating disorder, may be preceded by selective/picky eating. Patients are mainly young men with a long evolution of the disorder. Other eating disorders included in the avoidant/ restrictive range are: anorexia nervosa, food allergy and intolerance and orthorexia nervosa; the lately as a relatively recent syndromatic concept. It has been controversial whether orthorexia nervosa is a unique eating disorder, a consequence of its outcome or an obsessive-compulsive process. The historical background of an eating disorder is a significant predictive factor for orthorexia nervosa. All these disorders can produce different levels of malnutrition and interference in psychosocial performance. The therapeutic management requires a multidisciplinary team that includes physicians, psychotherapists, nutritionists, psychoeducation, cognitive-behavioural psychotherapy, nutritional counselling, and sometimes anti-serotonergic drug therapy. Conclusions: More evidence is needed in the research of these new phenotypes of eating disorders to determine their impact on demographic, nosological, clinical and therapeutic aspects.
Assuntos
Humanos , Anorexia Nervosa , Desnutrição , Comportamento Alimentar , Hipersensibilidade Alimentar , Intolerância Alimentar , Transtorno Alimentar Restritivo EvitativoRESUMO
The aim of this study was to investigate associations between oral health literacy (OHL), self-rated oral health (SROH), and oral health-related quality of life (OHRQoL) in Brazilian adults. A sample of 523 Brazilian adults completed the short-form Health Literacy in Dentistry (HeLD-14) and the Oral Health Impact Profile-14 (OHIP-14) instruments that measure OHL and OHRQoL, respectively. The prevalence ratios (PRs) for outcome variables and their 95% CIs were quantified. Multivariable log-binomial regression models were applied, as the statistical models, to estimate bivariate and multivariable relationships of oral health outcomes with OHL, after adjusting for covariates. No significant association was found between poor SROH (as measured by single items) and OHL (PR = 1.28; 95% CI: 0.87-1.88); by contrast, significant associations were found between poor SROH and income (PR = 1.52; 95% CI: 1.04-2.21), toothbrushing frequency (PR = 1.69; 95% CI: 1.11-2.58), reason for dental visiting (PR = 1.48; 95% CI: 1.03-2.13), and self-rated general health (PR = 3.44; 95% CI: 2.38-4.97). The OHL level (PR = 1.76; 95% CI: 1.21-2.56), educational level (PR = 0.62; 95% CI: 0.41-0.93), reason for dental visiting (PR = 1.84; 95% CI: 1.30-2.61), and self-rated general health (PR = 1.51; 95% CI: 1.03-2.23) were associated with poor OHRQoL.
Assuntos
Letramento em Saúde , Saúde Bucal , Adulto , Brasil , Estudos Transversais , Humanos , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Early childhood caries (ECC) affects about 621 million children worldwide, causing chronic pain, infections, sleeping disorders, and tooth extraction. AIM: To determine perspectives of parents and caregivers of preschoolers regarding ECC. DESIGN: Three focus groups were conducted with attendees of the Clinics of Paediatric Dentistry from the Bauru School of Dentistry. The meetings were video- and audio-recorded, and the contents were transcribed verbatim. Then, textual passages were examined and coded using the software NVivo 12 Plus. RESULTS: The participants associated the presence of dental caries lesions with negative consequences for children, such as problems for permanent dentition, discrimination, and psychological damages. Although regular oral hygiene and healthy diet were recognized as important factors for the prevention of ECC, specific doubts about feeding, toothpaste usage, oral hygiene, and dental eruption were detected among parents. Additionally, they declared that their children brush teeth alone, intake fermentable carbohydrates frequently, and sleep during breastfeeding without dental plaque removal, because uncooperativeness, permissiveness, and convenience. CONCLUSIONS: Based on these results, parents and caregivers understand the unfavourable effects of ECC on children's quality of life; however, their attitudes against the disease seemed to be inaccurate, influenced by their daily routines, doubts, and beliefs.
Assuntos
Cárie Dentária , Criança , Pré-Escolar , Humanos , Higiene Bucal , Pais , Pesquisa Qualitativa , Qualidade de VidaRESUMO
OBJECTIVE: To examine the associations of individual and food environmental factors with fruit and vegetable (F&V) intake in a city in a low-to-middle-income country (LMIC). DESIGN: Cross-sectional. SETTING: Representative sample of the Brazilian Primary Care service known as the Health Academy Program (HAP) in Belo Horizonte, a Brazilian city. SUBJECTS: Using a conceptual model as a guide, individual and food environment data were obtained through: (i) face-to-face interviews with participants aged 20 years or older; and (ii) F&V food store audits. A broad set of individual, household, and community and consumer nutrition environment variables was investigated. Multilevel linear regression was used to quantify area-level variations in F&V intake and to estimate associations with the factors. RESULTS: Eighteen HAP centres were selected and 2944 participants and 336 food stores were included. F&V intake varied between contexts, being higher in areas with better socio-economic conditions and food store quality, such as specialised F&V markets. Individual-level factors, including age, income, food insecurity, stage of change, self-efficacy and decisional balance, were significantly associated with F&V intake. After controlling for individual-level characteristics, greater F&V intake was also associated with higher quality of food stores. CONCLUSIONS: In one of the first studies to comprehensively assess the food environment in an LMIC, individual-level factors accounted for the largest variation in F&V intake; however, the food environment was also important, because area-level variables explained 10·5 % of the F&V intake variation. The consumer nutrition environment was more predictive of healthy eating than was the community nutrition environment. The findings suggest new possibilities for interventions.
Assuntos
Dieta/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Inquéritos Nutricionais/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Meio Social , Adulto , Brasil , Comércio/estatística & dados numéricos , Estudos Transversais , Características da Família , Feminino , Frutas , Promoção da Saúde , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Verduras , Adulto JovemAssuntos
Nefrite Intersticial , Insuficiência Renal Crônica , Humanos , Agricultura , América CentralRESUMO
OBJECTIVE: To evaluate the sociodemographic and lifestyle factors associated with insufficient and excessive use of folic acid supplements (FAS) among pregnant women. DESIGN: A pregnancy cohort to which multinomial logistic regression models were applied to identify factors associated with duration and dose of FAS use. SETTING: The Growing Up in New Zealand child study, which enrolled pregnant women whose children were born in 2009-2010. SUBJECTS: Pregnant women (n 6822) enrolled into a nationally generalizable cohort. RESULTS: Ninety-two per cent of pregnant women were not taking FAS according to the national recommendation (4 weeks before until 12 weeks after conception), with 69 % taking insufficient FAS and 57 % extending FAS use past 13 weeks' gestation. The factors associated with extended use differed from those associated with insufficient use. Consistent with published literature, the relative risks of insufficient use were increased for younger women, those with less education, of non-European ethnicities, unemployed, who smoked cigarettes, whose pregnancy was unplanned or who had older children, or were living in more deprived households. In contrast, the relative risks of extended use were increased for women of higher socio-economic status or for whom this was their first pregnancy and decreased for women of Pacific v. European ethnicity. CONCLUSIONS: In New Zealand, current use of FAS during pregnancy potentially exposes pregnant women and their unborn children to too little or too much folic acid. Further policy development is necessary to reduce current socio-economic inequities in the use of FAS.
Assuntos
Suplementos Nutricionais , Ácido Fólico , Comportamentos Relacionados com a Saúde , Gravidez/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Ácido Fólico/administração & dosagem , Ácido Fólico/uso terapêutico , Humanos , Nova Zelândia , Saúde PúblicaRESUMO
BACKGROUND: Studies concerning ideal cardiovascular (CV) health and its relationship with arterial stiffness are lacking. This study examined the association between arterial stiffness with ideal CV health as defined by the American Heart Association, across age groups and gender. METHODS: The cross-sectional study included 1365 adults. Ideal CV health was defined as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity, and Mediterranean diet adherence) and 3 factors (total cholesterol, blood pressure, and glycated hemoglobin). Patients were grouped into 3 categories according to their number of ideal CV health metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). We analyzed the pulse wave velocity (PWV), the central and radial augmentation indexes, and the ambulatory arterial stiffness index (AASI). RESULTS: The ideal CV health profile was inversely associated with lower arterial radial augmentation index and AASI in both genders, particularly in middle-aged (45-65 years) and in elderly subjects (>65 years). Also in elderly subjects, adjusted models showed that adults with at least 3 health metrics at ideal levels had significantly lower PWV than those with 2 or fewer ideal health metrics. CONCLUSIONS: An association was found between a favorable level of ideal CV health metrics and lower arterial stiffness across age groups.