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Barreto M.L.,Federal University of Bahia | Ribeiro-Silva R.C.,Federal University of Bahia | Malta D.C.,Health Surveillance Secretariat | Malta D.C.,Federal University of Minas Gerais | And 4 more authors.
Revista Brasileira de Epidemiologia | Year: 2014

Objective: This study aims to describe the prevalence rates of asthma symptoms in Brazil, its Regions and State capitals, according to data from the National Adolescent School-based Health Survey, 2012. Furthermore, it aims to compare the prevalence of asthma in the capitals evaluated by PeNSE 2012 with previous results of the International Study of Asthma and Allergies in Childhood (ISAAC). Methods: Cross sectional study of 9th grade students at public and private schools of all Brazilian states and the Federal District (Brasília). A self reported questionnaire containing items from the ISAAC was applied in order to identify the presence of asthma symptoms. Results: The results of PeNSE indicate a high prevalence of asthma symptoms (23.2%) and of reports of a previous medical diagnosis of asthma (12.4%). Of the five state capitals in which the PeNSE results were compared to the ISAAC, São Paulo, Curitiba and Porto Alleger presented an increase in the prevalence of asthma symptoms. In Salvador, there was a reduction. Conclusion: Brazil is among the countries with the highest prevalence of asthma in the world, and the prevalence is still growing.


Malta D.C.,Ministry of Health | Malta D.C.,Federal University of Minas Gerais | Oliveira-Campos M.,Ministry of Health | Oliveira-Campos M.,Federal University of Minas Gerais | And 6 more authors.
Revista Brasileira de Epidemiologia | Year: 2014

Objective: To evaluate the association between the consumption of psychoactive substances (tobacco, alcohol and illicit drugs) and demographic variables, mental health and family context among school-aged children. Methods: The National Adolescent School-based Health Survey was held with a national sample of 109,104 students. Data regarding demographic variables, family background and mental health were collected. Logistic regression was used to evaluate the associations of interest. Results: Multivariate analyses showed that alcohol consumption was higher among girls, drug experimentation was more frequent among boys and that there was no difference between sexes for smoking. Being younger and mulatto were negatively associated with the use of tobacco, alcohol and illicit drugs. Also negatively associated with such risk behaviors were characteristics of the family context represented by: living with parents, having meals together and parental supervision (when parents know what the child does in their free time). Moreover, characteristics of mental health such as loneliness and insomnia were positively associated with use of tobacco, alcohol and illicit drugs. Not having friends was positively associated with use of tobacco and illicit drugs and negatively associated with alcohol use. Conclusions: The study shows the protective effect of family supervision in the use of tobacco, alcohol and drugs and, on the contrary, the increasing use of substances according to aspects of mental health, such as loneliness, insomnia and the fact of not having friends. The study's findings may support actions from health and education professionals, as well as from the government and families in order to prevent the use of these substances by adolescents.


Brito C.,Oswaldo Cruz Foundation | Portela M.C.,Oswaldo Cruz Foundation | de Vasconcellos M.T.L.,Brazilian Institute of Geography and Statistics
BMC Cancer | Year: 2014

Background: Despite the excellent results obtained with hormone therapy, the long treatment period and the side effects associated with its use make patient adherence difficult. Moreover, certain aspects of health care can mitigate or exacerbate non-adherence. This study aimed to identify the factors associated with adherence to hormone therapy for breast cancer, with the goal of contributing to the reformulation of the care process and to improvements in outcomes.Method: This was a retrospective longitudinal study based on secondary data. The study integrated and analyzed data from a cohort of 5,861 women with breast cancer who were identified in the databases of the Brazilian National Cancer Institute [Instituto Nacional de Câncer - INCA] and the Unified Health System [Sistema Único de Saúde - SUS]. All of the patients were treated at INCA, which dispenses free medication, and the follow-up period lasted from 01/01/2004 to 10/29/2010. The outcome of interest was hormone treatment adherence, which was defined as the possession of medication, and a logistic regression model was employed to identify the socio-demographic, behavioral, clinical, and health care variables that were independently associated with the variations in this outcome.Results: The proportion of women who adhered to hormone therapy was 76.3%. The likelihood of adherence to hormone therapy increased with each additional year of age, as well as among women with a secondary or higher level education, those with a partner, those who underwent surgery, those who had more consultations with a breast specialist and clinical oncologist, and those who underwent psychotherapy; the effect for the latter increased with each additional consultation. Conversely, the likelihood of adherence was lower among patients at a non-curable stage, those who were alcohol drinkers, those who received chemotherapy, those who had undergone more tests and had more hospitalizations, and those who used tamoxifen and combined aromatase inhibitors.Conclusion: This study shows that approximately a quarter of the women with breast cancer did not adhere to hormone treatment, thus risking clinical responses below the expected standards. It also identifies the most vulnerable subgroups in the treatment process and the aspects of care that provide better results. © 2014 Brito et al.; licensee BioMed Central Ltd.


Dos Anjos L.A.,Federal University of Fluminense | Dos Anjos L.A.,Oswaldo Cruz Foundation | Da Mata MacHado J.,Federal University of Fluminense | Wahrlich V.,Federal University of Fluminense | And 3 more authors.
Medicine and Science in Sports and Exercise | Year: 2011

Background: Walking is commonly recommended for enhancing energy expenditure (EE), a basic principle in weight management, and cardiorespiratory fitness. However, walking EE varies with characteristics of a given population, especially by sex and age. Purpose: The study's purpose was to measure EE of walking as influenced by physical and physiological characteristics of a sample of adults (20 yr) living in Niterói, Rio de Janeiro, Brazil. Methods: Walking EE and HR were measured during a submaximal multistage treadmill test. The test stages lasted for 3 min each and started at a speed of 1.11 m•s and a grade of 0%. In the second stage, the grade was maintained at 0%, but the speed was increased to 1.56 m•s and maintained at this speed but with grade raised by 2.5% at each stage until 10% at stage 6. We measured resting oxygen consumption (METm) before the test with the participants sitting quietly. Results: METm (mL O2•kg•min1, mean ± SE) was lower both in women (2.85 ± 0.03) and in men (2.97 ± 0.04) by almost 19% and 15%, respectively, compared with the conventionally estimated MET (METe) of 3.5 mL O2•kg•min. Walking EE for any given speed and grade had an absolute intensity, expressed as multiples of METm or METe, that was practically equal between sexes and age groups, but it incurred higher individual physiological demand or relative intensity for women and older adults. Conclusions: Resting EE reflected by using METe is overestimated in the adult population of Niterói. Prescription of activities to counteract the existing worldwide obesity epidemic should be ideally based on individual physiological information, especially among women and older individuals. © 2011 by the American College of Sports Medicine.


Pfeffermann D.,University of Southampton | Correa S.,Brazilian Institute of Geography and Statistics
Biometrika | Year: 2012

We develop a method for bias correction, which models the error of the target estimator as a function of the corresponding estimator obtained from bootstrap samples, and the original estimators and bootstrap estimators of the parameters governing the model fitted to the sample data. This is achieved by considering a number of plausible parameter values, generating a pseudo original sample for each parameter and bootstrap samples for each such sample, and then searching for an appropriate functional relationship. Under certain conditions, the procedure also permits estimation of the mean square error of the bias corrected estimator. The method is applied for estimating the prediction mean square error in small area estimation of proportions under a generalized mixed model. Empirical comparisons with jackknife and bootstrap methods are presented. © 2012 Biometrika Trust.

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