Cervical cancer screening coverage and associated factors in a city in southern Brazil: a population-based study

This study focused on coverage of screening for cervical cancer and associated factors in women 20 to 59 years of age in Florianópolis, Santa Catarina State, Brazil, in 2009. This was a cross-sectional study using cluster random sampling. Two outcomes were examined: a history of at least one Papanicolaou test and delaying the test (never performed or performed more than three years previously). Among 952 women, 93% (95%CI: 91.5-94.7) had ever had a Pap smear, whereas 14% (95%CI: 11.8-16.2) had delayed the test. According to Poisson regression, both outcomes were associated with marital status, schooling, presence of chronic disease, and consulting a physician for other reasons. Age, income, and hospitalization in the previous year were only associated with ever having a Pap smear. Although test coverage was high, much of the screening was opportunistic. In addition, various social, economic, and demographic disparities influenced the odds of being screened.     

Metabolic syndrome (MetS) and associated factors in middle-aged women: a cross-sectional study in Northeast Brazil

ABSTRACT

We determined the prevalence of Metabolic Syndrome (MetS) and associated factors in 419 women (aged 40 to 65 years) in Northeast Brazil in a cross-sectional study conducted from April to November 2013. We defined MetS using the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Socio-demographic variables, reproductive factors, lifestyle factors, anthropometrics, body composition, quality of life, and physical performance were assessed for their associations. We constructed multivariate Poisson regression models to estimate prevalence rate ratios (PRR) and 95% confidence intervals (CI). We identified 275 (65.6%) cases of MetS. The three most prevalent indicators were obesity (73.5%), reduced high-density lipoprotein level (63.0%), and elevated blood pressure (60.9%). In the final adjusted model, black race (PR 1.30, 95% CI: 1.07–1.57), lower grip strength/body mass index (PR 1.31, 95% CI: 1.15–1.50), and low estradiol levels (PR 1.17, 95% CI: 1.00–1.35) were associated with MetS. MetS is a long-term threat to the health of middle-aged women and a potential public health burden. These results may help in developing health promotion strategies to prevent morbidity and mortality associated with MetS in this vulnerable population.     

Self-perceived oral health among elderly individuals in a medium-sized city in Northeast Brazil

This study focused on self-perceived oral health of the elderly and associated variables. The sample consisted of 321 functionally independent individuals 60 years or older living in Parnaíba, Piauí State, Brazil. Oral examinations were performed and questionnaires were applied during home visits. The elderly presented poor oral health, with mean DMFT 29.41 (SD = 4.10). However, their self-perceived oral health was positive, with 52% showing high scores according to the Geriatric Oral Health Assessment Index (GOHAI). Multivariate analysis showed that predictors of self-perceived oral health included the need for upper prostheses, oral mucosal lesions, and self-rated oral health. The most important predictor was self-rated oral health, with a weight of 20% variation in self-perceived oral health. In conclusion, subjective measurement of oral health in the elderly is less associated with their actual clinical status and more with other subjective factors.     

Prevalence of childhood stress and associated factors: a study of schoolchildren in a city in Rio Grande do Sul State, Brazil

This was a cross-sectional school-based study of 883 fourth-grade elementary schoolchildren at private (5), municipal (18), and State (11) schools in a city in Rio Grande do Sul State, Brazil. The objective was to identify the prevalence of childhood stress and its associated factors. The assessment used the Lipp & Lucarelli Childhood Stress Scale (2005) and a parental questionnaire. The results showed 18.2% stress prevalence in the schoolchildren. Factors associated with stress according to bivariate analysis were: gender (female), age (> 10 years), type of school (public), parents' marital status (not married), family relationship (fair/bad), social interaction (fair/bad), child's autonomous activities (lack of), and parents schooling' (elementary). After Cox regression, gender and social interaction remained in the final model as the factors associated with stress, demonstrating that girls and children with fair or bad social interaction had an increased likelihood of stress. The results point to the importance of early detection of childhood stress and the need for preventive measures to relieve the suffering caused by stress in so many children.     

Energy-drink consumption in college students and associated factors

Objective

To investigate the frequency of energy-drink consumption and associated factors in a group of college students.

Methods

A cross-sectional study was conducted in Hacettepe University (Ankara, Turkey) and included 439 students pursuing a career in medicine, sports, and arts. Only fourth-year students were approached. Data were collected using a self-administered standard questionnaire.

Results

In bivariate analyses, frequency of energy-drink consumption was higher in students of arts and sports and in those who did not have breakfast on a regular basis, ever smoked cigarettes, drank alcoholic beverages, and regularly engaged in sports compared with their counterparts. Many students who had “ever” tried an energy drink did so the first time because they wondered about its taste. Of regular users of energy drinks, reasons for using such drinks varied across the three selected groups of students and included obtaining getting energy, staying awake, boosting performance while doing sports, or mixing with alcoholic beverages. About 40% of all current users of energy drinks reported that they mixed those with alcoholic beverages. In multivariate analyses, statistically significant predictors of energy-drink consumption were faculty type, presence of any health insurance, use of alcoholic beverages, and monthly income, controlling for gender. Most students could not correctly define the ingredients of energy drinks or their potential hazardous health effects, and they could not distinguish energy and sports drinks when they were requested to select them from a list of commercial names of various drinks.

Conclusion

Consumption of energy drinks, despite the variation in the reason for choosing such drinks, is quite common in college students. Awareness of university students of the ingredients and potential health hazards of energy drinks, in particular in mixing with alcoholic beverages, should be increased.     

Alcohol consumption and its relation to cardiovascular risk factors in Germany

OBJECTIVE: To analyse the association of alcohol consumption and blood lipids, haemostatic factors, and homocysteine in German adults by gender and age groups. DESIGN: Cross-sectional population-based survey. SETTING: Data from the German National Health Interview and Examination Survey 1998, representative for age, gender, community size, and federal state. SUBJECTS: From a sample of 7124 Germans between 18 and 79 y old, 2420 women and 2365 men were selected. Only individuals who were not currently receiving medical treatment or did not have disorders related to cardiovascular disease were selected for this study. RESULTS: Using analyses of variance, mean blood levels of total cholesterol, HDL cholesterol, HDL/total cholesterol ratio, total glycerides, fibrinogen, antithrombin III, and homocysteine adjusted for age, socioeconomic status, East/West Germany residence, body mass index, tobacco use, sports activity, and coffee consumption, if appropriate are presented by alcohol consumption groups (0, >0-10, >10-20, >20-30 and >30 g/day). The HDL/total cholesterol ratio increased with higher alcohol groups up to 10-20 g/day (+15%) for women and >30 g/day (+18%) for men, showing the strongest rise among men aged 55-79 y. Fibrinogen decreased with higher alcohol groups up to 10-20 g/day for women and 20-30 g/day for men. Among women, homocysteine levels showed a U-shaped curve with a minimum of 8.49 mmol/l at 10-20 g alcohol/day (-8%, reference: nondrinking), whereas an inverse association was observed for men. CONCLUSIONS: Moderate alcohol consumption is associated with favourable levels of several cardiovascular risk factors. The most favourable cardiovascular risk factor profile among women was observed among those drinking 10-20 g alcohol/day. Beneficial effects seem to be more pronounced among older men.     

Alcohol consumption, metabolic cardiovascular risk factors and hypertension in women

BACKGROUND: Low to moderate alcohol consumption is associated with reduced mortality, primarily due to a reduction in coronary heart disease (CHD). Conversely, heavy drinking increases mortality, mainly due to haemorrhagic stroke and non-cardiovascular diseases. It is important to identify the threshold of alcohol consumption above which the balance of risk and benefit becomes adverse. We examine the relationship between reported alcohol consumption, cardiovascular disease (CVD) risk factors, a 10-year CHD risk score and hypertension in women. METHODS: In all, 14 077 female employees aged 30-64 years, underwent screening for CVD risk factors. Information was available on a range of personal and lifestyle factors, including height, weight, blood pressure, lipids, lipoproteins, apolipoproteins and blood glucose. Age-adjusted means were computed for the risk factors in each of five groups of reported alcohol intake: <1 (non-drinkers), 1-7, 8-14, 15-21, > or = 22 units/week. The relationships between alcohol and a derived coronary risk score and hypertension were also examined. RESULTS: Increasing consumption was associated with an age-adjusted increase in high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (both P < 0.001), a decline in body mass index, total cholesterol (TC), TC/HDL-C ratio, low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (all P < 0.001), and no trend in triglycerides (P = 0.06), lipoprotein (a) (P = 0.09) or fasting glucose (P = 0.14). Except for LDL-C (P = 0.06) the relationships remained statistically significant after adjustment for possible confounders. Compared to non-drinkers, there was a decrease in 10-year CHD risk with increasing consumption, with the greatest reduction in risk in women consuming 1-7 units/week, odds ratio (OR) = 0.79, (95% CI: 0.72-0.87), and an increase in the prevalence of hypertension among those consuming 15-21 units/week, OR = 1.68, (95% CI: 1.14-2.46). CONCLUSIONS: This study provides biological support for an inverse association between alcohol intake and CHD in women, associated with favourable changes in lipid and lipoprotein risk factors. Women consuming 1-14 units/week had a reduction in CHD risk, but there was an increased prevalence of hypertension among those consuming > or = 15 units/week. These data suggest that, in terms of the reduced risk of CVD, women should be advised to restrict their alcohol consumption to < or = 14 units/week.     

Physical violence and associated factors: a population-based study in Southern Brazil

OBJECTIVE: To estimate the prevalence of physical violence and its association with sociodemographic aspects, stressful life events, and the use of health services due to emotional problems. METHODS: A cross-sectional population-based study was conducted with a sample of 1,954 14-year-old or older inhabitants of the city of Canoas (Southern Brazil). They were selected by means of conglomerate sampling according to a pre-established system. Data were obtained in visits to households by means of a confidential semi-structured questionnaire. A bivariate analysis was carried out through multinomial logistic regression, and the multivariate analysis by polytomous logistic regression, categorizing the outcome by age group. RESULTS: The findings show a prevalence of 9.7% (CI 95%: 8.37;11.03) and association with: women 20 years old and older (OR=2.74; CI 95%: 1.52;4.94); higher schooling rate (p<0.03); higher experience of stressful life events at 20 years of age or more (OR=6.61; CI 95%: 2.71;16.1); and doctors' appointments due to emotional problems as of 10 years of age (p>0.001). CONCLUSIONS: The prevalence of physical violence in the population was significant, resulting in important emotional consequences and impact on health services, requiring capacity building of the professionals in the field.     

Heavy alcohol consumption and associated factors: a population-based study

OBJECTIVE: To determine the prevalence of heavy alcohol consumption and factors associated with it in a Brazilian adult population. METHODS: Cross-sectional population-based study including 2,177 adults (aged 20 to 69), living in the urban area of the municipality of Pelotas, Rio Grande do Sul State, Brazil. The sample was selected in multiple stages. Heavy alcohol consumption was defined as above 30g/day. The adjusted analysis was conducted by logistic regression. RESULTS: The prevalence of heavy alcohol consumption was 14.3% (29.2% among men and 3.7% among women). The following groups presented higher prevalences of heavy alcohol consumption after adjusted analysis: men, elderly people, blacks or mulattoes, heavy smokers, and people who present some kind of chronic disease. Men with minor psychiatric disorders showed higher prevalences of heavy alcohol consumption than other men. Among women, association between age and heavy alcohol consumption was inversely related. Furthermore, the study indicates that among hypertensive subjects, those with heavy alcohol consumption presented worse disease management. CONCLUSIONS: Heavy alcohol consumption is high and results in countless negative consequences for the individual's health and quality of life. Our results highlight the high prevalence of heavy alcohol consumption and indicate subsections of the whole population more susceptible to alcoholism.     

Young people's blood alcohol concentration and the alcohol consumption city law, Brazil

The paper assesses blood alcohol concentration and risk behaviors for traffic accidents before and after the implementation of a law which prohibits the use of alcoholic beverages on city gas stations. In Porto Alegre, Southern Brazil, young people go out at night and drive to gas station convenience stores to buy alcoholic beverages which are consumed on the premises of parking lots in gas stations. Data were obtained from self-administered questionnaires and breath analyzers in two cross-sectional collections with purposive samples of youngsters in May and July 2006 (n=62, and n=50, respectively). There were no significant differences between the groups before and after the city law was passed. Blood alcohol concentration greater than 0.06% was found in 35.5% of pre-law group and 40% of post-law group (p=0.62). Results point out heavy alcohol use in both groups, which did not change after the law was passed.     

Disseminated Cutaneous Leishmaniasis and Alcohol Misuse,Northeast Brazil, 2015–2018

Disseminated cutaneous leishmaniasis (DCL) is an uncommon form of Leishmania braziliensis infection. It remains unknown why some people develop this clinical condition. We describe 14 DCL patients in Northeast Brazil during 2015–2018. These patients regularly drank large amounts of alcohol, possibly increasing their risk for DCL.     

Child sexual abuse in southern Brazil and associated factors: a population-based study

Background  

The prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil.     

Prevalence of overweight and obesity and associated factors among adolescents in the Northeast and Southeast regions of Brazil, 1996 to 1997

The purpose of this study was to assess the prevalence and factors associated with overweight and obesity (OW/O) among Brazilian adolescents, based on the Living Standards Survey conducted in 1996 and 1997 (IBGE, 1998a). The sample included 1,027 and 854 adolescents aged 15 to 19 years from the Northeast and Southeast regions, respectively. Body Mass Index (w/h2) was calculated. Statistical analysis considered expansion factors and sample design. Prevalence of OW/O was 8.45% in the Northeast and 11.53% in the Southeast. In the Northeast there was a higher risk of OW/O for girls (PR = 3.00), with the same situation in both urban (PR = 3.21) and rural areas (PR = 2.27). In the Southeast, the risk of OW/O was lower among girls (PR = 0.58). The same situation occurred in girls from urban areas (PR = 0.51), but in rural areas there was an increased risk among girls (PR = 1.86). Per capita monthly income was associated with the risk of OW/O among boys in both regions. Programs to prevent OW/O should incorporate nutritional reeducation and encourage physical exercise, besides considering socioeconomic, cultural, and regional differences and the location of the target population.     

Risk factors for maternal mortality in an urban area of Northeast Brazil

A case-control study was conducted to investigate risk factors for maternal mortality in Recife, Pernambuco State, Brazil, in 2001-2005. Cases were 75 maternal obstetric deaths in Recife, identified from the Mortality Information System, investigated and analyzed by an expert committee on maternal mortality. Controls, selected from the Information System on Live Births using systematic sampling, were 300 women living in Recife whose last pregnancy occurred during the same period and ended in live births. Increased risk of maternal death was associated with use of the public health system (OR = 4.47; 95%CI: 1.87-10.29), age > 35 years (OR = 3.06; 95%CI: 1.59-5.92), < 4 years of schooling (OR = 4.95; 95%CI: 2.43-10.08), cesarean section (OR = 3.06; 95%CI: 1.77-5.29), and lack of prenatal care or fewer than four prenatal visits (OR = 9.78; 95%CI: 5.52-17.34). The results confirm social inequalities in maternal mortality in Recife and indicate the need to improve healthcare for women during the prenatal period, delivery, and postpartum.     

Unplanned pregnancy in Southern Brazil: prevalence and associated factors

The purpose of this study was to investigate factors associated with unplanned pregnancies in Rio Grande, Rio Grande do Sul State, Brazil. A standardized questionnaire was applied in 2007 to all pregnant women in the city, including demographic characteristics, childbearing history, socioeconomic status, and prenatal and childbirth care. The study used Poisson multivariate regression analysis with robust adjustment of variance. Among the 2,557 women included in the study, 65% had not planned the current pregnancy. After adjusting for confounders, the following variables were significantly associated with unplanned pregnancy: black or mixed race, age < 20 years, single marital status, low family income, household crowding, smoking, and multiparity. Previous abortion was a protective factor against unplanned pregnancy. The high unplanned pregnancy rate, especially among women with increased risk of complications during pregnancy and childbirth, highlights the need to target healthcare programs for this group.     

Alcohol consumption, serum gamma-glutamyltransferase levels, and coronary risk factors in a middle-aged occupational population

The relationships between alcohol consumption, serum gamma-glutamyltransferase (GGT) levels, and the prevalence of major coronary risk factors were analyzed cross-sectionally in 2,399 male and 1,402 female middle-aged workers, to clarify the effects of moderate alcohol consumption on the development of the metabolic syndrome. Male moderate drinkers, consuming less than 60 ml of alcohol per day, had a lower prevalence of upper body obesity and low serum HDL-cholesterolemia (LHDLC) in comparison with nondrinkers, but not of hypertension, impaired glucose tolerance or hypertriglyceridemia (HTG). In women, alcohol consumption did not show any significant associations with the coronary risk factors. Men with an elevated serum GGT (EGGT) of 40 U/l or above had a significantly higher odds ratio for all the coronary risk factors as compared with those with normal GGT, even after adjusting for alcohol consumption, together with age, body mass index, cigarette consumption and physical activity. Women with an EGGT of 25 U/l or above had similar findings, although significance was found only in HTG. Nearly 80% and 55% of the appearance of EGGT in men and women were attributable to alcohol consumption, and 20% and 10% of the male and female moderate drinkers had EGGT. These results suggest that even moderate alcohol consumption will increase coronary risk factors characteristic of the metabolic syndrome in drinkers who have an increase in serum GGT. Further studies are required to confirm the causal association between alcohol consumption, increase in serum GGT and development of the metabolic syndrome.     

Alcohol consumption in Guadeloupe

This study bears upon the patterns of alcohol consumption in Guadeloupe (French West Indies), and has been carried out over a representative sample of adults. Each subject was questioned about his or her consumption of alcoholic drinks and a blood sample taken to measure the biological indicators of chronic alcohol consumption. The resulting mean consumption has permitted Guadeloupeans to be classed among the world's foremost consumers of alcohol. For almost half of the adult population, this consumption takes place on a daily basis and therefore constitutes part of everyday life. The patterns of alcohol consumption are linked to sex, age, level of education, employment and socio-professional categories. The heavy-drinking man tends to be elderly, has a low level of education and is an agricultural worker; his consumption is based on rum. The woman is middle-aged and not working; her consumption is based on wine. These stated characteristics permit the setting up of tailored prevention programs.