Household food availability in Brazil: distribution and trends (1974-2003)

OBJECTIVE: Data from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil in 2002-2003 and trends from 1974 to 2003. METHODS: The study uses data from the "Pesquisa de Or?amento Familiar 2002-2003" budget survey conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística) from July 2002 to June 2003, including a national sample of 48,470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses with food and beverages for family consumption were registered. Crude weights of purchased foods were transformed into calories and nutrients with the use of food composition tables. RESULTS: Adequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socio-economic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet. CONCLUSIONS: Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.     

Effectiveness studies in the Italian Society of Occupational Medicine and Industrial Hygiene congresses (1989-2003)

BACKGROUND: Knowledge of the results of studies on effectiveness of preventive interventions is a fundamental requirement in occupational medicine. OBJECTIVES: The aim of this review was to identify Italian scientific production regarding this issue in the proceedings of the Italian Society of Occupational Medicine and Industrial Hygiene congresses over the last fifteen years. METHODS: An initial selection of the communications on intervention effectiveness studies was performed on the basis of titles, aims, tables and figures of each single presentation. A further selection was made via full reading of the previously selected communications. The selected articles were classified by type of strategy discussed, production sector, study design and several other criteria. RESULTS: 108 studies were selected out of the 3215 papers (3.4%) published in the congress proceedings examined (1989-2003). More than half of these discussed technical control strategies. In the vast majority of cases, the study design was a pre- and post-evaluation of effectiveness, and the 6 (non-randomised) trials concerned vaccination programmes. Almost a quarter of the studies on accident prevention regarded the effectiveness of training programmes. Only 5 studies could be detected in Medline as articles later published in international journals. CONCLUSIONS: On the basis of the Italian Society of Occupational Medicine congress proceedings over the last 15 years, the percentage of communications concerning effectiveness of preventive interventions in occupational health was 3.4%. Intervention effectiveness papers published in congress proceedings seem to reveal a quite unexpected production of effectiveness evaluation studies. Nonetheless, recommendations need to be made to improve study design and to promote effective prevention and control strategies.     

Trends in social and demographic inequalities in the prevalence of chronic diseases in Brazil. PNAD: 2003- 2008

The aims of this study are: to evaluate the prevalence of chronic diseases in the Brazilian population comparing data of 2008 with those of 2003; to estimate the impact of chronic conditions on the use of health services and on the restriction of daily activities and to measure the differentials in the prevalence of specific diseases according to educational strata and the affiliation to a private health plan. Data were obtained from PNAD 2008 and 2003. The analysis included estimations of crude and adjusted prevalence ratios, using svy commands from Stata 11 software. The prevalence of at least one disease was higher in: the elderly, women, low schooling level, black or indigenous people, urban residents, migrants and people living in the south region of Brazil. The most frequent diseases were: hypertension, back and spinal cord disorders, arthritis and depression. Between 2003 and 2008, an increase in the prevalence of diabetes, hypertension, cancer and cirrhosis was observed, and there was a reduction in chronic kidney failure and tuberculosis. All the diseases analyzed, with the exception of cancer and tendinitis/tenossinovitis, revealed a higher prevalence in low educational level strata. The greatest social inequalities were in chronic kidney failure, cirrhosis, tuberculosis and arthritis/rheumatism.     

Mesothelioma mortality in Brazil, 1980-2003

Although asbestos causes asbestosis, lung cancer, and mesothelioma, it remains widely used in Brazil, mostly in cement-fiber products. We report the Brazilian mesothelioma mortality trend 1980-2003, using records of the national System of Mortality Information of DATASUS, including all deaths with IX International Disease Classification (ICD9) codes 163.n--pleura cancer during the period 1980-1995; and ICD10 codes c45.n--mesotheliomas and c38.4--pleura cancer for the years 1996-2003. Mesothelioma mortality rates increased over the period studied, from 0.56 to 1.10 deaths per 100,000 habitants. The total number of mesothelioma deaths nationwide in the period studied was 2,414; the majority (1,415) were in the Southeast region. Mortality was highest among males and people over age 65. Given the history of asbestos exposure in Brazil, our findings support the need for policies that limit or ban the use of this product.     

A snapshot of the striking decrease in cigarette smoking prevalence in Brazil between 1989 and 2008

Objective

To evaluate the differences in cigarette smoking prevalence rates in Brazil between 1989 and 2008.

Methodology

We calculated absolute and relative differences in smoking prevalences, overall and stratified by gender, age, place of residence, educational level and birth cohort. Data were obtained from random samples from two National Household Surveys (1989,n = 39,969; 2008,n = 38,461). GLM models were specified to obtain estimates and assess whether differences in proportions of smokers differed by categories of the stratification variables.

Results

Adjusted absolute and relative differences in smoking prevalence rates between 1989 and 2008 were, respectively, − 12.4% and − 41.0%. Individuals aged 15-34 years and those with 9 or more years of education presented larger relative declines than their counterparts (p_s ≤ 0.001). After stratification by birth cohort, men presented larger reductions than women, only in the absolute scale (p_s ≤ 0.001), with the exception of the youngest birth cohort (i.e.,1965-1974).

Conclusions

In Brazil, several tobacco control measures have been adopted since 1986, in particular increasing taxation of tobacco products and strong health warnings, which may have contributed to the marked decline in smoking prevalence. It is important to understand the evolution of the tobacco epidemic to propose new actions to prevent initiation and encourage cessation among those who started/continued smoking.     

Childhood cancers in the Netherlands (1989-1997)

In a recent report by the Society of Integral Cancer Centres in the Netherlands, attention was devoted to the incidence of cancer in children and the mortality arising from this. In recent years the growing diagnostic and therapeutic possibilities have changed the perspective of childhood cancer enormously. Based on a careful classification and clinical staging, national and international investigations have resulted in new and successful therapeutical strategies. Overall prognoses of childhood cancer have improved dramatically from a 5-year survival rate in the 1960s and 1970s of less than 30%, to an 8-year survival rate of more than 70% between 1989 and 1997. However, this success means that more investigations into the long-term effects of childhood cancer and its treatment are needed. In a study at the Amsterdam University Hospital, 700 adult survivors of childhood cancer were reinvestigated of whom over 75% experienced one or more clinically relevant long-term effects. A continuous survey for long-term effects is needed for the development of new therapeutic strategies, which allow children treated for cancer to develop with the same possibilities in life as their healthy peers.     

2003-2018年某院医院感染现患率调查

目的 了解某医院感染的变化趋势,为预防与控制医院感染提供依据。方法 采用横断面调查方法,每50张床位配备1名调查人员,调查人员由医院感染管理专职人员和临床高年资住院医师组成,用床旁调查与病历调查相结合的方法调查该院2003-2018年某一日所有住院患者的医院感染现患率、日抗菌药物使用率及细菌培养送检率。结果 2003-2018年医院感染现患率从4.44%降低至2.70%,差异有统计学意义(P<0.001)。感染部位前4位为下呼吸道、手术部位、泌尿道和胃肠道。2003-2018年日抗菌药物使用率从79.79%降低至31.17%,差异有统计学意义(P<0.001)。细菌培养送检率由17.80%上升到57.30%,差异有统计学意义(P<0.001)。漏报率从28.57%下降至7.41%,差异有统计学意义(P<0.001)。结论 16年间医院感染横断面调查的长期趋势表明该院医院感染防控与抗菌药物管理取得初步成效,医院感染现患率、日抗菌药物使用率与漏报率均明显下降。     

Paracoccidioidomycosis mortality in Brazil (1980-1995)

This study analyzes 3,181 deaths from paracoccidioidomycosis in Brazil, based on 16 years of sequential data (from 1980 to 1995). During this period paracoccidioidomycosis showed considerable magnitude and low visibility, representing the eighth most common cause of death from predominantly chronic or recurrent types of infectious and parasitic diseases. It also had the highest mortality rate among the systemic mycoses. The mean annual mortality rate was 1.45 per million inhabitants, indicating a downward long-term trend (reduction of 31.28%), while spatial distribution among the different regions and States of Brazil was non-homogenous. The South (with the highest regional rate) and the Southeast showed a downward trend, while the Central West had the second highest rate in the country. At least one-fifth of Brazilian municipalities (or 22.71% of the country's total area) reported deaths from paracoccidioidomycosis. Overall nationwide mortality per area was 3.73/10,000km2. The disease was endemic in non-metropolitan areas. The majority of deaths occurred in males (84.75%), and there was a sex ratio of 562 men/100 women. The 30-59-year and over-60-year age groups were the most affected. The study showed that the mortality rate justifies classifying this disease as a major health problem in Brazil.