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Victor A, Aguiar IWO, Flores-Ortiz R, Mahoche M, Gotine ARM, Falcão I, Vasco MD, Ferreira A, Xavier SP, Omenka M, Antunes JLF, Rondo PH. Social Inequalities in Child Development: Analysis of Low-Birth-Weight Trends in Brazil, 2010-2020. J Prev (2022) 2024:10.1007/s10935-024-00768-0. [PMID: 38635018 DOI: 10.1007/s10935-024-00768-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Low birth weight (LBW) is a global issue prevalent in low-income countries. Economic assessments of interventions to reduce this burden are crucial to guide health policies. However, there is a relative scarcity of research that illustrates the magnitude of LBW by country and region to support the design of public policies. OBJECTIVE This study aimed to analyze the temporal trend of fetal growth in newborns in Brazil between 2010 and 2020. METHODS A time series study was conducted using data from the Live Births Information System (SINASC), which is managed by the Department of Information and Informatics of the Unified Health System (DATASUS) of the Brazilian Ministry of Health. The Prais-Winsten linear model was applied to analyze the annual proportions of LBW. The annual percentage changes (APC) and their respective 95% confidence intervals (95%CI) were calculated. Prevalence rate averages of LBW were calculated and displayed on thematic maps to visualize the evolution dynamics in each Federation Unit (FU). RESULTS A total of 31,887,329 women from all Federative Units of Brazil were included in the study from 2010 to 2020. The Southeast region had the largest proportion of participants, with records from 2015 accounting for 9.5% of the total. Among the women in the study, 49.6% were between the ages of 20 and 29, and the majority (75.5%) had between 8 and 12 years of schooling. The newborns of these women were predominantly male (58.8%) and non-white (59.5%). The study found that there was a trend towards stabilization of increasing proportions of LBW in the North, Northeast, and Centre-West regions between 2010 and 2020. In Brazil and other regions, these tendencies remained stable. CONCLUSION To improve living conditions and reduce social inequalities and health inequities, public policies and actions are necessary. Strengthening the Unified Health System (SUS), income transfer programs, quota policies for vulnerable groups, and gender equality measures such as improving access to education for women and the labor sector are among the suggested approaches.
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Affiliation(s)
- Audêncio Victor
- School of Public Health, Faculdade de Saúde Pública- USP, University of São Paulo-Brazil, Avenida Doutor Arnaldo, 715, São Paulo, SP, 01246-904, Brazil.
- Department of Nutrition, Ministry of Health of Mozambique, Zambezia, Mozambique.
| | | | - Renzo Flores-Ortiz
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Manuel Mahoche
- School of Public Health, Faculdade de Saúde Pública- USP, University of São Paulo-Brazil, Avenida Doutor Arnaldo, 715, São Paulo, SP, 01246-904, Brazil
| | - Ana Raquel Manuel Gotine
- School of Public Health, Faculdade de Saúde Pública- USP, University of São Paulo-Brazil, Avenida Doutor Arnaldo, 715, São Paulo, SP, 01246-904, Brazil
- Faculty of Health Science, Universiade Lúrio, Nampula, Mozambique
| | - Ila Falcão
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | | | - Andrêa Ferreira
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Center on Racism, Global Movements, and Population Health, Dornsife School of Public Health, Equity Drexel University, Philadelphia, US
| | - Sancho Pedro Xavier
- Institute of Collective Health, Federal University of Mato Grosso, Cuiabá, Brazil
| | | | - José Leopoldo Ferreira Antunes
- School of Public Health, Faculdade de Saúde Pública- USP, University of São Paulo-Brazil, Avenida Doutor Arnaldo, 715, São Paulo, SP, 01246-904, Brazil
| | - Patrícia H Rondo
- School of Public Health, Faculdade de Saúde Pública- USP, University of São Paulo-Brazil, Avenida Doutor Arnaldo, 715, São Paulo, SP, 01246-904, Brazil
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Velame KT, Antunes JLF. Cancer mortality in childhood and adolescence: analysis of trends and spatial distribution in the 133 intermediate Brazilian regions grouped by macroregions. Rev Bras Epidemiol 2024; 27:e240003. [PMID: 38294061 PMCID: PMC10824501 DOI: 10.1590/1980-549720240003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 10/26/2023] [Accepted: 11/01/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE To assess the magnitude, trend, and spatial patterns of childhood and adolescent cancer mortality between 1996 and 2017 in 133 Brazilian intermediate regions by using socioeconomic and healthcare services indicators. METHODS This is an ecological study for analyzing the trend of mortality from cancer in childhood and adolescence through time series. Data on deaths were extracted from the Brazilian Mortality Information System. Data on population were extracted from the 1991, 2000, and 2010 demographic censuses of the Brazilian Institute of Geography and Statistics, with interpolation for intercensal years. Time series were delineated for mortality by type of cancer in each intermediate region. Such regions were grouped by macroregions to present the results. The calculation and interpretation of mortality trends use the Prais-Winsten autoregression procedure. RESULTS Mortality rates for all neoplasms were higher in the Northern region (7.79 deaths per 100 thousand population), while for leukemias, they were higher in the Southern region (1.61 deaths per 100 thousand population). In both regions, mortality was higher in boys and in the 0-4 age group. The trend was decreasing (annual percent change [APC] - -2.11 [95%CI: -3.14; - 1.30]) for all neoplasms in the Brazilian regions and stationary (APC - -0.43 [95%CI: -1.61; 2.12]) for leukemias in the analyzed period. CONCLUSION The mortality rate for all neoplasms showed higher values in regions with smaller numbers of ICU beds in the public healthcare system.
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dos Santos CJ, de Miranda CB, Antunes JLF, Fischer FM. Occupational accident indicators among Social Security beneficiaries: temporal trend and magnitude in Brazil and its regions, 2009-2019. Epidemiol Serv Saude 2023; 32:e2023466. [PMID: 38088633 PMCID: PMC10712945 DOI: 10.1590/s2237-96222023000300013.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/04/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To evaluate the temporal trend and magnitude of occupational accident indicators among Social Security beneficiaries in Brazil and its regions from 2009 to 2019. METHODS A time series study was conducted on occupational accident indicators in the regions of Brazil, from 2009 to 2019. Data were retrieved from the Statistical Yearbook of Occupational Accidents and the Statistical Yearbook of Social Security. Prais-Winsten generalized linear regression models were used to estimate trends, and annual percentage change and their respective 95% confidence intervals were obtained. RESULTS There were 7,253,923 occupational accidents during the study period. The average incidence rate was 16.3 per 1,000 employment relationships, with a decreasing trend (APC = 4.3%; 95%CI -5.63;-3.26). CONCLUSION Brazil and its regions showed an overall decreasing trend in indicators representing morbidity burden and the magnitude of occupational accidents. MAIN RESULTS In Brazil, despite regional inequalities, there has been a decrease in occupational accident rates reported to Social Security. IMPLICATIONS FOR SERVICES The results suggest improvements in working conditions, control and prevention of occupational accidents among these workers and contribute to targeting measures to prevent and control these diseases in the regions with the highest incidence. PERSPECTIVES Further research could explore trends according to professional category and economic activity sector, aimed at improving the monitoring of safety conditions and the wellbeing of workers in the regions of Brazil.
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Menezes FDS, Verzinhasse Peres S, de Castro Junior G, Antunes JLF, Latorre MDRDDO, Toporcov TN. Survival inequalities in head and neck cancers: A hospital-based cohort study. Head Neck 2023; 45:2377-2393. [PMID: 37401537 DOI: 10.1002/hed.27433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/23/2023] [Accepted: 06/10/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND We investigated whether the socioeconomic status (SES) influenced survival rates in oropharynx cancers (OPC), oral cavity cancers (OCC), and larynx cancers (LC) in Brazilian patients. METHODS This hospital-based cohort study assessed the age-standardized 5-year relative survival (RS) using the Pohar Perme estimator. RESULTS Overall, we identified 37 191 cases, and 5-year RS were 24.4%, 34.1%, and 44.9% in OPC, OCC, and LC, respectively. In multiple Cox regression, the highest risk of death occurred in the most vulnerable social strata for all subsites-that is, illiterates or patients relying on publicly funded healthcare services. Disparities increased over time by 34.9% in OPC due to the rising of survival rates in the highest SES, whereas they reduced by 10.2% and 29.6% in OCC and LC. CONCLUSIONS The potential inequities were more significant for OPC than for OCC and LC. It is urgent to tackle social disparities to improve prognoses in highly unequal countries.
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Affiliation(s)
- Fabrício Dos Santos Menezes
- Department of Health Education, Federal University of Sergipe, Lagarto, Brazil
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Gilberto de Castro Junior
- Instituto do Câncer do Estado de São Paulo (ICESP) and School of Medicine, University of São Paulo, São Paulo, Brazil
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da Cunha AR, Velasco SRM, Hugo FN, Antunes JLF. Hospitalizations for oral and oropharyngeal cancer in Brazil by the SUS: impacts of the covid-19 pandemic. Rev Saude Publica 2023; 57:3s. [PMID: 37255114 PMCID: PMC10185317 DOI: 10.11606/s1518-8787.2023057004708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/03/2022] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE To analyze the impact of the different phases of the covid-19 pandemic on hospitalizations for oral (CaB) and oropharyngeal (CaOR) cancer in Brazil, carried out within the scope of the Brazilian Unified Health System (SUS). METHODS We obtained data regarding hospital admissions due to CaB and CaOR between January 2018 and August 2021 from the SUS Hospital Information System, analyzing hospital admissions as rates per 100,000 inhabitants. We divided the pandemic (January 2020 to August 2021) and pre-pandemic (January 2018 to December 2019) periods into four-month periods, comparing the pandemic period rates with analogous rates for the pre-pandemic period - for Brazil, by macro-region and by a group of procedures performed during hospitalization. We also analyzed the impact of the pandemic on the average cost of hospitalizations, expressing the results in percentage change. RESULTS Rates of hospitalization in the SUS due to CaB and CaOR decreased during the pandemic in Brazil. The most significant reduction occurred in the second four-month period of 2020 (18.42%), followed by decreases in the third four-month period of 2020 (17.76%) and the first and second four-month periods of 2021 (respectively, 14.64% and 17.07%), compared with 2019. The South and Southeast showed the most expressive and constant reductions between the different phases of the pandemic. Hospitalizations for clinical procedures suffered a more significant decrease than for surgical procedures. In Brazil, the average expenditure per hospitalization in the four-month pandemic periods was higher than in the reference periods. CONCLUSION After more than a year of the pandemic's beginning in Brazil, the SUS hospital care network for CaB and CaOR had yet to be re-established. The repressed demand for hospitalizations for these diseases, which have fast evolution, will possibly result in delays in treatment, negatively impacting the survival of these patients. Future studies are needed to monitor this situation.
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Affiliation(s)
- Amanda Ramos da Cunha
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de EpidemiologiaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Sofia Rafaela Maito Velasco
- Centro de Estudos, Pesquisa e Prática em APS e RedesHospital Israelita Albert EinsteinSão PauloSPBrasil Centro de Estudos, Pesquisa e Prática em APS e Redes. Hospital Israelita Albert Einstein. São Paulo, SP, Brasil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do SulFaculdade de OdontologiaDepartamento de Odontologia Preventiva e SocialPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul. Faculdade de Odontologia. Departamento de Odontologia Preventiva e Social. Porto Alegre, RS, Brasil
| | - José Leopoldo Ferreira Antunes
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de EpidemiologiaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
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Bousquat A, Antunes JLF. Responses of the Graduate Program in Public Health to the covid-19. Rev Saude Publica 2023; 57:1s. [PMID: 37255112 DOI: 10.11606/s1518-8787.2023057supl1ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- Aylene Bousquat
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Política, Gestão e Saúde. São Paulo, SP, Brasil
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Abanto J, Maruyama JM, Pinheiro E, Matijasevich A, Antunes JLF, Bönecker M, Cardoso MA. Authors' reply to the letter to the editor from Peres KG, Feldens CA, Nascimento GG, Peres MA, Vitolo MR and Barros AJD. Community Dent Oral Epidemiol 2023; 51:585-586. [PMID: 36973913 DOI: 10.1111/cdoe.12855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Jenny Abanto
- Department of Pediatric Dentistry, Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Emanuella Pinheiro
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Marcelo Bönecker
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Moura RF, Cesar CLG, Goldbaum M, Okamura MN, Antunes JLF. [Factors associated with inequalities in social conditions in the health of elderly white, brown and black people in the city of São Paulo, Brazil]. Cien Saude Colet 2023; 28:897-907. [PMID: 36888872 DOI: 10.1590/1413-81232023283.08582022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 09/02/2022] [Indexed: 03/08/2023] Open
Abstract
The scope of this study is to identify determining factors of disparities in social conditions in the health of non-institutionalized elderly people in the city of São Paulo, from the standpoint of self-declaration of skin color. It is a cross-sectional study with a representative sample of 1,017 elderly participants in the "2015 Health Survey of the Municipality of São Paulo". The analysis used crude and adjusted Poisson regression models, reporting the prevalence ratio and 95% confidence intervals as a measure of association between the variables. In the adjusted analysis, brown and black skin color was positively associated with worse schooling, negative self-assessment of health status, health insurance and access to public health services. On the one hand, black skin color was no longer associated with the lowest income, however, it was associated with arterial hypertension. On the other hand, brown skin color was associated with low income, but not with arterial hypertension. Elderly black and brown people had worse health conditions, less access to private health services and socioeconomic resources. These results are compatible with the hypothesis of structural racism in São Paulo's society and may inform social health policies aimed at promoting health and social justice.
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Affiliation(s)
- Roudom Ferreira Moura
- Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Centro de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo. Av. Dr. Enéas Carvalho de Aguiar 188, Cerqueira César. 05403-000 São Paulo SP Brasil.
| | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
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Corrêa EM, Gallo CDO, Antunes JLF, Jaime PC. The tendency of stunting among children under five in the Northern Region of Brazil, according to the Food and Nutrition Surveillance System, 2008-2017. J Pediatr (Rio J) 2023; 99:120-126. [PMID: 36055366 PMCID: PMC10031332 DOI: 10.1016/j.jped.2022.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE To analyze the temporal tendency of stunting prevalence among children under five years of age registered in the Food and Nutritional Surveillance System (SISVAN) in the Brazilian Northern Region, from 2008 to 2017. METHODS Ecological time-series study with data from SISVAN. The annual variation rate for the prevalence of undernutrition, measured by the presence of stunting (low height-for-age index), was estimated for the Northern Region and for each of its states using the Prais-Winsten regression model with and without variable adjustment for SISVAN coverage to explore the relationship between these variables. RESULTS The Northern Region showed a tendency toward the reduction of chronic child stunting, with an annual variation of -5.30% (95%CI -9.64; -0.77) in the period studied. The states of Acre (-7.19%; 95%CI -12.31; -1.77), Pará (-4.86%; 95%CI -9.44; -0.03), and Tocantins (-6.22%; 95%CI -9.88; -2.41) showed a tendency to reduce the prevalence of stunting, while the other four states showed stability during the period. A strong negative correlation was found between SISVAN coverage and the prevalence of stunting in the states of Acre (beta: -0.725), Amazonas (beta: -0.874), Pará (beta: -0.841), and Tocantins (beta: -0.871), indicating that the increase in system coverage is associated with a reduction of stunting. CONCLUSIONS There is a tendency toward a reduction in the prevalence of stunting particularly in three states and in the North Region as a whole, from 2008 to 2017. The coverage by the system was associated with a reduction in the prevalence of child stunting in four states.
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Affiliation(s)
- Ester Mourão Corrêa
- Universidade de São Paulo (USP), Faculdade de Saúde Pública, Departamento de Nutrição, Programa de Pós-graduação Nutrição em Saúde Pública, São Paulo, SP, Brazil
| | - Caroline de Oliveira Gallo
- Universidade de São Paulo (USP), Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, SP, Brazil.
| | | | - Patrícia Constante Jaime
- Universidade de São Paulo (USP), Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, SP, Brazil
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Andrade FRD, Antunes JLF. Time and memory in time series analysis. Epidemiol Serv Saude 2023; 32:e2022867. [PMID: 36946835 PMCID: PMC10027044 DOI: 10.1590/s2237-96222023000100027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
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Milagres CS, Tôrres LHDN, de Almeida TB, Neri AL, Antunes JLF, de Sousa MDLR. Self-assessed masticatory function and frailty in Brazilian older adults: the FIBRA Study. Rev Saude Publica 2022; 56:104. [PMID: 36515306 PMCID: PMC9749652 DOI: 10.11606/s1518-8787.2022056004195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/11/2022] [Indexed: 12/15/2022] Open
Abstract
OBJETIVE To investigate the relationship between the masticatory function and the frailty of older people. METHODS Exploratory cross-sectional study using secondary data from the FIBRA Project on the frailty conditions of older people living in urban areas of six Brazilian municipalities, from 2008 to 2009. The population consisted of older adults aged 65 and over with no cognitive impairment. A single session identification questionnaire and the Mini-Mental State Examination (MMSE) were applied, followed by collecting sociodemographic data and data on the participants' self-assessment of masticatory function, general health, and oral health. RESULTS 2,341 older people (164 frail older adults), of whom 63.2% reported not having seen a dentist in the last year, and approximately 26% of them had three or more functional feeding problems. Older participants (OR = 2.88; 95%CI: 2.01-4.13), who are retired (OR = 2.31; 95%CI: 1.18-5.53), those who were depressed (OR = 2.31; 95%CI: 1.58-3.38), and those who self-assessed their general health as worse compared to others of the same age (OR = 3.91; 95%CI: 2.39-6.40) were at higher risk of frailty. Three or more problems related to the functional aspects of mastication were associated with a greater chance of frailty (OR = 2.06; 95%CI: 1.25-3.41). CONCLUSION This study found an association between masticatory function and a greater chance of frailty among the studied population.
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Affiliation(s)
- Clarice Santana Milagres
- Faculdade São Leopoldo MandicDepartamento de MedicinaArarasSPBrasilFaculdade São Leopoldo Mandic. Departamento de Medicina. Araras, SP, Brasil
| | - Luísa Helena do Nascimento Tôrres
- Universidade Federal de Santa MariaDepartamento de EstomatologiaCentro de Ciências da SaúdeSanta MariaRSBrasilUniversidade Federal de Santa Maria. Centro de Ciências da Saúde. Departamento de Estomatologia. Santa Maria, RS, Brasil
| | - Talita Bonato de Almeida
- Universidade Anhembi MorumbiPiracicabaSPBrasilUniversidade Anhembi Morumbi. Piracicaba, SP, Brasil
| | - Anita Liberalesso Neri
- Universidade Estadual de CampinasFaculdade de EducaçãoDepartamento de Psicologia da EducaçãoCampinasSPBrasilUniversidade Estadual de Campinas. Faculdade de Educação. Departamento de Psicologia da Educação.
Campinas, SP, Brasil
| | - José Leopoldo Ferreira Antunes
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de EpidemiologiaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Maria da Luz Rosário de Sousa
- Universidade Estadual de CampinasFaculdade de OdontologiaDepartamento de Ciências da Saúde e
Odontologia InfantilPiracicabaSPBrasilUniversidade Estadual de Campinas. Faculdade de Odontologia. Departamento de Ciências da Saúde e
Odontologia Infantil. Piracicaba, SP, Brasil,Correspondence: Maria da Luz Rosário de Sousa Universidade Estadual de Campinas Av. Limeira, 901 - Areião 13414-018 Piracicaba, SP, Brasil E-mail:
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Velasco SRM, Moriyama CM, Bonecker M, Butini L, Abanto J, Antunes JLF. Relationship between oral health literacy of caregivers and the oral health-related quality of life of children: a cross-sectional study. Health Qual Life Outcomes 2022; 20:117. [PMID: 35907863 PMCID: PMC9338565 DOI: 10.1186/s12955-022-02019-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Oral health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate oral health decisions. However, scientific evidence about the oral health literacy of caregivers and the children’s oral health-related quality of life. The purpose of this study was to verify the relationship between the level of oral health literacy of caregivers and the children's oral health-related quality of life (OHRQOL). Methods This study was conducted with children aged 2 to 4 in Diadema, São Paulo, Brazil. Six hundred thirty children were examined to assess the prevalence of dental caries (dmft index). Parents were interviewed to obtain sociodemographic status, oral conditions, and oral health literacy (OHL). The variable outcome was the children's OHRQOL as assessed by the Early Childhood Oral Health Impact Scale (ECOHIS). We fitted zero-inflated negative binomial regression (ZINB) models to evaluate associations between the study outcome and covariates in terms of PR (Prevalence Ratios), RR (Rate Ratios), and their respective Confidence Intervals (95% CI). Results Children's OHRQOL was not associated with OHL. Dental caries had a negative impact on the children's quality of life (p < 0.05). A reduced impact on OHRQOL is also associated with having siblings (PR = 0.70, 95% CI 0.52–0.95). A higher age of the mother reduced OHRQOL impacts (PR = 0.72, 95% CI 0.52–0.98). Conclusions The factors associated with children's OHRQOL were the number of siblings, the mothers' age, and dental caries. This study observed no association between parental OHL and children's OHRQOL.
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Affiliation(s)
- Sofia Rafaela Maito Velasco
- Public Health School, University of São Paulo, São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, SP, 01246-904, Brazil.
| | - Caroline Moraes Moriyama
- Department of Paediatric and Orthodontic Dentistry, University of Sao Paulo, São Paulo, SP, Brazil.,Department of Postgraduation Program in Dentistry, Metropolitana de Santos University, Santos, SP, Brazil
| | - Marcelo Bonecker
- Department of Paediatric and Orthodontic Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
| | - Luciane Butini
- Oral Radiology in the School of Dentistry, School of Dentistry, São Leopoldo Mandic, Campinas, SP, Brazil
| | - Jenny Abanto
- Public Health School, University of São Paulo, São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, SP, 01246-904, Brazil
| | - José Leopoldo Ferreira Antunes
- Public Health School, University of São Paulo, São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, SP, 01246-904, Brazil
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Perea LME, Antunes JLF, Peres MA. Approaches to the problem of nonidentifiability in the age-period-cohort models in the analysis of cancer mortality: a scoping review. Eur J Cancer Prev 2022; 31:93-103. [PMID: 34723867 DOI: 10.1097/cej.0000000000000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aiming to detect age, period and cohort effects in cancer mortality, age-period-cohort models (APC) can be applied to distinguish these effects. The main difficulty with adjusting an APC model involving age, period and cohort factors is the linear relationship between them, leading to a condition known as the 'nonidentifiability problem'. Many methods have been developed by statisticians to solve it, but there is not a consensus. All these existing methods, with their advantages and disadvantages, create confusion when choosing which one of them should be implemented. In this context, the present scoping review intends not to show all methods developed to avoid the nonidentifiability problem on APC models but to show which of them are, in fact, applied in the literature, especially in the cancer mortality studies. A search strategy was made to identify evidence on MEDLINE (PubMed), Scopus, EMBASE, Science Direct and Web of Science. A total of 46 papers were analyzed. The main methods found were: Holford's method (n = 14; 30%), ntrinsic estimator (n = 10; 22%), Osmond & Gardner method n = 8; 17%), Carstensen (n = 6;13%), Bayesian approach (n = 6;13%) and others (n = 2; 5%). Even with their limitations, all methods have beneficial applications. However, the decision to use one or another method seemed to be more related to an observed geographic pattern.
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Affiliation(s)
| | | | - Marco A Peres
- Senior Principal Investigator, National Dental Research Institute Singapore, National Dental Centre Singapore; Director, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
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Gerbaldo TB, Antunes JLF. O impacto da pandemia de covid-19 na assistência à saúde mental de usuários de álcool nos Centros de Atenção Psicossocial. Saude soc 2022. [DOI: 10.1590/s0104-12902022210649pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Resumo A preocupação com o consumo prejudicial de álcool está na interseção da pandemia com a saúde mental. Mudanças nos padrões de consumo durante a crise sanitária têm sido documentadas no Brasil e internacionalmente. Este estudo avaliou o impacto da pandemia nos procedimentos a usuários de álcool no Brasil, por meio dos registros dos Centros de Atenção Psicossocial (CAPS). Selecionaram-se dados de janeiro de 2019 a dezembro de 2020, com discriminação por macrorregião geográfica, sexo, idade e raça/cor. Realizou-se análise descritiva, cálculo da variação percentual e distribuição em séries temporais. A análise comparativa apontou redução nos procedimentos no início da pandemia (-52,4%), com diferenças entre sexo e faixa etária. Observou-se diferenças entre macrorregiões, com pior resultado no Norte do país (-70,1%). O segundo semestre de 2020 apresentou retomada nos procedimentos, porém em quantidade aquém do realizado no ano anterior (-41,7%). Houve aprofundamento das desigualdades já existentes, especialmente com a queda mais elevada nas macrorregiões mais pobres, com maior fragilidade na rede de saúde mental. Dada a magnitude do álcool como problema de saúde pública e o papel central dos CAPS, ressalta-se a necessidade de instituir políticas e programas de saúde visando minimizar o impacto da pandemia na redução da assistência psicossocial.
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Bigoni A, Cunha ARD, Antunes JLF. Redistributing deaths by ill-defined and unspecified causes on cancer mortality in Brazil. Rev Saude Publica 2021; 55:106. [PMID: 34932696 PMCID: PMC8664061 DOI: 10.11606/s1518-8787.2021055003319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/25/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to discuss the impact four different redistribution strategies have on the quantitative and temporal trends of cancer mortality assessment in Brazil. METHODOLOGY This study used anonymized and georeferenced data provided by the Brazilian Ministry of Health (BMoH). Four different approaches were used to conduct the redistribution of ill-defined deaths and garbage codes. Age-standardized mortality rates used the world population as reference. Prais-Winsten autoregression allowed the calculation of region, sex, and cancer type trends. RESULTS Death rates increased considerably in all regions after redistribution. Overall, Elisabeth B. França’s and the World Health Organization methods had a milder impact on trends and rate magnitudes when compared to the Global Burden of Disease (GBD) 2010 method. This study also observed that, when the BMoH dealt with the problem of redistributing ill-defined deaths, results were similar to those obtained by the GBD method. The redistribution methods also influenced the assessment of trends; however, differences were less pronounced. CONCLUSIONS Since developing a comparative gold standard is impossible, matching global techniques to local realities may be an alternative for methodological selection. In our study, the compatibility of the findings suggests how valid the GBD method is to the Brazilian context. However, caution is needed. Future studies should assess the impact of these methods as applied to the redistribution of deaths to type-specific neoplasms.
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Affiliation(s)
- Alessandro Bigoni
- Universidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil.,Harvard T.H. Chan School of Public Health. Fulbright Fellow. Boston, MA, United States of America
| | - Amanda Ramos da Cunha
- Universidade Federal do Rio Grande do Sul. Faculdade de Odontologia. Porto Alegre, RS, Brasil
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Perea LME, Antunes JLF, Peres MA. Mortality from oral and oropharyngeal cancer: age-period-cohort effect, Brazil, 1983-2017. Rev Saude Publica 2021; 55:72. [PMID: 34755823 PMCID: PMC8555878 DOI: 10.11606/s1518-8787.2021055003093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Estimate the effect of age, period, and birth cohort on mortality from oral and oropharyngeal cancer in Brazil and its macro-regions. METHODS Deaths from oral and oropharyngeal cancer from 1983 to 2017 were analyzed. The Poisson regression model was applied, using estimable functions proposed by Holford. RESULTS From 1983 to 2017, 142,634 deaths from oral and oropharyngeal cancer were registered in Brazil, 81% among men, and the South and Southeast regions had the highest rates. The most significant period effects were observed in male mortality in the Southeast and Central-West regions for the 2003–2007 reference period. In the North, Northeast, and Central-West regions, an increased risk of mortality was observed in the most recent male cohorts. In the North region, the most significant risk identified was for men born during 1973–1977 (RR = 1.47; 95%CI 1.05–2.08); in the Northeast, for men born during 1988–1992 (RR = 2.77; 95%CI 1.66–4.63); and in the Central-West, for women born during 1973–1977 (RR = 2.01; 95%CI 1.19–3.39). In the Southeast and South regions, the most recent cohorts had lower mortality rates. The lowest risk in the Southeast region was observed in the male cohort born during 1978–1982 (RR = 0.53; 95%CI 0.45–0.62) and 1983–1987 in the South region (RR = 0.25; 95%CI 0.12–0.54). CONCLUSIONS Age had a significant effect on mortality from oral and oropharyngeal cancer in all regions. In the North, Northeast, and Central-West regions, an increase in risk was observed in the most recent cohorts, while in the South and Southeast regions, these cohorts presented a lower risk when compared to the older cohorts.
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Affiliation(s)
- Lillia Magali Estrada Perea
- Universidade Federal de Santa Catarina. Programa de Pós-graduação em Saúde Coletiva. Florianópolis, SC, Brasil
| | | | - Marco Aurelio Peres
- National Dental Research Institute Singapore. National Dental Centre Singapore. Singapore
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França MADSA, Nery NG, Antunes JLF, Freire MDCM. [Timeframe for initiating oral cancer treatment in Brazil since approval of new legislation in 2012: time trend, 2013-2019]. CAD SAUDE PUBLICA 2021; 37:e00293220. [PMID: 34730694 DOI: 10.1590/0102-311x00293220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/19/2021] [Indexed: 12/24/2022] Open
Abstract
The study aimed to investigate whether the maximum delay (60 days) for initiating oral cancer treatment following diagnosis, as provided in Federal Law n. 12,732/2012, was achieved in Brazil from 2013 to 2019 and to describe the trend in the number of cases that initiated treatment within this timeframe. A time series was performed with treatment data (N = 37,417) from the Oncology Dashboard of the Brazilian Health Informatics Department (DATASUS) database, according to the patient's region of residence. Analysis of trend used Prais-Winsten regression. In 2018 and 2019, we observed higher percentages of treatments within 60 days, and especially within 30 days. In 2019, 61.5% of treatments began within 60 days, with the highest proportions in the South (71.3%), Southeast (60.1%), and Central-west (59.1%) regions of Brazil. The time trend for the category from 0-60 days was upward in the North of Brazil, with 15.7% annual percent change (APC), and was stationary in the other four major geographic regions of Brazil. The time trend for 0-30 days was only upward in the North and Northeast, with APCs of 29.75% and 20.56%, respectively. In conclusion, since 2018 there were more cases that initiated oral cancer treatment within the stipulated timeframe, as provided in Law n. 12,732/2012 (up to 60 days), with regional differences and a stationary trend in most regions and in Brazil as a whole. Partial achievement of the target, the predominance of a stationary trend, and regional inequalities indicate the need to continue monitoring time-to-treatment for oral cancer in Brazil and to intensify efforts to guarantee timely healthcare.
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da Cunha AR, Bigoni A, Antunes JLF, Hugo FN. The impact of inequalities and health expenditure on mortality due to oral and oropharyngeal cancer in Brazil. Sci Rep 2021; 11:12845. [PMID: 34145332 PMCID: PMC8213849 DOI: 10.1038/s41598-021-92207-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/07/2021] [Indexed: 11/30/2022] Open
Abstract
This study aims to assess the magnitude and trend of mortality rates due to oral (OC) and oropharyngeal cancer (OPC) in the 133 Intermediate Geographic Regions (IGR) of Brazil between 1996 and 2018 and to analyze its association with sociodemographic variables and provision of health services. It also aims to compare the trend of mortality from neoplasms that have been reported as associated with HPV (OPC) with the trend of neoplasms that have been reported as not associated with HPV (OC). We obtained mortality data from the Mortality Information System in Brazil and analyzed the trends using the Prais-Winsten method. Then, we assessed the relationship between mortality trends and socioeconomic, health spending, and health services provision variables. The median of the annual percent change of the country’s mortality rates was 0.63% for OC and 0.83% for OPC. Trends in mortality in the IGRs correlated significantly with the Human Development Index and government expenditure on ambulatory health care and hospitalizations. Mortality from both types of cancer decreased in those IGR in which the government spent more on health and in the more socioeconomically developed ones. This study found no epidemiological indication that HPV plays the leading etiological factor in OPC in Brazil.
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Affiliation(s)
- Amanda Ramos da Cunha
- Faculty of Dentistry, Federal University of Rio Grande do Sul, 2492 Ramiro Barcelos St, Porto Alegre, RS, 90035-003, Brazil.
| | - Alessandro Bigoni
- School of Public Health, University of São Paulo, 715 Doutor Arnaldo Ave, São Paulo, SP, 01246-904, Brazil
| | | | - Fernando Neves Hugo
- Faculty of Dentistry, Federal University of Rio Grande do Sul, 2492 Ramiro Barcelos St, Porto Alegre, RS, 90035-003, Brazil
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Cunha ARD, Velasco SRM, Hugo FN, Antunes JLF. The impact of the COVID-19 pandemic on the provision of dental procedures performed by the Brazilian Unified Health System: a syndemic perspective. Rev Bras Epidemiol 2021; 24:e210028. [PMID: 34076147 DOI: 10.1590/1980-549720210028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/19/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This study investigated the impact of the COVID-19 pandemic on the provision of dental care procedures performed by the Brazilian Unified Health System (SUS) nationally and by regions. Considering that the most underprivileged population disproportionately suffers with the reduction in dental care provision, the study hypothesis suggests the presence of a syndemic nature. METHODOLOGY The SUS Outpatient Information System (SIA-SUS) was assessed to gather data on dental care activities and procedures performed between April and July 2018, 2019, and 2020 by dentists registered in the SUS. The 30 most frequent activities and procedures performed by dentists were selected and classified into three categories (urgent dental care, nonemergency dental care, and case-dependent urgency procedures), based on the guidance for dental care during the pandemic published by the American Dental Association. RESULTS Results demonstrated a reduction in the provision of dental care of all categories during the pandemic. Urgency dental consultations and procedures in primary and specialized dental care services decreased by 42.5 and 44.1%, respectively, between 2020 and 2019. Non-urgent procedures decreased by 92.3%. Although decreases in dental care activities and procedures were reported in all Brazilian regions, the largest relative decreases in urgent procedures - that should have been maintained during the pandemic - occurred in the North and Northeast regions, which are the poorest regions of the country. CONCLUSIONS These results suggest that the COVID-19 pandemic has a syndemic behavior. Further investigation into the pandemic-syndemic impacts on oral disease burden is necessary.
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Affiliation(s)
- Amanda Ramos da Cunha
- Faculty of Dentistry, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil
| | | | - Fernando Neves Hugo
- Faculty of Dentistry, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil
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Silva FBD, Antunes JLF, Frazão P. Deprived areas and community water fluoridation in Brazil: a multilevel approach for refocusing public policy. Epidemiol Health 2021; 43:e2021031. [PMID: 33957026 PMCID: PMC8289468 DOI: 10.4178/epih.e2021031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine whether geographic location, socioeconomic status, infant mortality, and mortality from diarrheal disease in health regions are associated with the provision of community water fluoridation (CWF) in Brazilian municipalities. METHODS A multilevel ecological study was conducted based on data from the National Survey of Basic Sanitation and Human Development Atlas. A multilevel analysis was carried out considering Brazilian municipalities as the first level and health regions as the second level, comprising sanitation, demographic, socioeconomic, and health characteristics. RESULTS The observation units comprised 5,565 municipalities clustered in 438 health regions in Brazil. The lack of CWF provision was positively associated with the following municipal characteristics: a below-median proportion of inhabitants covered by the sewage network, medium to very low human development index, below-median per capita gross domestic product, and an above-median percentage of expenditures on sanitation. In relation to the health regions, the likelihood of a lack of CWF provision was greater in the municipalities belonging to the health regions located in the Northern and Northeastern areas of Brazil and in those where child mortality due to acute diarrheal disease and the proportion of people with low income were higher when adjusted by municipal indicators. CONCLUSIONS Information on the characteristics associated with CWF provision constitutes important input for refocusing public policy to reduce inequalities among Brazilian municipalities and health regions. These findings may help policy-makers to understand the challenges facing CWF expansion in low-, middle-, and high-income countries.
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Affiliation(s)
| | | | - Paulo Frazão
- Department of Politics, Management and Health, Public Health School, University of São Paulo, São Paulo, Brazil
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21
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da Cunha AR, Antunes JLF, Martins MD, Petti S, Hugo FN. The impact of the COVID-19 pandemic on hospitalizations for oral and oropharyngeal cancer in Brazil. Community Dent Oral Epidemiol 2021; 49:211-215. [PMID: 33650167 PMCID: PMC8013296 DOI: 10.1111/cdoe.12632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/02/2021] [Accepted: 02/11/2021] [Indexed: 11/30/2022]
Abstract
Timely diagnosis and treatment of oral and oropharyngeal cancers are central for the patient's survival. Our objective was to document the impact of the COVID-19 pandemic on the rate of hospitalizations due to these cancers in Brazil's National Health System (SUS). The number of hospitalizations by these cancers during the first periods of the pandemic-and between the same period of 2016 to 2019-was retrieved from the SUS Hospital Information System. We compared hospitalization rates between pre- and pandemic periods, by State. The hospitalization rate for oral and oropharyngeal cancer during the pandemic was lower than that of the same period of previous years. The decline between 2019 and 2020 was of 49.3%, reaching 60% in the North. The reduction in hospitalization during an extended period suggests that oral and oropharyngeal cancer care will be postponed, with potentially detrimental impact on survival.
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Affiliation(s)
| | | | | | - Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Fernando Neves Hugo
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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22
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de Aquino ÉC, Antunes JLF, de Morais OL. Mortality by road traffic injuries in Brazil (2000-2016): capital cities versus non-capital cities. Rev Saude Publica 2020; 54:122. [PMID: 33237129 PMCID: PMC7671585 DOI: 10.11606/s1518-8787.2020054001703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 03/06/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To compare the magnitude and trend of mortality by road traffic injuries (RTI) in the capitals and other municipalities of each Brazilian state between 2000 and 2016. METHODS A time series analysis of mortality rates by RTI standardized by age was performed, comparing the capitals and the cluster of non-capital municipalities in each state. Data on deaths were obtained from the Sistema de Informações sobre Mortalidade (SIM - Mortality Information System). RTI deaths were considered to be those, whose root cause was designated by ICD-10 codes V01 to V89, with redistribution of garbage codes. To estimate mortality rates, we used the population projections of the Brazilian Institute of Geography and Statistics (IBGE) from 2000 to 2015 and the population estimated by polynomial interpolation for 2016. The trend analysis was performed using the Prais-Winsten method, using the Stata 14.0 program. RESULTS There were 601,760 deaths due to RTI in the period (114,483 of residents in capital cities). Mortality by RTI did not present an increasing trend in any of the Capitals in the period under study. Among non-capital municipalities, the trend was growing in 14 states. The greatest increase was observed in Piaui (AIR = 7.50%; 95%CI 5.50 - 9.60). There was a decreasing trend in RTI mortality in 14 capitals, among which Curitiba showed the greatest decrease (AIR = -4.82%; 95%CI -6.61 - -2.92). Only São Paulo and Rio Grande do Sul showed a decreasing trend in mortality by RTI in non-capital cities (AIR = 2.32%; 95%CI -3.32 - -1.3 and AIR = 1.2%, 95%CI -2.41 - 0.00, respectively). CONCLUSIONS We conclude that RTI mortality rates in non-capital cities in Brazil showed alarming trends when compared with those observed in capital cities. The development of effective traffic safety actions is almost always limited to Brazilian capitals and large cities. Municipalities with higher risk should be prioritized to strengthen public policies for prevention and control.
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Affiliation(s)
- Érika Carvalho de Aquino
- Instituto de Patologia TropicalPrograma de Pós-GraduaçãoGoiâniaGOBrasilUniversidade Federal de Goiás. Instituto de Patologia Tropical e Saúde Pública. Programa de Pós-Graduação em Medicina Tropical e Saúde Pública. Goiânia, GO, Brasil
| | - José Leopoldo Ferreira Antunes
- Faculdade de Saúde PúblicaDepartamento de EpidemiologiaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Otaliba Libânio de Morais
- Instituto de PatologiaTropical e Saúde PúblicaDepartamento de EpidemiologiaGoiâniaGOBrasilUniversidade Federal de Goiás. Instituto de Patologia Tropical e Saúde Pública. Departamento de Epidemiologia. Goiânia, GO, Brasil
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Perea LME, Antunes JLF, Peres MA. Oral and oropharyngeal cancer mortality in Brazil, 1983-2017: Age-period-cohort analysis. Oral Dis 2020; 28:97-107. [PMID: 33215764 DOI: 10.1111/odi.13732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 12/24/2022]
Abstract
AIM To estimate the effect of age, period, and birth cohort on mortality from oral and oropharyngeal cancer in Brazil. METHODS Deaths due to oral and oropharyngeal cancer from 1983 to 2017 were analyzed. The effect of age, period, and cohort was calculated using the Poisson regression model. RESULTS Between 1983 and 2017, 142,634 deaths were recorded from oral and oropharyngeal cancer in Brazil, 54% from oropharyngeal cancer. The male sex contributed to 81% of the deaths. The average mortality rate for men was 4.5 deaths per 100,000 inhabitants, and for women, it was 0.9 deaths per 100,000 inhabitants. There was a strong effect of age on mortality rates from oral and oropharyngeal cancer. The risk increases from 40 years of age in men and 55 years of age in women. An overall period effect was observed. The 2000 period showed the greatest risk when compared to the 1985 period in men. In women, the period of highest risk was 2010. The cohorts born between 1958 and 1962 had a higher risk of death. CONCLUSIONS The period effect is mainly attributed to mortality from oropharyngeal cancer. Most significant values regarding the effect on the cohort groups were observed in female mortality from oral cancer.
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Affiliation(s)
| | | | - Marco Aurélio Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Systems Research Programme, Duke-NUS Medical School, Oral Health ACP, Health Services, Singapore
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Fernandes GA, Menezes FDS, Silva LF, Antunes JLF, Toporcov TN. Inequalities in lung cancer mortality trends in Brazil, 2000-2015. Sci Rep 2020; 10:19164. [PMID: 33154465 PMCID: PMC7645723 DOI: 10.1038/s41598-020-76165-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 08/27/2020] [Indexed: 01/04/2023] Open
Abstract
The present study was conducted to evaluate the socioeconomic inequality related to lung cancer mortality rates and trends between 2000 and 2015 according to gender in Brazil. We retrieved the death records for cases of lung cancer (ICD-10 C33 C34) from 2000 to 2015 in adults age 30 years and older in Brazilian Regions from official databases (DATASUS) and corrected for ill-defined causes. The Prais-Winsten regression method and Pearson correlation were applied. The results were considered statistically significant when p < 0.05. The correlation between the lung cancer mortality rates and the HDI decreased when the rates for the first and last years of the historical series were compared in men (r = 0.77; r = 0.58) and women (r = 0.64; r = 0.41). However, the correlation between the trends in the lung cancer mortality rates and the HDI was negative in men (r = − 0.76) and women (r = − 0.58), indicating larger reductions (or smaller additions) among the Federative Units with the highest HDI, in contrast to trends reflecting a greater increase in those with the lowest HDI. Our results suggest a relevant inequality in the trends of mortality from lung cancer in Brazil.
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Affiliation(s)
- Gisele Aparecida Fernandes
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo, SP, Brazil. .,Group of Epidemiology and Statistics on Cancer, AC Camargo Cancer Center, São Paulo, SP, Brazil.
| | - Fabrício Dos Santos Menezes
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo, SP, Brazil.,Department of Health Education, Federal University of Sergipe, Lagarto, SE, Brazil
| | - Luiz Felipe Silva
- Institute of Natural Resources, Federal University of Itajubá, Itajubá, MG, Brazil
| | | | - Tatiana Natasha Toporcov
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
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Corrêa LLG, Sousa MDLRD, Frias AC, Antunes JLF. Factors associated with dental caries in adolescents: a cross-sectional study, São Paulo State, Brazil, 2015. ACTA ACUST UNITED AC 2020; 29:e2019523. [PMID: 33027427 DOI: 10.1590/s1679-49742020000500007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/10/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze association between prevalence and severity of dental caries and demographic, socioeconomic, behavioral and oral health status in adolescents. METHODS This was a cross-sectional study with secondary data on 5,558 adolescents examined in the São Paulo State Oral Health Survey in 2015. The zero-inflated negative binomial regression model was used, considering sample weights. Prevalence ratios (PR), ratios of mean (RM) and confidence intervals (CI) were estimated. RESULTS Caries prevalence was 71.7%, and was higher in females (PR=1.09 - 95%CI 1.04;1.15), associated with being behind at school (PR=1.11 - 95%CI 1.03;1.18), dental calculus (PR=1.10 - 95%CI 1.01;1.20) and no access to fluoridated water (PR=1.21 - 95%CI 1.01;1.45). CONCLUSION Identification of factors associated with dental caries can instruct the programming of health services aimed at controlling the disease.
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Affiliation(s)
| | | | - Antônio Carlos Frias
- Universidade de São Paulo, Faculdade de Odontologia, Social, São Paulo, SP, Brasil
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Andrade FBD, Pinto RDS, Antunes JLF. [Trends in performance indicators and production monitoring in Specialized Dental Clinics in Brazil]. CAD SAUDE PUBLICA 2020; 36:e00162019. [PMID: 32965377 DOI: 10.1590/0102-311x00162019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/13/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess time trends in production and performance indicators in secondary dental care services in the Brazilian Unified National Health System (SUS) from 2008 to 2018. A time series study was conducted, based on production data from the Specialized Dental Clinics (CEOs in Portuguese) obtained from the Ambulatory Information System of the SUS. The monitoring indicator was assessed as the proportion of clinics that met the monthly target set for each specialty (primary care, endodontics, surgery, periodontics). Dental services' performance was defined as poor for those that met only one or no targets in the four dental specialties. The time series were analyzed by the decomposition method, considering the components trend, seasonal variation, and random variation. All the analyses were performed for Brazil as a whole and for each of the country's five major geographic regions. A decline was seen in Brazil as a whole in the proportion of clinics that met the primary care targets. There were upward trends in the proportion of compliance with the targets for surgery and periodontics in Brazil as a whole. Important differences were seen between the regions of Brazil in the proportion of compliance with the targets, with the worst performance for the clinics in the North and Northeast regions. Time trends showed an improvement in the services for Brazil as a whole, while emphasizing the importance of assessing the country's regions and the need for constant monitoring of these indicators.
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Sato APS, Andrade FBD, Duarte YAO, Antunes JLF. Vaccine coverage and factors associated with influenza vaccination in the elderly in the city of São Paulo, Brazil: SABE Study 2015. CAD SAUDE PUBLICA 2020; 36 Suppl 2:e00237419. [PMID: 32876100 DOI: 10.1590/0102-311x00237419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/09/2020] [Indexed: 11/22/2022] Open
Abstract
This study evaluated influenza vaccine coverage among elderly individuals (≥ 60 years) living in the city of São Paulo, Brazil, in 2015, and analyzed associated factors. This was a cross-sectional population-based study of data from the SABE Study (Health, Well-Being, and Aging). The dependent variable was influenza vaccination in the 12 months prior to the interview, and the independent variables were sociodemographic and behavioral characteristics, self-reported health status, and use of health services. Data analysis considered the complex study sample, respecting the sampling weight. Poisson's regression was used, with significance set at 5%. Vaccine coverage was 79.7% (95%CI: 76.8-82.5). Influenza vaccination was associated with marital status (PR single/without partner = 0.84; 95%CI: 0.77-0.93), physical activity (PR yes = 1.08; 95%CI: 1.01-1.17), and medical appointment in the previous 12 months (PR yes = 1.22; 95%CI: 1.07-1.39). There were no differences between sociodemographic strata. Influenza vaccination in the elderly had already reached the target for universal coverage in the city of São Paulo. The results are relevant for planning the immunization program, pointing to priority groups to motivate for vaccination and valuing interaction between the elderly and health services.
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da Cunha AR, Antunes JLF, Martins MD, Petti S, Hugo FN. The impact of the COVID-19 pandemic on oral biopsies in the Brazilian National Health System. Oral Dis 2020; 28 Suppl 1:925-928. [PMID: 32852882 PMCID: PMC7461360 DOI: 10.1111/odi.13620] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Affiliation(s)
| | | | | | - Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Fernando Neves Hugo
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Nery NG, Antunes JLF, Jordão LMR, Freire MDCM. Can the school environment influence oral health-related behaviours? A multilevel analysis of the Brazilian National Adolescent School-Based Health Survey 2015. Community Dent Oral Epidemiol 2020; 49:23-32. [PMID: 32815223 DOI: 10.1111/cdoe.12569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 06/06/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the association between the potential support of schools for oral health promotion and a set of oral health-related behaviours among adolescent students in Brazilian state capitals. METHODS A cross-sectional study using individual and school environment data from the 2015 Brazilian National Adolescent School-Based Health Survey (PeNSE) was conducted. The sample consisted of 51 192 students from 1339 public and private schools in the 27 Brazilian State Capitals, aged 11-19 years old. The outcomes were six oral health-related behaviours: dental visits; toothbrushing frequency; soft drink and sweets consumption; smoking and alcohol consumption. The explanatory variable was the Oral Health Promotion School Environment index (OHPSE). Covariates were the adolescents' sociodemographic characteristics and organizational aspects of the schools. A two-level multilevel mixed-effects Poisson regression analysis with fixed slopes and random intercepts was performed, considering the complex sample design. RESULTS The prevalence of risk behaviours was 28.0% for 'low frequency of annual dental visits', 6.9% for 'low daily toothbrushing frequency', 28.8% for 'high weekly soft drink consumption', 41.7% for 'high weekly sweet consumption', 18.9% for 'cigarette experimentation' and 52.6% for 'alcoholic beverage experimentation'. The schools were classified as low (36.3%), intermediate (30.4%) and high (33.3%) OHPSE. In the adjusted model, schools with 'high OHPSE' had lower prevalence of 'low frequency of annual dental visits' (PR = 0.94 [95% CI 0.90; 0.99]), 'high weekly frequency of soft drink consumption' (PR = 0.94 [95% CI 0.89; 0.99]) and 'sweet consumption' (PR = 0.96 [95% CI 0.93; 1.00]) than those with 'low OHPSE'. In addition, schools with 'intermediate OHPSE' had higher prevalence's of 'low daily toothbrushing frequency' (PR = 1.12 [95% CI 1.03; 1.23]) and 'cigarette experimentation' (PR = 1.08 [95% CI 1.01; 1.16]) than those with 'low OHPSE'. 'Alcoholic beverage experimentation' was not associated with OHPSE. CONCLUSIONS The potential support of schools for oral health promotion was associated with most of the oral health-related behaviours among adolescent students. Those attending schools with higher OHPSE scores reported a higher annual frequency of dental visits and a lower weekly frequency of soft drink and sweet consumption, while those in schools with intermediate OHPSE had a lower daily toothbrushing frequency and a higher rate of cigarette experimentation.
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Tôrres LHDN, De Marchi RJ, Hilgert JB, Hugo FN, Ismail AI, Antunes JLF, Sousa MDLRD. Oral health and Obesity in Brazilian elders: A longitudinal study. Community Dent Oral Epidemiol 2020; 48:540-548. [PMID: 32786084 DOI: 10.1111/cdoe.12566] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Obesity is an important risk factor for chronic diseases and can also result in greater mortality. The aim of this longitudinal study was to investigate whether poor oral health acts as a risk factor for obesity as indicated by body mass index (BMI) and waist circumference (WC). METHODS We included in this analysis all participants who volunteered in a cohort study entitled 'Carlos Barbosa Cohort Study-CBCS' in the city of Carlos Barbosa, Southern Brazil. The interview questionnaire comprised socio-demographic information, behavioural questions and medical history. Oral examinations and anthropometric assessments were carried out. The outcome was obesity measured by both BMI (≥30 kg/m2 ) and WC (>0.80 for women and >0.94 for men). Variables were collected longitudinally. Those associated with the outcome and epidemiologically relevant to the conceptual framework participated in the analysis and were adjusted for socio-demographic, behavioural, general and oral health conditions. RESULTS Six hundred and thirty-three independently living elders participated. The baseline mean age was 67.5 ± 6.1 years. Individuals who never visited a dentist (OR = 3.02, 95% CI: 1.25-7.26) as well as participants who needed a dental prosthesis in the lower arch (OR = 4.38, 95% CI: 1.34-14.32) were more likely to be obese, through BMI and WC measures, respectively. Edentulous participants with complete dentures in both arches (OR = 0.23, 95% CI: 0.06-0.84) and those who perceived their oral health as unsatisfactory (OR = 0.41, 95% CI: 0.19-0.88) had a lower likelihood of being obese, according to BMI and WC measures. CONCLUSIONS Older persons with poor oral health may be at risk for general and central obesity, a relationship that may have important clinical implications.
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Affiliation(s)
| | - Renato José De Marchi
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Amid Ibrahim Ismail
- Department of Oral Health Sciences, Maurice H Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | | | - Maria da Luz Rosário de Sousa
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Andrade FRD, Antunes JLF. Distracted driving of a motor vehicle on Brazilian federal highways as a cause of traffic accidents. Rev Bras Epidemiol 2020; 23:e200085. [PMID: 32696932 DOI: 10.1590/1980-549720200085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 12/05/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Distracted driving (DD) of a motor vehicle is considered an increasing risk factor for land transport accidents. OBJECTIVE To identify the tendency in the number of victims in DD accidents and in the number of offences due to cell phone use on Brazilian federal highways, as well as analyze the DD category in depth as it is being used in the country. METHOD A time series study with data on accidents with victims, made available by the Federal Highway Police, whose cause was distracted driving, from 2007 to 2016 and data on offences for driving using a cell phone. RESULTS There was a tendency towards a monthly increase in the number of distracted driving accident victims in the country up to mid-2011 (percentage monthly variation - PMV = 0.57%), followed by a significant decrease (PMV = -0.45%). Macro-regions showed similar behavior, except in the Southeast. There was a monthly increase in the number of offences caused by drivers using cell phones from 2007 to 2013. CONCLUSION There was a tendency towards monthly increases in the number of victims of distracted driving in Brazil and in most macro-regions up to 2011, followed by a subsequent downward tendency. The inaccurate nature of the expression "distraction" compromises the quality of the data and, consequently, the adequate estimation of victims attributable to this risk factor. The cell phone-driving dyad could be the root cause of accidents with victims caused by distracted driving in the country.
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Andrade FBD, Antunes JLF, Andrade FCD, Lima-Costa MFF, Macinko J. Education-Related Inequalities in Dental Services Use among Older Adults in 23 Countries. J Dent Res 2020; 99:1341-1347. [PMID: 32623932 DOI: 10.1177/0022034520935854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50 y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7% and ranged from 18.7% in China to 81.2% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20 percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.
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Affiliation(s)
- F Bof de Andrade
- Oswaldo Cruz Foundation, Rene Rachou Institute, Belo Horizonte, Brazil
| | - J L F Antunes
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - F C D Andrade
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - M F F Lima-Costa
- Oswaldo Cruz Foundation, Rene Rachou Institute, Belo Horizonte, Brazil
| | - J Macinko
- Departments of Health Policy and Management and Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Sousa JLD, Alencar GP, Antunes JLF, Silva ZPD. [Markers of inequality in self-rated health in Brazilian adults according to sex]. CAD SAUDE PUBLICA 2020; 36:e00230318. [PMID: 32490914 DOI: 10.1590/0102-311x00230318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 10/21/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to analyze self-rated health in Brazil's adult population according to markers of health inequality (color or race, region of residence, schooling, per capita household income, and social class), stratified by sex. We studied 59,758 individuals 18 years or older who participated in the 2013 National Health Survey, a population-based household survey. Data collection used face-to-face interviews and key physical measurements. Self-rated health was classified as positive, fair, or negative. Multinomial logistic regression was used to estimate crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95%CI). Percentage agreement and kappa values were calculated to compare the results obtained by regression models and the expected values. Prevalence of positive self-rated health in the overall population was 66.2% (70% in men and 62.6% in women). In the adjusted analysis, the odds of worse self-rated health were significantly higher in individuals with lower per capita household income, less schooling, from the lowest social classes, residents of the North and Northeast regions, and those with brown and black color/race. Public policies for health promotion and recovery in these more vulnerable social groups can help reduce the persistent health inequalities in Brazil.
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Ventura DDFL, Ribeiro H, Giulio GMD, Jaime PC, Nunes J, Bógus CM, Antunes JLF, Waldman EA. Challenges of the COVID-19 pandemic: for a Brazilian research agenda in global health and sustainability. CAD SAUDE PUBLICA 2020; 36:e00040620. [PMID: 32321072 DOI: 10.1590/0102-311x00040620] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/26/2020] [Indexed: 01/29/2023] Open
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Santos EFDS, Antunes JLF. [Factors associated with lack of hospital care in deaths from cerebrovascular disease, São Paulo, Brazil: a comparative analysis of 1996-1998 and 2013-2015]. CAD SAUDE PUBLICA 2020; 36:e00227718. [PMID: 32267388 DOI: 10.1590/0102-311x00227718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 09/27/2019] [Indexed: 11/22/2022] Open
Abstract
The objective was to assess sociodemographic and clinical factors related to the lack of hospital care in deaths from ischemic and hemorrhagic cerebrovascular disease (CVD) in the state of São Paulo, Brazil, in 1996-1998 and 2013-2015. The study used data on deaths from the Mortality Information System. Poisson regression was used to analyze the association between lack of hospital care and the study variables. Of the 127,319 individuals that died of CVD in the two three-years periods, 19,362 (15.2%) had failed to receive hospital care. Lack of hospital care in deaths from CVD remained practically unchanged in relation to sociodemographic and clinical characteristics, except for distributions by sex. The more recent three-year period showed higher risk of death from CVD without hospital care among Asian-descendant individuals (RR = 1.48), while lower risk of death from CVD without hospital care in the more recent period was associated with black color (RR = 0.85), brown color (RR = 0.86), married individuals (RR = 0.70), those living in the capital city of São Paulo (RR = 0.92), those who received medical care (RR = 0.17), and those with hemorrhagic CVD (RR = 0.47). In addition, lack of hospital care in deaths from hemorrhagic CVD was lower among married individuals (RR = 0.67), those living in the capital city of São Paulo (RR = 0.74), and those who received medical care (RR = 0.08). Sociodemographic and clinical characteristics were associated with the lack of hospital care in deaths from ischemic and hemorrhagic CVD, suggesting that there are differences in care for CVD patients.
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Carvalho AS, Duarte DADS, Antunes JLF, Cangussu MCT, Cangussu MCT. Association between clinical manifestations of sickle cell anaemia in children and the occurrence of dental caries: A cross-sectional study. BDS 2020. [DOI: 10.14295/bds.2020.v23i2.1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: The aim of this study was to determine the association between clinical manifestations of sickle cell anemia (including hospitalization and pain crisis) and dental caries in children in Bahia. Material and Methods: The study design was crosssectional, and the population included children aged from 6 to 96 months from August 2007 to July 2008 (N = 686). Interviews were performed to identify the sociodemographic profiles of the participants, and oral examinations were conducted by three examiners who were previously trained and calibrated to identify the presence of dental caries according to World Health Organization (WHO) criteria. Logistic regression analysis was performed for confirmatory analysis and estimation of confidence intervals (CIs). Results: The results showed that pain crises and hospitalizations were positively associated with caries (crude odds ratio (OR) = 2.11 and adjusted OR = 1.24; crude OR = 2.50 and adjusted OR = 1.46, respectively), but these associations were not statistically significant. Conclusion: The severity of the sickle cell condition alone was not sufficient to aggravate the prevalence of caries; thus, there are no major differences in caries prevalence between children with and without sickle cell disease.KEYWORDSSickle cell anemia; Dental caries; Epidemiology; Paediatrics.
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Gushi LL, Sousa MDLRD, Frias AC, Antunes JLF. Fatores associados ao impacto das condições de saúde bucal nas atividades de vida diária de adolescentes, Estado de São Paulo, 2015. Rev bras epidemiol 2020; 23:e200098. [DOI: 10.1590/1980-549720200098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/01/2020] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Verificar a associação entre impacto nas atividades de vida diária e variáveis sociodemográficas e parâmetros bucais em adolescentes no Estado de São Paulo. Métodos: Estudo transversal com dados de 5.409 adolescentes que participaram da “Pesquisa Estadual de Saúde Bucal de São Paulo - SB”, de 2015. O impacto nas atividades de vida diária foi avaliado pelo índice de impacto das condições de saúde bucal nas atividades de vida diária (em inglês: oral impacts on daily performances [OIDP]), pela prevalência (presença ou ausência de impacto) e pela severidade do impacto (escores do OIDP). Utilizou-se o modelo de regressão binomial negativa inflado de zeros, considerando os pesos amostrais. Foram calculados as razões de prevalências (RP), as razões de médias (RM) e os intervalos de confiança (IC). Resultados: A prevalência de impacto nas atividades de vida diária foi de 37,4%. Após o ajuste, pôde-se observar que o sexo feminino permaneceu com maior prevalência (RP = 1,59; IC95% 1,36 ‒ 1,81) e severidade do impacto (RM = 1,49; IC95% 1,22 ‒ 1,81). Na comparação com brancos, os demais grupos tiveram maior prevalência de impacto. A renda familiar maior que R$ 2.501 (RM = 0,79; IC95% 0,64 ‒ 0,98) e a aglomeração domiciliar (RM = 1,18; IC95% 1,00 ‒ 1,39) foram associadas com a severidade do impacto. Nas condições de saúde bucal, verificou-se que a cárie não tratada (RP = 1,46; IC95% 1,23 ‒ 1,74) e o sangramento gengival (RP = 1,35; IC95% 1,14 ‒ 1,60) permaneceram associados com maior prevalência de impacto. Conclusão: Sexo feminino, ter cor não branca, ter cárie não tratada e sangramento gengival foram associados ao maior impacto nas atividades de vida diária. Ter renda maior que R$ 2.500 e residir em domicílios menos aglomerados associaram-se com menor impacto.
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Bigoni A, Ferreira Antunes JL, Weiderpass E, Kjærheim K. Describing mortality trends for major cancer sites in 133 intermediate regions of Brazil and an ecological study of its causes. BMC Cancer 2019; 19:940. [PMID: 31604464 PMCID: PMC6788078 DOI: 10.1186/s12885-019-6184-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 09/20/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In Brazil, 211 thousand (16.14%) of all death certificates in 2016 identified cancer as the underlying cause of death, and it is expected that around 320 thousand will receive a cancer diagnosis in 2019. We aimed to describe trends of cancer mortality from 1996 to 2016, in 133 intermediate regions of Brazil, and to discuss macro-regional differences of trends by human development and healthcare provision. METHODS This ecological study assessed georeferenced official data on population and mortality, health spending, and healthcare provision from Brazilian governmental agencies. The regional office of the United Nations Development Program provided data on the Human Development Index in Brazil. Deaths by misclassified or unspecified causes (garbage codes) were redistributed proportionally to known causes. Age-standardized mortality rates used the world population as reference. Prais-Winsten autoregression allowed calculating trends for each region, sex and cancer type. RESULTS Trends were predominantly on the increase in the North and Northeast, whereas they were mainly decreasing or stationary in the South, Southeast, and Center-West. Also, the variation of trends within intermediate regions was more pronounced in the North and Northeast. Intermediate regions with higher human development, government health spending, and hospital beds had more favorable trends for all cancers and many specific cancer types. CONCLUSIONS Patterns of cancer trends in the country reflect differences in human development and the provision of health resources across the regions. Increasing trends of cancer mortality in low-income Brazilian regions can overburden their already fragile health infrastructure. Improving the healthcare provision and reducing socioeconomic disparities can prevent increasing trends of mortality by all cancers and specific cancer types in Brazilian more impoverished regions.
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Affiliation(s)
- Alessandro Bigoni
- Department of Epidemiology, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, Pacaembu, Sao Paulo, SP CEP: 01246-904 Brazil
| | - José Leopoldo Ferreira Antunes
- Department of Epidemiology, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, Pacaembu, Sao Paulo, SP CEP: 01246-904 Brazil
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), WHO, Lyon, France
- Cancer Registry of Norway, Oslo, Norway
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Antunes JLF, Barros AJDD, Minayo MCDS. Caminhos da internacionalização dos periódicos de saúde coletiva. Saúde debate 2019. [DOI: 10.1590/0103-1104201912217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Esse texto teve como objetivo apresentar caminhos para que o meio editorial em saúde coletiva incremente a visibilidade das revistas brasileiras no exterior. Sinteticamente, essas medidas são: publicação dos artigos em inglês; indexação dos periódicos nas principais bases de dados internacionais (PubMed, Scopus, Web of Science etc.); inclusão das revistas nos repositórios on-line internacionais (SciELO, PMC, Europe PMC etc.); adoção de sistema de gestão editorial em inglês, permitindo a comunicação entre autores, editores e revisores de diferentes países; adoção de licença de direitos de cópia, permitindo a divulgação dos artigos publicados em repositórios individuais e institucionais. Muitas dessas sugestões já vêm sendo implantadas, e várias revistas no Brasil já avançaram no trajeto assinalado. Essas diretrizes implicam custos adicionais e empenho editorial. A produção de uma revista científica com impacto internacional não deveria ser responsabilidade apenas dos editores e dos autores. É fundamental que as agências de fomento à pesquisa criem fontes sustentáveis de financiamento e de internacionalização para as revistas brasileiras de reconhecido mérito.
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Andrade FRD, Antunes JLF. Trends in the number of traffic accident victims on Brazil's federal highways before and after the start of the Decade of Action for Road Safety. CAD SAUDE PUBLICA 2019; 35:e00250218. [PMID: 31483050 DOI: 10.1590/0102-311x00250218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 03/15/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the trend in the number of fatalities, severe injuries, and minor injuries from traffic accidents on Brazil's federal highways according to the country's major geographic regions before and after the start of the Decade of Action for Road Safety (DARS). This was an interrupted time series study of data on accidents with fatal or injured victims provided by the Brazilian Federal Highway Police from 2007 to 2017. The Prais-Winsten method was used to calculate the monthly percentage change (MPC) in the number of fatalities, severe injuries, and minor injuries. Before the DARS, there was an upward monthly trend in the number of fatalities in these accidents in the country as a whole (MPC 0.71%) and in all five regions, especially in the South (MPC 1.01%) and Central-West (MPC 0.84%). There was an inverse trend after the start of the DARS, with a significant decrease in Brazil as a whole (MPC -1.24%) and in the major geographic regions. For each person that dies in an accident on a federal highway, at least 12 others suffer non-fatal injuries. There was an upward trend in the number of victims with severe injuries (MPC 0.53%) and minor injuries (MPC 0.8%) in Brazil and in the major geographic regions in the period prior to the DARS. After the start of the DARS, there was a significant downward trend in the absolute frequencies of these outcomes at the national and regional levels. In conclusion, before the DARS, there was an upward monthly trend in the number of fatal and injured victims of traffic accidents on Brazil's federal highways. After the start of the DARS, in 2011, there was an inverse trend, namely a decline in these outcomes in the country.
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Antunes JLF. How to correct the odds ratio for lack of sensitivity and specificity. Community Dent Oral Epidemiol 2019; 47:449-453. [PMID: 31389620 DOI: 10.1111/cdoe.12489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/28/2019] [Accepted: 07/16/2019] [Indexed: 12/01/2022]
Abstract
This commentary explains and exemplifies a method to estimate the Odds Ratio-OR with a correction for possible errors in diagnosis. This procedure allows reassessing hypotheses of association between health outcomes and exposures when the database entails lack of accuracy, and the estimates of sensitivity and specificity of the diagnostic tool are available. Misclassification is not uncommon in dental public health research. Classification errors should not be ignored; they should instead be subject of measurement and adjustment. However, the lack of diagnostic validity is an elusive error, which cannot be entirely controlled. The method described here is solely an attempt to explore further the assessment of factors impacting on health outcomes.
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Goldbaum M, Antunes JLF, Camargo Júnior KR. [The relevance of Public Health Journals in informing research, education, health services, and citizenship]. Cien Saude Colet 2019; 26:1401-1405. [PMID: 33886768 DOI: 10.1590/1413-81232021264.33992018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 07/14/2019] [Indexed: 11/22/2022] Open
Abstract
This text presents in a synthetic manner the discussions of the working group of the same name, held during the international conference commemorating the twenty years of the SciELO Program. The objective is to inform the Public Health professional field about chronic problems affecting scientific periodicals in Brazil - financing, classification of journals, the impact of published works, among others.
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Affiliation(s)
- Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo (USP). Av. Dr. Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
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Nehme PA, Amaral FG, Middleton B, Lowden A, Marqueze E, França-Junior I, Antunes JLF, Cipolla-Neto J, Skene DJ, Moreno CRC. Melatonin profiles during the third trimester of pregnancy and health status in the offspring among day and night workers: A case series. Neurobiol Sleep Circadian Rhythms 2019; 6:70-76. [PMID: 31236522 PMCID: PMC6586602 DOI: 10.1016/j.nbscr.2019.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 03/28/2019] [Accepted: 04/05/2019] [Indexed: 12/31/2022] Open
Abstract
Successful pregnancy requires adaptation in maternal physiology. During intrauterine life the mother's circadian timing system supports successful birth and postnatal development. Maternal melatonin is important to transmit circadian timing and day length to the fetus. This study aims to describe the third trimester of pregnancy among day (n = 5) and night (n = 3) workers by assessing their melatonin levels in a natural environment. Additionally, we describe the worker's metabolic profiles and compare the health status of the newborns between groups of day and night working mothers. Our results indicate an occurrence of assisted delivery (cesarean and forceps) among night workers. Moreover, the newborns of night workers showed lower Apgar index and breastfeeding difficulty indicating a worse condition to deal with the immediate outside the womb environment. Additionally, there was lower night-time melatonin production among pregnant night workers compared to day workers. These findings may be related to light-induced suppression of melatonin that occurs during night work. We conclude that night work and consequent exposure to light at unconventional times might compromise the success of pregnancy and the health of the newborn. Further studies need to be carried out to monitor pregnancy and newborn health in pregnant night workers. There was lower night-time melatonin production among pregnant night workers compared to day workers. Night work might compromise the success of pregnancy. Night work during pregnancy might compromise the health of the newborn.
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Affiliation(s)
- P A Nehme
- School of Public Health, University of São Paulo, Brazil
| | - F G Amaral
- Department of Physiology, Federal University of São Paulo, Brazil
| | - B Middleton
- Faculty of Health and Medical Sciences, University of Surrey, UK
| | - A Lowden
- Stress Research Institute, University of Stockholm, Sweden
| | - E Marqueze
- School of Public Health, University of São Paulo, Brazil.,Catholic University of Santos, Brazil
| | | | - J L F Antunes
- School of Public Health, University of São Paulo, Brazil
| | - J Cipolla-Neto
- Department of Physiology and Biophysics Neurobiology Lab, Institute of Biomedical Sciences, University of São Paulo, Brazil
| | - D J Skene
- Faculty of Health and Medical Sciences, University of Surrey, UK
| | - C R C Moreno
- School of Public Health, University of São Paulo, Brazil.,Stress Research Institute, University of Stockholm, Sweden
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Fonseca RCLD, Antunes JLF, Cascaes AM, Bomfim RA. Individual and contextual factors associated with traumatic dental injuries in a population of Brazilian adolescents. Dent Traumatol 2019; 35:171-180. [DOI: 10.1111/edt.12469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 12/30/2022]
Affiliation(s)
| | | | - Andreia Morales Cascaes
- School of Dentistry Department of Community Health Federal University of Pelotas Pelotas Brazil
| | - Rafael Aiello Bomfim
- School of Dentistry Department of Community Health Federal University of Mato Grosso do Sul Campo Grande Brazil
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Andrade FBD, Teixeira DSDC, Frazão P, Duarte YAO, Lebrão ML, Antunes JLF. Oral health profile among community-dwellingelderly and its association with self-rated oral health. Rev Bras Epidemiol 2019; 21Suppl 02:e180012. [PMID: 30726357 DOI: 10.1590/1980-549720180012.supl.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/23/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The use of dental prosthesis and the tooth loss in elderly people are associated with significant impact on the overall health and quality of life. Continuous assessment of oral health profile in this population is important for planning the actions and policies of the area. OBJECTIVES The aims of this study were to assess the prevalence of tooth loss and use of dental prosthesis among the elderly people in different periods, to evaluate the association between functional dentition (20 teeth or more) and socioeconomic factors, and to evaluate the impact of tooth loss and use of dental prosthesis on self-rated oral health. METHODS Thesample consisted of people aged 60 years and older who participated in the Health, Well-Being, and Aging Study (SABE). Data from the years 2000, 2006, and 2010 were used to assess the prevalence of tooth loss and use of dental prosthesis. Analysis of the factors associated with the functional dentition and self-rated oral health was based on the data collected in 2010. Comparison of oral health profile over the 3 years was done through descriptive analysis and comparison of confidence intervals. Multiple logistic regression models were used to assess the factors associated with functional dentition and self-rated oral health. RESULTS The prevalence of tooth loss and use of dental prosthesis remained constant over the three periods analyzed. Functional dentition was significantly associated with education, sex, and race/gender. Individuals in need of dental prosthesis and with periodontal pocket were more likely to report poor oral health. CONCLUSION There was no reduction in the prevalence of tooth loss and in the use of dental prosthesis over 10 years. Functional dentition is associated with socioeconomic inequalities. Self-rated oral health is associated with the need of dental prosthesis.
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Affiliation(s)
| | | | - Paulo Frazão
- Departamento de Prática de Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | | | - Maria Lúcia Lebrão
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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Antunes JLF, Chiavegatto Filho ADP, Duarte YAO, Lebrão ML. Social inequalities in the self-rated health of the elderly people in the city of São Paulo, Brazil. Rev Bras Epidemiol 2019; 21Suppl 02:e180010. [PMID: 30726355 DOI: 10.1590/1980-549720180010.supl.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/20/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the prevalence of the self-rated poor and very poor health status among elderly people who were not in nursing homes and were living in São Paulo, Brazil, in 2010, and to identify whether the social inequalities previously reported for this condition persist. METHODS We carried out a cross-sectional study, with a representative sample of 1,344 people aged 60 years or more living in the city, who participated in the SABE Study (Health, Well-Being, and Aging). We applied a questionnaire about sociodemographic characteristics, which included three questions on self-rated health status: a direct question about the current condition, a comparison with the condition of the other people of the same age, and a comparison with oneself a year before. The comparative analysis used Poisson regression models, reporting the prevalence ratio as a measure of association between variables. RESULTS Only 7.8% of the elderly individuals reported a negative self-rated health status in 2010, similar proportion to those that consider themselves to be in worse health condition than the other people of the same age (8.7%). However, the prevalence of elderly people that reported worsening in comparison with the previous year was higher, of 29.2%. Regardless of the question used, the prevalence of negative self-rated health was directly associated with worse indicators of income, educational status, and consumer classes. Significant differences between genders, age groups, and skin color categories were also observed. CONCLUSION Differences in the prevalence of self-rated negative health status continue to affect the sociodemographic groups. The knowledge already available about social inequalities in health did not eliminate or attenuate social injustice in this outcome.
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Affiliation(s)
| | | | - Yeda Aparecida Oliveira Duarte
- Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil.,Escola de Enfermagem, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Maria Lúcia Lebrão
- Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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Andrade FBD, Antunes JLF, Souza Junior PRBD, Lima-Costa MF, Oliveira CD. Life course socioeconomic inequalities and oral health status in later life: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:7s. [PMID: 30379285 PMCID: PMC6255023 DOI: 10.11606/s1518-8787.2018052000628] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/30/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.
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Affiliation(s)
- Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | | | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Cesar de Oliveira
- University College London, Department of Epidemiology & Public Health. London, UK
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Abstract
Abstract Objective: to assess the prevalence of elderly persons living alone in Brazil, based on covariates of health status, behavior and socio-demographic characteristics. Method: data from 11,967 individuals (aged 60 or over) were obtained from the National Health Survey (Brazil, 2013). Living alone was defined as residing in a one-person household. The prevalence of individuals living alone was stratified by socio-demographic conditions and geographic region. Living alone was also assessed as a factor for outcomes of physical functioning, behavior and health conditions. Poisson regression models were used to evaluate the prevalence ratios and a 95% confidence interval was applied. Results: in Brazil, 15.3% of people aged 60 years and over live alone. This condition is more prevalent in higher income regions; however, more lower-income individuals were affected. Prevalence was higher among women and individuals aged 75 years or more. Living alone was associated with difficulties in instrumental activities of daily living (prevalence ratio 1.15; 95% confidence interval 1.04-1.28); the reporting of an illness in the two prior to the study (PR=1.35; 95%CI=1.16-1.57); watching television (five or more hours daily) (PR=1.40; 95%CI=1.26-1.56) and falls in the previous year (PR=1.35; 95%CI=1.10-1.66). Elderly persons living alone also had worse eating habits, with a less frequent intake of meat, beans and salads than their counterparts who lived with others. Conclusion: elderly persons living alone in Brazil have a worse health status and health-related habits. These findings represent a challenge and should motivate social and health policies aimed at fulfilling the greater needs of adults who grow old alone.
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Perea LME, Peres MA, Boing AF, Antunes JLF. Trend of oral and pharyngeal cancer mortality in Brazil in the period of 2002 to 2013. Rev Saude Publica 2018; 52:10. [PMID: 29412371 PMCID: PMC5802649 DOI: 10.11606/s1518-8787.2018052000251] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 01/30/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To analyze the trend of oral and pharyngeal cancer mortality rates in the period of 2002 to 2013 in Brazil according to sex, anatomical site, and macroregion of the country. METHODS The mortality data were obtained from the Mortality Information System and the population data were obtained from the Brazilian Institute of Geography and Statistics. The trend of the rates standardized by sex and age was calculated using the Prais-Winsten estimation, and we obtained the annual percentage change and the respective 95% confidence intervals, analyzed according to sex, macroregion, and anatomical site. RESULTS The average coefficient of oral cancer mortality was 1.87 per 100,000 inhabitants and it remained stable during the study period. The coefficient of pharyngeal cancer mortality was 2.04 per 100,000 inhabitants and it presented an annual percentage change of -2.6%. Approximately eight in every 10 deaths occurred among men. There was an increase in the rates of oral cancer in the Northeast region (annual percentage change of 6.9%) and a decrease in the Southeast region (annual percentage change of -2.9%). Pharyngeal cancer mortality decreased in the Southeast and South regions with annual percentage change of -4.8% and -5.1% respectively. Cancer mortality for tonsil, other major salivary glands, hypopharynx, and other and unspecified parts of mouth and pharynx showed a decreasing trend while the other sites presented stability. CONCLUSIONS Pharyngeal cancer mortality decreased in the period of 2002 to 2013. Oral cancer increased only in the Northeast region. Mortality for tonsil cancer, other major salivary glands, hypopharynx, and other and ill-defined sites in the lip, oral cavity, and pharynx decreased.
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Affiliation(s)
- Lillia Magali Estrada Perea
- Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil
| | - Marco Aurélio Peres
- University of Adelaide. Adelaide Dental School. Australian Research Center for Population Oral Health. Adelaide, Australia
| | - Antonio Fernando Boing
- Universidade Federal de Santa Catarina. Departamento de Saúde Pública. Florianópolis, SC, Brasil
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Singh A, Harford J, Antunes JLF, Peres MA. Area-level income inequality and oral health among Australian adults-A population-based multilevel study. PLoS One 2018; 13:e0191438. [PMID: 29364943 PMCID: PMC5783384 DOI: 10.1371/journal.pone.0191438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 01/04/2018] [Indexed: 11/11/2022] Open
Abstract
Background A lack of evidence exists on the association between area-level income inequality and oral health within Australia. This study examined associations between area-level income inequality and oral health outcomes (inadequate dentition (<21 teeth) and poor self-rated oral health) among Australian adults. Variations in the association between area-level income inequality and oral health outcomes according to area-level mean income were also assessed. Finally, household-income gradients in oral health outcomes according to area-level income inequality were compared. Methods For the analyses, data on Australian dentate adults (n = 5,165 nested in 435 Local Government Areas (LGAs)) was obtained from the National Dental Telephone Interview Survey-2013. Multilevel multivariable logistic regression models with random intercept and fixed slopes were fitted to test associations between area-level income inequality and oral health outcomes, examine variations in associations according to area-level mean income, and examine variations in household-income gradients in outcomes according to area-level income inequality. Covariates included age, sex, LGA-level mean weekly household income, geographic remoteness and household income. Results LGA-level income inequality was not associated with poor self-rated oral health and inversely associated with inadequate dentition (OR: 0.64; 95% CI: 0.48, 0.87) after adjusting for covariates. Inverse association between income inequality and inadequate dentition at the individual level was limited to LGAs within the highest tertile of mean weekly household income. Household income gradients in both outcomes showed poorer oral health at lower levels of household income. The household income gradients for inadequate dentition varied according to the LGA-level income inequality. Conclusion Findings suggest that income inequality at the LGA-level in Australia is not positively associated with poorer oral health outcomes. Inverse association between income inequality and inadequate dentition is likely due to the contextual differences between Australia and other high-income countries.
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Affiliation(s)
- Ankur Singh
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
- * E-mail:
| | - Jane Harford
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | | | - Marco A. Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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