Validity of self-reported weight and height by high school students in the city of Cordoba city

Objetivo: Examinar la validez del peso y la estatura declarados respecto de su medición directa, para el diagnóstico de sobrepeso y obesidad en adolescentes escolarizados de la ciudad de Córdoba. Métodos: Se realizó un estudio piloto transversal con 552 adolescentes de 1° a 3° año de tres escuelas secundarias. El peso y la talla se recolectaron mediante un cuestionario autoadministrado y fueron medidos directamente por personal entrenado. Se calcularon diferencias de promedio de peso, talla e índice de masa corporal (IMC=kg/cm2 ) y sensibilidad-especificidad y coeficiente de concordancia (k) para las categorías de diagnóstico. Resultados: El peso declarado promedio fue subestimado respecto del medido; no así la talla. El IMC declarado resultó subestimado en -0,85 kg/cm2 en mujeres y -0,26 kg/cm2 en varones. La sensibilidad-especificidad fue 61%-89% para detectar sobrepeso y 80%-98% para diagnosticar obesidad. Conclusión: El peso y la talla autoinformados produjeron subestimación de la prevalencia de sobrepeso pero no de obesidad.Objective: To examine the validity of self-reported weight and height versus their direct measurement for the diagnosis of overweight and obesity in adolescent students in the city of Cordoba. Methods: A cross-sectional pilot study was carried out with 552 adolescents attending 1st to 3rd year at three high schools. Weight and height were collected through a selfadministered questionnaire and were measured directly by trained staff. We calculated average differences for weight, height and body mass index (BMI = kg/cm2), and sensitivityspecificity and concordance coefficient (k) were analyzed for overweight and obesity diagnosis. Results: Average self-reported weight was underestimated compared to measured weight, but not self-reported height. Declared BMI was underestimated -0.85 kg/cm2 in women and -0.26 kg/cm2 in men. The sensitivity-specificity was 61%-89% to detect overweight, and 80%-98% to diagnose obesity. Conclusion: The self-reported weight and height underestimated the prevalence of overweight but not of obesity.Fil: Vitale, Romina. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Salud Pública; Argentina. Centro Interamericano de Estudios de Seguridad Social; MéxicoFil: Lavin Fueyo, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Interamericano de Estudios de Seguridad Social; MéxicoFil: Rivera, Carolina. Centro Interamericano de Estudios de Seguridad Social; MéxicoFil: Mamondi, Verónica. Centro Interamericano de Estudios de Seguridad Social; MéxicoFil: Berra, Silvina del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Interamericano de Estudios de Seguridad Social; Méxic

Development and validation of the Vietnamese primary care assessment tool

Objective : To adapt the consumer version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity. Design : A quantitative cross sectional study. Setting : 56 communes in 3 representative provinces of central Vietnam. Participants : Total of 3289 people who used health care services at health facility at least once over the past two years. Results : The Vietnamese adult expanded consumer version of the PCAT (VN PCAT-AE) is an instrument for evaluation of primary care in Vietnam with 70 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. Sixteen other items from the original tool were not included in the final instrument, due to problems with missing values, floor or ceiling effects, and item-total correlations. All the retained scales have a Cronbach’s alpha above 0.70 except for the subscale of Family Centeredness. Conclusions : The VN PCAT-AE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the consumer perspective. Additional work in the future to optimize valid measurement in all domains consistent with the original version of the tool may be helpful as the primary care system in Vietnam further develops

Desigualdades no uso do parque público de bairro para a atividade física de crianças : evidências multiníveis de Córdoba, Argentina

Introduction: The complexity of urbanization processes across Latin American societies encourages investigating its implications in health conditions, especially during childhood. One of the possible links between them is recreation, a component of the daily life of children and, therefore, essential to produce health and life itself. The objective of this study was to examine the associations between neighborhood context and active public park use among school-aged children in Cordoba, Argentina. Methods: A cross-sectional study was conducted with 1466 children, aged 9 to 11, attending 19 schools and living in 110 neighborhoods. Multilevel models with Poisson distribution were used for the analyses, stratified by gender. Socio-demographic, behavioral, and physical covariates were included at the individual level, and socioeconomic neighborhood conditions at second level. Results: Girls residing in neighborhoods with a worse socioeconomic context were less likely to report frequent public park use for physical activity, while those from neighborhoods with better socioeconomic conditions were more likely to, regardless of individual characteristics. Conclusion: This study suggests that socioeconomic conditions of neighborhoods are associated with public park use for physical activity in school-aged girls, demonstrating gender inequality in the use and appropriation of public spaces.Introdução: O processo de urbanização das sociedades latino-americanas estimula investigar suas consequências nas condições de saúde. Um dos elos possíveis é a recreação, componente do cotidiano das crianças essencial para a produção da saúde e da própria vida. O objetivo foi examinar as relações entre o contexto do bairro e o uso ativo do parque público entre as crianças em idade escolar em Córdoba, Argentina. Métodos: Foi realizado um estudo transversal com 1466 crianças que frequentam 19 escolas e moram em 110 bairros. Modelos multinível com distribuição de Poisson foram utilizados para as análises, estratificados por sexo. Covariáveis sociodemográficas, comportamentais e físicas foram incluídas no nível individual e as condições socioeconômicas do bairro, no segundo nível. Resultados: As meninas que residem em bairros com pior contexto socioeconômico foram menos prováveis a relatar o uso frequente de parques públicos para atividades físicas, enquanto aquelas provenientes de bairros com melhores condições eram mais prováveis, independentemente das características individuais. Conclusões: Este estudo sugere que as condições socioeconômicas dos bairros estão associadas ao uso de parques públicos para atividade física em meninas unicamente, demonstrando uma desigualdade de gênero.Fil: Lavin Fueyo, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; ArgentinaFil: Berra, Silvina del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentin

Colaboración iberoamericana para la investigación en atención primaria de la salud

La evaluación de la atención primaria de la salud debe ser una prioridad en la agenda política y científica. El desarrollo de la estrategia propuesta desde la reunión de Alma Ata ha sido hasta ahora insuficiente y necesitamos conocer en qué medida se cumplen aquellos principios, cada vez más convincentemente reconocidos como fundamentales para el logro de una mejor salud de la población y más equidad de un modo más eficiente.Fil: Berra, Silvina del Valle. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Salud Pública; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Places children use for physical activity in peripheral neighborhoods of the city of Cordoba

La forma en que se diseñan los barrios tiene un enorme potencial para fomentar la práctica de actividad física. El objetivo de este estudio fue explorar los espacios de recreación disponibles en los barrios periféricos de la ciudad de Córdoba, Argentina, y conocer la frecuencia con la que los niños y las niñas de escuelas primarias municipales los utilizan para realizar actividad física. Padres y madres respondieron en el año 2011 cuestionarios autoadministrados para informar sobre la distancia a dichos espacios, su frecuencia de utilización para realizar actividad física, sexo del menor y nivel de escolaridad de la madre. Se pudo observar que los espacios localizados a menor distancia del hogar de las niñas y los niños son más utilizados para la actividad física. Se detectaron diferencias por sexo y nivel de escolaridad materna. Los resultados muestran la importancia de estos espacios como recursos para la realización de actividad física, así como la presencia de desigualdades sociales en su uso.The way neighborhoods are designed can have enormous potential for encouraging physical activity. The aim of this study was to explore the recreational spaces available in peripheral neighborhoods of the city of Cordoba, Argentina, and determine the frequency with which children attending local public primary schools use them for physical activity. In 2011, parents answered self-administered questionnaires in which they reported their proximity to those spaces, the frequency with which children use them for physical activity, the sex of their child and the educational level of the mother. We found that places closer to the home were used more frequently by children for physical activity. Differences by the child’s sex and the mother’s educational level were observed. The results show the importance of these areas as resources for children’s physical activity as well as the social inequalities that exist in access to these spaces.Fil: Lavin Fueyo, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Salud Pública; ArgentinaFil: Berra, Silvina del Valle. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Prática de atividade fí­sica e ambiente percebido de usuários do Sistema Único de Saúde

Objective: to analyze the relationship between leisure-time physical activity and active commuting with the perception of the environment in people with chronic non-communicable diseases. Methods: cross-sectional study consisting of 719 SUS users. For data collection, the IPAQ and the Neighborhood Environmental Walkability Scale were used. Pearson’s chi-square test and logistic regression model were used. Results: of the 719 (100%), 512 (71.2%) participants were female and 504 (70.1%) reported having a chronic non-communicable disease. There are no relationships between women with chronic disease and perception of the environment for the practice of physical activity during leisure and active commuting. On the other hand, men and the elderly were more likely to be more active in the practice of physical activity. Conclusion: interventions to increase the practice of physical activity in women should be implemented in order to prevent and treat chronic non-communicable diseases.Objetivo: analizar la relación entre la actividad física com el nfer libre y los desplazamientos activos com la percepción del entorno com personas com nfermidades crónicas no transmisibles. Métodos: nfermi transversal compuesto por 719 usuarios del SUS. Para la recolección de datos, se utilizaron el IPAQ y la Escala de Caminabilidad Ambiental del Vecindario. Se nfermi la prueba de chi-cuadrado de Pearson y el modelo de regresión logística. Resultados: de los 719 (100%), 512 (71,2%) participantes eran mujeres y 504 (70,1%) informaron tener com enfermedad crónica no transmisible. No existen relaciones entre mujeres com enfermedad crónica y percepción del entorno para la práctica de actividad física durante el nfe y los desplazamientos activos. Por com lado, los hombres y los ancianos tenían más probabilidades de ser más activos com la práctica de actividad física. Conclusión: se deben implementar intervenciones para incrementar la práctica de actividad física com las mujeres com el fin de prevenir y tratar las nfermidades crónicas no transmisibles.Objetivo: analisar a relação da atividade fí­sica no lazer e de deslocamento ativo com a percepção do ambiente em pessoas com doenças crônicas não transmissí­veis. Métodos: estudo transversal constituí­do por 719 usuários do SUS. Para a coleta de dados utilizou-se o IPAQ e o Neighborhood Environmental Walkability Scale. Utilizou-se o teste qui-quadrado de Pearson e o modelo de regressão logí­stica. Resultados: dos 719 (100%), 512 (71,2%) participantes eram do sexo feminino e 504 (70,1%) relataram ter doença crônica não transmissí­vel. Não há relações entre mulheres com doença crônica e percepção do ambiente para a prática de atividade fí­sica no lazer e de deslocamento ativo. Por outro lado, os homens e os idosos apresentaram maior chance de serem mais ativos para a prática de atividade fí­sica. Conclusão: intervenções para incrementar a prática de atividade fí­sica em mulheres devem ser implementadas com vistas a prevenção e tratamento das doenças crônicas não transmissí­veis.Fil: Parisi Hodniki, Paula. Universidade de Sao Paulo; BrasilFil: de Souza Teixeira, Carla Regina. Universidade de Sao Paulo; BrasilFil: Zanetti, Maria Lúcia. Universidade de Sao Paulo; BrasilFil: de Moraes, Camila. Universidade de Sao Paulo; BrasilFil: Fermino, Rogerio Cesar. Universidade Tecnologia Federal do Parana; BrasilFil: Berra, Silvina del Valle. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Salud Pública; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentin

Risk genes in head and neck cancer: a systematic review and meta-analysis of last 5 years

Head and Neck Carcinoma (HNC), of which the majority are squamous cell carcinomas of the head and neck (SCCHN), is the sixth most prevalent cancers in mankind and, presents high morbidity and low rates of survival.1 It is known that the apoptotic and proliferation genes are involved in cancer development and these could be useful as a biomarker of this pathology. Systematic reviews and meta-analysis allow stronger and more generalized conclusions for identifying some models of risk markers. These models may help in screening, early diagnosis and/or therapy in the clinic.2-5 In recent decades, there has been increased interest in genetic predisposition studies in complex disease. This has led to the production of an enormous number of epidemiologic papers about the relationship between genetic polymorphism and disease. However, the magnitude of association between specific polymorphism and disease is still not established. The identification of a predictive model of risk polymorphisms could help in early diagnosis, and in understanding disease recurrence and/or progression in the subset of patientssubmittedVersio

How robust is the evidence of an emerging or increasing female excess in physical morbidity between childhood and adolescence? Results of a systematic literature review and meta-analyses

For asthma and psychological morbidity, it is well established that higher prevalence among males in childhood is replaced by higher prevalence among females by adolescence. This review investigates whether there is evidence for a similar emerging female ‘excess’ in relation to a broad range of physical morbidity measures. Establishing whether this pattern is generalised or health outcome-specific will further understandings of the aetiology of gender differences in health. Databases (Medline; Embase; CINAHL; PsycINFO; ERIC) were searched for English language studies (published 1992–2010) presenting physical morbidity prevalence data for males and females, for at least two age-bands within the age-range 4–17 years. A three-stage screening process (initial sifting; detailed inspection; extraction of full papers), was followed by study quality appraisals. Of 11 245 identified studies, 41 met the inclusion criteria. Most (n = 31) presented self-report survey data (five longitudinal, 26 cross-sectional); 10 presented routinely collected data (GP/hospital statistics). Extracted data, supplemented by additional data obtained from authors of the included studies, were used to calculate odds ratios of a female excess, or female:male incident rate ratios as appropriate. To test whether these changed with age, the values were logged and regressed on age in random effects meta-regressions. These showed strongest evidence of an emerging/increasing female excess for self-reported measures of headache, abdominal pain, tiredness, migraine and self-assessed health. Type 1 diabetes and epilepsy, based on routinely collected data, did not show a significant emerging/increasing female excess. For most physical morbidity measures reviewed, the evidence broadly points towards an emerging/increasing female excess during the transition to adolescence, although results varied by morbidity measure and study design, and suggest that this may occur at a younger age than previously thought

The experience of continuity with the primary care provider with schoolchildren

Objetivo: Conocer la experiencia de continuidad de escolares según sus cuidadores y analizar la asociación según el tipo de proveedor de Atención Primaria de la Salud (APS) (médico o centro de salud) y su financiamiento (público versus privado o de seguro médico). Métodos: Estudio transversal en cuatro escuelas primarias de la ciudad de Córdoba (Argentina) en 2011. Los cuidadores de los niños de 9 a 13 años respondieron a un cuestionario autoadministrado que incluyó el instrumento PCAT (Primary Care Assesment Tool) para medir la función de continuidad (subdimensiones afiliación y continuidad interpersonal) y preguntas sobre características sociodemográficas y del proveedor. Se obtuvieron puntuaciones medias entre los ítems que componen la dimensión con un valor óptimo de ≥3. Resultados: El 89% de las respuestas fueron suministradas por las madres de los niños. El proveedor de APS fue un centro de salud, hospital o clínica (79,9%), de financiamiento público (60,5%). Las puntuaciones medias del grado de afiliación al proveedor, fueron de 3,30 y 3,27 (p=0,86) cuando se referían a un médico y a un centro de salud, respectivamente; y las puntuaciones medias de la continuidad interpersonal fueron de 3,47 y 3,09 (p=0,01) refiriéndose a un médico y a un centro de salud, respectivamente. Entre quienes identificaron un centro de salud, la media del grado de afiliación fue 3,18 para centros públicos y 3,51 (p=0,04) para centros privados o del seguro médico. Conclusiones: Los cuidadores declaran mayor grado de afiliación cuando su proveedor es privado o del seguro médico; y mejor experiencia de continuidad interpersonal cuando identifican a un médico en vez de a un centro de salud.Objetivo: Conhecer a experiência de continuidade de escolares segundo seus cuidadores e analisar a associação conforme o tipo de provedor de Atenção Primária à Saúde (APS) (médico ou centro de saúde) e seu financiamento (público versus plano de saúde ou particular). Métodos: Estudo transversal em quatro escolas primárias da cidade de Córdoba (Argentina) em 2011. Os cuidadores das crianças de 9 a 13 anos responderam a um questionário autoadministrado que incluiu o instrumento PCAT (Primary Care Assesment Tool) para medir a função de continuidade (subdimensões afiliação e continuidade interpessoal) e perguntas sobre características sociodemográficas e do provedor. Obtiveram-se pontuações médias entre os itens que compõem a dimensão com um valor ótimo de ≥3. Resultados: 89% das respostas foram fornecidas pelas mães das crianças. O provedor de APS foi um centro de saúde, hospital ou clínica (79,9%), de financiamento público (60,5%). As pontuações médias do grau de afiliação ao provedor foram de 3,30 e 3,27 (p=0,86), quando se referiam a um médico e a um centro de saúde, respectivamente; e as pontuações médias de continuidade interpessoal foram de 3,47 e 3,09 (p=0,01). Entre quem identificou um centro de saúde, a média do grau de afiliação foi 3,18 para centros públicos e 3,51 (p=0,04) para centros de plano de saúde ou particulares. Conclusões: Os cuidadores declaram maior grau de afiliação quando seu provedor é um centro particular ou um plano de saúde; e melhor experiência de continuidade interpessoal quando identificam um médico em vez de um centro de saúde.Objective: To know the schoolchildren experience of continuity of care according to their caregivers’ perspective and to analyse its association with the type of Primary Health Care provider (PHC) (doctor or health center) and its funding modality (public versus private, or social security). Methods: A cross-sectional study was carried out in four elementary schools in the city of Cordoba, Argentina, in 2011. Caregivers of children between 9 and 13 years old responded to a self-administered questionnaire that included the Primary Care Assessment Tool (AR-PCAT-CE) to measure the continuity function (affiliation and interpersonal continuity subdomains), the type of PHC providers, and children’s socio-demographic characteristics. Mean scores of affiliation and interpersonal continuity were obtained, and a value ≥3 was considered optimal. Results: Eighty-nine percent of the respondents (n=230) were schoolchildren’s mothers. PHC provider was mainly (79.9%) a first level PHC unit, a hospital or a clinic, publicly funded in 60.5% of cases. The mean scores of the degree of affiliation to their PHC provider were 3.30 and 3.27 (p=0.86) when referring to a doctor and center, respectively, and the mean scores for interpersonal continuity were 3.47 and 3.09 (p=0.01), respectively. Among those who identified a health center as PHC provider, the affiliation score was 3.18 for public centers and 3.51 for social security or private centers (p=0.04). Conclusions: Caregivers report stronger affiliation when the PHC provider is private or a social security center; and a better experience of interpersonal continuity when they identify a physician as their provider rather than a health center.Fil: Rivera, Liliana Carolina. Universidad Nacional de Córdoba; ArgentinaFil: Felló, Gabriela. Universidad Nacional de Córdoba; ArgentinaFil: Berra, Silvina del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin