Relationship between respiratory tract diseases declared by parents and socioeconomic and cultural factors

OBJETIVO: Verificar a relação entre a doença respiratória das crianças declarada pelos pais e os seguintes aspectos: instituição de ensino da criança, grau de instrução dos pais, renda per capita, classe de consumo e grupo étnico da família. MÉTODOS: Estudo descritivo com enfoque retrospectivo, por meio da análise de dados coletados de pais de uma amostra de 959 escolares entre cinco e nove anos, que residiam no distrito estudado, em São Paulo, em 2004. O levantamento das informações foi realizado por meio de instrumento de coleta de dados. As doenças respiratórias pesquisadas no conjunto foram: rinite, rinossinusite, otite, laringite, faringoamigdalite, pneumonia e asma. A associação entre doença respiratória declarada e aspectos socioeconômicos foi avaliada pelo teste do qui-quadrado. RESULTADOS: Os pais de crianças que frequentavam escolas privadas declararam significativamente mais doenças respiratórias em seus filhos, em comparação aos pais de crianças que estudavam em escolas públicas. Os pais com grau de instrução superior ou ensino médio completo declararam significativamente mais doença respiratória em seus filhos. Não houve associação entre a doença respiratória com renda per capita, classe de consumo e etnia. CONCLUSÕES: A percepção mais apurada sobre a saúde dos filhos geralmente associa-se à maior escolaridade dos pais, o que também determina melhores condições de vida. Provavelmente, por isso, os pais cujos filhos frequentavam escolas privadas e com melhor nível de escolaridade referiram mais doenças respiratórias nas crianças. Infere-se, portanto, que conquistas na percepção de saúde e, consequentemente, nas condições de saúde associam-se à melhora do nível educacional.OBJECTIVE: To determine the association between children's respiratory diseases reported by parents and the following criteria: attendance at private or public school, parents' educational level; family per capita income; household socioeconomic class, and family ethnicity. METHODS: This retrospective descriptive study analyzed data collected from questionnaires responded by the parents of 959 schoolchildren between five to nine years old, living in the district selected for the study, in São Paulo, Brazil, over 2004. Respiratory diseases reported by parents were rhinitis, rhinosinusitis, ear infections, laryngitis, pharyngitis, pneumonia, asthma and asthma-like diseases. A chi-square test was used to evaluate the association between respiratory diseases reported by parents and family socioeconomic factors. RESULTS: Parents of children in private schools reported significantly more respiratory diseases in their children than those whose children attended public schools. More respiratory diseases were reported for children whose parents finished high school or college. There were no significant differences between respiratory diseases and per capita income, socioeconomic class or ethnicity. CONCLUSIONS: A more accurate perception about the health of children is generally associated with parents' higher education, which is also expected to ensure better living conditions. This may explain why parents with a higher level of education and whose children attended private schools reported more respiratory diseases in their children. Our findings suggest that improvement of educational level is associated with more accurate health perceptions and, consequently, better health conditions

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

A inclusão da perspectiva do paciente na consulta médica: um desafio na formação do médico

A insuficiência do modelo biomédico para a resolução da maioria dos problemas de saúde da população vem sendo discutida. Diversos autores referem que a realização da consulta médica se associa a melhores resultados quando apoiada nos pressupostos do modelo centrado no paciente, dentre os quais se destaca a inclusão da perspectiva do paciente. Para que isso ocorra, é necessário conhecer as dimensões físicas, psicossociais e culturais que a compõem e incluí-las na realização de entrevistas médicas. Como a formação do médico na graduação ainda é apoiada no modelo biomédico, a mudança de paradigma para a realização de consultas médicas suscita mudanças curriculares significante

Parasitismo por Cryptosporidium sp. em crianças com diarréia aguda

During the period from August 1987 to July 1990, 241 fecal samples collected from 1 to 48 months old children with acute diarrhea and examined in the Child's Institute of Hospital das Clínicas of Faculdade de Medicina da Universidade de São Paulo, were submitted to parasitological tests in the Enteroparasitosis Section of the Instituto Adolfo Lutz. Fourty two (17.43%) fecal samples showed Cryptosporidium sp. oocysts by carbol-fucsin stain. Parasitism by Cryptosporidium sp. was more frequent during the period comprised from March to May, in the studied three years. The authors discussed the Cryptosporidium sp. in association with other agents.No período de agosto de 1987 a julho de 1990, examinaram-se, na Seção de Enteroparasitoses do Instituto Adolfo Lutz, 241 amostras de fezes de crianças, com idade variável entre 1 e 48 meses, que apresentavam episódio agudo de diarréia e foram atendidas no Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Quarenta e duas (17,43%) amostras revelaram a presença de Cryptosporidium sp. após coloração por fucsina-carbólica. O achado de oocistos de Cryptosporidium sp. foi mais freqüente no período compreendido pelos meses de março a maio. Os autores discutem as associações entre Cryptosporidium sp. e outros agentes diarréicos

Human papillomavirus awareness among foreign- and US-born Hispanics, United States, 2017–2018

Introduction: Human papillomavirus (HPV) and HPV vaccine knowledge and awareness are known to be lower among Hispanics compared to non-Hispanic whites. However, Hispanics in the US are a non-homogenous population, with significant differences by nativity, particularly between the US-and foreign-born individuals. We examined HPV and HPV vaccine awareness among foreign-born Hispanics, US-born Hispanics, and US-born non-Hispanic whites. Methods: We analyzed data from the Health Information National Trends Survey (HINTS) 5, cycles 1 (2017) and 2 (2018), the most recent HINTS datasets including nativity information. We used descriptive statistics and multivariable regression to compare awareness of HPV and the HPV vaccine among ethnicity/nativity subgroups. Results: Over 50% of foreign-born Hispanics had not heard of HPV, compared to 32% of US-born Hispanics (P < 0.01) and 33% of non-Hispanic whites (p < 0.01). Lack of HPV vaccine awareness among foreign-born Hispanics was not significantly different from US-born Hispanics (52% vs. 44%, p = 0.12), but was significantly lower compared to non-Hispanic whites (52% vs. 32%, p < 0.01). In multivariable analyses, non-Hispanic whites had over twice the odds of having heard of HPV than foreign-born Hispanics (p < 0.05), while US-born Hispanics had 75% higher odds (p < 0.05). Regarding HPV awareness, non-Hispanic whites had 95% higher odds of having heard of the HPV vaccine than foreign-born Hispanics (p < 0.05), while differences between US and foreign-born Hispanics were not significant. Conclusion: There are significant nativity-related differences in HPV and HPV vaccine awareness and knowledge among US-born Hispanics. Over 50% of foreign-born Hispanic adults are unaware of HPV and the HPV vaccine