Data gaps in adolescent fertility surveillance in middle-income countries in Latin America and South Eastern Europe: Barriers to evidence-based health promotion

Adolescent health is a major global priority. Yet, as recently described by the World Health Organization (WHO), increased recognition of the importance of adolescent health rarely transforms into action. One challenge is lack of data, particularly on adolescent fertility. Adolescent pregnancy and childbirth are widespread and affect lifetime health and social outcomes of women, men, and families. Other important components of adolescent fertility include abortion, miscarriage, and stillbirth. Access to reliable, consistently-collected data to understand the scope and complexity of adolescent fertility is critical for designing strong research, developing meaningful policies, building effective programs, and evaluating success in these domains. Vital surveillance data can be challenging to obtain in general, and particularly in low- and middle-income countries and other under-resourced settings (including rural and indigenous communities in high-income countries). Definitions also vary, making comparisons over time and across locations challenging. Informed by the Adolescence and Motherhood Research project in Brazil and considering relevance to the Southern Eastern European (SEE) context, this article focuses on challenges in surveillance data for adolescent fertility for middle-income countries. Specifically, we review the literature to: (1) discuss the importance of understanding adolescent fertility generally, and (2) highlight relevant challenges and complexity in collecting adolescent fertility data, then we (3) consider implications of data gaps on this topic for selected middle-income countries in Latin America and SEE, and (4) propose next steps to improve adolescent fertility data for evidence-based health promotion in the middle-income country context

Data gaps in adolescent fertility surveillance in middle-income countries in Latin America and South Eastern Europe: Barriers to evidence-based health promotion

Adolescent health is a major global priority. Yet, as recently described by the World Health Organization (WHO), increased recognition of the importance of adolescent health rarely transforms into action. One challenge is lack of data, particularly on adolescent fertility. Adolescent pregnancy and childbirth are widespread and affect lifetime health and social outcomes of women, men, and families. Other important components of adolescent fertility include abortion, miscarriage, and stillbirth. Access to reliable, consistently-collected data to understand the scope and complexity of adolescent fertility is critical for designing strong research, developing meaningful policies, building effective programs, and evaluating success in these domains. Vital surveillance data can be challenging to obtain in general, and particularly in low- and middle-income countries and other under-resourced settings (including rural and indigenous communities in high-income countries). Definitions also vary, making comparisons over time and across locations challenging. Informed by the Adolescence and Motherhood Research project in Brazil and considering relevance to the Southern Eastern European (SEE) context, this article focuses on challenges in surveillance data for adolescent fertility for middle-income countries. Specifically, we review the literature to: (1) discuss the importance of understanding adolescent fertility generally, and (2) highlight relevant challenges and complexity in collecting adolescent fertility data, then we (3) consider implications of data gaps on this topic for selected middle-income countries in Latin America and SEE, and (4) propose next steps to improve adolescent fertility data for evidence-based health promotion in the middle-income country context.Conflicts of interest: None

Relação entre multiparidade e desempenho físico em mulheres de meia idade e idosas do nordeste do Brasil / Relationship between multiparity and physical performance in middle and elderly women from northeast Brazil

Tem sido sugerido que o número de filhos (paridade) é uma variável da história reprodutiva que poderia interferir nas condições de saúde das mulheres. A multiparidade tem sido associada à maior incapacidade e pior desempenho físico em mulheres com idades mais avançadas. Objetivo: Investigar a relação entre a multiparidade e o desempenho físico em mulheres de meia idade e idosas do  Nordeste do Brasil. Metodologia: Foi realizado um estudo transversal analítico para avaliar a relação entre a multiparidade e o desempenho físico de 589 mulheres entre 40 e 80 anos de idade, residentes nas cidades de Santa Cruz e Parnamirim, no estado do Rio Grande do Norte. A variável independente (paridade) foi coletada por meio de autorrelato e foi categorizada em menos de três filhos e três filhos ou mais e a avaliação do desempenho físico (variável dependente) foi realizada através dos testes de preensão manual, de sentar-levantar e de equilíbrio de olhos fechados e abertos. A relação entre a multiparidade e o desempenho físico foi analisada através da regressão linear múltipla. Resultados: As participantes foram divididas em dois grupos de acordo com a paridade para caracterização da amostra. Identificou-se que a multiparidade está associada a medidas de desempenho físico em mulheres de meia-idade e idosas. Conclusão: Os achados do presente estudo revelaram que as mulheres que tiveram 3 ou mais filhos apresentaram piores resultados de desempenho físico.

Relationship between functional performance and indicators of peripheral arterial disease in elderly women

OBJECTIVE: The presence of peripheral arterial disease (PAD) increases the risk and vulnerability to adverse clinical outcomes in the elderly. Therefore, we investigated the relationship between functional performance and indicators of PAD in elderly women. METHODS: Cross-sectional study in which 54 elderly were assessed by means of the Mini Mental State Examination (MMSE), Short Physical Performance Battery (SPPB), Ankle-Brachial Index (ABI), Human Activity Profile (HAP) and Edinburgh questionnaire. Statistical analysis was performed using ANOVA, Student's t test and Pearson correlation. We considered p &lt; 0.05 as the significance level. RESULTS: The mean age, SPPB and ABI were 69.2 (± 6.9) years, 9.42 (± 2.55) and 1.04 (± 0.14), respectively. The prevalence of PAD was of 16.3%. There was a significant correlation between ABI and gait speed (r = 0.75, p = 0.001) and between PAH and SPPB (p = 0.001). CONCLUSIONS: It is suggested that the decline in functional performance in the elderly, expressed in the gait velocity component of SPPB, is related to the presence of PAD.</p

Association between self-rated health and physical performance in middle-aged and older women from Northeast Brazil

Background Self-rated Health (SRH) is regarded as a simple and valid measure of a person’s health status, given its association to adverse health outcomes, including low physical performance in older populations. However, studies investigating these associations in low- and middle-income settings are scarce, especially for middle-aged populations. Understanding the validity of SRH in relation to objective health measures in low-income populations could assist in decision making about health policy and strategies, especially in under-resourced settings. Objective Assess the relationship between SRH and physical performance measures in middle-aged and older women in a low-income setting of Brazil. Methods This is a cross-sectional study of 571 middle-aged (40–59 years old) and older (60–80 years old) women living in Parnamirim and Santa Cruz in the Northeast region of Brazil. Participants reported their health status and were allocated to the “SRH good” or “SRH poor” groups. The physical performance evaluation included: handgrip strength, one-legged balance with eyes open and closed and chair stand test. The relationship between SRH and physical performance for middle-aged and older women was assessed by quantile regression (modeling medians) adjusted for potential confounders (age, socioeconomic variables, body mass index, menopause status, age at first birth, parity, chronic conditions and physical activity). Results Middle-aged women from the “SRH good” group presented better physical performance with 1.75 kgf stronger handgrip strength (95% CI [0.47–3.02]; p = 0.004), 1.31 s longer balance with eyes closed ([0.00–2.61]; p = 0.030), and they were 0.56 s faster in the chair stand test ([0.18–0.94]; p = 0.009) than those who reported “SRH poor”. No association was found for balance with eyes open. For older women, there was no evidence of associations between physical performance and SRH. Conclusion This study showed that SRH is significantly associated with objective measures of physical performance in a sample of low-income middle-aged women. SRH can be an important tool to indicate the need for further evaluation of physical performance among middle-aged women and can be particularly useful for low-income communities

Low back pain and disability in military police: an epidemiological study

Abstract Introduction: The low back pain is a major public health problem in industrialized societies, commonly affecting the adult population. The occupation is considered as a risk factor, especially those functions that require physical effort, we have as example the job of the military police, who are exposed to several risk factors, both those who perform administrative activities, and those who perform the ostensive policing. Objective: The aim of this study was to evaluate the prevalence of low back pain among military police, as well the presence of disability and associated factors. Methods: This is an analytical cross-sectional study. Was evaluated the level of disability, pain before and after the work shift, flexibility, postural alterations and anthropometric measures. It was used the regression analysis, considering 95% CI and p < 0.05. Were interviewed 97 military police with mean age of 39.30 (± 5.33), all males. Results: The complaint of low back pain was significantly larger after the work shift, and 82.5% reported difficulties in daily life activities due to low back pain. Conclusion: There is a high prevalence of low back pain and impairment in daily life activities because of military police. The data presented reinforce the need to consider low back pain as a public health problem that affects the whole population, especially the military police

Exploring the relationships between anthropometric indices of adiposity and physical performance in middle-aged and older Brazilian women: a canonical correlation analysis

OBJECTIVES This study analyzed the influence of anthropometric indices of adiposity on the physical performance of middle-aged and older women. METHODS A cross-sectional study was conducted among 368 women from 50 years to 80 years old. Anthropometric and biochemical characteristics were analyzed, and physical performance was evaluated. The statistical analysis used measures of central tendency and dispersion for descriptive data, Pearson correlations to demonstrate the initial associations between the variables, and canonical correlation (CC) to evaluate the relationship between the set of anthropometric adiposity indices and performance-related variables. RESULTS The participants had a mean age of 58.57±8.21 years, a visceral adiposity index of 7.09±4.23, a body mass index of 29.20±4.94 kg/m2, and a conicity index of 1.33±0.07. The average handgrip strength was 25.06±4.89 kgf, gait speed was 1.07±0.23 m/s, and the mean Short Physical Performance Battery (SPPB) score was 10.83±1.36. The first canonical function presented the highest shared variance, CC, and redundancy index (cumulative percentage of variance, 82.52; Wilks’ lambda, 0.66; CC, 0.532; p<0.001). From the analysis of this canonical function, the conicity index (-0.59) displayed inverse correlations with handgrip strength (0.84) and the SPPB (0.68), as well as a direct correlation with gait speed (-0.43). CONCLUSIONS In middle-aged and older women, there was an inverse relationship between the conicity index and muscle strength and power, while a direct relationship was found between the same index and gait speed

Low back pain and disability in military police: an epidemiological study

<div><p>Abstract Introduction: The low back pain is a major public health problem in industrialized societies, commonly affecting the adult population. The occupation is considered as a risk factor, especially those functions that require physical effort, we have as example the job of the military police, who are exposed to several risk factors, both those who perform administrative activities, and those who perform the ostensive policing. Objective: The aim of this study was to evaluate the prevalence of low back pain among military police, as well the presence of disability and associated factors. Methods: This is an analytical cross-sectional study. Was evaluated the level of disability, pain before and after the work shift, flexibility, postural alterations and anthropometric measures. It was used the regression analysis, considering 95% CI and p < 0.05. Were interviewed 97 military police with mean age of 39.30 (± 5.33), all males. Results: The complaint of low back pain was significantly larger after the work shift, and 82.5% reported difficulties in daily life activities due to low back pain. Conclusion: There is a high prevalence of low back pain and impairment in daily life activities because of military police. The data presented reinforce the need to consider low back pain as a public health problem that affects the whole population, especially the military police.</p></div

Dissatisfaction with body image and weight gain in middle-aged women: A cross sectional study.

ObjectivesTo investigate the relationship between weight gain and body image perception in in middle-aged women.MethodsCross-sectional study with 453 women. Body image was assessed using the Stunkard scale, in which women were classified as: satisfied or dissatisfied (general, thinness or obesity). The identification of possible factors associated with body image dissatisfaction was performed using binary logistic regression analysis.ResultsThe mean age was 55.7 (±9.6) years; 80.8% were classified as dissatisfied with body image. As for body composition, women satisfied with their body image had lower values of body fat and higher values of lean mass. In the logistic regression, for general dissatisfaction and obesity, the associated variables were BMI, education and physical activity. As for "dissatisfaction with thinness", only BMI was associated.ConclusionThus, the prevalence of body image dissatisfaction is high in women and part of associated factors are linked to lifestyle behaviors