Loss to follow-up in a cohort of HIV-negative men who have sex with men: Project Horizonte

OBJECTIVE The objective of this study is to estimate the attrition rates and evaluate factors associated with loss to follow-up between 1994 and 2011 in an open cohort of HIV-negative men who have sex with men. METHODS The Project Horizonte is an open cohort study that aimed to assess the incidence of HIV infection, evaluate the impact of educational interventions, and identify potential volunteers for HIV vaccine trials. The rates of losses to follow-up were estimated for three periods (1994–1999, 2000–2005, and 2006–2011). The variables analyzed were collected in a psychosocial questionnaire. Volunteers who dropped out were compared with the ones who remained in the study using a Cox regression model. RESULTS A total of 1,197 volunteers were recruited. The median follow-up time in the study (n = 626) was 4.2 years. The median follow-up time for the volunteers who dropped out of the study (n = 571) was 1.46 years. The overall rate of loss to follow-up was 11.6/100 person-years. Attrition rates by period were: 12.60 (1994–1999), 11.80 (2000–2005), and 9.00 (2006–2011) per 100 person-years. Factors associated with losses to follow-up were: age group of 21–30 years old, monthly per capita income of more than six or less than one Brazilian minimum wage, having more than two dependents, report of bisexual practice, and inconsistent use of condoms for receptive anal sex. CONCLUSIONS A slight decrease of the loss to follow-up was observed over time. Higher attrition rates happened in the first three years of follow-up. It is possible that the link of the volunteers were not yet well established. Those who reported inconsistent condom use in receptive anal sex were more likely to leave the study, suggesting an underestimation of the incidence of HIV infection in a cohort population. For greater effectiveness, retention strategies must be reassessed considering the connection between the characteristics of homosexual and bisexual behavior and the motivations to engage in health research

¿Puede la antropometría medir la grasa corporal de las personas que viven con el VIH/SIDA?: revisión sistemática

Introduction: Assessment of the quantity and distribution of body fat in people living with HIV/AIDS is of great importance in clinical practice, due to the association of body fat changes with clinical conditions. The aim of this systematic review was to answer the central question: Can anthropometry accurately measure the body fat in people living with HIV/AIDS?Material and Methods: Systematic review carried out using four databases: Medline, LILACS, Scopus and BDTD.Results: Of the 581 studies found, 11 met the eligibility criteria. To assess the validate of anthropometry, only two studies employed regress analysis to development of predictive body fat equations in people living with HIV/AIDS and nine studies employed correlation analysis. This coefficient only measures the strength of the relation between two variables, and there is not concordance between them and therefore, these studies did not accurately evaluate whether or not the anthropometric information showed good concordance with the gold standard. The other two studies developed five equations to evaluate the total fat and limbs (arm, leg and trunk) in people living with HIV/AIDS using antiretrovirals and showed R2 between 0.50 and 0.83.Conclusions: Further research needs to be conducted to answer the central question of this review, as the small number of articles that applied the correct statistical test and the absence of research on people living with HIV/AIDS without the use of antiretrovirals.Introducción: La evaluación de la cantidad y distribución de la grasa corporal en personas que viven con el VIH/SIDA es de gran importancia en la práctica clínica, debido a la asociación de los cambios de grasa corporal con condiciones clínicas. El objetivo de esta revisión es responder a la pregunta central: ¿Puede la antropometría medir con precisión la grasa corporal en las personas que viven con el VIH/SIDA?Material y Métodos: Revisión sistemática llevada a cabo por medio de cuatro bases de datos: Medline, LILACS, Scopus y BDTD.Resultados: De los 581 estudios encontrados, 11 cumplieron con los criterios de elegibilidad. Para evaluar la validación de la antropometría, sólo dos estudios emplearon análisis de regresión para el desarrollo de las ecuaciones de predicción de grasa corporal en las personas que viven con el VIH/SIDA y nueve estudios emplearon análisis de correlación. Este coeficiente sólo mide la fuerza de la relación entre dos variables, y no hay concordancia entre ellos y, por lo tanto, estos estudios no evaluaron con precisión si la información antropométrica mostró buena concordancia con el estándar de oro. Los otros dos estudios desarrollaron cinco ecuaciones para evaluar la grasa total y en las extremidades (brazos, piernas y tronco) en personas que viven con el VIH/SIDA y usan antirretrovirales y mostraron R2 entre 0,50 y 0,83.Conclusiones: Más investigación debe llevarse a cabo para responder a la pregunta central de esta revisión, dado el pequeño número de artículos en que se aplicó la prueba estadística correcta y la ausencia de investigaciones sobre personas que viven con el VIH/SIDA que no usan antirretrovirales

Anthropometric risk factors for metabolic syndrome in HIV patients.

OBJECTIVE: Metabolic syndrome, which affects the general population in epidemic proportions, is associated with a set of cardiovascular disease risk factors. The aims of this cross-sectional study were to determine the prevalence and investigate the risk factors associated with metabolic syndrome in outpatients living with HIV/AIDS using anthropometric and clinical evaluations. METHOD: The study was carried out on 253 HIV infected outpatients. Metabolic syndrome was classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATPIII) and the International Diabetes Federation (IDF) criteria. Logistic regression was used to identify factors associated with the metabolic syndrome. RESULTS: The prevalence of metabolic syndrome varied from 19.4% to 26.4%, according to the criterion used. The factors associated with it in the two classifications used, when adjusted by sex and BMI, were age (? 40years) and subscapular skinfold (> 12 mm). In the final model, using the NCEP/ATPIII criterion the risk factors associated with metabolic syndrome were age ? 40 years (OR = 3.18; CI95% = 1.42; 7.14) and subscapular skinfold > 12 mm (OR = 2.85, CI95% = 1.13; 7.17). In the final model, using the IDF criterion the risk factors associated with metabolic syndrome were age (OR = 3.38, CI95% = 1.61; 7.10) and subscapular skinfold > 12 mm (OR = 4.37, CI95% = 1.84; 10.39). CONCLUSION: In clinical practice, the regular monitoring of subscapular skinfold can help in the identification of HIV infected individuals in risk of MS

Avaliação antropométrica longitudinal de lactentes nascidos de mães infectadas pelo HIV-1

OBJETIVO: Evaluar los parámetros de crecimiento en lactantes nacidos de madres infectadas con el VIH-1. MÉTODOS: Evaluación longitudinal de los z-escores peso-edad (PI), estatura-edad (EI), peso-estatura (PE) fue realizada en una cohorte. Fueran estudiados 97 lactantes no infectados y 33 lactantes infectados nacidos de madres infectadas con el VIH-1 en Belo Horizonte, Sureste de Brasil, de 1995 a 2003. El tiempo medio de seguimiento para los lactantes infectados y no infectados fue de 15,8 meses (variación: 6,8 a 18,0 meses) y 14,3 meses (variación: 6,3 a 18,6 meses), respectivamente. Se utilizó el modelo de regresión linear de efectos mixtos ajustado por máxima verosimilitud restringida para construir las curvas de crecimiento. RESULTADOS: Los z-escores PI, EI y PE de los lactantes infectados con el VIH-1 presentaron decrecimiento. A los seis meses, la diferencia promedio en los z-escores PI, EI y PE entre lactantes infectados y no infectados con el VIH era, respectivamente, 1,02, 0,59 y 0,63 desviaciones-estándares. A los 12 meses, la diferencia promedio en los z-escores PI, EI y PE entre lactantes infectados y no infectados era, respectivamente, 1,15, 1,01 y 0,87 desviaciones-estándares. CONCLUSIONES: El comprometimiento precoz y creciente de los indicadores antropométricos de niños infectados con el VIH-1 muestra la importancia de identificar precozmente niños infectados con el VIH que están en riesgo nutricional y la necesidad de evaluarse continuamente las intervenciones nutricionales adoptadas.OBJECTIVE: To evaluate the growth parameters in infants who were born to HIV-1-infected mothers. METHODS: The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected children was 15.8 months (variation: 6.8 to 18.0 months) and 14.3 months (variation: 6.3 to 18.6 months), respectively. A mixed-effects linear regression model was used and was fitted using a restricted maximum likelihood. RESULTS: There was an observed decrease over time in the WAZ, LAZ and WLZ among the infected infants. At six months of age, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.02, 0.59, and 0.63 standard deviations, respectively. At 12 months, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.15, 1.01, and 0.87 standard deviations, respectively. CONCLUSIONS: The precocious and increasing deterioration of the HIV-infected infants' anthropometric indicators demonstrates the importance of the early identification of HIV-infected infants who are at nutritional risk and the importance of the continuous assessment of nutritional interventions for these infants.OBJETIVO: Avaliar os parâmetros de crescimento em lactentes nascidos de mães infectadas com o HIV-1. MÉTODOS: Avaliação longitudinal dos z-escores peso-idade (PI), estatura-idade (EI), peso-estatura (PE) foi realizada em uma coorte. Foram estudados 97 lactentes não-infectados e 33 lactentes infectados nascidos de mães infectadas com o HIV-1 em Belo Horizonte, MG, de 1995 a 2003. O tempo mediano de seguimento para os lactentes infectados e não-infectados foi de 15,8 meses (variação: 6,8 a 18,0 meses) e 14,3 meses (variação: 6,3 a 18,6 meses), respectivamente. Utilizou-se o modelo de regressão linear de efeitos mistos ajustado por máxima verossimilhança restrita para construir as curvas de crescimento. RESULTADOS: Os z-escores PI, EI e PE dos lactentes infectados com o HIV-1 apresentaram decréscimo. Aos seis meses, a diferença média nos z-escores PI, EI e PE entre lactentes infectados e não-infectados com o HIV era, respectivamente, 1,02, 0,59 e 0,63 desvios-padrão. Aos 12 meses, a diferença média nos z-escores PI, EI e PE entre lactentes infectados e não-infectados era, respectivamente, 1,15, 1,01 e 0,87 desvios-padrão. CONCLUSÕES: O comprometimento precoce e crescente dos indicadores antropométricos de crianças infectadas com o HIV-1 mostra a importância de identificar precocemente crianças infectadas com o HIV que estão em risco nutricional e a necessidade de se avaliarem continuamente as intervenções nutricionais adotadas

Pattern of alcoholic beverage consumption and academic performance among college students

BACKGROUND: Alcoholic beverages are widely available in the university environment, particularly at the parties. There are few studies addressing the relationship between alcohol consumption and academic performance among college students. OBJECTIVE: This study evaluated the behavior of college students regarding the profile of alcohol consumption and its academic consequences. METHODS: The volunteers (343 students) answered a questionnaire about their pattern of alcohol consumption and possible related behaviors, especially academic performance. Participants were classified as "non-drinkers" (ND), "non-binge drinkers" (nBD), "binge drinkers" (BD) and "heavy drinkers" (HD). RESULTS: 88.1% of the students reported ingesting alcoholic beverages, 44% as BD. Most of the drinker students (75.5% - nBD, BD or HD) stated getting intoxicated at least once a month. Binge drinking was the predominant pattern (66.2% of those who drank). HD students presented a risk 9.2 times higher of not being in the ideal period of the course. DISCUSSION: The college students evaluated presented high rates of alcohol abuse. Binge drinking might have interfered in their academic performance. Organic, social and behavioral consequences were also reported.CONTEXTO: Bebidas alcoólicas estão amplamente disponíveis no ambiente universitário, principalmente nas festas. Há poucos estudos abordando a relação entre o consumo de bebidas alcoólicas e o desempenho acadêmico entre estudantes universitários. OBJETIVO: Este trabalho avaliou o comportamento de estudantes universitários quanto ao padrão de consumo de bebidas alcoólicas e sua consequência acadêmica. MÉTODOS: Os voluntários (343 estudantes) responderam a um questionário sobre o padrão de consumo de álcool e possível comportamento relacionado a esse consumo, especialmente sobre o desempenho acadêmico. Os participantes foram classificados como não bebedores (ND), bebedores não em binge (nBD), bebedores em binge (BD) e bebedores pesados (HD). RESULTADOS: 88,1% dos estudantes relataram ingerir bebidas alcoólicas, sendo 44% bebedores em binge. A maioria dos bebedores (75,5% - nBD, BD ou HD) ficou embriagada pelo menos uma vez por mês. O padrão predominante de consumo foi em binge (66,2% dos que relataram beber). Estudantes HD apresentaram risco 9,2 vezes maior de não estarem no período ideal do curso. CONCLUSÃO: Os universitários avaliados apresentaram maiores taxas de abuso de álcool. O beber em binge pode ter interferido no seu desempenho acadêmico. Consequências orgânicas, sociais e comportamentais foram também relatadas

Huancavelica : ¿cómo vamos en educación?

Reúne información estadística relevante de la situación actual de la educación de la región Huancavelica, ha sido hecho para servir como una guía informativa amigable de todos aquellos actores de la región que puedan influir positivamente en su realidad educativa. Entre 2004 y 2013, la tasa media de crecimiento anual del gasto público educativo por alumno fue de 22% en inicial, 16.9% en primaria y 12.0% en secundaria. En los últimos tres años, el gasto por alumno en inicial y primaria ha crecido hasta llegar a ser mayor al gasto por alumno nacional a partir de 2008. El porcentaje de escuelas con acceso a Internet de Huancavelica en primaria pasó de 0.5% en 2005 a 15.1% en 2014. En secundaria el crecimiento fue mayor, pasando de 4.4% en 2005 a 29.7% en 2014. Sin embargo, estos valores siguen siendo menores a los valores nacionales, de 27.9% en primaria y 52% en secundaria. El indicador en primaria muestra que en la mayoría de distritos el valor es menor a 20%. En secundaria hay mayor heterogeneidad aunque pocos los distritos con porcentajes altos de instituciones con acceso a internet. Entre 2004 y 2013, las tasas de asistencia para los tres niveles de educación básica regular han crecido en Huancavelica, sobre todo en inicial y secundaria. El acceso a educación inicial aumentó de manera más amplia, pasando de 42.4% en 2004 a 78.5% en 2013. En el nivel secundaria, la tasa de asistencia pasó de 64.1% en 2004 a 80.3% en 2013. En primaria, la tasa de asistencia pasó de 86.5% a 94.9%. En 2014, el número promedio de alumnos por docente en Huancavelica fue de trece en inicial y de doce en primaria y secundaria, los que son mayores a los valores nacionales en inicial y primaria (16 y 14 respectivamente). En el nivel inicial, las provincias tienen valores entre nueve y catorce estudiantes por docente, mientras que en primaria y secundaria, las provincias tienen entre ocho y catorce y entre siete y catorce estudiantes por docente, respectivamente. Huancavelica presenta mayores tasas de atraso con respecto a todo el país, tanto en primaria como en secundaria. Asimismo, esta región presenta una mayor tasa de desaprobados en primaria y una mayor tasa de retirados en secundaria respecto al resto del país. El porcentaje de desaprobados en primaria en las provincias de Huancavelica fluctúa desde 2.6% en Castrovirreyna hasta 6.2% en Angaraes. En secundaria, el porcentaje de desaprobados oscila entre 4.1% en Huaytara y 11.1% en Angaraes. En ambos niveles educativos, la mayoría de distritos tiene menos del 10% de estudiantes con atraso escolar, aunque en secundaria existe un gran número de distritos con más del 20% de estudiantes con atraso escolar. En cuanto al porcentaje de retirados en 2013, la mayoría de distritos en primaria y secundaria se ubican debajo de 8%. Sin embargo, mientras que en primaria solo un distrito tiene más del 8% de retiro, en secundaria hay diez distritos que cumplen esta condición

AN EXPLORATION OF HEALTH AND SAFETY MANAGEMENT ISSUES IN NIGERIA’S EFFORT TO INDUSTRIALIZE

All organizations have a duty of care to ensure that employees and other persons who may be affected by the company’s undertakings remain safe at all times. This paper examines the background of occupational health and safety (OHS) practices in Nigeria, and highlights the importance of mitigating the OHS challenges identified from the moral, legal, financial and other dimensions. In the Nigerian context, the need to reinforce health and safety management (HSM) issues is exemplified from the unsavory recurrent reports of plane crashes in the aviation industry, high rates of motor vehicle accidents, numerous cases of death due to poisoning in the solid mineral sector, frequent accounts of disasters in the petroleum sector arising from oil spills, pipeline vandalism as well as accidents involving petroleum tankers. More effective and efficient management of these issues is a sine qua non to the industrialization efforts of an economy. Against the background of extant HS legislation in Nigeria, some reasons for the frequent violations of OHS standards and norms by the operators were identified as bribery and corruption in the system, the ‘Nigerian Factor’, inadequate funding of monitoring institutions, low level of education of employees as well as problems of persistent unemployment in the country. While recommending ways to mitigate the OHS flaws in Nigerian institutions, the relative duties and responsibilities of stakeholders in the OHS business were identified. The paper concludes by noting the importance of a virile HSM environment to the overall economic development and industrialization of the nation

Níveis de contaminantes inorgânicos em cachaças da região do Quadrilátero Ferrífero armazenadas em copos in natura de esteatito (pedra-sabão)

The levels of inorganic contaminants (As, Cd, Cu, Ni and Pb) were measured in 18 Brazilian spirit beverages, before and after 4 contact cycles of 24h each with in natura soapstone (steatite) cups. Results were compared to Brazilian regulation levels. Spirits contained As, Cd, Ni and Pb within permitted levels. For Cu, 5.6% of the brands were above the limit. The contact with soapstone cups decreased Cu levels in the spirits, while the other elements remained unchanged. The use of in natura soapstone cups was considered safe because this kind of vessel did not transfer inorganic contaminants to the spirits

Incidence of binge drinking in a cohort of university students of the south-east region of brazil, 2010-2011.

Objectives: The aim of the present study was to evaluate the prevalence and incidence of binge and at-risk alcohol consumption among new-entrant students in a public university in the South-East Region of Brazil. Methods: Longitudinal study undertaken with a random sample of undergraduates (N=1,168) in the first semesters of 2010 (n=256) and 2011 (n=183). In order to evaluate drinking patterns, participants were classified as abstainers, light, moderate, binge or heavy binge drinkers. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire score was used to define the risk categories for consumption: low risk, risk, harmful use and probable dependence. Statistical analysis was undertaken using Stata software, version 11.0. Results: Amongst the 256 students evaluated, 51.6% were women and 64.5% were aged ?19 years. The prevalence of consumption of alcoholic beverages was 75.8%. The average age of onset of alcohol consumption was 15.7?1.9 years. The incidence of binge + heavy drinkers was 2.6/100 persons per year, with vulnerability shown in individuals of male sex and of age 19 years or more. The incidence of risk level drinkers was 2.0/100 persons per year and greater for individuals of male sex and younger than 19 years. Conclusion: The students of this institution are at high risk for problems associated with alcohol use