Depression, anxiety, and lifestyle among essential workers : a web survey from Brazil and Spain during the covid-19 pandemic

Background: Essential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders. Objective: We aimed to assess the prevalence and predictors of depression, anxiety, and their comorbidity among essential workers in Brazil and Spain during the COVID-19 pandemic. Methods: A web survey was conducted between April and May 2020 in both countries. The main outcome was a positive screening for depression only, anxiety only, or both. Lifestyle was measured using a lifestyle multidimensional scale adapted for the COVID-19 pandemic (Short Multidimensional Inventory Lifestyle Evaluation–Confinement). A multinomial logistic regression model was performed to evaluate the factors associated with depression, anxiety, and the presence of both conditions. Results: From the 22,786 individuals included in the web survey, 3745 self-reported to be essential workers. Overall, 8.3% (n=311), 11.6% (n=434), and 27.4% (n=1027) presented positive screenings for depression, anxiety, and both, respectively. After adjusting for confounding factors, the multinomial model showed that an unhealthy lifestyle increased the likelihood of depression (adjusted odds ratio [AOR] 4.00, 95% CI 2.72-5.87), anxiety (AOR 2.39, 95% CI 1.80-3.20), and both anxiety and depression (AOR 8.30, 95% CI 5.90-11.7). Living in Brazil was associated with increased odds of depression (AOR 2.89, 95% CI 2.07-4.06), anxiety (AOR 2.81, 95%CI 2.11-3.74), and both conditions (AOR 5.99, 95% CI 4.53-7.91). Conclusions: Interventions addressing lifestyle may be useful in dealing with symptoms of common mental disorders during the strain imposed among essential workers by the COVID-19 pandemic. Essential workers who live in middle-income countries with higher rates of inequality may face additional challenges. Ensuring equitable treatment and support may be an important challenge ahead, considering the possible syndemic effect of the social determinants of health

HIV, HCV, HBV, and syphilis among transgender women from Brazil: Assessing different methods to adjust infection rates of a hard-to-reach, sparse population.

Different sampling strategies, analytic alternatives, and estimators have been proposed to better assess the characteristics of different hard-to-reach populations and their respective infection rates (as well as their sociodemographic characteristics, associated harms, and needs) in the context of studies based on respondent-driven sampling (RDS). Despite several methodological advances and hundreds of empirical studies implemented worldwide, some inchoate findings and methodological challenges remain. The in-depth assessment of the local structure of networks and the performance of the available estimators are particularly relevant when the target populations are sparse and highly stigmatized. In such populations, bottlenecks as well as other sources of biases (for instance, due to homophily and/or too sparse or fragmented groups of individuals) may be frequent, affecting the estimates.In the present study, data were derived from a cross-sectional, multicity RDS study, carried out in 12 Brazilian cities with transgender women (TGW). Overall, infection rates for HIV and syphilis were very high, with some variation between different cities. Notwithstanding, findings are of great concern, considering the fact that female TGW are not only very hard-to-reach but also face deeply-entrenched prejudice and have been out of the reach of most therapeutic and preventive programs and projects.We cross-compared findings adjusted using 2 estimators (the classic estimator usually known as estimator II, originally proposed by Volz and Heckathorn) and a brand new strategy to adjust data generated by RDS, partially based on Bayesian statistics, called for the sake of this paper, the RDS-B estimator. Adjusted prevalence was cross-compared with estimates generated by non-weighted analyses, using what has been called by us a naïve estimator or rough estimates

Conditions oral in Minas Gerais: a study of the Global Burden of Disease and the role of health services

Made available in DSpace on 2016-05-19T13:09:40Z (GMT). No. of bitstreams: 2 870.pdf: 2186450 bytes, checksum: 3e6c2390bd55675cb98a2b3e55fd6403 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2012Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Introdução: Os agravos orais são um problema de saúde pública devido à suaprevalência na população e as complicações físicas e psicológicas advindas de suas ocorrências. Objetivou-se estimar a carga de doença para as condições orais em Minas Gerais, no período 2004 - 2006, e identificar fatores contextuais e de serviços de saúdeassociados. Métodos: Estudo da Carga de Doença para cárie, edentulismo e doençaperiodontal, por sexo e faixa etária. O indicador usado foi o DALY, que medesimultaneamente o impacto da mortalidade e dos problemas de saúde que afetam a qualidade de vida. A Carga de Doença para condições orais foi analisada em números absolutos e taxas / 1.000 habitantes. Os procedimentos ambulatoriais odontológicos foram organizados em série histórica e examinados por meio de análise descritiva. A associação de fatores contextuais com agravos orais foi analisada com modelagem hierárquica. Resultados: Estimou-se 45.514 YLD para agravos orais, com taxa de 2,4/1.000 habitantes. Estimou-se 18.142 YLD para homens e 27.372 YLD para mulheres (1,9/1.000 e 2,8/1.000, respectivamente). O número de YLD para cárie foi de 8.332, com taxas de 0,4/1.000 para ambos os sexos. Estimou-se 33.888 YLD para edentulismo, com taxa de 2,2/1.000 nas mulheres. Na doença periodontal estimou-se 3.217 YLD, resultando em uma taxa de 0,2/1.000 para ambos os sexos. Observou-se aumento da oferta de alguns procedimentos odontológicos ambulatoriais nas Macrorregionais de Saúde menos favorecidas economicamente. As característicassocioeconômicas associaram-se à incidência de cárie dentária e à prevalência de edentulismo. Conclusões: O edentulismo contribuiu mais para a carga de doença orais,sendo mais frequente nas mulheres. Maiores taxas de edentulismo e doença periodontal foram de 45-69 anos, enquanto cárie de 1-14 anos. Minas Gerais encontra-se no processo de reestruturação do modelo de atenção à saúde, com ênfase aos problemasorais básicos mas, paralelamente, incluindo mais ações especializadas em odontologia. Identificaram-se associações entre características socioeconômicas e de serviços de saúde oral com a incidência de cárie dentária e prevalência de edentulismo. Os estudos de Carga Global de Doença representam um importante aspecto do diagnóstico desaúde, integrando desfechos fatais e não fatais. Além disso, disponibiliza informações de grande relevância na formulação de políticas de prevenção e tratamento.Introduction: Oral diseases are an important public health problem due to their significant prevalence and the physical and psychological impact of their manifestations. The aim of this study was to estimate the global burden of oral diseases in the state of Minas Gerais, Brazil, from 2004 to 2006, and to identify contextual factors and factors related to health services. Methods: Global Burden of Disease study for dental caries, edentulism and periodontal disease according to sex and age. The indicator used was DALY, which simultaneously measures the impact of mortality and the impact of health problems that affect the quality of life. The Global Burden of Oral Diseases was analysed in absolute terms and in rates per 1000 inhabitants. Procedures were organised in a historical series and examined using a descriptive analysis. A hierarchical model was used to study the association between contextual factors and oral diseases. Results: An estimated 45,514 YLD were lost due to oral diseases, with a rate of 2.4/1000 inhabitants: 18,142 YLD among men and 27,372 among women (1.9/1000 and 2.8/1000, respectively). The number of YLD lost due to dental caries was 8332, with a rate of 0.4/1000 for both sexes and a higher frequency among persons aged ≤14 years. An estimated 33,888 YLD were lost due to edentulism, with a rate of 1.8/1000 (2.2/1000 among women). An estimated 3217 YLD were lost due to periodontal disease, with a rate of 0.2/1000 for both sexes. An increased supply of certain outpatient dental procedures was found in the most economically disadvantaged regions. Socioeconomic characteristics were associated with the incidence of dental caries treatment and with the prevalence of edentulism. Conclusions: Edentulism was the condition that contributed the most to the Global Burden of Oral Diseases, being more frequent in women. Higher rates of edentulism and periodontal disease were found in persons aged 45-69 years, while dental caries were more frequent from 1-14 years. The state of Minas Gerais is restructuring its healthcare model, including more health actions focused on dentistry. The study found that socio-economic status and characteristics of oral health services were associated with the incidence of dental caries and the prevalence of edentulism. Global Burden of Disease studies represent an important aspect of health diagnosis, integrating both fatal and non-fatal outcomes. Furthermore, these studies provide highly relevant information for preventive and therapeutic policy making

Violence against the woman practised for the close partner: study of a service of specialized attention

Made available in DSpace on 2012-09-06T01:11:37Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 726.pdf: 780717 bytes, checksum: 1ecd162b352f5d457eb1dc1555e3fcce (MD5) Previous issue date: 2004Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.A violência familiar contra a mulher praticada pelo parceiro íntimo é um problema que ocorre em todas as classes sociais, independente de cultura, raça ou status econômico. É um fenômeno que apresenta várias faces, com complexas causas culturais, familiares e individuais. As mulheres sob situação de violência familiar do parceiro apresentam complicações na saúde física, emocional e sexual e, freqüentemente, fazem uso dos serviços hospitalares como conseqüência, direta ou indiretamente, das agressões sofridas. O presente trabalho tem como objetivo a análise das agressões contra a mulher praticadas pelo parceiro e sua relação com condições sociodemográficas registradas nas fichas de atendimento do Centro Integrado de Atendimento à Mulher (CIAM), no período de janeiro de 1999 a dezembro de 2000. Trata-se de um estudo descritivo, com 684 mulheres que buscaram atendimento no CIAM por terem sofrido violência do cônjuge atual ou passado, considerando-se o estado civil de fato. No artigo I, procurou-se investigar o padrão de associações entre os crimes registrados no CIAM e estabelecer, a partir dessas relações, critérios para a classificação das agressões. Para compor a classificação, os crimes foram submetidos à técnica de análise de correspondência múltipla, seguida das técnicas de classificação mista (hierárquica e não hierárquica). É uma técnica multivariada adequada para avaliar a associação entre variáveis categóricas. Os resultados da análise de correspondência mostram que os três primeiros fatores explicam 65% da variabilidade total. As categorias que mais contribuem para o 1º fator são a ameaça de morte e a ameaça As maiores contribuições para o 2º fator são: lesão corporal grave e lesão corporal leve. A maior contribuição ao 3º fator é dada pelo abuso sexual e lesão corporal leve. Identificou-se, a partir da técnica de classificação mista, três grupos de mulheres que se distinguem pela natureza do crime (físico, psicológico e sexual) e pelos níveis de gravidade. O grupo menos grave é formado, majoritariamente, pelos crimes de lesão corporal leve e ameaça. O de gravidade intermediária reúne, majoritariamente, crimes de lesão corporal grave e ameaça. No terceiro grupo, de maior gravidade em relação aos demais, estão, com maior freqüência, os crimes de ameaça de morte, estupro e abuso sexual. No artigo 2, buscou-se investigar as relações conjuntas entre grupos de violência e condições sociodemográficas da vítima e do agressor, visando estabelecer um perfil da população de mulheres atendidas no CIAM. Utilizou-se a técnica da análise de correspondência múltipla na caracterização desse perfil. É uma técnica estatística multivariada adequada para avaliar a associação entre variáveis categóricas. Os resultados mostram que os três primeiros eixos explicam 33% da variabilidade total. O primeiro eixo é formado por agressores aposentados, tempo de união maior que 10 anos e idade do homem. O segundo eixo é composto por vítima chefe de família ou não e lesões graves de origem sexual. O terceiro eixo é formado por agressores desempregados, mulheres com ensino médio completo e tempo de união inferior a 5 anos. Foi identificado um perfil diferenciado de mulheres vitimadas pelo parceiro no que se refere à gravidade da violência. As vítimas de lesão grave de origem sexual associaram-se ao ensino médio incompleto e com mais de três residentes trabalhadores. As vítimas de lesão grave de origem física e psicológica estão relacionadas ao ensino superior e pós-graduação e declaradas como chefes de família. O grupo das vítimas de lesões leves de origem física e psicológica se relaciona com tempo de união inferior a 5 anos, ensino médio completo da mulher, agressor mais novo, trabalhador e com até 3 residentes trabalhadores. Os resultados da presente pesquisa geram subsídios para a ampliação do conhecimento sobre violência praticada pelo parceiro e contribuem na elaboração de intervenções específicas relevantes para a população analisada.The family violence against woman practiced by the intimate partner is a problem that occur in all the social classes, independent of culture, race or economic status. It is a phenomenon that presents several faces, with complex cultural, family and individual causes. The women under situation of the partner's family violence present complications in the physical, emotional and sexual health and, frequently, they make use of the clinics services consequence, direct or indirectly, of the suffered aggressions. The present work has as objective the analysis of the aggressions against woman practiced by the partner and its relationship with conditions sociodemografic registered in the attendance records of the Integrated Center of Attendance to the Woman (CIAM), in the period of January of 1999 to December of 2000. It is a descriptive study, with 684 women that searched for attendance in CIAM for they have suffered the current or last spouse's violence, considering the civil state in fact. In the article I, it tried to investigate the pattern of associations among the crimes registered in CIAM and to establish, from those relationships, approaches for the classification of the aggressions. To compose the classification, the crimes were submitted to the technique of multiple correspondence analysis, followed by the techniques of mixed classification (hierarchical and not hierarchical). It is a technique statistical multivariate adapted to evaluate the association among categorical variables. The results of the correspondence analysis show that the first three factors explain 65% of the total variability. The categories that more contribute to the 1st factor are the death of the menace and the menace. The largest contributions for the 2nd factor are: serious corporal injury and light corporal injury. The largest contribution to the 3rd factor is given by the sexual abuse and light corporal injury. It was identified, from the technique of mixed classification, three groups of women that are distinguished for the nature of the crime (physical, psychological and sexual) and for the gravity levels. The less serious group is formed, for the most part, for the crimes of light corporal injury and menace. The one of intermediary gravity gathers, for the most part, crimes of serious corporal injury and menace. In the third group, of larger gravity in relation to the others, are, with larger frequency, the crimes of death menace, rape and sexual abuse. In the article 2, it inquire for to investigate the relationships joint between violence groups and the victim's conditions sóciodemográficas and of the aggressor, seeking to establish a profile of the women's population assisted in CIAM. The technique of the analysis of multiple correspondence was used in the characterization of that profile. The results show that the first three axes explain 33% of the total variability. The first axis is formed by pensioner aggressors, time of larger union than 10 years and the man's age. The second axis is composed by victim family boss or not and serious injury of sexual origin. The third axis is formed by aggressors unemployed, women with complete medium teaching and time of inferior union to 5 years. It was identified a differentiated profile of women victims by the partner in refers the gravity of the violence. The victims of serious injury of sexual origin associated to the incomplete medium teaching and with more than three hard-working residents. The victims of serious injury of origin physical and psychological are related to the higher education and postgraduation and declared as family bosses. The group of the victims' of light injury of origin physical and psychological links with time of inferior union to 5 years, the woman's complete medium teaching, newer aggressor, worker and with up to 3 hard-working residents. The results of the present research generate subsidies for the amplification of the knowledge on violence practiced by the partner and contribute in the elaboration of important specific interventions to the analyzed population

Correspondence analysis: a method for classifying similar patterns of violence against women

Violence against woman has received relatively little debate in society. It includes physical, psychological, and sexual abuse that jeopardizes the victim's health. Multivariate correspondence analysis and cluster analysis were applied to crimes reported to the Integrated Women's Aid Center in Rio de Janeiro, Brazil, to investigate associations between injury and define criteria for classifying the aggressions. Three groups of abuse were identified, differing according to the nature (physical, psychological, or sexual) and severity of the crimes. Less serious crimes consisted of threats and moderate physical injuries. The intermediate severity group included serious physical assault and threats. More serious crimes included death threats, rape, and sexual assault. The method thus allowed classification of the crimes in three groups according to severity

Health inequalities in Rio de Janeiro, Brazil: lower healthy life expectancy in socioeconomically disadvantaged areas

Submitted by Anderson Silva ([email protected]) on 2012-08-02T17:37:41Z No. of bitstreams: 1 Health_Inequalities_Rio.pdf: 537775 bytes, checksum: 45c49d9e6f46882f5d589f71342a0788 (MD5)Made available in DSpace on 2012-08-02T17:37:41Z (GMT). No. of bitstreams: 1 Health_Inequalities_Rio.pdf: 537775 bytes, checksum: 45c49d9e6f46882f5d589f71342a0788 (MD5) Previous issue date: 2011-03-13Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Rio de Janeiro. Laboratório de Análise da Violência. Rio de Janeiro, RJ, Brasil.Methods. We conducted a health survey of 576 adults in 2006. Census tracts were stratified by income level and categorization as a slum. We determined health status by degree of functional limitation, according to the approach proposed by the World Health Organization. We calculated healthy life expectancies by Sullivan's method with abridged life table. Results. We found the worst indicators in the slum stratum. The life expectancy at birth of men living in the richest parts of the city was 12.8 years longer than that of men living in deprived areas. For both men and women older than age 65 years, healthy life expectancy was more than twice as high in the richest sector as in the slum sector. Conclusions. Our analysis detailed the excess burden of poor health experienced by disadvantaged populations of Rio de Janeiro. Policy efforts are needed to reduce social inequalities in health in this city, especially among the elderly