Alcohol abuse and dependence in adults in the State of São Paulo, Brazil

OBJETIVO: Descrever as prevalências de consumo abusivo e dependência de álcool em população adulta de 20 a 59 anos no Estado de São Paulo, e suas associações com variáveis demográficas e socioeconômicas. MÉTODOS: Inquérito domiciliar do tipo transversal (ISA-SP), em quatro áreas do Estado de São Paulo: a) Região Sudoeste da Grande São Paulo, constituída pelos Municípios de Taboão da Serra, Itapecerica da Serra e Embu; b) Distrito do Butantã, no Município de São Paulo; c) Município de Campinas e; d) Município de Botucatu. Foi considerado consumo abusivo de álcool a ingestão em dia típico de 30 gramas ou mais de etanol para os homens, e 24 gramas ou mais para as mulheres. A dependência de álcool foi caracterizada pelo questionário CAGE. Análises bivariadas e multivariadas dos dados foram realizadas a partir de Modelos de Regressão de Poisson. Todas as análises foram estratificadas por sexo. RESULTADOS: Em 1.646 adultos entrevistados, a prevalência de consumo abusivo de álcool foi de 52,9% no sexo masculino e 26,8% no sexo feminino. Quanto à dependência de álcool, foram observadas duas ou mais respostas positivas no teste CAGE em 14,8% dos homens e em 5,4% das mulheres que relataram consumir álcool. Isto corresponde a uma prevalência populacional de dependência de 10,4% nos homens e 2,6% nas mulheres. O consumo abusivo de álcool no sexo masculino apresentou associação inversa à faixa etária e associação direta à escolaridade e ao tabagismo. No sexo feminino, observou-se associação direta do consumo abusivo de álcool com a escolaridade e o tabagismo, e com as situações conjugais sem companheiro. A dependência de álcool no sexo masculino associou-se a não exercer atividade de trabalho e à baixa escolaridade. No sexo feminino não houve associação do CAGE com nenhuma das variáveis estudadas. CONCLUSÕES: Pela alta prevalência de consumidores e dependentes, é essencial a identificação dos segmentos sociodemográficos mais vulneráveis ao consumo abusivo e dependência de álcool. As associações entre a dependência/abuso e não estar exercendo atividade de trabalho, no sexo masculino, e a maior prevalência em mulheres de escolaridade universitária, sugerem componentes para programas de intervenção e controle.OBJETIVE: To investigate alcohol abuse and dependence in adults aged 20-59 years, in the State of São Paulo, Brazil, according to demographic and socio-economic characteristics. METHODS: Cross-sectional household survey carried out in four areas of the State of São Paulo, Brazil. The CAGE questionnaire was used to investigate alcohol dependence. Alcohol abuse was defined as daily consumption of at least 30 grams of alcohol for men and 24 grams for women. Bivariate and multivariate Poisson regression analyses were performed to detect associations and high-risk groups. All analyses were stratified by gender. RESULTS: 1,646 adults were interviewed. The prevalence of alcohol abuse was 52.9% among men and 26.8% in women. With a CAGE cutoff point > 2, alcohol dependence was found in 14.8% of male drinkers and 5.4% of female drinkers. These proportions correspond to a population prevalence of alcohol addiction of 10.4% in men and 2.6% in women. With regard to alcohol abuse, in men, it was negatively associated with age and directly associated with schooling and smoking. In women, alcohol abuse was also associated with schooling and smoking, and with living without a partner. In men, a significant association was found between alcohol dependence and lower schooling levels. Unemployment was also significantly associated with alcohol dependence in men. No overall association was found in alcohol dependence in women. CONCLUSIONS: Our data revealed high prevalences of alcohol abuse and dependence. The association of alcohol abuse with higher schooling and the finding of alcohol dependence among unemployed men suggest elements for intervention and control policies.Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP 98/14099-7 e Secretaria da Saúde do Estado de São Paul

Diabetes autorreferido em idosos: comparação das prevalências e medidas de controle

OBJECTIVE The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. METHODS Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5%) and the Pearson’s Chi-square (Rao-Scott) tests were performed. The variables without overlap between the confidence intervals were not tested. RESULTS The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between >; 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6) in 2003 and 20.1% (95%CI 17.3;23.1) in 2008, which indicates a growth over this period (p at the limit of significance). The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. CONCLUSIONS Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients.OBJETIVO O objetivo deste trabalho foi analisar a prevalência de diabetes em idosos e as medidas de controle adotadas. MÉTODOS Foram analisados dados de idosos diabéticos participantes dos Inquéritos de Saúde no Município de São Paulo, SP, ISA-Capital, 2003 e 2008, estudos de base transversal. Compararam-se as prevalências e seus intervalos de confiança entre os dois anos de estudo, segundo variáveis sociodemográficas. Realizou-se a junção dos bancos de dados quando ocorreu sobreposição dos intervalos de confiança. Realizou-se teste Qui-quadrado com nível de significância de 5% e o Qui-quadrado de Pearson (Rao-Scott). Variáveis sem sobreposições entre os intervalos de confiança não foram testadas. RESULTADOS Os idosos tinham predominantemente de 60 a 69 anos, eram do sexo feminino, de cor branca, com renda >; 0,5 até 2,5 salários mínimos e baixa escolaridade. A prevalência de diabetes foi de 17,6% (IC95% 14,9;20,6) em 2003 e 20,1% (IC95% 17,3;23,1) em 2008, sugerindo crescimento no período (p no limite da significância). O uso de hipoglicemiantes apresentou maiores prevalências, seguido por dieta alimentar, entre os meios adotados para controlar o diabetes. Houve baixa frequência das práticas de atividade física, apesar da diferença significativa encontrada no período. Ocorreram diferenças significativas relacionadas ao acesso e ao uso de serviço público de saúde para controle do diabetes, maior em idosos com menor renda e menor escolaridade nos dois anos analisados. CONCLUSÕES O diabetes é uma doença complexa e desafiadora para o portador e para os sistemas de saúde. São necessárias iniciativas que encorajem práticas de promoção de saúde, uma vez que estas apresentaram percentuais inferiores ao uso de hipoglicemiantes. Deve-se investir em políticas públicas de saúde, principalmente direcionadas aos idosos de baixa renda e escolaridade. Tais mudanças são essenciais para a melhoria das condições de saúde dos idosos portadores de diabetes

Self-reported Diabetes In Older People: Comparison Of Prevalences And Control Measures.

The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5%) and the Pearson's Chi-square (Rao-Scott) tests were performed. The variables without overlap between the confidence intervals were not tested. The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between > 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6) in 2003 and 20.1% (95%CI 17.3;23.1) in 2008, which indicates a growth over this period (p at the limit of significance). The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients.48554-66

Alcohol abuse and dependence in adults in the state of São Paulo, Brazil

Descrever as prevalências de consumo abusivo e dependência de álcool em população adulta de 20 a 59 anos no Estado de São Paulo, e suas associações com variáveis demográficas e socioeconômicas. Inquérito domiciliar do tipo transversal (ISA-SP), em quatro áreas do Estado de São Paulo: a) Região Sudoeste da Grande São Paulo, constituída pelos Municípios de Taboão da Serra, Itapecerica da Serra e Embu; b) Distrito do Butantã, no Município de São Paulo; c) Município de Campinas e; d) Município de Botucatu. Foi considerado consumo abusivo de álcool a ingestão em dia típico de 30 gramas ou mais de etanol para os homens, e 24 gramas ou mais para as mulheres. A dependência de álcool foi caracterizada pelo questionário CAGE. Análises bivariadas e multivariadas dos dados foram realizadas a partir de Modelos de Regressão de Poisson. Todas as análises foram estratificadas por sexo. Em 1.646 adultos entrevistados, a prevalência de consumo abusivo de álcool foi de 52,9% no sexo masculino e 26,8% no sexo feminino. Quanto à dependência de álcool, foram observadas duas ou mais respostas positivas no teste CAGE em 14,8% dos homens e em 5,4% das mulheres que relataram consumir álcool. Isto corresponde a uma prevalência populacional de dependência de 10,4% nos homens e 2,6% nas mulheres. O consumo abusivo de álcool no sexo masculino apresentou associação inversa à faixa etária e associação direta à escolaridade e ao tabagismo. No sexo feminino, observou-se associação direta do consumo abusivo de álcool com a escolaridade e o tabagismo, e com as situações conjugais sem companheiro. A dependência de álcool no sexo masculino associou-se a não exercer atividade de trabalho e à baixa escolaridade. No sexo feminino não houve associação do CAGE com nenhuma das variáveis estudadas. Pela alta prevalência de consumidores e dependentes, é essencial a identificação dos segmentos sociodemográficos mais vulneráveis ao consumo abusivo e dependência de álcool. As associações entre a dependência/abuso e não estar exercendo atividade de trabalho, no sexo masculino, e a maior prevalência em mulheres de escolaridade universitária, sugerem componentes para programas de intervenção e controle1323314325FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP98/14099-7To investigate alcohol abuse and dependence in adults aged 20-59 years, in the State of São Paulo, Brazil, according to demographic and socio-economic characteristics. Cross-sectional household survey carried out in four areas of the State of São Paulo, Brazil. The CAGE questionnaire was used to investigate alcohol dependence. Alcohol abuse was defined as daily consumption of at least 30 grams of alcohol for men and 24 grams for women. Bivariate and multivariate Poisson regression analyses were performed to detect associations and high-risk groups. All analyses were stratified by gender. 1,646 adults were interviewed. The prevalence of alcohol abuse was 52.9% among men and 26.8% in women. With a CAGE cutoff point > 2, alcohol dependence was found in 14.8% of male drinkers and 5.4% of female drinkers. These proportions correspond to a population prevalence of alcohol addiction of 10.4% in men and 2.6% in women. With regard to alcohol abuse, in men, it was negatively associated with age and directly associated with schooling and smoking. In women, alcohol abuse was also associated with schooling and smoking, and with living without a partner. In men, a significant association was found between alcohol dependence and lower schooling levels. Unemployment was also significantly associated with alcohol dependence in men. No overall association was found in alcohol dependence in women. Our data revealed high prevalences of alcohol abuse and dependence. The association of alcohol abuse with higher schooling and the finding of alcohol dependence among unemployed men suggest elements for intervention and control policie

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Epidemiology of Leisure, Transportation, Occupational, and Household Physical Activity: Prevalence and Associated Factors

Background: To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. Methods: This was a cross-sectional study aimed at investigating living and health conditions among the population of So Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. Results: The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Conclusion: Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries.6562563

Epidemiology of leisure, transportation, occupational, and household physical activity: prevalence and associated factors

To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. This was a cross-sectional study aimed at investigating living and health conditions among the population of São Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries6562563