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Liu L, Nagar G, Diarra O, Shosanya S, Sharma G, Afesumeh D, Krishna A. Epidemiology for public health practice: The application of spatial epidemiology. World J Diabetes 2022; 13:584-586. [PMID: 36051429 PMCID: PMC9329838 DOI: 10.4239/wjd.v13.i7.584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/05/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
Spatial epidemiology is the description and analysis of geographic patterns and variations in disease risk factors, morbidity and mortality with respect to their distributions associated with demographic, socioeconomic, environmental, health behavior, and genetic risk factors, and time-varying changes. In the Letter to Editor, we had a brief description of the practice for the mortality and the space-time patterns of John Snow's map of cholera epidemic in London, United Kingdom in 1854. This map is one of the earliest public heath practices of developing and applying spatial epidemiology. In the early history, spatial epidemiology was predominantly applied in infectious disease and risk factor studies. However, since the recent decades, noncommunicable diseases have become the leading cause of death in both developing and developed countries, spatial epidemiology has been used in the study of noncommunicable disease. In the Letter, we addressed two examples that applied spatial epidemiology to cluster and identify stroke belt and diabetes belt across the states and counties in the United States. Similar to any other epidemiological study design and analysis approaches, spatial epidemiology has its limitations. We should keep in mind when applying spatial epidemiology in research and in public health practice.
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Affiliation(s)
- Longjian Liu
- Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, United States
| | - Garvita Nagar
- Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, United States
| | - Ousmane Diarra
- Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, United States
| | - Stephanie Shosanya
- Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, United States
| | - Geeta Sharma
- Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, United States
| | - David Afesumeh
- Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, United States
| | - Akshatha Krishna
- Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, United States
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Sokoty L, Rimaz S, Hassanlouei B, Kermani M, Janani L. Short-term effects of air pollutants on hospitalization rate in patients with cardiovascular disease: a case-crossover study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:26124-26131. [PMID: 33484464 DOI: 10.1007/s11356-021-12390-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Considering the increasing rate of hospitalization due to the symptoms intensification, and the increasing trend of air pollution, this study aimed to determine the relationship between the amount of air pollutants and the incidence of cardiovascular disease leading to hospitalization. This case-crossover study was carried out on the data of admitted patients with cardiovascular disease such as hypertension, ischemic heart disease, and cerebrovascular disease in Urmia during 2011-2016. Weather data about air pollutants (NO2, PM10, SO2, and CO) were obtained from the meteorological department of Urmia. The data were coded for each patient and matched with the meteorological data for statistical modeling. The data were analyzed through STATA version 14. Conditional logistic regression was used to estimate the effects of air pollutants on cardiovascular disease adjusted to air temperature, relative humidity, and air pollutants. The final analysis was performed on 43,424 patients with cardiovascular disease using code I10-I99 including ischemic heart disease, hypertension, and cerebrovascular disease adjusted to air temperature and relative humidity. Of all pollutants, CO with each increase 10 μg/m3 had a meaningful relationship with the incidence of cardiovascular hospitalization. By selecting the window of exposure, 1, 2, and 6 days before admission, lag 6 (6 days) was the best estimation for exposure time in the patients with cardiovascular patients (OR 1.0056, CI 1.0041-1.007), and in the patients with ischemic heart disease (OR 1.000055, CI 1.000036-1.000075) and in the patients with hypertension (OR 1.000076, CI 1.00002-1.000132). Regarding cerebrovascular disease, no statistically significant association was observed. The results showed that only CO was associated with an increased risk of admission in patients with cardiovascular disease, ischemic heart disease, and hypertension, and there was no clear evidence for pollution effects on cerebrovascular diseases.
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Affiliation(s)
- Leily Sokoty
- Department of Epidemiology, School of Public Health, Iran of University of Medical Sciences, Tehran, Iran
| | - Shahnaz Rimaz
- Research Center for Environmental Health Technology, Radiation Biology Research Center, Department of Epidemiology, School of Public Health, Iran of University of Medical Sciences, Tehran, Iran
| | - Babak Hassanlouei
- Department of Epidemiology, School of Public Health, Iran of University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Biostatistics, School of Public Health, Preventive Medicine and Public Health Research Center, Iran University of Medical Science, Tehran, Iran.
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Hosseini M, Yousefifard M, Baikpour M, Fayaz M, Koohpayehzadeh J, Rafei A, Etemad K, Gouya MM, Asgari F, Mohammad K. Age, period and cohort analysis of high cholesterol levels in Iranian adults over a 20-year period. J Diabetes Metab Disord 2019; 18:289-299. [PMID: 31890653 PMCID: PMC6915163 DOI: 10.1007/s40200-019-00410-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/08/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Hypercholesterolemia is one of the most important modifiable risk factors of non-communicable diseases and data on their values in different societies and their trend of changes should be updated every couple of years. Many studies have focused on assessing the prevalence of high cholesterol. We must emphasise that most of these studies were cross-sectional and did not directly investigate the temporal trends of change for age, period and birth cohort (APC). The aim of this study is to evaluate the effect of age, period and birth cohort on the prevalence of borderline to high cholesterol levels in Iranian adult population. METHODS The data were collected from 110,302 subjects between 25 and 69 years of age over the period of 1990-2011. Data from these subjects were collected by using five national cross-sectional surveys conducted in 1990-91, 1999, 2003, 2007 and 2011. The APC effect on the prevalence of borderline and high cholesterol levels was assessed using the Intrinsic Estimator model. RESULTS The overall prevalence of borderline cholesterol level among male subjects was found to be lower than that of females (39.8% vs. 46.3%). Similarly, the prevalence of high cholesterol level in men was reported to be 13.1%, which was lower than the 18.0% calculated in women. The prevalence of borderline and high cholesterol levels increased with age in men between the ages of 45-49. Then it stayed quite steady and eventually declined. Then it stayed quite steady and eventually declined. The prevalence in women also increased with age, with its maximum rise after the ages of menopause and a slight decline at the ages of 65-69. As for the birth cohorts, the prevalence of borderline and high cholesterol levels followed a declining trend by going from earlier birth cohorts to the later ones. CONCLUSION The present study provides evidence that age, period and birth cohort affect the prevalence of borderline and high cholesterol levels. Thus, these factors should be considered when developing and implementing care plans for people with hypercholesterolemia.
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Affiliation(s)
- Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran
| | - Mahmoud Yousefifard
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Baikpour
- Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Fayaz
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalil Koohpayehzadeh
- Department of Community Medicine, Preventive medicine & Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Rafei
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Koorosh Etemad
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Mehdi Gouya
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Fereshteh Asgari
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran
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Riyahi A, Rassafiani M, Nobakht Z, Abdolrazaghi H, Moradzadeh R. Validity and reliability of the Persian version of the Eating and Drinking Ability Classification System. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2017.0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/AimsThe ability to eat and drink is the most important factor in health, survival and longevity. Children with cerebral palsy can suffer from severe dysphagia, which can lead to a high risk of aspiration and choking. As classifying eating and drinking ability in children with cerebral palsy is important in research and treatment, the aim of this study was to determine the cross-cultural validation and reliability of the Persian version of the Eating and Drinking Ability Classification System.MethodsAfter translation procedures, the face validity, content validity, test–retest reliability and interrater reliability of the Eating and Drinking Ability Classification System were evaluated. In total, 130 parents of children with cerebral palsy and 34 therapists participated in the evaluation of the scale's reliability. The 73 boys and 57 girls with cerebral palsy were aged 3–20 years (mean age 4.4 years) and had various types of cerebral palsy. They were classified according to the Eating and Drinking Ability Classification System by both their parents and the therapists.ResultsThe overall results indicated that the words and sentences used were simple, clear, understandable, relevant and necessary. The intraclass correlation coefficients for test–retest reliability for parents, occupational therapists and speech therapists were 0.98, 0.98 and 0.995, respectively. The interrater reliability between parents and occupational therapists was 0.96, between parents and speech therapists was 0.95, and between occupational therapists and speech therapists was 0.985.ConclusionsThe Persian version of the Eating and Drinking Ability Classification System seems to be valid and reliable. This system may be used to evaluate children with cerebral palsy.
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Affiliation(s)
- Azade Riyahi
- Instructor, Department of Occupational Therapy, School of Rehabilitation, Arak University of Medical Sciences, Arak, Iran
| | - Mehdi Rassafiani
- Associate Professor, Occupational Therapy Department, Faculty of Allied Health Sciences, Health Science Center, Kuwait University, Kuwait
| | - Zahra Nobakht
- Assistant Professor, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hosseinali Abdolrazaghi
- Assistant Professor, Department of Hand and Reconstructive Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Rahmatollah Moradzadeh
- Assistant Professor, Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
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Firneisz G, Rosta K, Al-Aissa Z, Hadarits O, Harreiter J, Nádasdi Á, Bancher-Todesca D, Németh L, Igaz P, Rigó J, Sziller I, Kautzky-Willer A, Somogyi A. The MTNR1B rs10830963 Variant in Interaction with Pre-Pregnancy BMI is a Pharmacogenetic Marker for the Initiation of Antenatal Insulin Therapy in Gestational Diabetes Mellitus. Int J Mol Sci 2018; 19:E3734. [PMID: 30477160 PMCID: PMC6321391 DOI: 10.3390/ijms19123734] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 11/26/2022] Open
Abstract
The rs10830963 variant of the Melatonin Receptor 1B (MTNR1B) gene is associated with the development of gestational diabetes mellitus (GDM). We hypothesized that carrying the rs10830963/G risk allele had effect on antenatal insulin therapy (AIT) initiation in GDM in a body mass index (BMI)-dependent manner. Design: In this post hoc analysis the MTNR1B rs10830963 genotype and the clinical data of 211 Caucasian GDM patients were assessed. As a first step, a pre-pregnancy BMI threshold was determined where the effect of MTNR1B rs10830963/G allele carrying on AIT initiation was the most significant using logistic regression. Maternal age adjusted real-life odds ratios (OR) values were calculated. The chi-square test was also used to calculate the p value and 10.000 bootstrap simulations were performed in each case to re-assess the statistical power and the OR. Carrying the MTNR1B rs10830963/G allele increased the odds of AIT initiation (OR = 5.2, p = 0.02 [χ² test], statistical power = 0.53) in GDM patients with pre-pregnancy BMI ≥ 29 kg/m². The statistical power reached 0.77, when the pre-pregnancy BMI cutoff of 27 kg/m² was used and the genetic effect on AIT initiation was still significant, but only using the logistic regression model. Carrying the MTNR1B rs10830963/G risk allele-in interaction with pre-pregnancy BMI-is likely be considered as a candidate pharmacogenetic marker of antenatal insulin therapy initiation and should be further assessed in precision medicine trials in GDM.
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Affiliation(s)
- Gábor Firneisz
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
- MTA-SE Molecular Medicine Research Group, Hungarian Academy of Sciences⁻Semmelweis University, H-1088 Budapest, Hungary.
| | - Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, A-1090 Vienna, Austria.
- Department of Obstetrics and Gynecology, Semmelweis University, H-1088 Budapest, Hungary.
| | - Zahra Al-Aissa
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
| | - Orsolya Hadarits
- Department of Obstetrics and Gynecology, Semmelweis University, H-1088 Budapest, Hungary.
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, A-1090 Vienna, Austria.
| | - Ákos Nádasdi
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
| | - Dagmar Bancher-Todesca
- Department of Obstetrics and Gynecology, Medical University of Vienna, A-1090 Vienna, Austria.
| | - László Németh
- Department of Probability Theory and Statistics, Eötvös Loránd University, H-1088 Budapest, Hungary.
| | - Péter Igaz
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
- MTA-SE Molecular Medicine Research Group, Hungarian Academy of Sciences⁻Semmelweis University, H-1088 Budapest, Hungary.
| | - János Rigó
- Department of Obstetrics and Gynecology, Semmelweis University, H-1088 Budapest, Hungary.
| | - István Sziller
- Department of Obstetrics and Gynecology, Szent Imre Teaching Hospital, H-1088 Budapest, Hungary.
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, A-1090 Vienna, Austria.
| | - Anikó Somogyi
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
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Hu JM, Zhuang LH, Bernardo BA, McCandless LC. Statistical Challenges in the Analysis of Biomarkers of Environmental Chemical Exposures for Perinatal Epidemiology. CURR EPIDEMIOL REP 2018. [DOI: 10.1007/s40471-018-0156-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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LIMA RLFCD, MEDEIROS ARC, MEDEIROS LBD, SALERNO AAP, MORAES RMD, VIANNA RPDT. Self-reported and measured weight, height and body mass index for the diagnosis of the nutritional status in people living with HIV/AIDS. REV NUTR 2017. [DOI: 10.1590/1678-98652017000500002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To validate self-reported weight and height data for people living with HIV/AIDS. Methods This cross-sectional study involved 481 people living with HIV/AIDS seen at a reference unit in João Pessoa, state of Paraíba, Brazil, between September and December 2015, 99 (20.5%) of whom had their weight and height measured. The intraclass correlation coefficient was calculated to determine the relationship between the self-reported and measured weight, height and body mass index values, and linear regression analysis was used to generate equations to predict weight and height. It were significant p-value under 5% for statistic tests applied. Results In the sample with measured values, 57.6% of men, with a mean age of 44 years old and a mean income per capita equivalent to US$145.50, high correlations (r>0.90) between the self-reported and measured values for weight, height and body mass index were observed. The accuracy was 92.6%, and the Kappa coefficient was greater than 0.85. Women tended to underestimate weight and overestimate height. The men overestimated weight and underestimated height. The intraclass correlation coefficients were greater than 0.95. Conclusion The use of self-reported measures of weight, height and body mass index for nutritional assessment of people living with HIV/AIDS is valid and must be considered for similar populations when time and resources are limiting factors.
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Amanati A, Karimi A, Fahimzad A, Shamshiri AR, Fallah F, Mahdavi A, Talebian M. Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit. CHILDREN-BASEL 2017; 4:children4070056. [PMID: 28671616 PMCID: PMC5532548 DOI: 10.3390/children4070056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 06/21/2017] [Accepted: 06/27/2017] [Indexed: 12/03/2022]
Abstract
Background: Among hospital-acquired infections (HAIs) in children, ventilator-associated pneumonia (VAP) is the most common after blood stream infection (BSI). VAP can prolong length of ventilation and hospitalization, increase mortality rate, and directly change a patient’s outcome in Pediatric Intensive Care Units (PICU). Objectives: The research on VAP in children is limited, especially in Iran; therefore, the identification of VAP incidence and mortality rate will be important for both clinical and epidemiological implications. Materials and Methods: Mechanically ventilated pediatric patients were assessed for development of VAP during hospital course on the basis of clinical, laboratory and imaging criteria. We matched VAP group with control group for assessment of VAP related mortality in the critically ill ventilated children. Results: VAP developed in 22.9% of critically ill children undergoing mechanical ventilation. Early VAP and late VAP were found in 19.3% and 8.4% of VAP cases, respectively. Among the known VAP risk factors that were investigated, immunodeficiency was significantly greater in the VAP group (p = 0.014). No significant differences were found between the two groups regarding use of corticosteroids, antibiotics, PH (potential of hydrogen) modifying agents (such as ranitidine or pantoprazole), presence of nasogastric tube and total or partial parenteral nutrition administration. A substantial number of patients in the VAP group had more than four risk factors for development of VAP, compared to those without VAP (p = 0.087). Mortality rate was not statistically different between the VAP and control groups (p = 0.477). Conclusion: VAP is still one of the major causes of mortality in PICUs. It is found that altered immune status is a significant risk factor for acquiring VAP. Also, occurrence of VAP was high in the first week after admission in PICU.
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Affiliation(s)
- Ali Amanati
- Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1551415468, Iran.
| | - Abdollah Karimi
- Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1551415468, Iran.
| | - Alireza Fahimzad
- Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1551415468, Iran.
| | - Ahmad Reza Shamshiri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1439955991, Iran.
| | - Fatemeh Fallah
- Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1551415468, Iran.
| | - Alireza Mahdavi
- Pediatric anesthesiologists and intensivist, Mofid children's hospital, Shahid Beheshti Medical University, Tehran 1551415468, Iran.
| | - Mahshid Talebian
- BS of Nursery, Head Nurse of Pediatric Intensive Care Unit, Mofid children's hospital, Shahid Beheshti University of Medical Sciences, Tehran 1551415468, Iran.
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Carvalho AMD, Piovezan LG, Selem SSADC, Fisberg RM, Marchioni DML. Validation and calibration of self-reported weight and height from individuals in the city of São Paulo. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2016; 17:735-46. [PMID: 25272265 DOI: 10.1590/1809-4503201400030013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 05/09/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the validity of self-reported weight and height measurements among residents of São Paulo, as well as the accuracy of these measurements for determining nutritional status, and to present calibration coefficients. METHODS A cross-sectional, population-based study was performed with a sample of 299 adolescents, adults and elderly of both genders, in São Paulo in 2008. Bland-Altman difference plot and intraclass correlation were used to determine agreement between measured and self-reported parameters. Sensitivity and specificity were assessed for overweight, and calibration coefficients were estimated for correction of weight, height and body mass index data. RESULTS The intraclass correlation was high between self-reported and measured parameters for weight (r > 0,94) and body mass index (BMI) (r > 0,85). The agreement between measured and self-reported weight, height and BMI was good. Sensibility was > 91% and specificity was > 83%. CONCLUSION Self-reported weight measurements can substitute measured parameters in this population, in both genders and in the age groups studied. Self-reported height measurements should be used with caution. Calibration coefficients can be used to adjust self-reported measurements.
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Affiliation(s)
| | - Lívia Gonçalves Piovezan
- Department of Nutrition, School of Public Health, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, Universidade de São Paulo, São Paulo, SP, Brazil
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Neves ACMD, Gonzaga LAA, Martens IBG, Moura EC. Validação de indicadores do consumo de alimentos e bebidas obtidos por inquérito telefônico em Belém, Pará, Brasil. CAD SAUDE PUBLICA 2010; 26:2379-88. [DOI: 10.1590/s0102-311x2010001200016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 06/21/2010] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi avaliar a validade relativa dos indicadores de consumo de alimentos e bebidas obtidos pelo sistema de vigilância por entrevista telefônica (VIGITEL). Foi avaliada uma amostra aleatória (n = 100) da amostra total de aproximadamente dois mil adultos, estudada pelo sistema, em 2009, em Belém, Pará, Brasil. Os indicadores avaliados foram fatores de proteção (consumo adequado de frutas, legumes e verduras) e de risco (consumo de gordura saturada, refrigerante e bebidas alcoólicas) para doenças crônicas não transmissíveis. Compararam-se os resultados obtidos a partir de entrevista telefônica e de três recordatórios de 24 horas (padrão de referência). O padrão de referência evidenciou subestimação na frequência dos indicadores, à exceção de refrigerantes e bebidas alcoólicas. As médias das frequências do consumo foram, em geral, maiores no grupo exposto (entrevistados pelo VIGITEL). Não se pode concluir que o VIGITEL não seja um bom indicador de consumo, pois o padrão de referência também apresenta limitações, portanto o uso daquele como instrumento de monitoramento é justificável.
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White VA, Trotter MJ. Intraoperative Consultation/Final Diagnosis Correlation: Relationship to Tissue Type and Pathologic Process. Arch Pathol Lab Med 2008; 132:29-36. [PMID: 18181670 DOI: 10.5858/2008-132-29-ifdcrt] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2007] [Indexed: 11/06/2022]
Abstract
Abstract
Context.—The correlation of the diagnosis made at intraoperative consultation (IC) with the final diagnosis is one of the cornerstones of quality assurance in the anatomic pathology laboratory.
Objective.—To review correlation of IC diagnoses with final diagnoses during a 1-year period in a regionalized, multisite hospital setting in a major Canadian city.
Design.—One pathologist reviewed all surgical pathology cases at Calgary Laboratory Services from June 2004 through May 2005 that had an IC to extract the following data points: intraoperative diagnoses, final diagnoses, correlation between the two, anatomic site of the tissue on which the IC was requested, pathologic procedure requested of the IC, types of disagreements encountered, reasons for disagreement, and deferrals.
Results.—Intraoperative consultations occurred for 2812 specimens, of which 87 were discordant and 135 were deferred. Percent agreement was 96.75% (95% confidence interval, 96.08–97.42) with a κ statistic of 0.94 (95% confidence interval, 0.92–0.95). Lymph nodes for evaluation for metastases (427), thyroid/parathyroid (401), and central/peripheral nervous system (378) specimens were sent most frequently for IC, and the latter 2 tissue types accounted for the greatest number of disagreements. The most common assessments requested were the presence/ typing of a neoplasm (1161) and assessment of margins (730), which also accounted for the largest number of disagreements. Disagreements were most frequently due to interpretive (53) and gross sampling (23) errors; false-negative disagreements were nearly 3 times as common as false positives.
Conclusions.—The IC was an excellent diagnostic test. Agreement and deferral rates varied by specimen site and by type of assessment requested.
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Affiliation(s)
- Valerie A. White
- From the Department of Pathology and Laboratory Medicine, Vancouver Coastal Health Research Institute and University of British Columbia, Vancouver (Dr White); and the Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, Alberta
| | - Martin J. Trotter
- From the Department of Pathology and Laboratory Medicine, Vancouver Coastal Health Research Institute and University of British Columbia, Vancouver (Dr White); and the Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, Alberta
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Abstract
There is consistency in the findings that relate the acute increases in urban air pollution (mainly the particulate matter) and the short-term health effects (i.e. mortality and hospital admissions) on patients suffering from chronic obstructive pulmonary disease (COPD). Beyond the acute effects, a relevant public health and scientific question is to what extent chronic exposure to air pollution is related with lung function impairment and development of COPD. The few cross-sectional studies showed an increase of self-reported diagnosis of chronic bronchitis and emphysema, breathlessness and mucus hypersecretion and lower levels of lung function in the more polluted areas. The two cohort studies in children have found a retardation of pulmonary function growth, and the only cohort in adults a faster decline of lung function. Given the intrinsic limitations of cross-sectional studies to separate the timing between exposure and effects, and the weaknesses of the cohorts (ie. few areas, short follow-up, only one retest, lack of individual weighting of air pollution measure) there is a need for new prospective studies. These should be performed in a large number of geographical areas and with a long follow-up to asses the impact of long-term air pollution on lung function growth and decline, and on incidence, duration, severity and survival of chronic obstructive pulmonary disease.
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Affiliation(s)
- J Sunyer
- Unitat de Recerca Respiratòria i Ambiental, Institut Municipal d'Investigació Médica, Barcelona, Spain
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