Family out-of-pocket expenditure for type 2 diabetes mellitus care and percentage of family income.

BACKGROUND: Type 2 diabetes has economic implications involving family income and out-of-pocket spending. OBJECTIVE: Determine family out-of-pocket expenditure for type 2 diabetes mellitus care and percentage of family income. MATERIAL AND METHODS: Study of family out-of-pocket spending in families with patients with type 2 diabetes treated at primary care level. Out-of-pocket expenses included expenses for transportation, food-drinks, and external medications. Family income corresponded to the total economic income contributed by family members. The percentage of out-of-pocket spending in relation to family income was identified with the relationship between these two variables. Statistical analysis included averages and percentages. RESULTS: The annual family out-of-pocket expenditure on transportation was $2,621.24, the family out-of-pocket expenditure on food and beverages was $1,075.67, and the family out-of-pocket expenditure on external medications was $722.08. The total annual family out-of-pocket expense was $4,418.89 and corresponds to 4.73% of family income. CONCLUSION: The family out-of-pocket expense in the family with a patient with diabetes mellitus 2 was $4,418.89 and represents 4.73% of the family income.

ANTECEDENTES: La diabetes tipo 2 tiene implicaciones económicas en el ingreso familiar y el gasto de bolsillo. OBJETIVO: Determinar el gasto de bolsillo familiar en la atención de la diabetes mellitus tipo 2 y el porcentaje que representa en el ingreso familiar. MATERIAL Y MÉTODOS: Estudio de gasto de bolsillo de las familias con pacientes con diabetes tipo 2 atendidos en el primer nivel de atención. El gasto de bolsillo familiar incluyó gasto en traslado, alimentos-bebidas y medicamentos externos. El ingreso familiar correspondió al total de ingresos económicos aportados por los miembros de la familia. El porcentaje del gasto de bolsillo con relación al ingreso familiar se identificó con la relación entre estas dos variables. El análisis estadístico incluyó promedios y porcentajes. RESULTADOS: El gasto de bolsillo familiar anual en transporte fue de $2621.24, en alimentos y bebidas fue de $1075.67 y en medicamentos externos fue de $722.08. El gasto familiar de bolsillo total anual fue de $4418.89 y correspondió a 4.73 % del ingreso familiar. CONCLUSIÓN: El gasto de bolsillo en las familias con un paciente con diabetes mellitus tipo 2 fue de $4418.89 y representó 4.73 % del ingreso familiar.

The impact of low income on long-term mortality of myocardial infarction patients: results from the Brazilian Heart Study.

BACKGROUND: Low socioeconomic status has for long been considered an important modifiable risk factor for developing cardiovascular disease, plausibly by lower access to healthcare, lower therapeutic adhesion, and overlapping of other known risk factors. Nevertheless, whether family income and social isolation of poor communities seen in Brazil impact outcomes following ST-segment elevation myocardial infarction (STEMI) remain scarcely understood. METHODS: STEMI diagnosed patients were consecutively enrolled from the Brazilian Heart Study (ClinicalTrials.gov Identifier: NCT02062554) and categorized according to median family income (US$350), address-based human development index (HDI), and distance between communities and a tertiary hospital (DCTH). Incidence of death after 48 months was compared by using adjusted Cox regressions. p-alues < .05 were considered significant. RESULTS: Among 542 subjects, there were 69 deaths (13.2%) after a median follow-up time of 611 d (IQR = 724). The low-income group had a higher incidence of all-cause mortality compared to high income (18.4 vs. 7.1%; p = .001), with an adjusted HR of 2.16 (95%CI: 1.25-3.75; p = .006). Compared to high-income, low-income individuals had the worst clinical presentation of myocardial infarction and less frequently received dual antiplatelet therapy and statins at hospital discharge. The population attributable risk of low income was 44.8%. HDI and DCTH did not influence the delay to reperfusion therapy nor the risk of death. CONCLUSIONS: Low income was independently associated with a higher long-term mortality rate, lower prescription of guidelines-recommended therapy, and worst clinical presentation of myocardial infarction in STEMI patients.

[Urban and rural: differences in the diet of Argentine households according to income level and area of residence]. / Urbano y rural: diferencias en la alimentación de los hogares argentinos según nivel de ingreso y área de residencia.

The environment and the socioeconomic level are determinants of eating behavior because they affect availability, accessibility and food preferences. In order to describe the apparent consumption of food and the availability of energy and nutrients in urban and rural households in Argentina according to their income level, the 2004-2005 National Household Expenditure Survey was analyzed. The average apparent consumption of food and beverages was calculated in grams or milliliters of net weight per adult equivalent per day, for urban and rural households, and by household income per capita quintiles. Rural households made up 7% of the sample, and had a higher proportion of low-income families than urban households. There is different pattern of apparent consumption of food and beverages among rural and urban households in Argentina, and there are also differences between households according to the level of income in both environments. Knowing the content and magnitude of these contrasts is of great use in looking for strategies to improve the population's diet.

El entorno y el nivel socioeconómico son determinantes del comportamiento alimentario porque inciden en la disponibilidad, la accesibilidad y las preferencias alimentarias. Con el objetivo de describir el consumo aparente de alimentos y la disponibilidad de energía y nutrientes de hogares urbanos y rurales de la Argentina, según su nivel de ingresos, se analizó la Encuesta Nacional de Gastos de los Hogares 2004-2005. Se calculó el consumo aparente promedio de alimentos y bebidas en gramos o mililitros de peso neto por adulto equivalente por día, de hogares urbanos y rurales, y según quintil de ingresos per cápita del hogar. El 7% fueron hogares rurales, y presentaron mayor proporción de familias con bajos ingresos respecto a los urbanos. Existe un patrón de consumo aparente de alimentos y bebidas distinto entre hogares rurales y urbanos de Argentina, y además existen diferencias entre los hogares según el nivel de ingresos en ambos entornos. Conocer los contrastes y su magnitud es de gran utilidad para buscar estrategias tendientes a mejorar la alimentación de la población.

Change in overweight and obesity over a decade according to sociodemographic factors in Brazilian adolescents / Mudança no sobrepeso e obesidade após uma década de acordo com fatores sociodemográficos em adolescentes brasileiros

Abstract The aims were to examine changes in the prevalence of overweight and obesity among students from 2001 to 2011, and to verify if these changes differ according to age group, area of residence, and family income. We analyzed two cross-sectional surveys conducted in 2001 and 2011 with brazilian adolescents. Sociodemographic and anthropometric characteristics were self-reported using a questionnaire. Multinomial logistic regression was used to analyze changes in overweight and obesity between the two surveys. The nutritional status was the outcome of the present study and the surveys (2001 and 2011) were the exposure. The odds of being overweight and obese were higher among boys and girls in urban areas in the 2011 survey compared to the 2001. Boys and girls with higher income were also more likely to present overweight and obesity in the second survey compared to the first. An increase of overweight and obesity was observed over a decade. We suggest that future interventions consider the area of residence and the family income to strengthen the effectiveness of actions developed to prevent and control these indicators among adolescents.

Resumo Os objetivos do estudo foram examinar as mudanças na prevalência de sobrepeso e obesidade entre os estudantes de 2001 a 2011 e verificar se essas alterações diferem de acordo com a faixa etária, a área de residência e a renda familiar. Analisamos dois levantamentos transversais realizados em 2001 e 2011 com adolescentes brasileiros. As características sociodemográficas e antropométricas foram autorrelatadas por meio de um questionário. Regressão logística multinomial foi utilizada para analisar as mudanças no sobrepeso e obesidade entre os dois inquéritos. O estado nutricional foi considerado o desfecho do presente estudo e os inquéritos (2001 e 2011) foram as exposições. As razões de chance de sobrepeso e obesidade foram maiores entre os meninos e meninas em áreas urbanas no inquérito de 2011 em comparação com 2001. Meninos e meninas com maior renda também apresentaram maior chance de sobrepeso e obesidade no segundo inquérito. Sugerimos que futuras intervenções considerem a área de residência e a renda familiar para fortalecer a eficácia das ações desenvolvidas para prevenir e controlar esses indicadores entre os adolescentes.

Urbano y rural: diferencias en la alimentación de los hogares argentinos según nivel de ingreso y área de residencia / Urban and rural: differences in the diet of Argentine households according to income level and area of residence

RESUMEN El entorno y el nivel socioeconómico son determinantes del comportamiento alimentario porque inciden en la disponibilidad, la accesibilidad y las preferencias alimentarias. Con el objetivo de describir el consumo aparente de alimentos y la disponibilidad de energía y nutrientes de hogares urbanos y rurales de la Argentina, según su nivel de ingresos, se analizó la Encuesta Nacional de Gastos de los Hogares 2004-2005. Se calculó el consumo aparente promedio de alimentos y bebidas en gramos o mililitros de peso neto por adulto equivalente por día, de hogares urbanos y rurales, y según quintil de ingresos per cápita del hogar. El 7% fueron hogares rurales, y presentaron mayor proporción de familias con bajos ingresos respecto a los urbanos. Existe un patrón de consumo aparente de alimentos y bebidas distinto entre hogares rurales y urbanos de Argentina, y además existen diferencias entre los hogares según el nivel de ingresos en ambos entornos. Conocer los contrastes y su magnitud es de gran utilidad para buscar estrategias tendientes a mejorar la alimentación de la población.

ABSTRACT The environment and the socioeconomic level are determinants of eating behavior because they affect availability, accessibility and food preferences. In order to describe the apparent consumption of food and the availability of energy and nutrients in urban and rural households in Argentina according to their income level, the 2004-2005 National Household Expenditure Survey was analyzed. The average apparent consumption of food and beverages was calculated in grams or milliliters of net weight per adult equivalent per day, for urban and rural households, and by household income per capita quintiles. Rural households made up 7% of the sample, and had a higher proportion of low-income families than urban households. There is different pattern of apparent consumption of food and beverages among rural and urban households in Argentina, and there are also differences between households according to the level of income in both environments. Knowing the content and magnitude of these contrasts is of great use in looking for strategies to improve the population's diet.

Background familiar e desempenho escolar: uma abordagem com variáveis binárias a partir dos resultados do Saresp / Family background and school performance: an approach with binary variables from SARESP results / Fondo familiar y desempeño escolar: Un enfoque con variables binarias a partir de los resultados del SARESP

No presente estudo investiga-se o impacto de fatores externos à escola sobre a escolarização do indivíduo. Renda e escolaridade materna são consideradas para medir o efeito de aspectos familiares no desempenho em matemática do aluno. Para tanto, foram utilizados dados referentes à nota em matemática dos alunos da 3ª série do ensino médio e as respostas dos pais ao questionário socioeconômico, aplicado pelo Sistema de Avaliação do Rendimento Escolar do Estado de São Paulo (Saresp) na edição de 2013. São propostos modelos com variáveis binárias e obtidas estimativas para os parâmetros por meio do software SPSS. Os resultados mostram que rendas mais altas proporcionam melhores desempenhos educacionais, porém há restrições. O nível de escolaridade materna atua positivamente sobre o desempenho do aluno, mas está limitado ao nível adequado de proficiência.

This study researches the impact of outside school factors on individuals' schooling. Income and maternal schooling are taken into consideration when measuring the effect of familiar aspects on students' performance in Mathematics. Therefore, we used data referring to the Mathematics grade of students in 3rd year High School, and the answers provided by their parents for the socioeconomic questionnaire, applied by SARESP in its 2013 edition. Models with binary variables are proposed and estimates for parameters are obtained with SPSS. Results show that students from families with higher incomes indicate better educational performance, but there are restrictions. The level of maternal education positively influences student's performance, but is limited to appropriate proficiency levels.

El presente estudio investiga el impacto de los factores externos a la escuela sobre la escolarización del individuo. Se consideran la renta y la escolaridad materna para medir el efecto de los aspectos familiares en el desempeño del alumno en Matemáticas. Para eso, se utilzaron datos sobre la nota en Matemáticas de los alumnos de la tercera serie de Enseñanza Media y las respuestas de los padres al cuestionario socioeconómico aplicado por la Secretaria da Educação do Estado de São Paulo (SARESP) en la edición de 2013. Se proponen modelos con variables binarias y estimativos para los parámetros que se obtienen con el SPSS. Los resultados muestran que las rentas más altas proporcionan mejores resultados educativos, a pesar de lo cual hay restricciones: el nivel de escolaridad materna actúa positivamente sobre el desempeño del alumno, pero está limitado al nivel adecuado de competencia.

The impacts of minimum alcohol pricing on alcohol attributable morbidity in regions of British Colombia, Canada with low, medium and high mean family income.

BACKGROUND AND AIMS: Previous research indicates that minimum alcohol pricing (MAP) is associated negatively with alcohol-attributable (AA) hospitalizations. Modeling studies predict that this association will be stronger for people on lower incomes. The objective of this study was to test whether the association between MAP and AA hospitalizations is greater in low-income regions. DESIGN: Cross-sectional versus time-series analysis using multivariate multi-level effect models. SETTING: All 89 Local Health Areas in British Columbia (BC), Canada, 2002-13 (48 quarters). PARTICIPANTS: BC population. MEASUREMENTS: Quarterly rates of AA hospital admissions, mean consumer price index-adjusted minimum dollars per standard alcoholic drink and socio-demographic covariates. FINDINGS: Family income was related inversely to the effect of minimum prices on rates of some types of AA morbidity. A 1% price increase was associated with reductions of 3.547% [95% confidence interval (CI) = -5.719, -1.377; P < 0.01] in low family-income regions and 1.64% (95% CI = -2.765, -0.519; P < 0.01) across all income regions for 100% acute AA hospital admissions. Delayed (lagged) effects on chronic AA morbidity were found 2-3 years after minimum price increases for low income regions and all regions combined; a 1% increase in minimum price was associated with reductions of 2.242% (95% CI = -4.097, -0.388; P < 0.05) for 100% chronic AA and 2.474% (95% CI = -3.937, -1.011; P < 0.01) for partially chronic AA admissions for low-income regions. CONCLUSION: In Canada, minimum price increases for alcohol are associated with reductions in alcohol attributable hospitalizations, especially for populations with lower income, both for immediate effects on acute hospitalizations and delayed effects on chronic hospitalizations.

Idosos Provedores: a importância dos recursos da aposentadoria para as famílias brasileiras / Providers elderly: the importance of resources toretirement the brazilian families / Proveedores ancianos: la importancia de los fondos dejubilación para las familias brasileñas

Este trabalho traz como recorte o “idoso provedor” que através do benefício da previdência social (aposentadoria e pensões) é o mantenedor de sua família, o “chefe”. Nesta investigação foram entrevistadas 34 pessoas com mais de 60 anos, provedores do núcleo familiar com o recurso de sua aposentadoria e/ou pensão. Encontrou-se na amostra 59% de aposentados e 57,3 % destes relatam viver somente dos recursos da aposentadoria, 22,4% dos pesquisados vivem de pensão e 14,2 % apontam os alugueis como forma de se manter. Os idosos se reconhecem como provedores dos seus núcleos familiares e, isto está lhes causando preocupação e restrição da liberdade, porém também se sentem importantes e valorizados.(AU)

This paper presents how snip the "old provider" that through the benefit of social foresight (retirement and pension) is the maintainer of your family, the "boss". In this investigation we interviewed 34 people with over 60 years old, core family providers with the resource of your retirement and / or pension. It was found in the sample 59% of retirees and 57,3% from these report that live only with the retirement resources, 22,4% of the surveyed lives from the pension and 14,2% link the rents as a way of keeping. The elderly recognize it self as providers of their core family and, this is causing concern and restriction of freedom, but also they feel important and valued.(AU)

En este trabajo se lleva a cabo el corte de edad "anciano proveedor" que utilizade los beneficios de la seguridad social (jubilaciones y pensiones) es elencargado de mantener a su familia , el "jefe". En esta investigación seentrevistó a 34 personas con más de60 años, los proveedores de la familianuclear con la capacidad de jubilación y / o pensión. Se encontró en la muestra59 % de los pensionistas y el 57,3 % de ellos informan experimentar sólo de losfondos de retiro, el 22,4 % de los encuestados viven de pensiones y el 14,2 %dijo rentas con el fin de mantener. Los ancianos son reconocidos comoproveedores de sus hogares,y esto les está causando preocupación y larestricción de la libertad, sino también sentir importante y valorado.(AU)

Idosos Provedores: a importância dos recursos da aposentadoria para as famílias brasileiras / Providers elderly: the importance of resources toretirement the brazilian families / Proveedores ancianos: la importancia de los fondos dejubilación para las familias brasileñas

Este trabalho traz como recorte o “idoso provedor” que através do benefício da previdência social (aposentadoria e pensões) é o mantenedor de sua família, o “chefe”. Nesta investigação foram entrevistadas 34 pessoas com mais de 60 anos, provedores do núcleo familiar com o recurso de sua aposentadoria e/ou pensão. Encontrou-se na amostra 59% de aposentados e 57,3 % destes relatam viver somente dos recursos da aposentadoria, 22,4% dos pesquisados vivem de pensão e 14,2 % apontam os alugueis como forma de se manter. Os idosos se reconhecem como provedores dos seus núcleos familiares e, isto está lhes causando preocupação e restrição da liberdade, porém também se sentem importantes e valorizados.(AU)

This paper presents how snip the "old provider" that through the benefit of social foresight (retirement and pension) is the maintainer of your family, the "boss". In this investigation we interviewed 34 people with over 60 years old, core family providers with the resource of your retirement and / or pension. It was found in the sample 59% of retirees and 57,3% from these report that live only with the retirement resources, 22,4% of the surveyed lives from the pension and 14,2% link the rents as a way of keeping. The elderly recognize it self as providers of their core family and, this is causing concern and restriction of freedom, but also they feel important and valued.(AU)

En este trabajo se lleva a cabo el corte de edad "anciano proveedor" que utilizade los beneficios de la seguridad social (jubilaciones y pensiones) es elencargado de mantener a su familia , el "jefe". En esta investigación seentrevistó a 34 personas con más de60 años, los proveedores de la familianuclear con la capacidad de jubilación y / o pensión. Se encontró en la muestra59 % de los pensionistas y el 57,3 % de ellos informan experimentar sólo de losfondos de retiro, el 22,4 % de los encuestados viven de pensiones y el 14,2 %dijo rentas con el fin de mantener. Los ancianos son reconocidos comoproveedores de sus hogares,y esto les está causando preocupación y larestricción de la libertad, sino también sentir importante y valorado.(AU)

Gestantes tardias de baixa renda: dados sociodemográficos, gestacionais e bem-estar subjetivo / Low-income late-age pregnant women: sociodemographic, gestational data and subjective well-being / Embarazadas tardías de bajos ingresos: datos sociodemográficos, gestacionales y bienestar subjetivo

Estudo transversal descritivo e correlacional cujos objetivos foram traçar o perfil sociodemográfico e gestacional, avaliar o bem-estar subjetivo (BES) e relacionar os indicadores do BES com as variáveis idade, escolaridade e renda. Participaram 80 gestantes com 35 anos ou mais (grávidas tardias) de baixa renda. Os instrumentos de pesquisa foram questionário estruturado e escala de bem-estar subjetivo. Os dados são apresentados na forma de análises descritivas e correlacionais, conforme a natureza das variáveis. A maioria das gestantes vivia com o companheiro, não tinha renda pes­soal, pois tratava-se de donas de casa, e não planejou a gestação; e o bem-estar subjetivo apresentou valores equivalentes às médias para cada indicador (afetos positivos, afetos negativos e satisfação com a vida), enquanto as correlações significativas obtidas foram fracas. Conclui-se que, para o grupo avaliado, a baixa escolaridade e a baixa renda familiar foram variáveis associadas à satisfação com a vida das gestantes entrevistadas.

Descriptive and correlational cross-sectional study whose objectives were to delineate sociodemographic and gestational profile, to assess the subjective well-being (SWB) and to relate the indicators of SWB with the variables age, education and income. The study included 80 low-income with 35 or more years old (late-age pregnant women). The research tools were structured questionnaire and the subjective well-being scale. Data are presented as correlation and descriptive analysis according to the nature of the variables. The majority of pregnant women lives with a partner and has no personal income. They are housewives and did not plan the pregnancy; the subjective well-being index was equivalent values to the mean for each indicator (posi­tive emotions, negative emotions and life satisfaction), while significant correlations were weak. The conclusion is that low scholarship and low familiar income were varia­bles associated to the life satisfaction in the assessed pregnant women.

Estudio descriptivo y correlacional de corte transversal que tuvo como objetivos delinear el perfil sociodemográfico y embarazos anteriores, evaluar el bienestar subjetivo (BS) y relacionar los indicadores de lo BS con las variables: edad, nivel de educación e ingreso. Participaron 80 mujeres embarazadas con 35 años o más (tardías) de bajos ingresos. Los instrumentos de investigación fueron cuestionario estructurado y escala de bienestar subjetivo. Los datos son presentados como análisis descriptivas y correlaciones, de acuerdo con la naturaleza de las variables. La mayoría de las mujeres embarazadas vivían con el compañero, no tenía ingresos personales, porque eran amas de casa y no planearan lo embarazo; y el bienestar subjetivo tuve valores equivalentes a las medias para cada indicador (afectos positivos, afectos negativos y satisfacción con la vida), mientras las correlaciones significativas fueran débiles. La conclusión es que para el grupo evaluado el bajo nivel de educación y bajos ingresos fueron variables asociadas a la satisfacción con la vida de las embarazadas entrevistadas.

Padrões de uso e motivos para envolvimento nas redes sociais virtuais na adolescência / Patterns of use and reasons for involvement in virtual social networks in adolescentes

Este trabalho investigou se há diferenças no acesso à internet e uso das redes sociais entre alunos de escolas públicas e privadas e quais os motivos para se conectarem nas mesmas. Um questionário aplicado em quatros escolas buscou compreender a opinião dos jovens sobre o assunto. Os resultados apontaram diferenças no tempo de uso das redes sociais por estudantes de escolas públicas e privadas. Ademais, os alunos indicaram conectar-se nas redes sociais para falar, principalmente, com familiares e amigos já conhecidos. Entende-se que os adolescentes consideram as redes sociais um local de circulação de informações e que é necessária cautela para navegar neste universo cibernético

This research investigated whether there are differences in internet access and use of social networks among students in public and private schools and what the reasons for connecting same. A questionnaire was applied in four schools in order to understand the views of young people about the subject. Results showed students from public and private schools differ in the amount of time spent in social networks. In addition, students indicated using social networks to chat, specially, with family and friends already known. In this study, it's understood that adolescents considered social networks as a place where can flow information and that caution is require to navigate in the cyber universe

La caries dental y los factores relacionados en una población de adultos de la ciudad de la rioja, Argentina / The dental caries and related factors in adult population of the city of rioja, Argentina

La caries dental es un proceso patológico post-eruptivo, localizado, externo, involucra un reblandecimiento de los tejidos duros del diente procediendo a la formación de una cavidad1. Se determinó la presencia de caries dental, su relación con factores patológicos y preventivos en adultos de La Rioja, Argentina. A partir de 183 adultos de 25 a 35 años de edad se estudiaron los dientes con caries, obturaciones, perdidos e índice CPOD y se registraron en una ficha dental. Por cada adulto se obtuvo una historia clínica. El 77% de los adultos presentó un promedio de 3,73±4,28 caries, 4,75±4,61 obturaciones, 1,91±2,92 perdidos e índice CPOD 10,39±5,90. El CPOD para el género femenino fue mayor que para el masculino (p=0,042). La caries se relacionó con bajo nivel de educación (p=0,0001), ingreso económico (p=0,0086), cepillado dental diario (p=0,0340), cepillado nocturno (p=0,0018), con consulta prevalente por dolor (p<0,0001), falta de visita bucal anual (p=0,0003) y de obra social (p=0,0064). La caries dental es una enfermedad presente en la población adulta se asocia con bajo nivel de educación, económico y preventivo dental. Necesita del abordaje económico cultural integrado de la sociedad para mejorar la salud bucal del adulto y asegurar su calidad de vida en su senectud.

The dental caries is defined a post eruptive pathological process of external origin located tooth involves softening of the hard tissues of the tooth proceeding consequently to the formation of a tooth cavity1. The presence of dental caries was determined, its relationship with pathological and preventive factors in adults of La Rioja, Argentina. From 183 adults from 25-35 years of age, were studied decayed, fillings, missing teeth and index DMFT and recorded on a dental chart. For each adult, a clinic history was obtained. The 77% of adults had a mean of 3,73 ±4,28 caries, 4,75 ±4,61 filling, 1,91 ±2,92 missing and DMFT 10,39 ±5,90. The DMFT was higher for the female gender than for males (p=0,042). Caries was associated with low level of education (p=0,0001), low income (p=0,0086) lack tooth daily brushing (p<0,0340), lack of night brushing (p=0,018), check only for pain (p< 0,0001), lack of annual dental visit (p=0,0003) and absence of coverage social (p=0,0064). Dental caries is a disease present in the population of adults, is associated with low level education, economic and lack of prevention dental. Requires a socio cultural economic work of society to improve the oral health of adults and ensure their senescence.

Longitudinal changes in health-related quality of life scores in Brazilian incident peritoneal dialysis patients (BRAZPD): socio-economic status not a barrier.

BACKGROUND AND OBJECTIVES: A large proportion of the patients on peritoneal dialysis (PD) in Brazil have low levels of education and family income. The present study assessed whether education level and family income are associated with baseline and longitudinal changes in health-related quality of life (HRQOL) scores during the first year of PD therapy. METHODS: We evaluated 1624 incident patients from the Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD) at baseline, and 486 of them after 12 months. The SF-36 was used to determine HRQOL and the Karnofsky index (KI), physical performance. RESULTS: At baseline, patients received high KI scores compared with scores on the SF-36. The means of the mental and physical components at baseline and after 12 months were 39.9 ± 10.5 compared with 38.7 ± 11.7 and 41.8 ± 9.6 compared with 40.7 ± 9.8 respectively, which were not statistically different. A multivariate regression analysis showed that age, sex, diabetes, and cardiovascular disease were predictors of the mental component (respectively, ß = 0.12, p < 0.001; ß = 0.11, p < 0.001; ß = -0.08, ß = 0.007; and ß = -0.07, p = 0.007) and that age, sex, diabetes, cardiovascular disease, hemoglobin, glucose, and creatinine were predictors of the physical component (respectively, ß = -0.28, p < 0.001; ß = 0.06, p = 0.009; ß = -0.09, p = 0.002; ß = -0.09, p = 0.001; ß = 0.07, p = 0.004; ß = -0.05, p = 0.040; and ß = 0.05, p = 0.040). Education level and family income were not significantly associated with HRQOL (mental and physical components) in the multivariate regression. CONCLUSIONS: The results indicate that, as predictors, family income and education level have no impact on HRQOL, supporting the idea that socio-economic status should not be a barrier to the selection of PD as a treatment modality in Brazil.

Consumo de bebida alcoólica, fatores socioeconômicos e excesso de peso: um estudo transversal no sul do Brasil / Alcohol consumption, social and economic factors and excess weight: a cross-sectional study

O objetivo do estudo foi investigar o consumo de álcool e verificar sua associação com escolaridade, renda e excesso de peso em uma amostra de mulheres. Trata-se de um estudo transversal com 317 mulheres. Aplicou-se um questionário padronizado e pré-codificado para determinar a quantidade, a frequência e o tipo de bebida alcoólica consumida. As mulheres foram classificadas em dois grandes grupos, conforme a quantidade de bebida consumida. O primeiro grupo "Consumo de Álcool", formado por duas subcategorias: (1) mulheres que bebiam no mínimo 10g/dia de etanol; (2) mulheres que referiram não consumir 10g/dia de etanol e as que beberam em algum período da vida ou previamente, mas que o deixaram de fazer. O segundo grupo, "Contato com Álcool", foi composto por três subcategorias: (1) bebedoras (mulheres que bebiam no mínimo 10g/dia de etanol), (2) ex-bebedoras (já beberam regularmente, mas deixaram de consumir a bebida) e (3) não bebedoras. Das investigadas, 30% eram bebedoras e 36,6% se declararam ex-bebedoras. Tinham sobrepeso 39,4% das participantes e 34,3% eram obesas. As investigadas com maior grau de instrução consumiam maior quantidade de álcool, quando comparadas às mulheres com menor escolaridade (analfabetas) que consumam menos (p = 0,010).

The scope of this study was to investigate alcohol consumption and its association with educational level, income and weight in a sample of women. It involved a cross-sectional study with 317 women. A standardized and pre-encoded questionnaire was applied to determine the amount, frequency and type of alcoholic beverage consumed. The women were classified in two large groups according to the number of drinks consumed. The first group "Alcohol Consumption," was comprised of two subcategories: (1) women who drank at least 10g/day of ethanol; (2) women who reported not consuming 10g/day of ethanol, and those who drank at some period of their lives or previously, but no longer did so. The second group, "Contact with Alcohol," was composed of three subcategories: (1) drinkers (women who drank at least 10g/dia of ethanol); (2) former drinkers (women who used to drink regularly, but no longer drink alcohol); and (3) non-drinkers. 30% of the women investigated were drinkers, and 36.6% reported they were former drinkers. 39.4% of the total sample was overweight and 34.3% obese. Women with higher educational levels were found to consume a larger amount of alcohol when compared to women with less education (illiterate) who consume less (p = 0.010).

Risco reprodutivo e renda familiar: análise do perfil de gestantes / Reproductive risk and family income: analysis of the profile of pregnant women

Em face do desafio de enfrentar a morbimortalidade materna e perinatal, a discussão sobre risco reprodutivo e sua associação com situações de vulnerabilidade em saúde é relevante à saúde publica. A pesquisa realizada teve como objetivos descrever o perfil de risco reprodutivo de 3440 mulheres matriculadas em um serviço de pré-natal de alto risco, entre 2006 e 2008, e investigar sua relação com renda familiar e situações de vulnerabilidade em saúde. Trata-se de estudo transversal que teve como fonte o banco de dados do pré-natal. O perfil econômico do grupo estudado é de baixa renda. Encontrou-se associação entre baixa renda familiar e malformações fetais, gravidez antes dos 15 anos e HIV. Renda familiar mais elevada foi associada à idade materna acima de 35 anos, translucência nucal alterada, ginecopatias e abortamento habitual. Os achados podem refletir situações de vulnerabilidade de mulheres de baixa renda, como condições de saúde desfavoráveis e menor acesso e utilização de serviços de saúde. É necessário obter um maior conhecimento do perfil do risco reprodutivo no Brasil e sua distribuição segundo características socio­demográficas, visando ao aperfeiçoamento das práticas assistenciais.

Faced with the challenge of tackling maternal and perinatal morbidity and mortality, the discussion of reproductive risk and its association with health vulnerability situations is relevant to public health. The research carried out at Instituto Fernandes Figueira/Fiocruz sought to describe the reproductive risk profile of women admitted to prenatal care between 2006 and 2008 and investigating its relation to family income and health vulnerability situations. This is a cross-sectional study which used the prenatal care database as its source. The economic profile of the group under scrutiny is a low income group. An association between low income and fetal malformations, pregnancy before 15 years of age, and HIV was detected. A higher family income was associated with the mother's age over 35 years, abnormal nuchal translucency, gynecopathies, and habitual abortion. The findings may reflect vulnerability situations of low income women, such as unfavorable health conditions and limited access to and use of health services. It is necessary to acquire in-depth knowledge of the reproductive risk profile in Brazil and its distribution according to socio-demographic characteristics, seeking to enhance health care practices provided.

Condições de vida de famílias ribeirinhas moradoras nas residências populares do município de Porto Rico, Estado do Paraná, Brasil / Living conditions of riverine families residing in affordable housing in Porto Rico, Paraná State, Brazil

Como parte de um conjunto maior de estudos ecológicos, procurou-se conhecer as condições de vida dos moradores dos três conjuntos habitacionais do município de Porto Rico, Estado do Paraná, Brasil. A amostra constituiu-se de 63 famílias. Um adulto de cada moradia foi entrevistado, após ciência dos objetivos da pesquisa e da confidencialidade dos dados. As informações socioeconômicas do grupo amostral foram obtidas por meio de um inquérito domiciliar, nos meses de julho/2005 e janeiro/2006. Os dados foram processados no Programa Statistical Analysis Software (SAS). Os resultados indicaram que a maioria dos moradores era jovem (idade média de 26 anos); do sexo masculino; solteiro ou vivendo com companheiro; 53,5% completaram o ensino fundamental. Predominaram as famílias nucleares, chefiadas por homens e a média de ocupação era de 3,5 habitantes por moradia. A força de trabalho concentrou-se em atividades urbanas e as rendas familiares variavam de um a sete salários mínimos. Apesar de ser uma cidade ribeirinha, as oportunidades de trabalho ligadas ao rio e a terra eram escassas. Políticas públicas voltadas para o ensino e trabalho são necessárias para melhorar as condições de vida deste segmento da população.

As part of a larger group of ecological studies, this work aimed to determine the living conditions of people residing in the three affordable housing complexes in Porto Rico, Paraná State, Brazil. The sample was comprised of 63 families. One adult per household was interviewed, after informed consent and confidentiality terms were expressed. Socioeconomic data were obtained from the sampled group by means of home surveys, during the months of June 2005 and January 2006. Data were analyzed using the Statistical Analysis Software (SAS) software. The results indicated that the majority of residents were young (mean age = 26 years); male; single or living with a partner; 53.5% had completed middle school. Nuclear families prevailed, headed by men, and the occupancy average was 3.5 inhabitants/household. The lines of work were concentrated in urban activities, and family income varied between one and seven times the minimum wage. Despite being a riverine municipality, work opportunities associated with the river and land were scarce. Public policies geared towards education and labor are necessary in order to improve the living conditions of this segment of the population.

Aleitamento materno exclusivo: análise desta prática na região sul do Brasil / Exclusive breastfeeding: analysis of practice in southern Brazil

Introdução: O ato do aleitamento materno representa a forma natural de alimentar uma criança nos primeiros meses de vida, sendo inquestionável o relevante papel que esta prática desempenha no crescimento e no desenvolvimento infantil. Os objetivos deste estudo foram: Estudar o tempo do aleitamento materno exclusivo em duas regiões do Rio Grande do Sul RS, estudar a associação entre o aleitamento materno e a escolaridade materna, trabalho materno e renda familiar. Metodologia: Estudo observacional, transversal e descritivo realizado em cinco idades do Rio Grande do Sul (Porto Alegre, Canoas, São Leopoldo, Caxias do Sul e Flores da Cunha). Para análise dos dados, com relação ao aleitamento materno exclusivo até os 6 meses, a amostra foi dividida em 2 grupos com 100 crianças, além da análise geral dessa variável. Esta divisão levou em consideração a localização de residência das mesmas. Resultados: Separando a amostra por regiões, verificou-se que na região serrana 60% das crianças receberam leite materno exclusivamente até os 6 meses de idade. Na região metropolitana, constatou-se que 30% receberam leite materno exclusivo até os 6 meses de idade. Conclusão: Constatamos que o aleitamento materno exclusivo até os 6 meses foi o dobro na região da serra riograndense, em comparação com a região metropolitana.

Introduction: Breastfeeding is the natural way of feeding a child in the first months of life, and the relevant role played by this practice in child growth and development is undisputed. The aims of this study were to study the length of exclusive breastfeeding in two regions of Rio Grande do Sul (RS), and to assess the association of maternal breastfeeding with mother schooling, maternal employment, and family income. Methods: Observational, cross-sectional descriptive study performed in 5 cities of RS (Porto Alegre, Canoas, São Leopoldo, Caxias do Sul and Flores da Cunha). For data analysis, regarding exclusive maternal breastfeeding until 6 months, the sample was divided in two groups with 100 children, besides the general analysis of this variable. Results: By analyzing the sample by region, we found that 60% of the infants in the countryside (Caxias do Sul and Flores da Cunha) were exclusively breastfed until 6 months of age. In the metropolitan region (Porto Alegre, Canoas, São Leopoldo), this proportion was 30%. Conclusion: We found that exclusive breastfeeding until 6 months of age in the “Região Serrana” was twice as common as in the metropolitan region

Relação entre renda, trabalho e qualidade de vida de pacientes submetidos ao transplante de medula óssea / Relationship between income, work and quality of life of patients submitted to bone marrow transplantation

Embora a literatura aponte a necessidade de avaliação das condições de trabalho, suporte social e familiar dos pacientes submetidos ao transplante de medula óssea (TMO), são poucas as pesquisas nacionais acerca da influência do perfil socioeconômico sobre a qualidade de vida do paciente transplantado. Resultados de estudos internacionais não são conclusivos quanto à associação entre estas variáveis e a readaptação pós-TMO. O objetivo do presente estudo foi identificar possíveis relações entre renda, trabalho e qualidade de vida em pacientes submetidos ao TMO. A amostra foi composta por 62 pacientes adultos, com 4,3 anos de transplante em média. Para a coleta de dados foram utilizados: Instrumental de Avaliação Socioeconômica, Entrevista de Recuperação Pós-TMO, SF-36 e FACT-BMT. Os resultados mostraram que 43,5 por cento dos pacientes tinham renda familiar de até dois salários mínimos. A situação de afastamento do trabalho foi encontrada em 46,7 por cento dos pacientes. A variável renda foi significativamente associada com qualidade de vida, sentimento de competência pessoal e ajustamento psicológico do paciente.

Although the literature points towards the need to assess the work conditions and the social and familiar support of patients submitted to BMT, few Brazilian data are available about the influence of the socio-economic profile on the quality of life. Results of international studies about the association between these variables and post-BMT re-adaptation are inconclusive. This study aims to identify possible relationships between income, work and quality of life in patients submitted to BMT. The study sample consisted of 62 adult patients, with an average adaptation period of 4.3 years after transplant. To collect data, we used: the Socio-economic Assessment Instrument, Post-TMO Recovery Interview, SF-36 and FACT-BMT. Results showed that 43.5 percent of the patients had a family income of up to two minimum wages and 46.7 percent of the patients were absent from work at some time during the follow-up. A significant relationship was observed between income, patient's quality of life, feeling of personal competence and psychological adjustment.

Disponibilidade de energia e nutrientes nos domicílios: o contraste entre as regiões Norte e Sul do Brasil / Energy and nutrients disposal in residences: the contrast between north and south regions of Brazil

Com o objetivo de analisar a disponibilidade domiciliar de energia, a participação relativa dos macronutrientes no Valor Energético Total (VET) e a contribuição dos diferentes grupos de alimentos na energia disponível nos domicílios das regiões Norte e Sul do país, segundo o rendimento mensal familiar, foi proposto o presente estudo. Utilizou-se para a elaboração das análises os microdados da Pesquisa de Orçamentos Familiares - 2002/2003 realizada pelo Instituto Brasileiro de Geografia e Estatística (IBGE). Para as análises nutricionais, utilizou-se o software Virtual Nutri. O teste de regressão linear múltipla foi aplicado para analisar o efeito dos rendimentos sobre a disponibilidade de energia e nutrientes. Verificou-se uma relação inversa entre a participação dos carboidratos no VET e a renda. A contribuição dos lipídios para o VET apresentou tendência de crescimento, de acordo com o aumento da renda. Quanto à participação dos distintos grupos de alimentos no VET, destaca-se a reduzida contribuição energética das frutas, verduras e legumes para praticamente a totalidade dos grupamentos familiares. Foram identificadas indesejáveis contribuições (consideradas excessivas) dos doces, açúcares e refrigerantes para o VET disponível para as famílias de ambas as regiões estudadas.

This study was proposed to analyze the domiciliary energy disposal, the relative participation of macronutrients in the Total Energy Value (VET) and the contribution of different food groups in the disposal energy in residences of the North and South regions of Brazil according to the monthly family income. It was used the micro data of the Family Budget Research - POF related to the period of 2002/2003 which was carried out by the Brazilian Institute of Geography and Statistics - IBGE. The nutritional analyses were made by using the Virtual Nutri software. The multiple linear regression test was used to capture the income effect over energy and nutrients disposal. There is a reciprocal and inverse relation between the carbohydrates participation in the VET and the family income. The participation of lipids to the VET presented a growth tendency, according to the income increase. Regarding the participation of various food groups in the VET, the energetic contribution of fruits, greens and vegetables was outstandingly reduced to the almost entire family groupings. It was identified the undesirable contribution of sweets, simpler carbohydrates and soft drinks, which was considered excessive to the disposable VET.

Disponibilidade de energia e de carotenóides nos domicílios brasileiros / Availability of energy and carotenoids in Brazilian households

O objetivo deste trabalho foi analisar a disponibilidade de energia e de carotenóides para as famílias residentes nas áreas rurais e urbanas do Brasil. Utilizou-se como base de dados as informações obtidas por meio da Pesquisa de Orçamentos Familiares (POF) 2002/2003 do Instituto Brasileiro de Geografia e Estatística (IBGE). As análises de energia foram viabilizadas por meio da utilização do software Virtual Nutri e, para identificação do conteúdo de carotenóides nos alimentos, adotaram-se as informações contidas na tabela Nutrient Database for Standard Reference Release 19 United States of Department Agriculture (USDA). Os resultados mostram reduzida disponibilidade de energia para as famílias brasileiras e particularmente para aquelas moradoras das áreas urbanas do país. Observou-se ainda, baixa disponibilidade de carotenóides, e um aumento no conteúdo disponível desses compostos conforme ocorre crescimento dos rendimentos.(AU)

The aim of this work was to analyze the availability of energy and carotenoids for families who live in rural and urban areas of Brazil. For this, the chosen sources of information were Household Expenditure Survey 2002-2003 applied by the Brazilian Institute of Geography and Statistics (IBGE). For energy analyses, the software Virtual Nutri was used. On the table Nutrient Database for Standard Reference Release 19 - United States of Department Agriculture (USDA), all information regarding carotenoids contents in foods was found. The results related reduced availability of energy identified for the totality of the Brazilians and particularly for people who live in urban areas. It was still observed a low availability of carotenoids, and an increase of these nutrients contents according to the increase of family's income. (AU)