Marcos Pascoal Pattussi

Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies

Studies have suggested that chronic exposure to stress may have an influence on increased blood pressure. A systematic review followed by a meta-analysis was conducted aiming to assess the effect of psychological stress on blood pressure increase. Research was mainly conducted in Ingenta, Psycinfo, PubMed, Scopus and Web of Science. Inclusion criteria were: published in any language; from January 1970 to December 2006; prospective cohort design; adults; main exposure psychological/emotional stress; outcome arterial hypertension or blood pressure increase > 3.5mmHg. A total of 2,043 studies were found, of which 110 were cohort studies. Of these, six were eligible and yielded 23 comparison groups and 34,556 subjects. Median follow-up time and loss to follow-up were 11.5 years and 21%. Results showed individuals who had stronger responses to stressor tasks were 21% more likely to develop blood pressure increase when compared to those with less strong responses (OR: 1.21; 95%CI: 1.14-1.28; p < 0.001). Although the magnitude of effect was relatively small, results suggest the relevance of the control of psychological stress to the non-therapeutic management of high blood pressure.

Impact of nightshift work on overweight and abdominal obesity among workers of a poultry processing plant in southern Brazil.

The authors examined the associations of shiftwork with overweight and abdominal obesity through a cross-sectional study of 1206 employees 18 to 50 yrs of age who were working on a production line in a poultry processing plant. Night-shift workers (n = 800) were considered exposed, whereas day shiftworkers (n = 406) were considered nonexposed. Overweight was defined as a body mass index ≥25 kg/m2 and abdominal obesity as a waist circumference ≥88 cm in women and ≥102 cm in men. The mean age of the workers was 30.5 yrs (standard deviation = 8.7 yrs), and 65.2% were women. Nightshift workers compared to dayshift workers showed higher prevalences of overweight (42.2% vs. 34.3%; p = .020) and abdominal obesity (24.9% vs. 19.5%; p = .037). After adjusting for sociodemographics, parental overweight status, behavioral characteristics, and sleep characteristics, including hours of sleep, the prevalence ratios for overweight and abdominal obesity were 1.27 (95% confidence interval [ CI]: 1.00–1.61) and 1.45 (95% CI: 1.10–1.92), respectively, for the nightshift workers compared to the dayshift workers. A consistent finding in our study was the independent contribution of night shiftwork to overweight and abdominal obesity among Brazilian workers. Further studies are needed to understand the biological mechanisms involved and the complex behavioral and social adaptations experienced by night-shift workers. (Author correspondence: mtolinto@gmail.com)

Socioeconomic, demographic and lifestyle factors associated with dietary patterns of women living in Southern Brazil

This study focused on the association between dietary patterns and socio-demographic and lifestyle factors. A population-based cross-sectional study was performed in 1,026 adult women from Southern Brazil. Dietary patterns were identified using principal components analysis. In the multivariable analysis, a Poisson regression model was used to estimate the prevalence ratio and 95%CI. Wealthier women were more likely to follow healthy diets. A Low Cost Healthy Diet was more prevalent among women with a partner, and a High Cost Healthy Diet was more prevalent among women not currently working and who exercised regularly. Women with lower education levels were less likely to follow a Low Cost Healthy Diet, but more likely to follow the Higher-Risk Low Cost Diet. The Low Cost Higher-Risk Diet was more prevalent among women with a lower income. Low and medium cost healthy diets were positively associated with age. The results showed that womens dietary choices are influenced by socioeconomic factors and are not only dependent on food prices.

Prevalência de hipertensão arterial sistêmica e fatores associados: um estudo de base populacional em mulheres no Sul do Brasil

A cross-sectional study was carried out among women 20 to 60 years of age living in São Leopoldo, Rio Grande do Sul State, Brazil, to determine the prevalence of hypertension and associated factors. Census tract sampling was used, and the outcome was defined by the presence of arterial pressure >or= 140/90mmHg and/or use of anti-hypertensive drugs. Among 1,020 interviewed people, 267 (26.2%; 95%CI: 23.5-28.9) presented hypertension. Poisson regression showed a statistically significant association with age, skin color, marital status, family history, educational background, and nutritional status. The highest attributable fractions were observed among women with schooling <or=4 years (18.38%); obese women (33.86%); and overweight women (22.55%). The results were compared to other hypertension prevalence studies in the State of Rio Grande do Sul, and the results showed the need for inter-sector efforts, highlighting the possible contribution of increasing peoples level of schooling. The study also showed the relevance of weight loss measures in the adult population.

The association between individual and contextual factors and functional dentition status among adults in Rio Grande do Sul State, Brazil: a multilevel study

Functional dentition plays an important role in maintaining masticatory function, which is closely related to the number of teeth present in the mouth. The objective of this study was to investigate the association between individual and contextual factors and functional dentition (defined as the presence of at least 20 teeth) in Brazilian adults. This was a multilevel cross-sectional population-based study with a two-level structure and a total sample of 10,407 adults from 84 municipalities (counties). The exposures at both levels were demographic, socioeconomic, and oral health treatment-related. Multivariate analyses showed that higher prevalence rates of functional dentition were associated (p < 0.01) with municipalities having higher mean income and fluoridated water supply and with individuals living in urban areas, younger adults, males, those with more schooling and higher income, those that reported having visited the dentist in the previous 12 months, and those with access to information on prevention. The findings suggest that research on tooth loss and functional dentition should take different socioeconomic factors into account.

Desigualdades na realização do exame clínico de mama em São Leopoldo, Rio Grande do Sul, Brasil

This cross-sectional population-based survey focused on the coverage of clinical breast examination (CBE) in women 20 to 60 years of age in São Leopoldo, Rio Grande do Sul State, Brazil, and described the factors associated with lack of CBE. The outcome was defined as having received a CBE by a physician during the year prior to the interview. Two different multivariate models were analyzed. Among the 1,026 women included in the sample, 556 (54.2%; 95%CI: 51.1-57.2) had received CBEs. Multivariate analysis including the entire sample of women showed that low socioeconomic status (SES) was the only variable associated with not having a CBE. In the other multivariate model (only women who had consulted physicians in the previous year, with or without CBE), a statistically significant effect was found for both SES and skin color. Thus, low SES was significantly associated with lack of CBE in both models. However, in the model limited to women with physician consultations in the previous year, skin color was the main factor for receiving CBE, suggesting that once differences in initial access to the health service were overcome, white women had a higher probability of receiving a clinical breast examination as part of their consultation.

Neighborhood sociodemographic and environmental contexts and self-rated health among Brazilian adults: a multilevel study

The aim of this study was to investigate the association between sociodemographic and environmental contexts on self-rated health. A population-based cross-sectional study with a random sample of 38 neighborhoods (census tracts) and 1,100 adults was carried out. Data analysis used multilevel logistic regression. Data from the Brazilian Census of 2000, mean income, years of study of the head of household and mean number of residents per tract were R

Confiabilidade teste-reteste do Índice de Capacidade para o Trabalho em trabalhadores metalúrgicos do Sul do Brasil

955 (SD = 586), 8 years (SD = 3), and 746 residents (SD = 358) respectively. Higher prevalences of fair/poor self-rated health were found in neighborhoods with greater populations and lower income/schooling levels. After control for individual variables, the odds for fair/poor self-rated health was twice as high in more populous (OR = 2.04; 95%CI: 1.15-3.61) and lower-income neighborhoods (OR = 2.29; 95%CI: 1.16-4.50) compared to less populous, higher-income ones. Self-rated health depends on individual characteristics and the sociodemographic context of neighborhoods.

Utilização dos serviços ambulatoriais de saúde por mulheres: estudo de base populacional no Sul do Brasil

INTRODUCAO: O Indice de Capacidade para o Trabalho (ICT) tem sido utilizado para mensurar a capacidade fisica, mental e social dos trabalhadores. Porem, nao ha relato de estudos que avaliem o grau de estabilidade do indice na lingua portuguesa. O objetivo deste estudo foi testar a confiabilidade teste-reteste do ICT. METODOS: A populacao de estudo foi composta por trabalhadores de duas empresas (N= 153) do setor metal-mecânico do municipio de Caxias do Sul, RS. Os trabalhadores responderam questionarios autoadministrados por duas vezes com intervalo de 4 semanas entre eles. A analise dos dados incluiu o coeficiente de correlacao intra-classe (CCI), o t-teste pareado e o coeficiente Kappa. RESULTADOS: A confiabilidade teste-reteste (ICT continuo) apresentou um CCI igual a 0,84 (IC95%0,78 a 0,88, P<0,001) e o teste t-pareado nao apresentou diferencas significativas entre as aplicacoes. O valor do coeficiente Kappa Ponderado para o indice categorizado foi igual a 0,72 (IC95% 0,56 a 0,87). CONCLUSOES: O ICT apresentou niveis de confiabilidade aceitaveis para a classificacao da capacidade para o trabalho na populacao de estudo. Novos estudos sao necessarios para melhor avaliar a confiabilidade e validade do indice e a fim de complementar a avaliacao e a qualidade das informacoes fornecidas pelo instrumento.

Prevalência de capacidade mastigatória insatisfatória e fatores associados em idosos brasileiros

The aim of this study was to verify the use of outpatient health services and associated factors among women ages 20 to 60 years living in the urban area of São Leopoldo, Rio Grande do Sul State, Brazil. This was a cross-sectional, population-based study with a sample of 1,026 women in 2003. The association between the independent variables and the outcome was evaluated by means of prevalence ratios and 95% confidence intervals (95%CI). Poisson regression was used with a hierarchical model. Among 1,022 women, 136 (13.3%; 95%CI: 11.2-15.4) had not used outpatient services in the 12 months prior to the interview. Women in lower socioeconomic classes (C, D, and E), with less schooling, and with lower income showed lower use of outpatient health services. Thus, the most vulnerable women and those with the greatest health needs showed the lowest use of health services, suggesting unfavorable conditions in the local health system and pointing to the presence of lack of universal care and equal access.