21 results on '"Schilithz AO"'
Search Results
2. Ecological analysis of the relationship between infant mortality and cardiovascular disease mortality at ages 45-69 in the Brazilian 1935 birth cohort.
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Schilithz AO, da Silva CM, Costa AJ, and Kale PL
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BACKGROUND: International ecological studies have shown a positive association between infant mortality as a proxy for low birth weight and cardiovascular disease mortality in adult life. METHODS: Mortality rates due to Cardiovascular Diseases (CVDMR) standardised by age in adults between 45 and 69years of age and by place of birth (pob) and residence (res) were related to Infant Mortality Rates (IMR) in the Brazilian 1935 birth cohort. RESULTS: Two relationship patterns were noted between IMR and CVDMR: for the Southeast, South and Centre-West group of regions (r(pob)=0.46; r(res)=0.29) and for the North and Northeast group of regions (r(pob)=0.21; r(res)=0.33). For the latter pattern, two states were identified (Rio Grande do Norte and Paraíba) as atypical areas, whose exclusion strengthened the association (r(pob)=0.73; r(res)=0.91). CONCLUSIONS: The direction of the associations changed after the analysis by group of Brazilian regions (indirect control of socio-economic levels, coverage and quality of the information). There is a positive, although weak association between IMR and CVDMR. Attempts to control or minimise the interference of migratory movements, cohort effects and socio-economic levels represented methodological progress in ecological analyses of foetal programming in Brazil. [ABSTRACT FROM AUTHOR]
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- 2011
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3. Correction: Current and future costs of cancer attributable to insufficient leisure-time physical activity in Brazil.
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Ferreira da Silva RC, Malhão TA, Rezende LFM, da Silva Barbosa R, Correa Schilithz AO, Moreira LGM, Nunes Machado PA, de Carvalho FFB, and Leão Diogenes ME
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[This corrects the article DOI: 10.1371/journal.pone.0287224.]., (Copyright: © 2023 Ferreira da Silva et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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4. Nutritional status at hospital admission and prediction of clinical outcomes in children and adolescents with cancer: Results of the Brazilian survey on oncological nutrition in paediatrics.
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Afonso WV, Peres WAF, de Pinho NB, Corrêa Schilithz AO, Martucci RB, Rodrigues VD, Braga JSDN, Costa JDD, and Padilha PC
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- Child, Humans, Adolescent, Nutritional Status, Brazil epidemiology, Nutrition Assessment, Hospitals, Malnutrition diagnosis, Malnutrition epidemiology, Malnutrition etiology, Neoplasms complications, Neoplasms therapy, Pediatrics
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Background: Changes in nutritional status are recognised as predictors of unfavourable outcomes in children and adolescents with cancer, particularly in developing countries. There have been no studies on children and adolescents with cancer from every region of Brazil or on the impact of nutritional status on clinical outcomes. The aim of this study is to assess the association between the nutritional status of children and adolescents with cancer and the prediction of clinical outcomes., Methods: This was a longitudinal, multicentre, hospital-based study. An anthropometric nutritional assessment was performed, and the Subjective Global Nutritional Assessment (SGNA) was administered within 48 h of admission. Seven hundred and twenty-three patients (aged 2-18 years) were included in the sample, undergoing cancer treatment. They were recruited in 13 reference centres in the five macro-regions of Brazil between March 2018 and August 2019. The outcomes evaluated were readmission within 30 days and death within 60 days of admission. To identify predictors of 60-day survival, Cox regression and log-rank statistics were used to compare Kaplan-Meier curves between the strata., Results: About 36.2% (n = 262) of the samples were malnourished according to the SGNA. Severe malnutrition by the SGNA (relative risk [RR] = 8.44, 95% confidence interval [CI]: 3.35-21.3, P = 0.001) and living in the North region (RR = 11.9, 95% CI: 3.34-42.7, P = 0.001) were associated with the poorest survival. The North (RR = 5.77, 95% CI: 1.29-25.8, P = 0.021), Northeast (RR = 1.46, 95% CI: 1.01-2.11, P = 0.041), Midwest (RR = 0.43, 95% CI: 0.20-0.095, P = 0.036), age group 10-18 years (RR = 0.65, 95% CI: 0.45- 0.94, P = 0.022) and haematologic malignancy (RR = 1.52, 95% CI: 1.10-2.10, P = 0.011) were predictors of readmission within 30 days., Conclusions: The prevalence of malnutrition was high and related to death. These results highlight the need to use the SGNA in clinical practice alongside classic anthropometric methods for the diagnosis of malnutrition, and the need to standardise care across all Brazilian regions, which should include nutritional care for children and adolescents with cancer., (© 2023 The British Dietetic Association Ltd.)
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- 2023
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5. Current and future costs of cancer attributable to insufficient leisure-time physical activity in Brazil.
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Ferreira da Silva RC, Malhão TA, Rezende LFM, da Silva Barbosa R, Correa Schilithz AO, Moreira LGM, Nunes Machado PA, Carvalho FFB, and Leão Diogenes ME
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- Adult, Female, Humans, Brazil epidemiology, Motor Activity, Exercise, Health Care Costs, Leisure Activities, Neoplasms epidemiology, Neoplasms prevention & control
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Objectives: Cancer is an increasing cause of death and disability in Brazil and a pivotal vector for growing health expenditures. Lower levels of leisure-time physical activity are associated with a higher risk of some cancers. We quantified the current and future cancer direct healthcare costs attributable to insufficient leisure-time physical activity in Brazil., Methods: We performed a macrosimulation model using: (i) relative risks from meta-analyses; (ii) prevalence data of insufficient leisure-time physical activity in adults ≥ 20 years; (iii) national registries of healthcare costs of adults ≥ 30 years with cancer. We used simple linear regression to predict cancer costs as a function of time. We calculated the potential impact fraction (PIF) considering the theoretical-minimum-risk exposure and other counterfactual scenarios of physical activity prevalence., Results: We projected that the costs of breast, endometrial, and colorectal cancers may increase from US$ 630 million in 2018 to US$ 1.1 billion in 2030 and US$ 1.5 billion in 2040. The costs of cancer attributable to insufficient leisure-time physical activity may increase from US$ 43 million in 2018 to US$ 64 million in 2030. Increasing leisure-time physical activity could potentially save US$ 3 million to US$ 8.9 million in 2040 by reducing the prevalence of insufficient leisure-time physical activity in 2030., Conclusion: Our results may be helpful to guide cancer prevention policies and programs in Brazil., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ferreira da Silva et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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6. Can the sustainable development goals for cancer be met in Brazil? A population-based study.
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De Camargo Cancela M, Bezerra de Souza DL, Leite Martins LF, Borges L, Schilithz AO, Hanly P, Sharp L, Pearce A, and Soejomataram I
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Background: A one-third reduction in premature mortality (30-69 years) from chronic noncommunicable diseases is goal 3.4 of the United Nations Sustainable Development Goals (UN SDG). The burden of NCDs is expected to continue to increase in low- and middle-income countries, including Brazil., Objectives: The aim of this study was to assess geographical and temporal patterns in premature cancer mortality in Brazil between 2001 and 2015 and to predict this to 2030 in order to benchmark against the 3.4 SDG target., Methods: We used data on deaths from cancer in those aged 30-69, by age group, sex and cancer site, between 2001 and 2015 from the National Mortality Information System of Brazil (SIM). After correcting for ill-defined causes, crude and world age-standardised mortality rates per 100,000 inhabitants were calculated nationally and for the 5 regions. Predictions were calculated using NordPred, up to 2030., Results: The difference in observed (2011-2015) and predicted (2026-2030) mortality was compared against the SDG 3.4 target. Between 2011-2015 and 2026-2030 a 12.0% reduction in premature cancer age-standardised mortality rate among males and 4.6% reduction among females is predicted nationally. Across regions this varied from 2.8% among females in North region to 14.7% among males in South region. Lung cancer mortality rates are predicted to decrease among males but not among females nationally (men 28%, females 1.1% increase) and in all regions. Cervical cancer mortality rates are projected to remain very high in the North. Colorectal cancer mortality rates will increase for both sexes in all regions except the Southeast., Conclusions and Recommendation: Cancer premature mortality is expected to decrease in Brazil, but the extent of the decrease will be far from the SDG 3.4 target. Nationally, only male lung cancer will be close to reaching the SDG 3.4 target, reflecting the government's long-term efforts to reduce tobacco consumption. Projected colorectal cancer mortality increases likely reflect the epidemiological transition. This and, cervical cancer control will continue to be major challenges. These results will help inform strategic planning for cancer primary prevention, early detection and treatment programs; such initiatives should take cognizance of the regional differences highlighted here., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 De Camargo Cancela, Bezerra de Souza, Leite Martins, Borges, Schilithz, Hanly, Sharp, Pearce and Soejomataram.)
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- 2023
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7. Factors associated with maternal near miss in childbirth and the postpartum period: findings from the birth in Brazil National Survey, 2011-2012.
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Domingues RM, Dias MA, Schilithz AO, and Leal MD
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- Adolescent, Adult, Brazil epidemiology, Child, Female, Health Care Surveys, Humans, Incidence, Infant, Newborn, Pregnancy, Risk Factors, Young Adult, Maternal Mortality trends, Obstetric Labor Complications epidemiology, Parturition, Postpartum Period, Pregnancy Complications epidemiology
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Background: Maternal near-miss (MNM) audits are considered a useful approach to improving maternal healthcare. The aim of this study was to evaluate the factors associated with maternal near-miss cases in childbirth and the postpartum period in Brazil., Methods: The study is based on data from a nationwide hospital-based survey of 23,894 women conducted in 2011-2012. The data are from interviews with mothers during the postpartum period and from hospital medical files. Univariate and multivariable logistic regressions were performed to analyze factors associated with MNM, including estimation of crude and adjusted odds ratios and their respective 95 % confidence intervals (95 % CI)., Results: The estimated incidence of MNM was 10.2/1,000 live births (95 % CI: 7.5-13.7). In the adjusted analyses, MNM was associated with the absence of antenatal care (OR: 4.65; 95 % CI: 1.51-14.31), search for two or more services before admission to delivery care (OR: 4.49; 95 % CI: 2.12-9.52), obstetric complications (OR: 9.29; 95 % CI: 6.69-12.90), and type of birth: elective C-section (OR: 2.54; 95 % CI: 1.67-3.88) and forceps (OR: 9.37; 95 % CI: 4.01-21.91). Social and demographic maternal characteristics were not associated with MNM, although women who self-reported as white and women with higher schooling had better access to antenatal and maternity care services., Conclusion: The high proportion of elective C-sections performed among women in better social and economic situations in Brazil is likely attenuating the benefits that could be realized from improved prenatal care and greater access to maternity services. Strategies for reducing the rate of MNM in Brazil should focus on: 1) increasing access to prenatal care and delivery care, particularly among women who are at greater social and economic risk and 2) reducing the rate of elective cesarean section, particularly among women who receive services at private maternity facilities, where C-section rates reach 90 % of births.
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- 2016
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8. Labor and birth care by nurse with midwifery skills in Brazil.
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Gama SG, Viellas EF, Torres JA, Bastos MH, Brüggemann OM, Theme Filha MM, Schilithz AO, and Leal MD
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- Adolescent, Adult, Brazil, Child, Female, Home Childbirth, Humans, Infant, Newborn, Practice Patterns, Nurses', Pregnancy, Young Adult, Labor, Obstetric, Maternal Health Services standards, Midwifery methods, Nurse Midwives statistics & numerical data, Prenatal Care standards
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Background: The participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections., Methods: Birth in Brazil is a national, population-based study consisting of 23,894 postpartum women, carried out in the period between February 2011 and October 2012, in 266 healthcare settings. The study included all vaginal births involving physicians or nurses/nurse-midwives. A logistic regression model was used to examine the association between the implementation of good practices and suitable interventions during labor and birth, and whether care was a physician or a nurse/nurse-midwife led care. We developed another model to assess the association between the use of obstetric interventions during labor and birth to the personnel responsible for the care of the patient, comparing hospitals with decisions revolving exclusively around a physician to those that also included nurses/nurse-midwives as responsible for vaginal births., Results: 16.2 % of vaginal births were assisted by a nurse/nurse-midwife. Good practices were significantly more frequent in those births assisted by nurses/nurse-midwives (ad lib. diet, mobility during labor, non-pharmacological means of pain relief, and use of a partograph), while some interventions were less frequently used (anesthesia, lithotomy position, uterine fundal pressure and episiotomy). In maternity wards that included a nurse/nurse-midwife in labour and birth care, the incidence of cesarean section was lower., Conclusions: The results of this study illustrate the potential benefit of collaborative work between physicians and nurses/nurse-midwives in labor and birth care. The adoption of good practices in managing labor and birth could be the first step toward more effective obstetric and midwifery care in Brazil. It may be easier to introduce new approaches rather than to eliminate old ones, which may explain why the reduction of unnecessary interventions during labor and birth was less pronounced than the adoption of new practices.
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- 2016
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9. Factors associated with cesarean delivery during labor in primiparous women assisted in the Brazilian Public Health System: data from a National Survey.
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Dias MA, Domingues RM, Schilithz AO, Nakamura-Pereira M, and do Carmo Leal M
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- Adolescent, Adult, Brazil epidemiology, Child, Female, Humans, Infant, Newborn, Obstetric Labor Complications surgery, Pregnancy, Public Health, Risk Factors, Surveys and Questionnaires, Young Adult, Cesarean Section statistics & numerical data, Obstetric Labor Complications epidemiology, Parity
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Background: The rate of cesarean delivery (CD) in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS)., Methods: This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns. The rate of CD in primiparous women was estimated. Univariate and multivariable logistic regression was performed to analyze factors associated with CD during labor in primiparous women with a single cephalic pregnancy, including estimation of crude and adjusted odds ratios and their respective 95 % confidence intervals., Results: The analyzed data are related to the 2814 eligible primiparous women who had vaginal birth or CD during labor in SUS hospitals. In adjusted analyses, residing in the Southeast region was associated with lower CD during labor. Occurrence of clinical and obstetric conditions potentially related to obstetric emergencies before delivery, early admission with < 4 cm of dilatation, a decision late in pregnancy for CD, and the use of analgesia were associated with a greater risk for CD. Favorable advice for vaginal birth during antenatal care, induction of labor, and the use of any good practices during labor were protective factors for CD. The type of professional who attended birth was not significant in the final analyses, but bivariate analysis showed a higher use of good practices and a smaller proportion of epidural analgesia in women cared for by at least one nurse midwife., Conclusions: The CD rate in primiparous women in SUS in Brazil is extremely high and can compromise the health of these women and their newborns. Information and support for vaginal birth during antenatal care, avoiding early admission, and promoting the use of good practices during labor assistance can reduce unnecessary CD. Considering the experience of other countries, incorporation of nurse midwives in childbirth care may increase the use of good practices during labor.
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- 2016
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10. Determinants of gestational night blindness in pregnant women from Rio de Janeiro, Brazil.
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Saunders C, Leal Mdo C, Neves PA, Padilha Pde C, da Silva LB, and Schilithz AO
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- Abortion, Induced, Adult, Anemia, Iron-Deficiency complications, Anemia, Iron-Deficiency drug therapy, Brazil epidemiology, Cross-Sectional Studies, Dietary Supplements, Female, Humans, Logistic Models, Night Blindness etiology, Night Blindness prevention & control, Postpartum Period, Pregnancy, Prenatal Care, Prevalence, Socioeconomic Factors, Vitamin A Deficiency complications, Vitamin A Deficiency drug therapy, Young Adult, Ascorbic Acid administration & dosage, Folic Acid administration & dosage, Food, Fortified, Iron, Dietary administration & dosage, Night Blindness epidemiology, Vitamin A administration & dosage
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Objective: To describe the prevalence and determinants of gestational night blindness in pregnant women receiving care in a hospital in Rio de Janeiro, Brazil., Design: Cross-sectional study of pregnant and postpartum women receiving care in a public hospital in Rio de Janeiro from 1999 to 2001 (group I; n 225) or from 2005 to 2008 (group II; n 381). Night blindness was identified through a standardized and validated interview (WHO, 1996). The determinants of gestational night blindness were identified through a hierarchical logistic regression model., Setting: Public maternity hospital in Rio de Janeiro, RJ, Brazil., Subjects: Adult pregnant and postpartum women (n 606), aged ≥20 years., Results: The prevalence of gestational night blindness was 9·9 %. The final model revealed that not living in the South Zone of Rio de Janeiro (distal level: adjusted OR=1·846; 95 % CI 1·002, 3·401), belonging to group I (intermediate level: adjusted OR=2·183; 95 % CI 1·066, 4·471) and for the proximal level, having a history of abortion (adjusted OR=2·840; 95 % CI 1·134, 7·115) and having anaemia during the first and second trimesters of pregnancy (adjusted OR=3·776; 95 % CI 1·579, 9·029) were determinants of gestational night blindness., Conclusion: Gestational night blindness should be assessed for during the prenatal care of all pregnant women, especially those living in deprived areas of the city and/or who have a history of abortion or anaemia. Nutritional monitoring is recommended during pregnancy to control gestational night blindness.
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- 2016
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11. Differences in utility scores obtained through Brazilian and UK value sets: a cross-sectional study.
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Takemoto ML, Lopes da Silva N, Ribeiro-Pereira AC, Schilithz AO, and Suzuki C
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- Adaptation, Psychological, Adult, Algorithms, Brazil, Cross-Sectional Studies, Fatigue, Female, Humans, Male, Middle Aged, Multiple Sclerosis therapy, Pain Measurement statistics & numerical data, Psychometrics statistics & numerical data, Reproducibility of Results, Multiple Sclerosis psychology, Quality of Life psychology, Severity of Illness Index, Surveys and Questionnaires standards
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Background: Multiple sclerosis (MS) is a chronic disease associated with several impacts; especially regarding patients' health-related quality of life (HRQL). EuroQol 5 Dimensions questionnaire (EQ-5D) provides self-reported analysis of HRQL and utility scores. Although the British algorithm to convert EQ-5D responses into utility is the most used in the literature, national settings is more appropriate for health policy decision makers. A Brazilian algorithm is available, but not used in MS patients yet. Primarily, this study aimed to address potential differences in utility scores obtained through Brazilian and British value sets. Secondary objective was to determine the role of disability, fatigue and patients socio-demographic and clinical characteristics relevant to MS on the utility scores reported by Brazilian patients., Methods: Cross-sectional study with MS patients treated in 8 Brazilian sites. Patients were interviewed about socio-demographic and clinical characteristics, self-reported disability level, HRQL and impact of fatigue on daily living. Disability level, HRQL and impact of fatigue were assessed using the Expanded Disability Status Scale (EDSS) and the Brazilian versions of EQ-5D-3 L and Modified Fatigue Impact Scale (MFIS-BR), respectively. Patients were classified in subgroups according to EDSS (mild: 0-3; moderate: 4-6.5; severe: >7) and the self-perceived impact of fatigue (absent: ≤ 38 points; low: 39-58; high: ≥ 59). EQ-5D-3 L data was converted into a utility index using an algorithm developed by a Brazilian research group (QALY Brazil) and also the UK algorithm. Differences between utility scores were analysed through Wilcoxon test., Results: Two hundred and ten patients were included in the study. Utility index mean scores of 0.59 (SD = 0.22) and 0.56 (SD = 0.32) for the Brazilian and UK algorithms were observed, respectively, without statistically significant difference for the distribution of data (p = 0.586). However, when utility scores were lower than 0.5, Brazilian algorithm provided higher estimates than UK with a better agreement between the scores found closer to 1. The same trend was observed when data was stratified for EDSS and impact of fatigue, with statistically significant difference between scores in categories of mild/severe disabilities and absent/high impact of fatigue., Conclusions: Results suggest that Brazilian value set provided higher utility scores than the UK, particularly for measures below 0.5.
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- 2015
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12. Incidence of maternal near miss in hospital childbirth and postpartum: data from the Birth in Brazil study.
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Dias MA, Domingues RM, Schilithz AO, Nakamura-Pereira M, Diniz CS, Brum IR, Martins AL, Theme Filha MM, Gama SG, and Carmo Leal Md
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- Adolescent, Adult, Age Factors, Brazil epidemiology, Child, Female, Humans, Incidence, Live Birth epidemiology, Pregnancy, Risk Factors, World Health Organization, Young Adult, Maternal Health Services statistics & numerical data, Maternal Mortality, Obstetric Labor Complications epidemiology, Pregnancy Complications epidemiology
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This study evaluated data on the incidence of maternal near miss identified on World Health Organization (WHO) criteria from the Birth in Brazil survey. The study was conducted between February 2011 and October 2012. The results presented are estimates for the study population (2,337,476 births), based on a sample of 23,894 women interviewed. The results showed an incidence of maternal near miss of 10.21 per 1,000 live births and a near-miss-to-mortality ratio of 30.8 maternal near miss to every maternal death. Maternal near miss was identified most prevalently by clinical criteria, at incidence of 5.2 per 1,000 live births. Maternal near miss was associated with maternal age 35 or more years (RR=1.6; 95%CI: 1.1-2.5), a history of previous cesarean delivery (RR=1.9; 95%CI: 1.1-3.4) and high-risk pregnancy (RR=4.5; 95%CI: 2.8-7.0). incidence of maternal near miss was also higher at hospitals in capital cities (RR=2.2; 95%CI: 1.3-3.8) and those belonging to Brazil's national health service, the Brazilian Unified National Health System (SUS) (RR=3.2; 95%CI: 1.6-6.6). Improved quality of childbirth care services can help reduce maternal mortality in Brazil.
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- 2014
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13. Determining gestational age based on information from the Birth in Brazil study.
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Pereira AP, Leal Mdo C, da Gama SG, Domingues RM, Schilithz AO, and Bastos MH
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- Brazil, Female, Humans, Infant, Newborn, Infant, Premature, Menstrual Cycle, Pregnancy, Ultrasonography, Prenatal, Algorithms, Gestational Age
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This study aimed at assessing the validity of different measures for estimating gestational age and to propose the creation of an algorithm for gestational age at birth estimates for the Birth in Brazil survey--a study conducted in 2011-2012 with 23,940 postpartum women. We used early ultrasound imaging, performed between 7-20 weeks of gestation, as the reference method. All analyses were performed stratifying by payment of maternity care (public or private). When compared to early ultrasound imaging, we found a substantial intraclass correlation coefficient of ultrasound-based gestational age at admission measure (0.95 and 0.94) and of gestational age reported by postpartum women at interview measure (0.90 and 0.88) for the public and private payment of maternity care, respectively. Last menstrual period-based measures had lower intraclass correlation coefficients than the first two measures evaluated. This study suggests caution when using the last menstrual period as the first measure for estimating gestational age in Brazil, strengthening the use of information obtained from early ultrasound imaging results.
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- 2014
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14. Process of decision-making regarding the mode of birth in Brazil: from the initial preference of women to the final mode of birth.
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Domingues RM, Dias MA, Nakamura-Pereira M, Torres JA, d'Orsi E, Pereira AP, Schilithz AO, and Carmo Leal Md
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- Adult, Brazil, Female, Health Knowledge, Attitudes, Practice, Hospitals, Private statistics & numerical data, Hospitals, Public statistics & numerical data, Humans, Pregnancy, Prenatal Care, Socioeconomic Factors, Young Adult, Cesarean Section statistics & numerical data, Choice Behavior, Natural Childbirth statistics & numerical data
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The purpose of this article is to describe the factors cited for the preference for type of birth in early pregnancy and reconstruct the decision process by type of birth in Brazil. Data from a national hospital-based cohort with 23,940 postpartum women, held in 2011-2012, were analyzed according to source of funding for birth and parity, using the χ2 test. The initial preference for cesarean delivery was 27.6%, ranging from 15.4% (primiparous public sector) to 73.2% (multiparous women with previous cesarean private sector). The main reason for the choice of vaginal delivery was the best recovery of this type of birth (68.5%) and for the choice of cesarean, the fear of pain (46.6%). Positive experience with vaginal delivery (28.7%), cesarean delivery (24.5%) and perform female sterilization (32.3%) were cited by multiparous. Women from private sector presented 87.5% caesarean, with increased decision for cesarean birth in end of gestation, independent of diagnosis of complications. In both sectors, the proportion of caesarean section was much higher than desired by women.
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- 2014
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15. Factors associated with caesarean section among primiparous adolescents in Brazil, 2011-2012.
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Gama SG, Viellas EF, Schilithz AO, Theme Filha MM, Carvalho ML, Gomes KR, Costa MC, and Carmo Leal Md
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- Adolescent, Brazil, Choice Behavior, Female, Humans, Natural Childbirth statistics & numerical data, Pregnancy, Risk Factors, Socioeconomic Factors, Young Adult, Cesarean Section statistics & numerical data, Parity
- Abstract
This paper presents the factors associated with caesarean section in primiparous adolescents in Brazil using data from a national hospital-based survey conducted between 2011 and 2012. Information was obtained from postpartum women through face-to-face and telephone interviews and a theoretical model with three levels of hierarchy was used to analyze associations with the dependent variable mode of delivery (caesarean or vaginal). The results show that the caesarean section rate among primiparous teenagers is high (40%). The most significant contributing factors for caesarean section were: considering this mode of delivery safer (OR=7.0; 95%CI: 4.3-11.4); giving birth under the private health system (OR=4.3; 95%CI: 2.3-9.0); being attended by the same health care professional throughout prenatal care and delivery (OR=5.7; 95%CI: 3.3-9.0) and clinical history of risk and complications during pregnancy (OR=10.8; 95%CI: 8.5-13.7). Adolescent pregnancy continues to be an important concern on the reproductive health agenda and the rates observed by this study are worrying given the effects of early exposure to caesarean section.
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- 2014
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16. Sampling design for the Birth in Brazil: National Survey into Labor and Birth.
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Vasconcellos MT, Silva PL, Pereira AP, Schilithz AO, Souza Junior PR, and Szwarcwald CL
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- Brazil epidemiology, Female, Humans, Models, Theoretical, Research Design, Sampling Studies, Birth Rate, Health Surveys, Live Birth epidemiology
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This paper describes the sample design for the National Survey into Labor and Birth in Brazil. The hospitals with 500 or more live births in 2007 were stratified into: the five Brazilian regions; state capital or not; and type of governance. They were then selected with probability proportional to the number of live births in 2007. An inverse sampling method was used to select as many days (minimum of 7) as necessary to reach 90 interviews in the hospital. Postnatal women were sampled with equal probability from the set of eligible women, who had entered the hospital in the sampled days. Initial sample weights were computed as the reciprocals of the sample inclusion probabilities and were calibrated to ensure that total estimates of the number of live births from the survey matched the known figures obtained from the Brazilian System of Information on Live Births. For the two telephone follow-up waves (6 and 12 months later), the postnatal woman's response probability was modelled using baseline covariate information in order to adjust the sample weights for nonresponse in each follow-up wave.
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- 2014
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17. Caesarean section and neonatal outcomes in private hospitals in Brazil: comparative study of two different perinatal models of care.
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Torres JA, Domingues RM, Sandall J, Hartz Z, Gama SG, Theme Filha MM, Schilithz AO, and Leal Mdo C
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- Adult, Brazil, Breast Feeding, Female, Hospitals, Private standards, Humans, Perinatal Care standards, Pregnancy, Socioeconomic Factors, Young Adult, Cesarean Section statistics & numerical data, Hospitals, Private statistics & numerical data, Standard of Care
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This study aims at comparing caesarean section rates and neonatal outcomes of two perinatal models of care provided in private hospitals in Brazil. Birth in Brazil data, a national hospital-based cohort conducted in the years 2011/2012 was used. We analysed 1,664 postpartum women and their offspring attended at 13 hospitals located in the South-east region of Brazil, divided into a "typical"--standard care model and "atypical"--Baby-Friendly hospital with collaborative practices between nurse-midwives and obstetricians on duty to attend deliveries in an alternative labour ward. The Robson's classification system was used to compare caesarean sections, which was lower in the atypical hospital (47.8% vs. 90.8%, p<0.001). Full term birth, early skin-to-skin contact, breastfeeding in the first hour, rooming-in care, and discharge in exclusive breastfeeding were more frequent in the atypical hospital. Neonatal adverse outcome did not differ significantly between hospitals. The atypical hospital's intervention should be further evaluated since it might reduce caesarean section prevalence and increase good practices in neonatal care.
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- 2014
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18. Risk groups in children under six months of age using self-organizing maps.
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Schilithz AO, Kale PL, Gama SG, and Nobre FF
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- Algorithms, Breast Feeding, Cluster Analysis, Cross-Sectional Studies, Developing Countries, Female, Health Status Indicators, Hospitalization, Humans, Infant, Infant, Newborn, Male, Models, Statistical, Neural Networks, Computer, Pregnancy, Prevalence, Risk, Software, Child Development, Growth Disorders diagnosis, Infant, Premature growth & development
- Abstract
Fetal and infant growth tends to follow irregular patterns and, particularly in developing countries, these patterns are greatly influenced by unfavorable living conditions and interactions with complications during pregnancy. The aim of this study was to identify groups of children with different risk profiles for growth development. The study sample comprised 496 girls and 508 boys under six months of age from 27 pediatric primary health care units in the city of Rio de Janeiro, Brazil. Data were obtained through interviews with the mothers and by reviewing each child's health card. An unsupervised learning, know as a self-organizing map (SOM) and a K-means algorithm were used for cluster analysis to identify groups of children. Four groups of infants were identified. The first (139) consisted of infants born exclusively by cesarean delivery, and their mothers were exclusively multiparous; the highest prevalences of prematurity and low birthweight, a high prevalence of exclusive breastfeeding and a low proportion of hospitalization were observed for this group. The second (247 infants) and the third (298 infants) groups had the best and worst perinatal and infant health indicators, respectively. The infants of the fourth group (318) were born heavier, had a low prevalence of exclusive breastfeeding, and had a higher rate of hospitalization. Using a SOM, it was possible to identify children with common features, although no differences between groups were found with respect to the adequacy of postnatal weight. Pregnant women and children with characteristics similar to those of group 3 require early intervention and more attention in public policy., (Copyright © 2014. Published by Elsevier Ireland Ltd.)
- Published
- 2014
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19. Housing conditions as a social determinant of low birthweight and preterm low birthweight.
- Author
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Vettore MV, Gama SG, Lamarca Gde A, Schilithz AO, and Leal Mdo C
- Subjects
- Adult, Brazil epidemiology, Case-Control Studies, Female, Housing statistics & numerical data, Humans, Infant, Newborn, Pregnancy, Premature Birth epidemiology, Risk Factors, Socioeconomic Factors, Housing standards, Infant, Low Birth Weight, Premature Birth etiology, Prenatal Care statistics & numerical data
- Abstract
Objective: To assess the relationship between housing conditions and low birthweight and preterm low birthweight among low-income women., Methods: A case-control study was conducted with post-partum women living in the city of Rio de Janeiro, Southeast Brazil, in 2003-2005. Two groups of cases, low birthweight (n=96) and preterm low birthweight infants (n=68), were compared against normal weight term controls (n=393). Housing conditions were categorized into three levels: adequate, inadequate, and highly inadequate. Covariates included sociodemographic and anthropometric characteristics, risk behaviors, violence, anxiety, satisfaction during pregnancy, obstetric history and prenatal care., Results: Poor housing conditions was independently associated with low birthweight (inadequate--OR 2.3 [1.1;4.6]; highly inadequate--OR 7.6 [2.1;27.6]) and preterm low birthweight (inadequate--OR 2.2 [1.1;4.3]; highly inadequate--OR 7.6 [2.4;23.9]) and factors associated with outcomes were inadequate prenatal care and previous preterm birth. Low income and low maternal body mass index remained associated with low birthweight., Conclusions: Poor housing conditions were associated with low birthweight and preterm low birthweight.
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- 2010
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20. [The decision of women for cesarean birth: a case study in two units of the supplementary health care system of the State of Rio de Janeiro].
- Author
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Dias MA, Domingues RM, Pereira AP, Fonseca SC, da Gama SG, Theme Filha MM, Bittencourt SD, da Rocha PM, Schilithz AO, and Leal Mdo C
- Subjects
- Adult, Brazil, Consumer Behavior statistics & numerical data, Cross-Sectional Studies, Delivery of Health Care, Demography, Female, Humans, Socioeconomic Factors, Young Adult, Cesarean Section statistics & numerical data
- Abstract
Cesarean section rates are very high in Brazil mainly in private hospitals, probably due to socioeconomic and cultural factors. The objective of this study was to describe socioeconomic, demographic, cultural and reproductive characteristics of women in the postpartum period and the factors that had determined their decision for caesarean section in two units of the supplementary health care system of the State of Rio de Janeiro. The study population was composed of 437 women that had vaginal or caesarean childbirths in the two selected units. Data were collected by means of interviews with mothers and consultation of hospital records. The factors associated with the decision for cesarean section as mode of delivery were evaluated using non-conditional logistic regression analysis and following the hierarchic models established at three definite moments. Although 70% of the women had no initial preference for cesarean section, 90% of them had this mode of birth. It was verified that, despite their initial desire, the interaction with the health services resulted in cesarean section as mode of birth. Educative actions directed to pregnant women and to the public at large as well as changes in the childbirth care model can be promising strategies for reverting this picture.
- Published
- 2008
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21. [The influence of falls on the quality of life of the aged].
- Author
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Ribeiro AP, de Souza ER, Atie S, de Souza AC, and Schilithz AO
- Subjects
- Aged, Aged, 80 and over, Brazil, Female, Humans, Male, Middle Aged, Accidental Falls, Quality of Life
- Abstract
The objective of this study is to analyze the effect of falls and their consequences on the quality of life of elderly people living in a low-income community in the city of Rio de Janeiro. This article is part of an explorative research conducted at CLAVES, using quantitative and qualitative methods. In this study we used quantitative data about falls and quality of life. 72 elderly aged over 60 years participated in the study. 51,4% of them were females, 20,8% lived alone and 37,5% admitted having suffered a fall during the last year. Among the most frequently mentioned consequences were fractures (24,3%), the fear of falling (88,5%), abandonment of activities (26,9%), change of habits (23,1%) and immobilization (19%). The analysis showed that falls have influence upon in the quality of life of the aged. The WHOQOL-Bref domain scores showed a reduction in the means of the group that had suffered falls during the last year in comparison to those who didn't fall, and the difference was more significant in the psychological field. In short, falls are frequent among the elderly and bring consequences that change the quality of life of these people in a negative way. Their incidence can be avoided by identifying the causes and developing appropriate preventive measures.
- Published
- 2008
- Full Text
- View/download PDF
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