scholarly journals Brazilians’ experiences with iron fortification: evidence of effectiveness for reducing inadequate iron intakes with fortified flour policy

2016 ◽  
Vol 20 (2) ◽  
pp. 363-370 ◽  
Author(s):  
Diva Aliete dos Santos Vieira ◽  
Josiane Steluti ◽  
Eliseu Verly-Jr ◽  
Dirce Maria Marchioni ◽  
Regina Mara Fisberg
Keyword(s):  
Survey Design ◽  
Age Groups ◽  
Substantial Reduction ◽  
Population Based ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Complex Survey ◽  
Before And After ◽  
Complex Survey Design ◽  
Fortified Flour

AbstractObjectiveTo assess Fe intake, calculate the prevalence of inadequate Fe intake and identify food contributors to Fe intake during 2003 and 2008 in a population-based study, reflecting before and after the mandatory fortification of flour with Fe.DesignTwo cross-sectional population-based studies conducted in 2003 and 2008. Dietary intake was evaluated by 24 h recall and the Software for Intake Distribution Estimation (PC-SIDE) was used to estimate within-person variance and prevalence of inadequate Fe intake. The statistical analysis was conducted considering the complex survey design.SettingSão Paulo, Brazil.SubjectsAdolescents, adults and elderly adults of both sexes, interviewed in 2003 (n 2386) and 2008 (n 1661).ResultsThe Fe intake mean increased in all populations in the post-fortification period. A reduction of over 90 % was observed in the prevalence of inadequate Fe intake among men for all age groups analysed. When evaluating women, despite the substantial reduction (over 63 %), prevalence of inadequate Fe intake remained high (34 %) in those aged 19–50 years. Major food contributors to Fe intake before fortification were beans, beef, vegetables and dairy. There was an alteration in the contributors in the post-fortification period, with bread, beef, beans and biscuits as main contributors.ConclusionsThe mandatory fortification with Fe significantly furthered the reduction in the prevalence of inadequacy, except among women of reproductive age, and changed the main contributors to this nutrient in the studied population. Therefore, monitoring of Fe addition in flour is essential to assess compliance to the fortified flour policy and to guarantee a safe Fe intake for all the population.

scholarly journals Interpretation of vitamin B-12 and folate concentrations in population-based surveys does not require adjustment for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project

2020 ◽  
Vol 111 (4) ◽  
pp. 919-926 ◽  
Author(s):  
Melissa F Young ◽  
Junjie Guo ◽  
Anne Williams ◽  
Kyly C Whitfield ◽  
Sabiha Nasrin ◽  
...  
Keyword(s):  
Survey Design ◽  
Serum Vitamin ◽  
Correlation Coefficients ◽  
Population Based ◽  
Reproductive Age ◽  
Serum Folate ◽  
Vitamin B ◽  
Cross Sectional ◽  
Population Prevalence ◽  
Vitamin B 12

ABSTRACT Background Vitamin B-12 and folate deficiencies in women and children have important public health implications. However, the evidence is conflicting and limited on whether the influence of inflammation on biomarker concentrations may be sufficiently and consistently influenced by inflammation to require adjustment for interpreting concentrations or estimating population prevalence of deficiencies. Objective We examined correlations between concentrations of the inflammation biomarkers C-reactive protein (CRP) and α1-acid glycoprotein (AGP) and serum vitamin B-12 and serum and RBC folate among nonpregnant women of reproductive age (WRA; 15–49 yr) and preschool children (PSC; 6–59 mo). Methods We analyzed cross-sectional data from 16 nationally representative nutrition surveys conducted in WRA (n = 32,588) and PSC (n = 8,256) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project. Spearman correlations between CRP or AGP and vitamin B-12 or folate concentrations were examined, taking into account complex survey design effects. Results Correlations between inflammation and vitamin B-12 or folate were weak, with no clear pattern of association in either WRA or PSC. Correlation coefficients between CRP and vitamin B-12 for WRA and PSC ranged from −0.25 to 0.16, and correlations between AGP and vitamin B-12 ranged between −0.07 and 0.14. Similarly, correlations between CRP and serum folate ranged from −0.13 to 0.08, and correlations between AGP and serum folate between −0.21 and 0.02. Only 3 surveys measured RBC folate, and among them, correlations for WRA ranged from −0.07 to 0.08 for CRP and −0.04 for AGP (1 country). Conclusions Based on the weak and inconsistent correlations between CRP or AGP and vitamin B-12 or folate biomarkers, there is no rationale to adjust for inflammation when estimating population prevalence of vitamin B-12 or folate deficiencies in WRA or PSC.

scholarly journals Physical violence and violent threats reported by Aboriginal and Torres Strait Islander people with a disability: cross sectional evidence from a nationally representative survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jeromey B. Temple ◽  
Heather Wong ◽  
Angeline Ferdinand ◽  
Scott Avery ◽  
Yin Paradies ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Physical Violence ◽  
Survey Design ◽  
Exposure To Violence ◽  
Royal Commission ◽  
Torres Strait Islander People ◽  
Cross Sectional ◽  
Complex Survey ◽  
Complex Survey Design ◽  
Torres Strait

Abstract Background A recent Royal Commission into the treatment of Australians living with disabilities has underscored the considerable exposure to violence and harm in this population. Yet, little is known about exposure to violence among Aboriginal and Torres Strait Islander people living with disabilities. The objective of this paper was to examine the prevalence, disability correlates and aspects of violence and threats reported by Aboriginal and Torres Strait Islander people living with disabilities. Methods Data from the 2014–15 National Aboriginal and Torres Strait Islander Social Survey were used to measure physical violence, violent threats and disability. Multivariable logistic and ordinal logistic regression models adjusted for complex survey design were used to examine the association between measures of disability and exposure to violence and violent threats. Results In 2014–15, 17% of Aboriginal and Torres Strait Islander people aged 15–64 with disability experienced an instance of physical violence compared with 13% of those with no disability. Approximately 22% of those with a profound or severe disability reported experiencing the threat of physical violence. After adjusting for a comprehensive set of confounding factors and accounting for complex survey design, presence of a disability was associated with a 1.5 odds increase in exposure to physical violence (OR = 1.54 p < 0.001), violence with harm (OR = 1.55 p < 0.001), more frequent experience of violence (OR = 1.55 p < 0.001) and a 2.1 odds increase (OR = 2.13 p < 0.001) in exposure to violent threats. Severity of disability, higher numbers of disabling conditions as well as specific disability types (e.g., psychological or intellectual) were associated with increased odds of both physical violence and threats beyond this level. Independent of these effects, removal from one’s natural family was strongly associated with experiences of physical violence and violent threats. Aboriginal and Torres Strait Islander women, regardless of disability status, were more likely to report partner or family violence, whereas men were more likely to report violence from other known individuals. Conclusion Aboriginal and Torres Strait Islander people with disability are at heightened risk of physical violence and threats compared to Aboriginal and Torres Strait Islander people without disability, with increased exposure for people with multiple, severe or specific disabilities.

scholarly journals The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia

2018 ◽  
Vol 15 (11) ◽  
pp. 2333 ◽  
Author(s):  
Jeromey Temple
Keyword(s):  
Food Insecurity ◽  
Stressful Life Events ◽  
Survey Design ◽  
General Social Survey ◽  
Stressful Events ◽  
Economic Policies ◽  
Cross Sectional ◽  
Complex Survey ◽  
Complex Survey Design ◽  
Nationally Representative

A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. Using nationally representative data from the 2014 General Social Survey and multivariable logistic regression, this paper reports on the association between 18 discrete stressors and the likelihood of reporting food insecurity in Australia. The results, adjusted for known correlates of food insecurity and complex survey design, show that exposure to stressors significantly increased the likelihood of experiencing food insecurity. Importantly, stressors related to employment and health approximately doubled the odds of experiencing food insecurity. The results underscore the complex correlates of food insecurity and indicates that conceptually it interacts with many important social and economic problems in contemporary Australia. There is no simple fix to food insecurity and solutions require co-ordination across a range of social and economic policies.

scholarly journals Outcomes of Multiple Gestation Births Compared to Singleton: Analysis of Multicenter KID Database

2021 ◽  
Author(s):  
Renjithkumar Kalikkot Thekkeveedu ◽  
Nilesh Dankhara ◽  
Jagdish Desai ◽  
Angelle L Klar ◽  
Jaimin M Patel
Keyword(s):  
Length Of Stay ◽  
Gestational Age ◽  
Survey Design ◽  
Age Groups ◽  
Population Data ◽  
Higher Order ◽  
Multiple Gestation ◽  
Complex Survey ◽  
Complex Survey Design ◽  
Inpatient Database

Abstract BackgroundThe available data regarding morbidity and mortality associated with multiple gestation births is also conflicting and contradictingObjectiveTo compare morbidity, mortality, and length of stay (LOS) outcomes between multiple gestation (twin, triplet and higher-order) and singleton births.Methods Data from national multicenter Kids’ Inpatient Database of the Healthcare Cost and Utilization Project from the years 2000, 2003, 2006, 2009, 2012, and 2016 were analyzed using complex survey design using SAS. Neonates with ICD9 and ICD10 codes indicating singletons, twins or triplets, and higher-order multiples were included. Mortality was compared between these groups after excluding transfer outs to avoid duplicate inclusion. To analyze LOS, we included inborn neonates, and excluded transfers and who died inpatient and any neonates who appear to have been discharged less than 33 weeks PMA. The LOS was compared by gestational age groups. ResultsA total of 22,853,125 neonates were analyzed for mortality after inclusion-exclusion; 2.96% were twins, and 0.13% were triplets or more. A total of 22,690,082 neonates were analyzed for LOS. Mean GA, expressed as mean (SD), for singleton, twins and triplets were 38.30(2.21), 36.39 (4.21), and 32.72(4.14), respectively. The adjusted odds for mortality were similar for twin births compared to singleton (aOR: 1.004, 95% CI:0.960-1.051, p=0.8521). The adjusted odds of mortality for triplet or higher-order gestation births were higher (aOR: 1.33, 95% CI: 1.128-1.575, p =0.0008) as compared to singleton. Median LOS (in days) was significantly longer in multiple gestation compared to singleton overall (Singletons: 1.59 [1.13, 2.19] vs twins 3.29 [2.17, 9.59] vs triplets or higher order multiples 19.15 [8.80, 36.38], p <.0001), and this difference remained significant within each GA category. ConclusionMultiple gestation births have higher mortality and longer LOS when compared to singleton births. This population data from multiple centers across the country could be useful in counseling parents when caring for multiple gestation pregnancies.

scholarly journals Perceived Cognitive Ability in Lesbian, Gay, Bisexual, and Heterosexual Vietnam Era Veterans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 311-311
Author(s):  
Michelle Hilgeman ◽  
John Blosnich ◽  
Yasmin Cypel ◽  
Fatema Akhtar ◽  
Aaron Schneiderman ◽  
...  
Keyword(s):  
Cognitive Abilities ◽  
Survey Design ◽  
Subjective Cognitive Decline ◽  
Good Reliability ◽  
Cross Sectional ◽  
Complex Survey ◽  
Vietnam Era ◽  
Increase Risk ◽  
Complex Survey Design ◽  
And Bisexual

Abstract Lesbian, gay, and bisexual (LGB) Veterans report stress (e.g., discrimination under Don’t Ask Don’t Tell policies) and mental health conditions (e.g., depression) that may increase risk for neurocognitive changes like dementia. Subjective cognitive decline (SCD) can be an early indicator of neurocognitive change – yet no known studies have examined SCD in LGB Veterans. Cross-sectional data from the Vietnam Era Health Retrospective Observational Study (VE-HEROeS) were examined for 260 LGB and 17,796 heterosexual Veterans. VE-HEROeS is the latest probability-based survey of Vietnam Era Veterans (1961–1975) as older adults (2016-2017). SCD was assessed using two subscales of the Functional Assessment of Cancer Therapy-Cognitive Instrument Version-3 (FACT-Cog). Good reliability was observed in this sample: Cronbach’s alpha =.94 for the 7-item Perceived Cognitive Abilities subscale and .88 for the 4-item Comments from Others. Analyses were weighted to account for the complex survey design. LGB Veterans were slightly younger (M=68.3, range 59-84) than heterosexual Veterans (M=69.1, range 58-99, p=.03); were more likely to be female (13% vs 3%, p&lt;.01); and had fewer people living in the household (M=1.7 vs. M=2.1, p&lt;.01). LGB Veterans were also more likely than heterosexual Veterans to report feeling depressed most or all of the time over the past 30 days (5.7% vs. 3.6%, respectively, p&lt;0.01) on a single 5-point Likert-scale. SCD indicators did not vary by Veteran sexual orientation (M=19.69 and M=19.69; M=14.2 and M=14.1) and were elevated compared to published studies in healthy adult samples. More work is needed to examine neurocognitive risk factors in aging LGB Veterans.

scholarly journals Outcomes of multiple gestation births compared to singleton: analysis of multicenter KID database

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Renjithkumar Kalikkot Thekkeveedu ◽  
Nilesh Dankhara ◽  
Jagdish Desai ◽  
Angelle L. Klar ◽  
Jaimin Patel
Keyword(s):  
Survey Design ◽  
Age Groups ◽  
Population Data ◽  
Higher Order ◽  
Multiple Gestation ◽  
Complex Survey ◽  
Statistical Analysis System ◽  
Complex Survey Design ◽  
Analysis System ◽  
Inpatient Database

Abstract Background The available data regarding morbidity and mortality associated with multiple gestation births is conflicting and contradicting. Objective To compare morbidity, mortality, and length of stay (LOS) outcomes between multiple gestation (twin, triplet and higher-order) and singleton births. Methods Data from the national multicenter Kids’ Inpatient Database of the Healthcare Cost and Utilization Project from the years 2000, 2003, 2006, 2009, 2012, and 2016 were analyzed using a complex survey design using Statistical Analysis System (SAS) 9.4 (SAS Institute, Cary NC). Neonates with ICD9 and ICD10 codes indicating singletons, twins or triplets, and higher-order multiples were included. Mortality was compared between these groups after excluding transfer outs to avoid duplicate inclusion. To analyze LOS, we included inborn neonates and excluded transfers; who died inpatient and any neonates who appear to have been discharged less than 33 weeks PMA. The LOS was compared by gestational age groups. Results A total of 22,853,125 neonates were analyzed for mortality after applying inclusion-exclusion criteria; 2.96% were twins, and 0.13% were triplets or more. A total of 22,690,082 neonates were analyzed for LOS. Mean GA, expressed as mean (SD), for singleton, twins and triplets, were 38.30 (2.21), 36.39 (4.21), and 32.72 (4.14), respectively. The adjusted odds for mortality were similar for twin births compared to singleton (aOR: 1.004, 95% CI:0.960–1.051, p = 0.8521). The adjusted odds of mortality for triplet or higher-order gestation births were higher (aOR: 1.33, 95% CI: 1.128–1.575, p = 0.0008) when compared to the singleton births. Median LOS (days) was significantly longer in multiple gestation compared to singleton births overall (singletons: 1.59 [1.13, 2.19] vs. twins 3.29 [2.17, 9.59] vs. triplets or higher-order multiples 19.15 [8.80, 36.38], p < .0001), and this difference remained significant within each GA category. Conclusion Multiple gestation births have higher mortality and longer LOS when compared to singleton births. This population data from multiple centers across the country could be useful in counseling parents when caring for multiple gestation pregnancies.

Reporting More but Moving Less? The Complex Relationship between Acculturation and Physical Activity Among US Adults

2017 ◽  
Vol 32 (2) ◽  
pp. 446-452
Author(s):  
Hua Zan ◽  
Jessie X. Fan
Keyword(s):  
Physical Activity ◽  
Leisure Time ◽  
Language Use ◽  
Survey Design ◽  
The United States ◽  
Complex Relationship ◽  
Cross Sectional ◽  
Complex Survey ◽  
Health And Nutrition ◽  
Complex Survey Design

Purpose: To investigate the association between acculturation and physical activity (PA). Design: Cross sectional. Setting: The National Health and Nutrition Examination Surveys (NHANES) 2003 to 2006. Subjects: A total of 4029 adults (aged 20-64), including 2063 men and 1966 women. Measures: The outcome measures included both self-reported PA and device-assessed PA. The acculturation measure was constructed based on nativity, language use at home, and length of residence in the United States. Analysis: Regressions with domain analysis were conducted to adjust for the influence of confounding factors and complex survey design. Results: For men, self-reported PA increased with acculturation, especially leisure-time PA. However, device-assessed PA decreased with acculturation. For women, the results were more mixed. Conclusion: All evidence considered, we concluded that PA decreased with acculturation for US men.

scholarly journals Multimorbidity and Disability Among Venezuelan Migrants: A Population-Based Survey in Peru

2021 ◽  
Author(s):  
Antonio Bernabe-Ortiz ◽  
Rodrigo M. Carrillo-Larco
Keyword(s):  
Chronic Conditions ◽  
Survey Design ◽  
Prevalence Ratio ◽  
Population Based ◽  
Short Version ◽  
Refugee Status ◽  
Complex Survey ◽  
Complex Survey Design ◽  
Venezuelan Population ◽  
Population Based Survey

AbstractThe political and economic crisis in Venezuela has originated an unprecedented migration. As of November 2020, 1.04 million Venezuelans have moved to Peru. Understanding their health profile is needed to identify their needs, provide care and secure resources without affecting the healthcare of nationals. We quantified the burden of multimorbidity and disability in the Venezuelan population in Peru. We analyzed the 2018 Survey of Venezuelan Population Living in Peru; population-based with random sampling survey in six cities in Peru. Participants were asked about the presence of 12 chronic conditions (self-reported); this information was grouped into 0, 1 and ≥ 2 conditions (i.e., multimorbidity). Disability was also ascertained with a self-reported questionnaire adapted from the short version of the Washington Group on Disability Statistics. Socioeconomic variables were analyzed as potential determinants. Variables were described with frequencies and 95% confidence interval (95% CI), compared with Chi2 test, and association estimates were derived with a Poisson regression reporting prevalence ratio and 95% CI. Results accounted for the complex survey design. The analysis included 7554 migrants, mean age 31.8 (SD: 10.2), 46.6% were women, 31.7% migrated alone and 5.6% had refugee status. The prevalence of multimorbidity was 0.6% (95% CI 0.4–0.9%), and was often present in women (p < 0.001), people ≥ 50 years (p < 0.001) and those without recent job (p < 0.001). The prevalence of disability was 2.0% (95% CI 1.5–2.7%), and was common among people ≥ 50 years (p < 0.001) and those without recent job (p < 0.001). Migration alone and refugee status were not associated with multimorbidity or disability. The self-reported prevalence of multimorbidity and disability in Venezuelan migrants in Peru was low, and were not strongly influenced by migration status. While these results could suggest a healthy migrant effect, the healthcare system should be prepared to deliver acute and preventive care for these migrants, while also securing primary prevention to delay the onset of chronic conditions in this population.

The German Version of the Satisfaction With Life Scale (SWLS)

2011 ◽  
Vol 27 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Heide Glaesmer ◽  
Gesine Grande ◽  
Elmar Braehler ◽  
Marcus Roth
Keyword(s):  
Convergent Validity ◽  
Satisfaction With Life ◽  
Age Groups ◽  
Population Based ◽  
Factorial Invariance ◽  
Satisfaction With Life Scale ◽  
Small Samples ◽  
Cross Sectional ◽  
Confirmatory Factor Analyses ◽  
Life Scale

The Satisfaction with Life Scale (SWLS) is the most commonly used measure for life satisfaction. Although there are numerous studies confirming factorial validity, most studies on dimensionality are based on small samples. A controversial debate continues on the factorial invariance across different subgroups. The present study aimed to test psychometric properties, factorial structure, factorial invariance across age and gender, and to deliver population-based norms for the German general population from a large cross-sectional sample of 2519 subjects. Confirmatory factor analyses supported that the scale is one-factorial, even though indications of inhomogeneity of the scale have been detected. Both findings show invariance across the seven age groups and both genders. As indicators of the convergent validity, a positive correlation with social support and negative correlation with depressiveness was shown. Population-based norms are provided to support the application in the context of individual diagnostics.

scholarly journals Stillbirth outcome capture and classification in population-based surveys: EN-INDEPTH study

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Hannah Blencowe ◽  
◽  
Matteo Bottecchia ◽  
Doris Kwesiga ◽  
Joseph Akuze ◽  
...  
Keyword(s):  
Gestational Age ◽  
A Priori ◽  
Healthcare Providers ◽  
Population Based ◽  
Reproductive Age ◽  
Group Discussions ◽  
Cross Sectional ◽  
Vital Status ◽  
Neonatal Deaths ◽  
Adverse Pregnancy

Abstract Background Household surveys remain important sources of stillbirth data, but omission and misclassification are common. Classifying adverse pregnancy outcomes as stillbirths requires accurate reporting of vital status at birth and gestational age or birthweight for every pregnancy. Further categorisation, e.g. by sex, or timing (intrapartum/antepartum) improves data to understand and prevent stillbirth. Methods We undertook a cross-sectional population-based survey of women of reproductive age in five health and demographic surveillance system sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda (2017–2018). All women answered a full birth history with pregnancy loss questions (FBH+) or a full pregnancy history (FPH). A sub-sample across both groups were asked additional stillbirth questions. Questions were evaluated using descriptive measures. Using an interpretative paradigm and phenomenology methodology, focus group discussions with women exploring barriers to reporting birthweight for stillbirths were conducted. Thematic analysis was guided by an a priori codebook. Results Overall 69,176 women reported 98,483 livebirths (FBH+) and 102,873 pregnancies (FPH). Additional questions were asked for 1453 stillbirths, 1528 neonatal deaths and 12,620 surviving children born in the 5 years prior to the survey. Completeness was high (> 99%) for existing FBH+/FPH questions on signs of life at birth and gestational age (months). Discordant responses in signs of life at birth between different questions were common; nearly one-quarter classified as stillbirths on FBH+/FPH were reported born alive on additional questions. Availability of information on gestational age (weeks) (58.1%) and birthweight (13.2%) was low amongst stillbirths, and heaping was common. Most women (93.9%) were able to report the sex of their stillborn baby. Response completeness for stillbirth timing (18.3–95.1%) and estimated proportion intrapartum (15.6–90.0%) varied by question and site. Congenital malformations were reported in 3.1% stillbirths. Perceived value in weighing a stillborn baby varied and barriers to weighing at birth a nd knowing birthweight were common. Conclusions Improving stillbirth data in surveys will require investment in improving the measurement of vital status, gestational age and birthweight by healthcare providers, communication of these with women, and overcoming reporting barriers. Given the large burden and effect on families, improved data must be made available to end preventable stillbirths.

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