Primitive Reflexes and Dementia in Adults With Down Syndrome

2021 ◽  
pp. 10.1212/CPJ.0000000000001135
Author(s):  
Jordan Harp ◽  
Lisa Koehl ◽  
Kathryn Van Pelt ◽  
Elizabeth Head ◽  
Gregory Jicha ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Multinomial Logistic Regression ◽  
Chi Square ◽  
Cross Sectional ◽  
Informant Ratings ◽  
Clinical Assessments ◽  
Primitive Reflexes ◽  
Direct Assessment ◽  
Severe Impairment ◽  
Behavioral Assessments

ABSTRACTObjective:To determine whether primitive reflexes serve as an indicator of dementia in adults with Down syndrome (DS), we collected neurologic examination data, cognitive and behavioral assessments, and clinical consensus diagnoses of dementia from 92 adults with DS.Methods:In a cross-sectional, observational study of a regional cohort, chi-square and Fisher’s exact tests examined individual reflexes across diagnostic group (No, Possible, or Probable Dementia). In 64 participants with all 8 reflexes assessed, the number of primitive reflexes was assessed as a predictor of diagnosis using age-controlled multinomial logistic regression and of performance on clinical assessments (Brief Praxis Test [BPT], Severe Impairment Battery [SIB], and the Dementia Questionnaire for People with Learning Disabilities [DLD] using age-adjusted linear regression.Results:Primitive palmomental, grasp, snout, and suck reflexes were more frequent in individuals with probable dementia, but all participants showed at least one primitive reflex. Multiple primitive reflexes in combination served as a better indicator of dementia, with each additional abnormal reflex tripling probability of Probable Dementia group membership controlling for age. Abnormal reflex count was not associated with direct assessment of cognition and praxis (SIB and BPT) but associated with informant ratings of cognitive and behavioral functioning (DLD).Conclusions:The presence of multiple reflexes serves as an indicator of dementia status in DS as a supplement to direct assessment of cognition and praxis. The reflex examination may serve as a tool in the multimethod evaluation for dementia in DS, as it appears unaffected by intellectual disability and language mastery.

scholarly journals Socioeconomic characteristics influence attitudes towards sexuality in adolescents

2021 ◽  
Vol 31 (1) ◽  
pp. 101-115
Author(s):  
Juliani Da Silva Araújo Alves ◽  
Silvana Granado Nogueira da Gama ◽  
Maria Carmen Moldes Viana ◽  
Katrini Guidolini Martinelli ◽  
Edson Theodoro dos Santos Neto
Keyword(s):  
Family Income ◽  
Multinomial Logistic Regression ◽  
Social Contexts ◽  
Sexual Practices ◽  
Chi Square ◽  
Cross Sectional ◽  
Four Dimensions ◽  
School Based ◽  
Lower Socioeconomic ◽  
Chi Square Test

Backgroung: Attitudes Towards Sexuality in Adolescents (ATSA) are built according to the experiences and different social contexts. Objectives: to analyze attitudes towards sexuality itself, according to socioeconomic factors in adolescents aged. Methods: Cross-sectional school-based study was carried out with 2,292 adolescents enrolled in high school, in 54 schools, through interviews using the Attitudes Toward Sexuality in Adolescents (AFSA) instrument that has four dimensions, and measures the Permissiveness, Communion, Instrumentality and Sexual Practices. Then, the attitude of each adolescent was classified as: unfavorable, indifferent and favorable. Pearson’s Chi-square test and Multinomial Logistic Regression were used in statistical analyses. Results: It was verified that the majority of the adolescents presented unfavorable AFSA, being these behaviors directly associated to: age of 15/16 and 17 years (OR=0.59; OR=0.47); lower secondary education (OR=2.03); adolescent’s head of family having low education (OR=2.00); to live with the partner (OR=2.77); race / color black (OR=2.04) and brown (OR=1.88); and lower family income (OR=2.50). Conclusion: Adolescents with lower socioeconomic status are more likely to have unfavorable attitudes towards their own sexuality.

scholarly journals Household Food Insecurity Scores are Higher among Adults Infected with COVID-19: A Cross-Sectional Online Study among an Iranian Population

2021 ◽  
Author(s):  
Naser Kalantari ◽  
Hassan Eini-Zinab ◽  
Neda Ezzeddin ◽  
Nastaran Miri
Keyword(s):  
Food Insecurity ◽  
Multinomial Logistic Regression ◽  
Cross Sectional Study ◽  
Healthcare Personnel ◽  
Household Food Insecurity ◽  
Chi Square ◽  
Cross Sectional ◽  
Infected People ◽  
Household Food ◽  
Chi Square Test

Introduction: Food insecurity has negative impacts on health, including the function of the immune system. The association between food insecurity and COVID-19 infection rates has not been fully understood. This study aimed to examine whether food-insecure households are more vulnerable to COVID-19 infection. Materials and Methods: This online cross-sectional study was conducted on 2,871 Iranian adults (31 provinces), from August to September 2020. Demographic and socio-economic information was collected using a questionnaire. The Household Food Insecurity Access Scale (HFIAS) was used for assessing household food insecurity. The data analysis was performed by SPSS.22, using Chi-square test, ANOVA test, and Multinomial Logistic Regression Model. Results: The findings indicated that healthcare personnel were at higher risk of COVID-19 (CI = 1.90, 7.05; OR = 3.66; P < 0.001). It was also shown that HFIAS scores were significantly higher among infected people compared to non-infected (CI = 1.00, 1.05; OR = 1.03; P < 0.05). Women were at lower risk of infection compared to men (CI = 0.41, 0.87; OR = 0.60; P < 0.05). Conclusions: Based on the results, in addition to long-term policies to improve food security, policymakers are recommended to implement short-term policies to reduce the vulnerability of the community to COVID-19 virus.

Demographic Correlates of Suicidal Ideation and Suicide Attempts among Adults with and without Depression

2020 ◽  
Author(s):  
Areen Omary
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempts ◽  
Multinomial Logistic Regression ◽  
Model Fitting ◽  
College Education ◽  
The United States ◽  
Chi Square ◽  
Cross Sectional ◽  
Demographic Groups ◽  
Mlr Model

Background: This study examines the national prevalence rates of suicidal ideation and attempts among adults with and without major depressive episode (MDE) in five demographic groups –race, sex, age, education, and marital status – in the United States. Methods: Data extracted from the 2018 National Survey on Drug Use and Health (NSDUH) were analyzed , producing 42,551 records. Wald chi-square diagnostic examination was conducted on the multinomial logistic regression (MLR) model with five demographic predictor variables.Results: The highest rates of suicidal ideation for those with MDE occurred in White females (40.6%), adults 18-25 years old (36.4%), individuals with some college education (40.4%), and unmarried adults (57.1%). For those without MDE, the highest rates of suicidal ideation occurred among White males (31.9%), adults 18-25 years old (31.9%), individuals with some college education (38.7%), and unmarried adults (49.6%). Among the same demographic groups, proportions of suicide attempts were highest for those with MDE. A chi-square test indicated significant differences across adults with and without MDE in all demographic groups. The MLR model fitting results showed that the five demographic variables were significant predictors of suicidal ideation and attempts in both populations (p&lt;0.05).Limitations: Our data are cross-sectional and no directionality or causality can be assumed between study variables. A small proportion of the population was excluded from the survey.Conclusions: serious mental health needs are unmet for many demographic groups, especially among individuals with depression. Population-based clinical interventions are needed to reduce rates of depression, suicidal ideation, and attempts.

scholarly journals Nutritional Status and its Related Factors in Khalwa Residents, Khartoum state, Sudan

2019 ◽  
Author(s):  
Israa Hassan Giha ◽  
Mahasin Ibrahim Shaddad ◽  
Abdulrahman Yusuf ◽  
Ibrahim Abba Paga ◽  
Mounkaila Noma ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Multinomial Logistic Regression ◽  
Statistical Tests ◽  
Educational Institution ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Related Factors ◽  
Cross Sectional ◽  
Multistage Sampling

AbstractIntroductionKhalwa is an Islamic educational institution, known as such in Sudan and called elsewhere Koranic institution. Our research aimed to assess the nutritional status and its related factors among Khalwa residents in Khartoum State.MethodsA facility-based cross-sectional study was implemented in two localities of Khartoum State. A multistage sampling technique was used to selected 1273 residents. At first level, four khalwa were selected in the seven localities of Khartoum State through a stratified random sampling technique. At second level, in each of the khalwa selected, all the residents fulfilling the inclusion and exclusion criteria were included in the study. The collected data were firstly summarized numerically and graphically. Then, associations/differences among variables were determined through chi-square tests and ANOVA. A multinomial logistic regression established the relationship between the nutritional status of the residents and its related factors. All statistical tests were considered statistically significant whenp< 0.05.ResultsThe age of 1273 residents varied from 6 to 60 years with an average age of 15 years. Their mean body mass index (BMI) of 16.6±3.4 ranged from 7.8 to 34.0. 73.8% (939/1272) of the residents were undernourished, 23.9% (23.9%, 309/1272) were well nourished and 2.3% (29/1272) were overweight/obese. The statistically significant factors related to the nutritional status of the residents were age (under-nourishedp=0.000; well-nourishedp=0.004), status in the khalwa (p=0.001 vsp=0.075), resting time (p=0.002 vsp=0.038), practices of hand washing (p=0.165 vsp=0.011) and exercising (p=0.032 vsp=0.027). The food practices, despite their contributions to the model, were not statistically significant (p > 0.05).DiscussionThe nutritional status of khalwa should be translated urgently in a community-directed intervention based on a partnership involving the affected communities, political and administrative authorities, national, bilateral and international donors to overcome the burden of malnutrition.

scholarly journals Dukungan Keluarga Dengan Penerimaan Ibu Yang Memiliki Anak Down Syndrome Di Rumah Ceria Down Syndrome Jakarta Selatan

2018 ◽  
Vol 2 (2) ◽  
pp. 58-65
Author(s):  
Nadira Dwi Artika ◽  
Sang Ayu Made Adyani ◽  
Diah Ratnawati
Keyword(s):  
Down Syndrome ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional

Down syndrome merupakan penyebab genetik paling sering pada keterbelakangan mental, Memiliki anak berkebutuhan khusus tentunya menjadi beban berat bagi ibu. Dukungan keluarga merupakan faktor penting dalam menerima keadaan yang dialami ibu. Penelitian ini bertujuan untuk mengetahui hubungan dukungan keluarga dengan penerimaan ibu yang memiliki anak down syndrome di Rumah Ceria Down Syndrome Jakarta Selatan. Desain penelitian ini kuantitatif menggunakan deskriptif analitik dengan pendekatan cross sectional. Teknik pengambilan sampel menggunakan total sampling sebanyak 45 ibu. Analisa bivariat menggunakan uji chi-square. Dari hasil uji statistik chi-square dapat disimpulkan bahwa ada hubungan antara dukungan keluarga dengan penerimaan ibu yang memiliki anak down syndrome (p value sebesar 0,005 < 0.05) dan ada hubungan antara dukungan sosial dengan penerimaan ibu yang memiliki anak down syndrome (p value sebesar 0,15 < 0,05). Hasil penelitian ini menjadi masukan bagi ibu sehingga memiliki penerimaan diri yang baik agar dapat mempersiapkan pengasuhan yang tepat untuk perkembangan dan pertumbuhan anak maksimal.

scholarly journals Periodontal Condition and Subgingival Microbiota Characterization in Subjects with Down Syndrome

2021 ◽  
Vol 11 (2) ◽  
pp. 778 ◽  
Author(s):  
Maigualida Cuenca ◽  
María José Marín ◽  
Lourdes Nóvoa ◽  
Ana O`Connor ◽  
María Carmen Sánchez ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Dental Plaque ◽  
Quantitative Polymerase Chain Reaction ◽  
Anaerobic Bacteria ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Microbiological Methods ◽  
Medical Histories ◽  
Subgingival Microbiota

The aim was to study the subgingival microbiota in subjects with Down syndrome (DS) with different periodontal health status, using cultural and molecular microbiological methods. In this cross-sectional study, DS subjects were selected among those attending educational or occupational therapy centers in Galicia (Spain). Medical histories, intraoral and periodontal examinations and microbiological sampling were performed. Samples were processed by means of culture and quantitative polymerase chain reaction (qPCR). Microbiological data were compared, by one-way ANOVA or Kruskal-Wallis and chi-square or Fisher tests, according to their periodontal status. 124 subjects were included, 62 with a healthy periodontium, 34 with gingivitis and 28 with periodontitis. Patients with periodontitis were older (p < 0.01) and showed lower prevalence of hypothyroidism and levothyroxine intake (p = 0.01), presented significantly deeper pockets and more attachment loss (p ≤ 0.01). Both gingivitis and periodontitis subjects showed higher levels of bleeding and dental plaque. PCR counts of T. forsythia and culture counts of E. corrodens and total anaerobic counts were significantly higher in periodontitis patients. Relevant differences were observed in the subgingival microbiota of DS patients with periodontitis, showing higher levels of anaerobic bacteria, T. forsythia and E. corrodens, when compared with periodontally healthy and gingivitis subjects. Moreover, periodontitis subjects were older, had lower frequency of hypothyroidism and higher levels of dental plaque.

scholarly journals Investigation of Anxiety Sensitivity Levels of Cancer Patients In Terms of Covid 19 Vaccine: A Cross-Sectional Study

2021 ◽  
Author(s):  
GÖKÇE İŞCAN ◽  
BÜLENT ÇETİN ◽  
FARUK KILIÇ ◽  
HAKAN KALAYCI ◽  
AYŞEGÜL KALAYCI
Keyword(s):  
Cancer Patients ◽  
Anxiety Sensitivity ◽  
Multinomial Logistic Regression ◽  
Cross Sectional Study ◽  
Sensitivity Index ◽  
Sectional Study ◽  
Long Term Effects ◽  
Negative Effects ◽  
Chi Square ◽  
Cross Sectional

Abstract Introduction: The goal of our research was to look into the perspectives of cancer patients who had not yet been vaccinated, aged from 21 to 88 years old and had applied to Süleyman Demirel University's oncology outpatient clinic in May and June, as well as their anxieties and concerns about vaccination. Methods The goal of this descriptive cross-sectional study was to investigate cancer patients’ perceptions of Covid vaccination. We applied 3 questionnaires, one of them prepared by us, the other two questionnaires were The State-Trait Anxiety Inventory (STAI) form and Anxiety Sensitivity index to a total of 497 participants. Chi-Square, Spearmen correlation test, multivariable multinomial logistic regression tests were used when comparing. Results Our participants were between the ages of 21 and 88, with a mean age of 61,38 (SD = 11,68). 48,6% (n=251) of all participants were female. We discovered that 79.1% (n=408) of respondents were not afraid of getting the COVID-19 vaccine. 27,7 % (n=143) of this population's respondents were concerned about the COVID-19 vaccine's negative effects and 24,2% (n=125) were afraid of its side effects with their treatments. 91,1% (n=470) of the patients did not know which vaccine they would have and the type of the vaccine. Due to the high level of anxiety in women in general, it was thought that anxiety scores were higher in patients with breast and ovarian cancer, which are important cancers in women during the pandemic period, while anxiety scores were lower in patients with prostate cancer since it was seen in men. Special patient groups should not be neglected during this vaccine season, and their concerns should be addressed. When a new vaccine is found, it can have long-term effects, which should not be ignored.

scholarly journals HUBUNGAN ANTARA DUKUNGAN SOSIAL DENGAN PENERIMAAN ORANG TUA ANAK DOWN SYNDROME

2018 ◽  
Vol 2 (2) ◽  
pp. 62
Author(s):  
Abdul Wakhid ◽  
Hartawan Saputra ◽  
Zumrotul Choiriyyah
Keyword(s):  
Social Support ◽  
Down Syndrome ◽  
Emotional Support ◽  
Sampling Technique ◽  
Information Support ◽  
Instrumental Support ◽  
Questionnaire Data ◽  
Chi Square ◽  
Cross Sectional ◽  
Children With Down Syndrome

AbstrakAnak down syndrome merupakan kondisi yang amat sangat tidak diharapkan oleh orang tua. Pada umumnya orang tua mengalami sedih, stres, perasaan bersalah, sakit hati tidak dapat menerima kenyataan, dan lain sebagainya. Dukungan sosial sangat diperlukan untuk memberikan dukungan perawatan dan penerimaan diri orang tua. Penelitian ini bertujuan untuk menganalisis hubungan antara dukungan sosial dengan penerimaan orang tua anak down syndrome di SLB Kabupaten Semarang. Jenis penelitian ini adalah deskriptif korelasi dengan pendekatan cross sectional. Populasi penelitian ini adalah orang tua anak down syndrome di SLB Kabupaten Semarang. Sampel sebesar 49 orang dengan teknik total sampling. Instrumen penelitian dukungan sosial dan penerimaan orang tua diukur dengan kuesioner. Analisis data menggunakan chi square (α= 0,05). Gambaran dukungan sosial orang tua anak down syndrome di SLB Kabupaten Semarang dalam kategori baik sebanyak 38 orang (77,6%). Gambaran penerimaan orang tua anak down syndrome di SLB Kabupaten Semarang dalam kategori baik sebanyak 41 orang (83,7%). Ada hubungan antara dukungan sosial dengan penerimaan orang tua anak down syndrome di SLB Kabupaten Semarang (p=0,000). Diharapkan keluarga, teman atau kerabat dan masyarakat memberikan dukungan sosial baik dari dukungan emosional, dukungan instrumental, dukungan informasi, dan dukungan penghargaan untuk orang tua anak down syndrome di SLB Kabupaten Semarang. Kata kunci: Dukungan Sosial, penerimaan diri, down syndrome AbstractThe correlation between social support and parent’s acceptance of down syndrome children. Down syndrome children is a condition that is extremely not expected by the parents. Generally, parents will experience sadness, stress, guilt, hurt can not accept reality, and others. One of the factors that affect the acceptance of parents is social support. This study aimed to analyzed the correlation between social support and parent’s acceptance of down syndrome children at SLB Semarang Regency. This study was descriptive correlation with cross sectional approach. The population in this study were parents of down syndrome children at SLB Semarang Regency. Sample of 49 people with total sampling technique. The research instrument of social support and acceptance of parents were measured with a questionnaire. Data analysis used chi square (α = 0.05). The description of social support of down syndrome children at SLB Semarang Regency is in good category as many as 38 people (77.6%). The description of of parents acceptance of children with down syndrome at SLB Semarang Regency is in good category as many as 41 people (83.7%).  There is a correlation between social support and parent acceptance of children with down syndrome at SLB Semarang. Regency (p = 0.000). It is expected that family, friends or relatives and the community provide social support in from of emotional support, instrumental support, information support, and award support to the parents of children with down syndrome at SLB Semarang Regency. Keywords: Social support, self-acceptance, down syndrome

scholarly journals KEBIASAAN MAKAN, AKTIVITAS FISIK DAN INDEKS MASSA TUBUH (IMT) MAHASISWA S-1 UNIVERSITAS SEBELAS MARET SURAKARTA

2018 ◽  
pp. 19-25
Author(s):  
Aisyah Nurkhopipah ◽  
Ari Natalia Probandari ◽  
Sapja Anantanyu
Keyword(s):  
Physical Activity ◽  
Transition Period ◽  
Eating Habits ◽  
Multinomial Logistic Regression ◽  
Overweight And Obesity ◽  
The Body ◽  
Chi Square ◽  
Cross Sectional ◽  
Student College ◽  
Prevalence Of Obesity

Bagian penting dari mahasiswa adalah mereka mengalami masa transisi kuat dengan perubahanlingkungan yang ditandai dengan pola makan yang tidak sehat dan kurang aktivitas Þ sik yangmenempatkan mahasiswa pada risiko yang lebih besar dari kenaikan berat badan. Kelebihan beratbadan dan obesitas terjadi pada mahasiswa, menurut Centers for Disease Control (CDC), prevalensiobesitas pada mahasiswa laki-laki adalah 29,5% dan pada mahasiswa perempuan sebesar 32,6%.Tujuan penelitian ini adalah untuk menganalisis hubungan kebiasaan makan dan aktivitas Þ sik denganIndeks Massa Tubuh mahasiswa S-1 UNS. Jenis penelitian ini adalah observasional analitik denganpendekatan Cross Sectional. Subjek penelitian ini adalah seluruh mahasiswa program studi S-1 UNSpada tahun 2016 yaitu sejumlah 24.826 orang. Data dianalisis dengan chi square dan regresi logisticmultinomial. Hasil uji korelasi chi square, menunjukkan bahwa kebiasaan makan tidak berhubungansecara signiÞ kan dengan IMT Normal-Kurus ataupun IMT Normal-Gemuk (p = 0,193 & p = 0,446),sedangkan aktivitas Þ sik mempunyai hubungan yang signiÞ kan dengan IMT Normal-Gemuk (p =0,029),tetapi tidak berhubungan dengan IMT normal-kurus (p=0,655). Kesimpulan dalam penelitianini adalah tidak terdapat hubungan yang signiÞ kan antara kebiasaan makan dengan IMT normalkurusataupun IMT normal-gemuk. Tidak ada hubungan antara aktiÞ tas Þ sik dengan IMT normal-kurusnamun terdapat hubungan yang signiÞ kan antara variable aktivitas Þ sik dengan IMT normal-gemuk. Kata kunci: kebiasaan, makan, aktivitas Þ sik, mahasiswa, IMT.The important part of the students is that they experience a strong transition period with environmentalchanges characterized by an unhealthy diet and lack of physical activity that puts students at greaterrisk of weight gain. Overweight and obesity occurs in college students, according to the Centers forDisease Control (CDC), the prevalence of obesity in male students is 29.5% and in female students32.6%. The purpose of this study was to analyze the relationship between eating habits and physicalactivity with the body mass index of S-1 UNS students. Type of observational analytic research withCross Sectional approach. The subjects of this study are all S-1 students of UNS program in 2016 thatis 24,826 people. Data were analyzed by chi square and multinomial logistic regression. The result ofchi square correlation test showed that Eating Habits did not correlate signiÞ cantly with Normal BMI- Thin or Normal BMI - Overweight (p = 0,193 & p = 0,446), whereas Physical Activity had signiÞ cantrelation with Normal BMI – Overweight (p = 0,029 ), But not related to normal BMI-thin (p = 0.655).Conclusion of the research is there was no signiÞ cant association between eating habits with normalBMI-thin or normal-fat BMI. There was no relationship between physical activity and normal BMI-butthere was a signiÞ cant relationship between physical activity variables and normal-fat BMI.Keywords:Eating Habits, Physical Activity, student college, BMI.

scholarly journals Access to medicines: relations with the institutionalization of pharmaceutical services

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Rafael Damasceno de Barros ◽  
Ediná Alves Costa ◽  
Djanilson Barbosa dos Santos ◽  
Gisélia Santana Souza ◽  
Juliana Álvares ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Multinomial Logistic Regression ◽  
Access To Medicines ◽  
Pharmaceutical Services ◽  
Bivariate Analysis ◽  
Management Tools ◽  
Chi Square ◽  
Cross Sectional ◽  
Health Council ◽  
Computerized System

OBJETIVE: To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. METHODS: This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services 2015), a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS: Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3); there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1); there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0); those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5); there is computerized system for pharmaceutical services management, OR = 4.3 (95%CI 2.4-7.5). CONCLUSIONS: Aspects related to the institutionalization of pharmaceutical services have been strongly related to access to medicines. Our results indicate the need to prioritize its implementation, contributing to its consolidation in Brazil and to the effectiveness of health services regarding the purposes of pharmaceutical services policies

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