cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.19933409.v1
title: Brazilian adaptation of the questionnaire to assess adherence to treatment for arterial hypertension

description: OBJECTIVE To describe the cross-cultural adaptation of the questionnaire evaluating adhesion to treatment for arterial hypertension from its original Spanish version to a Portuguese version, to be applied in Brazil. METHODS In order to establish conceptual, semantic and operational equivalents of the items, two independent translations to Portuguese, and two back-translations into Spanish were performed. The translations and back-translations were assessed for changes in referential and general meanings. The synthesis of the translations was applied in pre-tests with patients with arterial hypertension and/or diabetes, which were important to identify different problems and confirm earlier decisions. RESULTS In general, the second translation and back translation were evaluated more positively because the translation process did not affect the meanings in five of the twelve items of the questionnaire. Operational changes were made and a vignette with response options and an example included in the instrument facilitated application in interviews. CONCLUSIONS The results obtained in the process of evaluating the items’ conceptual, semantic and operational equivalence allowed the construction of a Portuguese version of the MBG questionnaire to assess adherence to treatment which can be applied in the Brazilian context.
DOI: 10.6084/m9.figshare.19933425
title: Adaptation and content validation of the Brazilian version of the Posttraumatic Cognitions Inventory

description: OBJECTIVE To translate, adapt and validate the contents of the Brazilian version of the Posttraumatic Cognitions Inventory. METHODS: The process of translation and adaptation of the initial instructions and items involved five steps: (1) translation; (2) back translation; (3) correction and semantic adaptation; (4) content validation by professional experts (judges); and (5) test of final version through a verbal-numbered scale. As performance indicators for understanding, the scores of central tendency (mean) and dispersion (standard deviation) were calculated for each item in step 5. Satisfactory comprehension was defined as a mean score ≥ 3. RESULTS The 36 questions and the initial instructions were translated and adapted to create the Brazilian version of the Posttraumatic Cognitions Inventory. In the final stage of testing, 45 adults answered the items and demonstrated an adequate understanding of the instrument in the verbal-numbered scale (M = 4.13; dp = 0.11). CONCLUSIONS The Posttraumatic Cognitions Inventory is an easily understood and semantically valid instrument. Further studies are needed to verify and evaluate the appropriateness of its psychometric properties for the Brazilian population.
DOI: 10.6084/m9.figshare.19933425.v1
title: Adaptation and content validation of the Brazilian version of the Posttraumatic Cognitions Inventory

description: OBJECTIVE To translate, adapt and validate the contents of the Brazilian version of the Posttraumatic Cognitions Inventory. METHODS: The process of translation and adaptation of the initial instructions and items involved five steps: (1) translation; (2) back translation; (3) correction and semantic adaptation; (4) content validation by professional experts (judges); and (5) test of final version through a verbal-numbered scale. As performance indicators for understanding, the scores of central tendency (mean) and dispersion (standard deviation) were calculated for each item in step 5. Satisfactory comprehension was defined as a mean score ≥ 3. RESULTS The 36 questions and the initial instructions were translated and adapted to create the Brazilian version of the Posttraumatic Cognitions Inventory. In the final stage of testing, 45 adults answered the items and demonstrated an adequate understanding of the instrument in the verbal-numbered scale (M = 4.13; dp = 0.11). CONCLUSIONS The Posttraumatic Cognitions Inventory is an easily understood and semantically valid instrument. Further studies are needed to verify and evaluate the appropriateness of its psychometric properties for the Brazilian population.
DOI: 10.6084/m9.figshare.19933430.v1
title: Anthropological view of the decentralization of the Mexican health system

description: OBJECTIVE: To analyze organizational, political and economic changes resulting from the decentralization of the health system for those in Mexico without health insurance. METHODS: Three states, selected by considering the percentage of the population living in poverty, the political party in power and their stage of decentralization (the first was in 1984 and the second in 1997) were included. Interviews were conducted during 2007 with key informants from the state health care services, users of health care services, and community leaders. Data were analyzed from an anthropological and economic perspective. RESULTS: Decentralization occurred in a heterogeneous way in each state, with responsibilities being transferred from federal to state level but without breaking the dependence on the central-federal level. The reforms driven from the federal level to create a scheme based on a principle of financial subsidies and democratization of the health system face challenges for their political and organizational consolidation. CONCLUSIONS: The anthropological approach adopted in this analysis shows the relevance of considering organizational, economic and political factors as key components of the decentralization process.
DOI: 10.6084/m9.figshare.19933430
title: Anthropological view of the decentralization of the Mexican health system

description: OBJECTIVE: To analyze organizational, political and economic changes resulting from the decentralization of the health system for those in Mexico without health insurance. METHODS: Three states, selected by considering the percentage of the population living in poverty, the political party in power and their stage of decentralization (the first was in 1984 and the second in 1997) were included. Interviews were conducted during 2007 with key informants from the state health care services, users of health care services, and community leaders. Data were analyzed from an anthropological and economic perspective. RESULTS: Decentralization occurred in a heterogeneous way in each state, with responsibilities being transferred from federal to state level but without breaking the dependence on the central-federal level. The reforms driven from the federal level to create a scheme based on a principle of financial subsidies and democratization of the health system face challenges for their political and organizational consolidation. CONCLUSIONS: The anthropological approach adopted in this analysis shows the relevance of considering organizational, economic and political factors as key components of the decentralization process.
DOI: 10.6084/m9.figshare.19933436
title: Preventable infant mortality and barriers to access to primary care in Recife, Northeastern Brazil

description: OBJECTIVE: Analyze the factors infl uencing avoidable infant mortality from the perspective of the protagonists involved. METHODS: Qualitative study with a critical-constructivist approach, examining children’s access to health care and avoiding preventable infant mortality through health care campaigns and services in Health District I of Recife, Northeastern Brazil, between February 2007 and February 2008. The theoretical sample was designed in two stages: I) institutions providing health services to children; II) interviewees: managers (11); professionals from the Family Health Strategy and Programme of Community Health Workers (48); and from outpatient clinics (12); mothers (20), with sample size defi ned by “saturation of the speeches”. Data was collected using individual semistructured interviews and case studies of avoidable infant death. Thematic content analysis was used, generating mixed categories (emerging and scripted). RESULTS: There were perceived to be confl icting positions between different stakeholder groups refl ecting their role in the care network. All institutional participants related infant deaths to the absence/poor dissemination of child health policies and inter-sectoral actions; professionals and mothers highlighted diffi culties in accessing health care due to insuffi cient global resources, especially the lack of doctors in Family Health Strategy, shifting health care to nurses. Lack of doctors, acute diseases rejection, and dehumanized and/or poor technical quality care were the main factors which the mothers related to deaths. Family Health Strategy participants from the Programme of Community Health Workers and mothers identifi ed the condition of social exclusion and maternal neglect with deaths, but the case study of death revealed the association with lower quality of care offered. CONCLUSIONS: Numerous barriers to access indicate insuffi cient the Brazilian Unifi ed Health System implementation and lack of resolution of the main access route, the Family Health Strategy. The results indicate the need for improvement of structural and organizational factors of supply, with emphasis on mechanisms to stimulate the recruitment of doctors for the Family Health Strategy professional training of all staff consistent with the model of care to comply with health care policies for children and avoiding preventable infant mortality.
DOI: 10.6084/m9.figshare.19933436.v1
title: Preventable infant mortality and barriers to access to primary care in Recife, Northeastern Brazil

description: OBJECTIVE: Analyze the factors infl uencing avoidable infant mortality from the perspective of the protagonists involved. METHODS: Qualitative study with a critical-constructivist approach, examining children’s access to health care and avoiding preventable infant mortality through health care campaigns and services in Health District I of Recife, Northeastern Brazil, between February 2007 and February 2008. The theoretical sample was designed in two stages: I) institutions providing health services to children; II) interviewees: managers (11); professionals from the Family Health Strategy and Programme of Community Health Workers (48); and from outpatient clinics (12); mothers (20), with sample size defi ned by “saturation of the speeches”. Data was collected using individual semistructured interviews and case studies of avoidable infant death. Thematic content analysis was used, generating mixed categories (emerging and scripted). RESULTS: There were perceived to be confl icting positions between different stakeholder groups refl ecting their role in the care network. All institutional participants related infant deaths to the absence/poor dissemination of child health policies and inter-sectoral actions; professionals and mothers highlighted diffi culties in accessing health care due to insuffi cient global resources, especially the lack of doctors in Family Health Strategy, shifting health care to nurses. Lack of doctors, acute diseases rejection, and dehumanized and/or poor technical quality care were the main factors which the mothers related to deaths. Family Health Strategy participants from the Programme of Community Health Workers and mothers identifi ed the condition of social exclusion and maternal neglect with deaths, but the case study of death revealed the association with lower quality of care offered. CONCLUSIONS: Numerous barriers to access indicate insuffi cient the Brazilian Unifi ed Health System implementation and lack of resolution of the main access route, the Family Health Strategy. The results indicate the need for improvement of structural and organizational factors of supply, with emphasis on mechanisms to stimulate the recruitment of doctors for the Family Health Strategy professional training of all staff consistent with the model of care to comply with health care policies for children and avoiding preventable infant mortality.
DOI: 10.6084/m9.figshare.19933442
title: Public spending on drugs for the treatment of osteoporosis in post-menopause

description: OBJECTIVE: To analyze expenditure on treatment for postmenopausal osteoporosis and associated factors on mean per capita expenditure. METHODS: A probabilistic-deterministic linkage between the database of Authorizations for Highly Complex Procedures and the mortality information system was constructed, resulting in a historical cohort of patients using high-cost medications for the treatment of postmenopausal osteoporosis, between 2000-2006. Mean monthly spending on medicines was stratified by age group and described according to demographic and clinical characteristics and the type of drug used. A linear regression model was used to assess the impact of demographic and clinical characteristics on per capita mean monthly expenditure on medicines. RESULTS: We identified 72,265 women who received drugs for the treatment of postmenopausal osteoporosis. The average monthly expenditure per capita in the first year of treatment was $ 54.02 (sd $ 86.72). The population was predominantly composed of women aged 60-69 years old, who had started treatment in 2000, resident in the Southeast of Brazil, who had previously suffered osteoporotic fractures, and Alendronate sodium was the drug most commonly used at baseline. For most of the patients, the same active ingredient remained in use throughout the treatment period. During the program, 6,429 deaths were identified among participants. More than a third of women remained in treatment for up to 12 months. Raloxifen and calcitonin were the therapeutic alternatives with the greatest impact on the average monthly expenditure on medicine using alendronate sodium as a reference standard. CONCLUSIONS: Due to the high impact of the type of drug used on expenditure on medication, it is recommended that criteria for prescribing and dispensing be established by prioritizing those with lower costs and greater effectiveness in order to optimize the process of pharmaceutical care and provide the population with a greater number of pharmaceutical units.
DOI: 10.6084/m9.figshare.19933442.v1
title: Public spending on drugs for the treatment of osteoporosis in post-menopause

description: OBJECTIVE: To analyze expenditure on treatment for postmenopausal osteoporosis and associated factors on mean per capita expenditure. METHODS: A probabilistic-deterministic linkage between the database of Authorizations for Highly Complex Procedures and the mortality information system was constructed, resulting in a historical cohort of patients using high-cost medications for the treatment of postmenopausal osteoporosis, between 2000-2006. Mean monthly spending on medicines was stratified by age group and described according to demographic and clinical characteristics and the type of drug used. A linear regression model was used to assess the impact of demographic and clinical characteristics on per capita mean monthly expenditure on medicines. RESULTS: We identified 72,265 women who received drugs for the treatment of postmenopausal osteoporosis. The average monthly expenditure per capita in the first year of treatment was $ 54.02 (sd $ 86.72). The population was predominantly composed of women aged 60-69 years old, who had started treatment in 2000, resident in the Southeast of Brazil, who had previously suffered osteoporotic fractures, and Alendronate sodium was the drug most commonly used at baseline. For most of the patients, the same active ingredient remained in use throughout the treatment period. During the program, 6,429 deaths were identified among participants. More than a third of women remained in treatment for up to 12 months. Raloxifen and calcitonin were the therapeutic alternatives with the greatest impact on the average monthly expenditure on medicine using alendronate sodium as a reference standard. CONCLUSIONS: Due to the high impact of the type of drug used on expenditure on medication, it is recommended that criteria for prescribing and dispensing be established by prioritizing those with lower costs and greater effectiveness in order to optimize the process of pharmaceutical care and provide the population with a greater number of pharmaceutical units.
DOI: 10.6084/m9.figshare.19933466
title: Prevalence of trachoma in Brazilian schoolchildren

description: OBJECTIVE: To estimate the prevalence and describe the distribution of trachoma among schoolchildren in Brazilian municipalities.METHODS: Cross-sectional study, using cluster sampling, of the schoolchildren population of the Brazilian municipalities with Human Development Index - Municipal lower than the national average. This trachoma prevalence survey was conducted by the Ministry of Health, in the period 2002-2007. There were 119,531 schoolchildren selected from 2,270 schools located in 1,156 municipalities. The selected schoolchildren underwent an external ocular examination, with a magnifying glass (2.5X), to detect clinical signs of trachoma according to the WHO criteria. The prevalence of trachoma, by state and national level, and their respective 95% confidence intervals were estimated. Chi-square and Chi-square for trends tests were used to compare categorical variables.RESULTS: There were 6,030 cases of trachoma detected, resulting in a prevalence of 5.0% (95%CI 4.5;5.4). There was no significant difference between the sexes. The prevalence of trachoma was 8.2% among children under 5 years of age, decreasing among higher age groups (p &lt; 0.01). There was a significant difference in prevalence between urban and rural areas, 4.3% versus 6.2% respectively (p &lt; 0.01). Cases were detected in 901 municipalities (77.7% of the sample), in all regions of the country. In 36.8% of the selected municipalities, the prevalence was higher than 5%.CONCLUSIONS: The study shows that trachoma is a significant public health problem in Brazil, contradicting the belief that the disease had been controlled in the country. The survey provides a baseline for evaluating planned interventions aimed at achieving the goal of global certification of elimination of trachoma as a cause of blindness in Brazil by 2020.
DOI: 10.6084/m9.figshare.19933466.v1
title: Prevalence of trachoma in Brazilian schoolchildren

description: OBJECTIVE: To estimate the prevalence and describe the distribution of trachoma among schoolchildren in Brazilian municipalities.METHODS: Cross-sectional study, using cluster sampling, of the schoolchildren population of the Brazilian municipalities with Human Development Index - Municipal lower than the national average. This trachoma prevalence survey was conducted by the Ministry of Health, in the period 2002-2007. There were 119,531 schoolchildren selected from 2,270 schools located in 1,156 municipalities. The selected schoolchildren underwent an external ocular examination, with a magnifying glass (2.5X), to detect clinical signs of trachoma according to the WHO criteria. The prevalence of trachoma, by state and national level, and their respective 95% confidence intervals were estimated. Chi-square and Chi-square for trends tests were used to compare categorical variables.RESULTS: There were 6,030 cases of trachoma detected, resulting in a prevalence of 5.0% (95%CI 4.5;5.4). There was no significant difference between the sexes. The prevalence of trachoma was 8.2% among children under 5 years of age, decreasing among higher age groups (p &lt; 0.01). There was a significant difference in prevalence between urban and rural areas, 4.3% versus 6.2% respectively (p &lt; 0.01). Cases were detected in 901 municipalities (77.7% of the sample), in all regions of the country. In 36.8% of the selected municipalities, the prevalence was higher than 5%.CONCLUSIONS: The study shows that trachoma is a significant public health problem in Brazil, contradicting the belief that the disease had been controlled in the country. The survey provides a baseline for evaluating planned interventions aimed at achieving the goal of global certification of elimination of trachoma as a cause of blindness in Brazil by 2020.
DOI: 10.6084/m9.figshare.19933493
title: Screening for dependence in activities of daily living in the elderly: minimum set of questions

description: OBJECTIVE: To analyze non-redundant questions on independence in activities of daily living in the elderly, representing the spectrum of dependency.METHODS: Multicenter project with a probabilistic population sample of 5,371 elderly residents in Sao Paulo, SP, Rio de Janeiro, RJ, Fortaleza, CE and Bambui, MG in 2008. A household survey was carried out and a questionnaire with 20 activities of daily living applied for the elderly to self-assess the difficulty/need for help in performing them. The responses were analyzed according to: the prevalence of some kind of difficulty/need for help for each activities of daily living, the frequency of non-response, and the grouping of activities in factor analysis.RESULTS: The personal activities (e.g., dressing) have, on average, a low prevalence of difficulty or need for help, compared to instrumental activities (e.g., shopping), and have lower rates of non- response. In factor analysis it was possible to identify three factors grouping the activities of daily living: one relative to mobility (e.g., walking 100 m), another for personal needs (e.g., bathing) and one relative to what someone else can do for the elderly (e.g., washing clothes). The activities of daily living with the highest eigenvalues in each group were also analyzed in the light of the prevalence of reported need for help and the proportion of non response. Three activities of daily living were selected as representing the spectrum of dependency and being well understood by the elderly - getting out of bed, bathing and walking 100 m.CONCLUSIONS: With only three activities of daily living we can have a simple and reliable screening instrument capable of identifying elderly in need of help in daily life. Estimating demand for care on a daily basis is an important indicator for planning and administration of health services within the paradigm of chronic diseases and population aging.
DOI: 10.6084/m9.figshare.19933493.v1
title: Screening for dependence in activities of daily living in the elderly: minimum set of questions

description: OBJECTIVE: To analyze non-redundant questions on independence in activities of daily living in the elderly, representing the spectrum of dependency.METHODS: Multicenter project with a probabilistic population sample of 5,371 elderly residents in Sao Paulo, SP, Rio de Janeiro, RJ, Fortaleza, CE and Bambui, MG in 2008. A household survey was carried out and a questionnaire with 20 activities of daily living applied for the elderly to self-assess the difficulty/need for help in performing them. The responses were analyzed according to: the prevalence of some kind of difficulty/need for help for each activities of daily living, the frequency of non-response, and the grouping of activities in factor analysis.RESULTS: The personal activities (e.g., dressing) have, on average, a low prevalence of difficulty or need for help, compared to instrumental activities (e.g., shopping), and have lower rates of non- response. In factor analysis it was possible to identify three factors grouping the activities of daily living: one relative to mobility (e.g., walking 100 m), another for personal needs (e.g., bathing) and one relative to what someone else can do for the elderly (e.g., washing clothes). The activities of daily living with the highest eigenvalues in each group were also analyzed in the light of the prevalence of reported need for help and the proportion of non response. Three activities of daily living were selected as representing the spectrum of dependency and being well understood by the elderly - getting out of bed, bathing and walking 100 m.CONCLUSIONS: With only three activities of daily living we can have a simple and reliable screening instrument capable of identifying elderly in need of help in daily life. Estimating demand for care on a daily basis is an important indicator for planning and administration of health services within the paradigm of chronic diseases and population aging.