The use of databases of social and gender statistics in the development of policies and programmes

The unavailability of data to inform policy planning and formulation has been repeatedly cited as the main challenge to economic and social progress in the Caribbean. Furthermore, even in instances when data is produced, broader gaps exist between its production and eventual use for evidence-based policy formulation. Owing to those challenges, this report explores the use of databases of social and gender statistics in the development of policies and programmes in the Caribbean subregion. The report offers a general appraisal of databases against two main considerations: (i) maximizing the use of existing databases in relevant policies and programmes; and (ii) bridging the gaps in data availability of relevant statistical databases and their analyses. The assessment entailed an inventory of social and gender databases maintained by data producers in the region and analysis of the extent to which the databases are used for policy formulation. To that end, a literature search as well as consultations with a number of knowledgeable persons active in the field of statistics and data provision was conducted. Based on the review, a set of recommendations were produced to improve current practices within the region with respect evidence based policy formulation.

Socio-demographic analysis of youth in the Caribbean- a three country case study

Many Caribbean youth are doing reasonably well. They live in loving and caring families, attend school and are involved in various social activities in their communities. The health and well-being of the children and youth1 in the Caribbean is, and has been, the centre of attention of many studies, meetings and policy directives set at the regional, subregional and national levels. Programmes have been put in place to address the basic needs of young children in the areas of health and education and to provide guidance and directives to youth and adolescents in the area of professional formation and transition to adulthood. Critical issues such as reproductive health and family planning combined with access to education and information on these topics have been promoted to some extent. And finally, the Caribbean is known for rather high school enrolment rates in primary education that hardly show any gender disparities. While the situation is still good for some, growing numbers of children and youth cannot cope anymore with the challenges experienced quite early in their lives. Absent parents, instable care-taking arrangements, violence and aggression subjected to at home, in schools and among their friends, lack of a perspective in schools and the labour-market, early sexual initiation and teenage pregnancies are some of those issues faced by a rising number of young persons in this part of the world. Emotional instability, psychological stress and increased violence are one of the key triggers for increased violence and involvement in crime exhibited by ever younger youth and children. Further, the region is grappling with rising drop-out rates in secondary education, declining quality schooling in the classrooms and increasing numbers of students who leave school without formal certification. Youth unemployment in the formal labour market is high and improving the quality of professional formation along with the provision of adequate employment opportunities would be critical to enable youth to complete consistently and effectively the transition into adulthood and to take advantage of the opportunities to develop and use their human capital in the process. On a rather general note, the region does not suffer from a shortage of policies and programmes to address the very specific needs of children and youth, but the prominent and severe lack of systematic analysis and monitoring of the situation of children, youth and young families in the Caribbean does not allow for targeted and efficient interventions that promise successful outcomes on the long term. In an effort to assist interested governments to fill this analytical gap, various initiatives are underway to enhance data collection and their systematic analysis2. Population and household censuses are conducted every decade and a variety of household surveys, such as surveys of living conditions, labour force surveys and special surveys focusing on particular sub-groups of the population are conducted, dependent on the resources available, to a varying degree in the countries of the region. One such example is the United Nations Children’s Fund (UNICEF)-funded Multi-Indicator Cluster Surveys (MICS) that assess the situation of children and youth in a country. Over the past years and at present, UNICEF has launched a series of surveys in a number of countries in the Caribbean3. But more needs to be done to ensure that the data available is analyzed to provide the empirical background information for evidence-based policy formulation and monitoring of the efficiency and effectiveness of the efforts undertaken.

Identification of Candida Spp. In Patients with Denture Stomatitis: Relationship with Gender, Age, Time of Denture use and Newton’s Classification

Epidemiological researches are important to understand the distribution and etiology of oral diseases. The actual researches that show the relationship between patient ages, denture status and denture stomatitis are scarce. So, the aim of this study was to identify of Candida spp. in patients with Denture Stomatitis (DS) and to correlate with gender, age, time of denture use and Newton’s classification. 204 complete denture patients (46 males and 158 females) were selected. DS was classified according to Newton’s classification and it was related to gender, age and time of denture use. Samples from the palatal mucosa and the surface of the upper denture of patients with DS were evaluated using PCR test for identification of Candida species. T-test, chisquare and Fisher’s exact tests were used for statistical analysis. DS was evidenced in 54.4% of the sample. According to gender 41.3% of the males and 58.3% females had the disease and the differences were statistically significant (p = 0.032). The type of DS was directly influenced by the time of denture use (p<0.001), but it was not significantly related to the age of the participants (p>0.05). C. albicans, C. tropicalis, C. glabrata, C. krusei and C. dubliniensis were identified by PCR test. DS is more prevalent in women and the prevalence of DS was influenced by the time of denture use (years). C. albicans was identified as the most frequent specie in patients with DS.

Preoperative somatostatin analogues versus direct transsphenoidal surgery for newly-diagnosed acromegaly patients: a systematic review and meta-analysis using the GRADE system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of concurrent training on gender-specific biochemical variables and adiposity in obese adolescents

Objective The purpose of the present study was to analyze the effects of a 20-week concurrent training (20 WCT) intervention program on gender-specific body composition and metabolic variables in obese adolescents.Subjects and methods Sample was composed of twenty-five obese adolescents, aged between 12 and 15 (13.4 ± 0.96) years. Fat-free mass (FFM), percentage trunk fat mass (TFM%) and percentage fat mass (%FM) were evaluated through dual-energy X-ray absorptiometry (DXA). Measurement of intra-abdominal adiposity (IAAT) was performed using ultrasound. Blood pressure was measured and blood samples analyzed for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG) and plasma glucose. All participants performed the concurrent training (combination of weight training and aerobic training) three times per week, one hour per day, for 20 weeks. Descriptive analysis and analysis of variance (ANOVA) for repeated measures were used to compare baseline, 10 week and 20 week moments using the Bonferroni post-hoc test. Statistical significance was set at p < 0.05. Significant decrease in TC, LDL-c and TFM% were verified in both genders after the 10 initial weeks of concurrent training.Results A significant increase in height was found in both the male and female groups (p = 0.001 and p = 0.047, respectively), after 20 weeks of concurrent training. In addition, several modifications were observed in body composition and metabolic variables, with a significant decrease in BMI (p = 0.002 and p = 0.017), BMI z-score (p = 0.033 and p = 0.004), FM% (p = 0.002 and p = 0.002), TFM% (p = 0.009 and p = 0.018), TC (p = 0.042 and p = 0.001) and LDL-c (p = 0.006 and p = 0.001) in the male and female groups, respectively, after 20 weeks of intervention when compared with baseline.Conclusion Our results identified that concurrent training was an effective intervention for treating metabolic variable and body composition disorders, in both genders, by decreasing adiposity with consequent improvement in BMI and BMI z-scores, and enhancement in lipid profile variables.

Automated peritoneal dialysis is associated with better survival rates compared to continuous ambulatory peritoneal dialysis: a propensity score matching analysis

The impact of peritoneal dialysis modality on patient survival and peritonitis rates is not fully understood, and no large-scale randomized clinical trial (RCT) is available. In the absence of a RCT, the use of an advanced matching procedure to reduce selection bias in large cohort studies may be the best approach. The aim of this study is to compare automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) according to peritonitis risk, technique failure and patient survival in a large nation-wide PD cohort. This is a prospective cohort study that included all incident PD patients with at least 90 days of PD recruited in the BRAZPD study. All patients who were treated exclusively with either APD or CAPD were matched for 15 different covariates using a propensity score calculated with the nearest neighbor method. Clinical outcomes analyzed were overall mortality, technique failure and time to first peritonitis. For all analysis we also adjusted the curves for the presence of competing risks with the Fine and Gray analysis. After the matching procedure, 2,890 patients were included in the analysis (1,445 in each group). Baseline characteristics were similar for all covariates including: age, diabetes, BMI, Center-experience, coronary artery disease, cancer, literacy, hypertension, race, previous HD, gender, pre-dialysis care, family income, peripheral artery disease and year of starting PD. Mortality rate was higher in CAPD patients (SHR1.44 CI95%1.21-1.71) compared to APD, but no difference was observed for technique failure (SHR0.83 CI95%0.69-1.02) nor for time till the first peritonitis episode (SHR0.96 CI95%0.93-1.11). In the first large PD cohort study with groups balanced for several covariates using propensity score matching, PD modality was not associated with differences in neither time to first peritonitis nor in technique failure. Nevertheless, patient survival was significantly better in APD patients.

Analysis of relevant factors in patients with oral and pharyngeal cancers

This study presented an epidemiological data of 177 medical records of patients affected by oral and pharyngeal cancers with prosthesis indication. The gender, age, sun exposure, disease diagnosis, cancer anatomic site, radiation treatment and type of prosthesis, death from oral and pharyngeal cancers were collected. Data were analyzed by summary measures and logistic regression analysis. The mean age of the patients was 62.7 years, and 46.8％ died between 52 and 62 years old. Most of the patients were male (74％), and 42％ died among them. Squamous cell carcinoma was the most prevalent cancer (75.1％) and 42.1％ of these patients died. The age, gender, diagnosis and the interaction of these factors exhibited strong association with the patients’ death (P<.05, Chi-square test). The multivariate odds ratios (OR) of the death were 0.40 for women and 0.39 for other pathologies versus male and squamous cell carcinoma, respectively. It was concluded that age, gender and diagnosis of cancer had significant effect on patients’ death.

Television violence and young adults in Brazil: a content analysis of the popular telenovella, Malhação = Violência na televisão brasileira e jovens : uma análise de conteúdo da telenovela popular, Malahção

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

P-215-Quantitative variation of some gut bacteria in Crohn's disease can be related to the patient's gender

Background: Imbalance in bacterial species composition of the gut microbiota is one of the factors associated with the cause or complication of the symptoms of Crohn's disease (CD). This disequilibrium consists in the reduction of biodiversity, decrease of genus such as Bifidobacterium and elevation of species such as Escherichia coli. Human microbiota varies among subjects of a same population irrespective of their health condition and among individuals living in distinct geographic locations. In animal models, sex related differences could also be observed in gut bacterial species composition under some pathological conditions. Experiments conducted with mice have demonstrated that the manifestation of type 1 diabetes (T1D) could be under the influence of the animal sex and its serum level of testosterone, which in turn could be modulated by a particular gut microbiota. Considering the existence of similar features between T1D and CD, such as strong genetic component and malfunctioning of the immune system, we investigated whether differences could be observed in the gut microbiota dysbiosis of male and female CD patients. Methods: Fifty and 5 gut mucosal biopsies from 25 adult CD patients (11 males and 14 females) and 43 specimens of an equivalent clinical material from 22 control subjects (11 males and 11 females) were screened for bacterial biodiversity by analyzing sequences of 16SrDNA V6 region. A number of 2-3 samples each from distinct gut segments (from ileum to rectum) were taken from each subject. The 16SrDNA sequences were obtained by sequencing PCR amplicons of the corresponding gene in the Ion torrent PGM sequencer. Identification and classification of the bacterial groups followed the Ribosomal Database Project (RDP) website pipeline. The relationships of the bacterial taxa with each of the study parameters was performed by compiling the data in a MS Excel and the level of statistical significance determined by the Chi-square test. Results: A total of 3203 16SrDNA sequences were detected in the 98 biopsies samples, the majority of which matching Proteobacteria, Firmicutes, Bacterioidetes, and Actinobacteria. The percentage of DNA sequences for each of these phyla found in Male control subjects/Male CD patients was 40.5/33, 32.7/32.4, 20.8/24.5, and 4.4/4,4 for Proteobacteria, Firmicutes, Bacterioidetes, and Actinobacteria, respectively. In Female comparisons, these values were 35.6/42, 39.2/26.3, 19.8/23.3, 5.2/7. Both Male and Female CD patients presented higher numbers of sequences of Actinobacteria and Bacterioidetes than those of control subjects of the same gender. Case-control differences for Firmicutes could be observed only in female comparisons and, for Proteobacteria, although case-control differences were observed in both genders, the nature of difference was distinct, since while in CD female patients a higher number of sequences matching this phylum was detected, in males a reduced number was observed, in comparison with controls. The species responsible for the Proteobacteria variation in both gender was Escherichia coli. Conclusions: The data presented above suggest that any analysis of dysbiosis in CD must take in account the patient's gender, an observation particularly relevant for Escherichia coli, whose association with CD has been most intensively investigated and for which the present study shows a reverse quantitative variation regarding the patients' gender.

Gender parity and drug use: are girls catching up with boys?

Objective: To evaluate the association between gender and use of alcohol, tobacco, and other drugs in adolescents aged 10 to 18 years in the municipalities of Jacare and Diadema, Sao Paulo, Brazil. Methods: A total of 971 adolescents completed the Drug Use Screening Inventory (DUSI). Results: In our sample, 55% of adolescents were male, 33.8% reported having made use in the previous month of alcohol, 13.5% of cigarettes, and 6.4% of illicit drugs. There was no significant difference between genders in the use of alcohol, tobacco, and illicit drugs in any of the analysis (p > 0.05). The use of alcohol, tobacco, and illicit drugs was associated with the city, age, educational level, school failure, and relationship with parents (p < 0.05). Conclusions: Substance abuse among adolescents in our sample seems to follow the recent global trend towards the equalization of drug use between genders. This result should be taken into account by public health professionals in developing policies for this problem. (C) 2012 Elsevier Editora Ltda. All rights reserved.

Gender differences in incidence and determinants of disability in activities of daily living among elderly individuals: SABE study

Determining the groups that are most susceptible to developing disability is essential to establishing effective prevention and rehabilitation strategies. The aim of the present study was to determine gender differences in the incidence of disability regarding activities of daily living (ADL) and determinants among elderly residents of Sao Paulo, Brazil. In 2000, 1634 elderly with no difficulties regarding ADL (modified Katz Index) were selected. These activities were reassessed in 2006 and disability was the outcome for the analysis of determinants. The following characteristics were analyzed at baseline: sociodemographic, behavioral, health status, medications, falls, hospitalizations, depressive symptoms, cognition, handgrip, mobility and balance. The incidence density was 42.4/1000 women/year and 17.5/1000 men/year. After adjusting for socioeconomic status and health conditions, women with chronic diseases and social vulnerability continued to have a greater incidence of disability. The following were determinants of the incidence of disability: age and depressive symptoms in both genders; stroke and slowness on the sit-and-stand test among men; and osteoarthritis and sedentary lifestyle among women. Better cognitive performance and handgrip strength were protective factors among men and women, respectively. Adverse clinical and social conditions determine differences between genders regarding the incidence of disability. Decreased mobility and balance and health conditions that affect the central nervous system or lead to impaired cognition disable men more, whereas a sedentary lifestyle, reduction in muscle strength and conditions that affect the osteoarticular system disable women more. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

Ameloblastoma demographic, clinical and treatment study - analysis of 40 cases

Dental lesions represent about 1% of oral cavity tumors being ameloblastoma the most common one. It is a tumor of epithelial origin that mainly affects the jaw, and less commonly the maxilla. Its clinical presentation is that of an asymptomatic slow-growing tumor. Despite being a benign tumor, it has an invasive behavior with a high rate of recurrence if not treated properly. Objective: To describe the cases of ameloblastoma in a reference department. Methods: Retrospective analysis of 40 cases. The variables analyzed were: age, gender, ethnicity, tumor location, type of treatment, complications and recurrence. Results: The most affected gender was male - 21 cases (52.5%); with a predominance of Caucasians - 24 cases (60%). The mean age was 35.45 years; the most common location was in.the jaw - 37 cases (92.5%). Facial asymmetry was the most frequent complaint. Of the 40 cases, 33 were submitted to surgery. Of those submitted to surgery, 24 (72.72%) underwent segmental resection, with recurrence in 4 (12.12%) cases. Conclusion: Ameloblastoma may relapse when treatment is not performed with broad surgical resection of the lesion with wide safety margins.

The standpoint of professionals on the presence and demands of men on the healthcare services: perspectives for the analysis of the implementation of the Comprehensive Healthcare Policy for Men

In 2009, the Brazilian Comprehensive Healthcare Policy for Men (PNAISH) was launched in Brazil, seeking to reduce morbidity and mortality in this population group. This article strives to analyze the conceptions that health professionals have about the specific demands and behaviors of the male population served by the healthcare services. The data analyzed are part of a larger research project, the objective of which was to evaluate the initial actions of the implementation of PNAISH. Ethnographic observations in 11 health services and semi-structured interviews were conducted with 21 health professionals. From the perspective of health professionals, the presence of men in the healthcare services is still limited. According to them, it is comprised of two types of clients: workers and the elderly. The male behavior characteristics - haste, objectivity, fear and resistance - and the difficulty faced by health services in receiving this population are the main factors that drive men away from health services. Although the concept of gender is central to PNAISH, it is only triggered by healthcare professionals in order to justify the social standards expected in terms of men's behavior. The attribution of men's behavior to cultural factors ultimately obscures the relations of power that underlie gender relations.

Efficacy of brief alcohol screening intervention for college students (BASICS): a meta-analysis of randomized controlled trials

Background: Many studies reported that brief interventions are effective in reducing excessive drinking. This study aimed to assess the efficacy of a protocol of brief intervention for college students (BASICS), delivered face-to-face, to reduce risky alcohol consumption and negative consequences. Methods: A systematic review with meta-analysis was performed by searching for randomized controlled trials (RCTs) in Medline, PsycInfo, Web of Science and Cochrane Library databases. A quality assessment of RCTs was made by using a validated scale. Combined mean effect sizes, using meta-analysis random-effects models, were calculated. Results: 18 studies were included in the review. The sample sizes ranged from 54 to 1275 (median = 212). All studies presented a good evaluation of methodological quality and four were found to have excellent quality. After approximately 12 months of follow-up, students receiving BASICS showed a significant reduction in alcohol consumption (difference between means = -1.50 drinks per week, 95% CI: -3.24 to -0.29) and alcohol-related problems (difference between means = -0.87, 95% CI: -1.58 to -0.20) compared to controls. Conclusions: Overall, BASICS lowered both alcohol consumption and negative consequences in college students. Gender and peer factors seem to play an important role as moderators of behavior change in college drinking. Characteristics of BASICS procedure have been evaluated as more favorable and acceptable by students in comparison with others interventions or control conditions. Considerations for future researches were discussed.

Relations between Depression, Alcohol and Gender in the Metropolitan Region of Sao Paulo, Brazil

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of Sao Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.