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      The study of cardiovascular risk in adolescents – ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents

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      BMC Public Health
      BioMed Central
      Cardiovascular diseases, Metabolic syndrome X, Adolescent

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          Abstract

          Background

          The Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”) is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA.

          Methods/Design

          Participants answered a self-administered questionnaire using an electronic device, in order to obtain information on demographic and lifestyle characteristics, including physical activity, smoking, alcohol intake, sleeping hours, common mental disorders and reproductive and oral health. Dietary intake was assessed using a 24-hour dietary recall. Anthropometric measures (weight, height and waist circumference) and blood pressure were also be measured. Blood was collected from a subsample of approximately 44,000 adolescents for measurements of fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glycated hemoglobin and fasting insulin.

          Discussion

          The study findings will be instrumental to the development of public policies aiming at the prevention of obesity, atherosclerotic diseases and diabetes in an adolescent population.

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          Most cited references13

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          Effectiveness of the US Department of Agriculture 5-step multiple-pass method in assessing food intake in obese and nonobese women.

          National surveys of food intake rely on the 24-h dietary recall method for assessing the nutrient intakes of Americans. This observational validation study was conducted under controlled conditions to test the effectiveness of the US Department of Agriculture (USDA) 5-step multiple-pass method for dietary recall; to test the ability of normal weight, overweight, and obese women to recall food intake; and to test the accuracy of macronutrient recall. Women (n = 49) aged 21-65 y with a body mass index (in kg/m(2)) of 20-45 selected all meals and snacks for 1 d from a wide variety of foods. A 24-h dietary recall with the use of the USDA 5-step multiple-pass method was administered by telephone the following day. Analysis of variance and covariance tested the overall accuracy of recall and the effect of BMI on dietary recall. As a population, the women overestimated their energy and carbohydrate intakes by 8-10%. No significant differences between mean actual and recalled intakes of energy and the macronutrients were observed in the obese women. Normal-weight and overweight women significantly (P < 0.01) overestimated their energy, protein, and carbohydrate intakes. Recalled fat intake was not significantly different from actual intake in women across the BMI range studied. The USDA 5-step multiple-pass method effectively assessed mean energy intake within 10% of mean actual intake on the previous day. Obese women more accurately recalled food intake than did overweight and normal-weight women despite undereating on the day of the study.
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            V Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose

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              A comparison of the validity of two psychiatric screening questionnaires (GHQ-12 and SRQ-20) in Brazil, using Relative Operating Characteristic (ROC) analysis.

              The General Health Questionnaire (GHQ-12) (Goldberg, 1972) and the Self Report Questionnaire (SRQ-20) (Harding et al. 1980) were simultaneously validated against the criterion of the Clinical Interview Schedule (CIS) (Goldberg et al. 1970) in three primary care clinics in the city of Sao Paulo, Brazil. A comparison between the two screening instruments was carried out. The product-moment correlation between the two sets of scores was +0.72, and the validation coefficients for the GHQ-12 and the SRQ-20 were respectively: sensitivity 85% and 83%; specificity 79% and 80%; overall misclassification rate 18% and 19%. The two screening instruments were further compared by the application of Relative Operating Characteristic (ROC) analysis and, again, were found to be very similar in performance. The area under the ROC curve was 0.87 for the GHQ and 0.90 for the SRQ-20 (Z = 0.92, NS). Both psychiatric screening instruments were therefore found to be acceptably valid when assessed against the CIS in three primary care settings in Brazil. The application of ROC analysis to studies of this kind was feasible and straightforward. It was found to be superior to the conventional method of presentation of validity data. It is recommended that the application of ROC analysis to psychiatric screening studies be further utilized and explored.
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                Author and article information

                Contributors
                kbloch@globo.com
                mszklo1@jhu.edu
                cristina.kuschnir@gmail.com
                gabrinut@gmail.com
                lauraabarufaldi@gmail.com
                kleincarlosh@gmail.com
                mautlv@gmail.com
                gvveiga@globo.com
                valeskacf@gmail.com
                adias@fmb.unesp.br
                moraes.reumato@gmail.com
                analuizavb@gmail.com
                anamayra@uol.com.br
                beatrizschaan@gmail.com
                brutav@gmail.com
                cecilacroix@yahoo.com.br
                cristianedefreitascunha@gmail.com
                denisegiannini@uol.com.br
                dilsonbelfort@gmail.com
                ribasdulce@uol.com.br
                eduardolimasantos@gmail.com
                elisadleon@yahoo.com.br
                efujimor@gmail.com
                elizabete_regina@hotmail.com
                erikamagliano@yahoo.com.br
                fguedes@ccs.ufsc.br
                georgedantas.faimer@gmail.com
                gbrunken@gmail.com
                glauber.dias@gmail.com
                helenocorrea@uol.com.br
                inesmon@fcm.unicamp.br
                isabelcbguimaraes@gmail.com
                jose.faria@pucpr.br
                juliana_nutricao@yahoo.com.br
                kenia@unb.br
                luisgonga@yahoo.com.br
                marizesantos@ufpi.edu.br
                pascoaltorres@uol.com.br
                fvjardim@terra.com.br
                pedroamf@terra.com.br
                renanmmjr@gmail.com
                ricardoqgurgel@gmail.com
                vianna@ccs.ufpb.br
                sandra-mary@hotmail.com
                profsandrodamatta@terra.com.br
                stellamsmartins@hotmail.com
                tamara@fmb.unesp.br
                thiagolns@gmail.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                7 February 2015
                7 February 2015
                2015
                : 15
                : 94
                Affiliations
                [ ]Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, Brazil
                [ ]Universidade do Estado do Rio de Janeiro, Núcleo de Estudos da Saúde do Adolescente, Rio de Janeiro, Brazil
                [ ]Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública, Rio de Janeiro, Brazil
                [ ]Escola Nacional de Ciências Estatísticas, Fundação Instituto Brasileiro de Geografia e Estatística (ENCE/IBGE), Rio de Janeiro, Brazil
                [ ]Universidade Federal do Rio de Janeiro, Instituto de Nutrição Josué de Castro, Rio de Janeiro, Brazil
                [ ]Universidade Estadual Paulista, Faculdade de Medicina, São Paulo, Brazil
                [ ]Universidade Federal do Pará, Instituto Ciências da Saúde, Pará, Brazil
                [ ]Universidade Federal de Goiás, Faculdade de Enfermagem e Nutrição, Goiás, Brazil
                [ ]Universidade Estadual de Feira de Santana, Departamento de Saúde, Bahia, Brazil
                [ ]Universidade federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
                [ ]Universidade Federal do Amazonas, Instituto de Saúde e Biotecnologia, Amazonas, Brazil
                [ ]Universidade do Estado do Rio de Janeiro, Departamento de Nutrição, Rio de Janeiro, Brazil
                [ ]Universidade federal de Minas Gerais, Hospital de Clínicas da UFMG, Minas Gerais, Brazil
                [ ]Universidade do Estado do Rio de Janeiro, Centro Biomédico – Nutrição, Rio de Janeiro, Brazil
                [ ]Universidade Federal do Amapá, Amapá, Brazil
                [ ]Universidade Federal do Mato Grosso do Sul, Curso de Nutrição, Mato Grosso do Sul, Brazil
                [ ]Instituto Federal de Educação Técnico Tecnológico do Tocantins, Tocantis, Brazil
                [ ]Universidade Federal do Amazonas, Faculdade de Educação Física e Fisioterapia, Amazonas, Brazil
                [ ]Universidade de São Paulo, Departamento de Enfermagem em Saúde Coletiva, São Paulo, Brazil
                [ ]Universidade Federal do Espirito Santo, Departamento de Enfermagem, Espírito Santo, Brazil
                [ ]Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Nutrição, Santa Catarina, Brazil
                [ ]Universidade Federal do Rio Grande do Norte, Centro de Biociências, Departamento de Morfologia, Rio Grande do Norte, Brazil
                [ ]Universidade Federal de Mato Grosso, Instituto de Saúde Coletiva, Departamento de Saúde Coletiva, Mato Grosso, Brazil
                [ ]Instituto Nacional de Cardiologia, Laboratório de Biologia e Diagnósticos Moleculares, Rio de Janeiro, Brazil
                [ ]Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Medicina Preventiva e Social, São Paulo, Brazil
                [ ]Universidade Estadual de Campinas, Faculdade de Enfermagem, São Paulo, Brazil
                [ ]Universidade Federal da Bahia, Hospital Ana Neri, Bahia, Brazil
                [ ]Pontifícia Universidade Católica do Paraná, Escola de Medicina, Paraná, Brazil
                [ ]Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Pernambuco, Brazil
                [ ]Universidade de Brasília, Departamento de Nutrição, Distrito Federal, Brazil
                [ ]Universidade Federal de Rondônia, Núcleo de Saúde, Departamento de Educação Física, Rondônia, Brazil
                [ ]Universidade Federal do Piauí, Centro de Ciências da Saúde, Departamento de Nutrição, Piauí, Brazil
                [ ]Universidade Federal do Acre, Departamento de Ciências da Saúde e Educação Física, Acre, Brazil
                [ ]Universidade Federal de Goiás, Faculdade de Medicina, Goiás, Brazil
                [ ]Universidade Federal do Maranhão, Programa de Pós-graduação em Saúde Coletiva, Maranhão, Brazil
                [ ]Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Saúde Comunitária, Ceará, Brazil
                [ ]Universidade Federal de Sergipe, Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Sergipe, Brazil
                [ ]Universidade Federal da Paraíba, Centro de Ciências da Saúde - Campus I, Departamento de Nutrição, Paraíba, Brazil
                [ ]Universidade Federal de Alagoas, Departamento de Nutrição, Alagoas, Brazil
                [ ]Hospital Estadual Getúlio Vargas, Núcleo Hospitalar de Geriatria e Gerontologia, Rio de Janeiro, Brazil
                [ ]Universidade Federal de Roraima, Centro de Ciências da Saúde, Roraima, Brazil
                [ ]Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Pediatria, São Paulo, Brazil
                Article
                1442
                10.1186/s12889-015-1442-x
                4334602
                25880653
                a1d53e4b-f783-486d-ba1e-a004f7dd5b91
                © Bloch et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 December 2014
                : 19 January 2015
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2015

                Public health
                cardiovascular diseases,metabolic syndrome x,adolescent
                Public health
                cardiovascular diseases, metabolic syndrome x, adolescent

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