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New episodes of asthma during the epidemic on 24 and 25 June 1994 were associated with a fall in air temperature and a rise in grass pollen concentration. Non-epidemic asthma was significantly associated with a greater number of environmental changes. This may indicate that the patients with thunderstorm associated asthma were a separate population, sensitive to different environmental stimuli.

O estudo objetivou conferir validade à terceira versão do Questionário Alimentar do Dia Anterior (QUADA-3) para escolares. O QUADA-3 é um instrumento estruturado com seis refeições e 21 alimentos. Participaram 164 escolares de 6 a 11 anos de idade, de uma escola pública de período integral, em 2007. A validade foi testada pela comparação entre os itens alimentares selecionados no questionário e a observação direta de alimentos consumidos em três refeições escolares do dia anterior (lanche da manhã, almoço, lanche da tarde). Análise de regressão logística multivariada foi conduzida para avaliar a discordância entre as respostas do questionário e o registro das observações. Os resultados indicaram alta sensibilidade e especificidade para a maioria dos itens alimentares. Em média, os valores de sensibilidade e especificidade foram de 70,2% e de 96,2%, respectivamente, para os 12 itens alimentares nas três refeições combinadas. Os escolares de 6 a 8 anos, quando comparados aos de 9 a 11 anos, apresentam maiores taxas de discordância de respostas entre o QUADA-3 e as observações. Os resultados indicaram que o QUADA-3 pode gerar dados válidos para avaliar o consumo alimentar do dia anterior em nível de grupo de escolares.

Children older than 8 years old, who owned a computer and completed a food diary, performed better in the CAAFE. A high incidence of disagreement was found in relation to the schools and the type of meal. Overall matches (43%), intrusions (29%) and omissions (28%) indicate that further studies are required to improve the validity of the CAAFE.

ResumoObjetivo Analisar a prevalência e os fatores de risco relacionados ao uso indevido de drogas entre estudantes de uma escola pública de primeiro e segundo graus. Métodos Foi realizado estudo descritivo transversal, utilizando, como instrumento de pesquisa, um questionário anônimo, padronizado e amplamente testado no Brasil para levantamento do uso de drogas. A população estudada foi constituída de 478 estudantes de escola pública de primeiro e segundo graus, de Florianópolis, SC. Os questionários foram aplicados por estudantes universitários devidamente treinados. Entre os estudantes pesquisados, 43% e 32% foram de faixa etária de 13 a 15 anos e de 16 a 18 anos, respectivamente, com predomínio de classes socioeconômicas mais altas. Resultados A prevalência de uso de maconha na vida (19,9%), solventes (18,2%), anfetamínicos (8,4%) e álcool (86,8%) foi elevada em Florianópolis, comparada a outras capitais da região Sul e à média brasileira. Notou-se elevado e freqüente uso (seis ou mais vezes por mês) de álcool (24,2%), maconha (4,9%), solventes (2,5%) e anfetamínicos (2,3%). Os fatores demográficos relacionados ao uso de drogas na vida foram idade, sexo, classe socioeconômica e vida junto aos pais. A chance de garotas usarem remédios para emagrecer ou ficarem acordadas foi o dobro da chance de garotos e, quanto ao uso de tranqüilizantes, quase o triplo. Os garotos tinham um risco quase duas vezes maior de uso de solvente do que as garotas. A classe socioeconômica alta foi associada a um risco duas vezes maior do uso de álcool do que a classe baixa. O risco de uso de cigarro e maconha na vida foi 84% e 67% maior, respectivamente, para alunos cujos pais estavam separados. Conclusão Constatou-se alta prevalência de uso de várias drogas entre os alunos de primeiro e segundo graus. Abstract ObjectiveTo assess prevalence and risk factors associated with drug abuse among public elementary and high school students in the southern city of Florianópolis, Brazil.

Background: Childhood overweight and obesity are recognized as predictors of the risk of obesity in adulthood. The aim of this systematic literature review was to determine the association between dietary pattern and obesity risk among children. Methods: Articles were selected from databases (Cochrane Library, Lilacs, Eric, Livivo, and PubMed/Medline), without limitations regarding language or date. Database-specific search terms included the key words ''obesity,'' ''diet,'' ''dietary pattern,'' ''childhood,'' ''children,'' ''adolescents,'' and relevant synonyms. The review included studies that reported the assessment of the dietary pattern in childhood and that correlated eating patterns with the obesity risk through cluster analysis (CA) and/or factor analysis and/or principal component analysis and presented odds ratios (ORs). The methodology of the selected studies was evaluated using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Owing to the heterogeneity among the assessments of the association of dietary patterns and obesity, the results are described narratively. Results: Using a selection process in two phases, 16 articles were included. Fifteen studies used a cross-sectional design, and one case-control study. The included studies showed variation in sample size (range = 232 to 10,187 children/adolescents) and age (range = 1-19 years old). The studies reported between two and five dietary patterns each. The OR for the relationship between the dietary pattern and the risk of childhood obesity ranged from OR = 1.02; confidence interval (95% CI) (0.91-1.15) to OR = 3.55; 95% CI (1.80-7.03). In this study, the dietary patterns identified by the studies were given different names. The food intake patterns identified could, in most factor or CA studies, be categorized as (1) potentially obesogenic foods that increased risk of becoming overweight (including fatty cheeses, sugary drinks, processed foods, fast food, candies, snacks, cakes, animal products, whole milk, and refined grains) or (2) food classified as healthy with the weakest association with the risk of becoming overweight or obese (including low levels of sugar and fat and high levels of fruits, vegetables, whole grains, fish, nuts, legumes, and yogurt). Conclusion: Overall, the results indicated from most studies that a diet with a lower percentage of obesogenic foods should be effective in reducing the risk of developing obesity.

BackgroundStructural equation modelling (SEM) has been increasingly used in medical statistics for solving a system of related regression equations. However, a great obstacle for its wider use has been its difficulty in handling categorical variables within the framework of generalised linear models.MethodsA large data set with a known structure among two related outcomes and three independent variables was generated to investigate the use of Yule's transformation of odds ratio (OR) into Q-metric by (OR-1)/(OR+1) to approximate Pearson's correlation coefficients between binary variables whose covariance structure can be further analysed by SEM. Percent of correctly classified events and non-events was compared with the classification obtained by logistic regression. The performance of SEM based on Q-metric was also checked on a small (N = 100) random sample of the data generated and on a real data set.ResultsSEM successfully recovered the generated model structure. SEM of real data suggested a significant influence of a latent confounding variable which would have not been detectable by standard logistic regression. SEM classification performance was broadly similar to that of the logistic regression.ConclusionThe analysis of binary data can be greatly enhanced by Yule's transformation of odds ratios into estimated correlation matrix that can be further analysed by SEM. The interpretation of results is aided by expressing them as odds ratios which are the most frequently used measure of effect in medical statistics.

BackgroundInformation and communication technology (ICT) has been used with increasing frequency for the assessment of diet and physical activity in health surveys. A number of Web-based questionnaires have been developed for children and adolescents. However, their usability characteristics have scarcely been reported, despite their potential importance for improving the feasibility and validity of ICT-based methods.ObjectiveThe objective of this study was to describe the usability evaluation of the Consumo Alimentar e Atividade Física de Escolares (CAAFE) questionnaire (Food Consumption and Physical Activity Questionnaire for schoolchildren), a new Web-based survey tool for the self-assessment of diet and physical activity by schoolchildren.MethodsA total of 114 schoolchildren aged 6 to 12 years took part in questionnaire usability testing carried out in computer classrooms at five elementary schools in the city of Florianopolis, Brazil. Schoolchildren used a personal computer (PC) equipped with software for recording what is on the computer screen and the children’s speech during usability testing. Quantitative and qualitative analyses took into account objective usability metrics such as error counts and time to complete a task. Data on the main difficulties in accomplishing the task and the level of satisfaction expressed by the children were assessed by the observers using a standardized form and interviews with the children. Descriptive statistics and content analysis were used to summarize both the quantitative and the qualitative aspects of the data obtained.ResultsThe mean time for completing the questionnaire was 13.7 minutes (SD 3.68). Compared to the children in 2nd or 3rd grades, those in 4th or 5th grades spent less time completing the questionnaire (median 12.4 vs 13.3 minutes, P=.022), asked for help less frequently (median 0 vs 1.0 count, P=.005), had a lower error count (median 2.0 vs 8.0 count, P<.001), and obtained a higher overall performance score (median 73.0 vs 68.0, P=.005). Children with a PC at home spent less time completing the questionnaire (median 12.3 vs 14.9 minutes, P<.001), had a lower overall error count (median 2.0 vs 9.0 count, P=.03), and had a higher performance score (median 72.0 vs 64.0, P=.005) compared to the children without a PC at home. The most common difficulty in completing the questionnaire was in using the scroll bar. The majority of children reported a positive evaluation (liked a lot or liked) for the four design elements, which were evaluated.ConclusionsThe results of the present study provided feedback to improve the final version of the CAAFE questionnaire. Quantitative data showed minor errors and system failures, while qualitative data indicated that, overall, the children enjoyed the CAAFE questionnaire. Grade levels and PC use must be taken into account in Web-based tools designed for children.