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- Do self-reported data accurately measure health inequalities in risk factors for cardiovascular disease?Publication . Kislaya, Irina; Perelman, Julian; Tolonen, Hanna; Nunes, BaltazarObjectives: This study aimed to compare the magnitude of educational inequalities in self-reported and examination-based hypertension and hypercholesterolemia and to assess the impact of self-reported measurement error on health inequality indicators. Methods: We used the Portuguese National Health Examination Survey data (n = 4911). The slope index of inequality (SII) and the relative index of inequality (RII) were used to determine the magnitude of absolute and relative education-related inequalities. Results: Among the 25-49-year-old (yo) men, absolute and relative inequalities were smaller for self-reported than for examination-based hypertension (SIIeb = 0.18 vs. SIIsr = - 0.001, p < 0.001; RIIeb = 1.99 vs. RIIsr = 0.86, p = 0.031). For women, the relative inequalities were similar despite differences in self-reported and examination-based hypertension prevalence. For hypercholesterolemia, self-reported relative inequalities were larger than examination-based inequalities among the 50-74-yo men (RIIsr = 2.28 vs. RIIeb = 1.21, p = 0.004) and women (RIIsr = 1.22 vs. RIIeb= 0.87, p = 0.045), while no differences were observed among 25-49-yo. Conclusions: Self-reported data underestimated educational inequalities among 25-49-yo men and overestimated them in older individuals. Inequality indicators derived from self-report should be interpreted with caution, and examination-based values should be preferred, when available.
- Mapeamento de índice de vulnerabilidade a ondas de calorPublication . Silva, Susana Pereira; Roquette, Rita; Nunes, BaltazarIntrodução: Os efeitos diretos da temperatura ambiente na saúde humana são conhecidos e, no caso das temperaturas elevadas, podem ir desde irritações cutâneas moderadas ao denominado golpe de calor. O excesso de temperatura pode igualmente ter efeitos negativos sobre a saúde ao agravar doenças pré-existentes como as doenças cardiovasculares e cerebrovasculares, respiratórias, diabetes entre outras. Em Portugal, à semelhança de outros países, estão descritos efeitos do excesso de calor na saúde, especificamente na mortalidade, em situações de aumento de temperatura súbito e intenso, ou seja durante as chamadas ondas de calor. Objetivo: Apresentar em maior detalhe para a Área Metropolitana de Lisboa o estudo do Mapeamento de índice de vulnerabilidade a ondas de calor (http://hdl.handle.net/10400.18/3870)
- Ten years of external quality assessment (EQA) of Neisseria gonorrhoeae antimicrobial susceptibility testing in Europe elucidate high reliability of dataPublication . Cole, Michelle J.; Quaye, Nerteley; Jacobsson, Susanne; Day, Michaela; Fagan, Elizabeth; Ison, Catherine; Pitt, Rachel; Seaton, Shila; Woodford, Neil; Stary, Angelika; Pleininger, Sonja; Crucitti, Tania; Hunjak, Blaženka; Maikanti, Panayiota; Hoffmann, Steen; Viktorova, Jelena; Buder, Susanne; Kohl, Peter; Tzelepi, Eva; Siatravani, Eirini; Balla, Eszter; Hauksdóttir, Guðrún Svanborg; Rose, Lisa; Stefanelli, Paola; Carannante, Anna; Pakarna, Gatis; Mifsud, Francesca; Cassar, Rosann Zammit; Linde, Ineke; Bergheim, Thea; Steinbakk, Martin; Mlynarczyk-Bonikowska, Beata; Borrego, Maria-José; Shepherd, Jill; Pavlik, Peter; Jeverica, Samo; Vazquez, Julio; Abad, Raquel; Weiss, Sabrina; Spiteri, Gianfranco; Unemo, MagnusBackground: Confidence in any diagnostic and antimicrobial susceptibility testing data is provided by appropriate and regular quality assurance (QA) procedures. In Europe, the European Gonococcal Antimicrobial Susceptibility Programme (Euro-GASP) has been monitoring the antimicrobial susceptibility in Neisseria gonorrhoeae since 2004. Euro-GASP includes an external quality assessment (EQA) scheme as an essential component for a quality-assured laboratory-based surveillance programme. Participation in the EQA scheme enables any problems with the performed antimicrobial susceptibility testing to be identified and addressed, feeds into the curricula of laboratory training organised by the Euro-GASP network, and assesses the capacity of individual laboratories to detect emerging new, rare and increasing antimicrobial resistance phenotypes. Participant performance in the Euro-GASP EQA scheme over a 10 year period (2007 to 2016, no EQA in 2013) was evaluated. Methods: Antimicrobial susceptibility category and MIC results from the first 5 years (2007-2011) of the Euro-GASP EQA were compared with the latter 5 years (2012-2016). These time periods were selected to assess the impact of the 2012 European Union case definitions for the reporting of antimicrobial susceptibility. Results: Antimicrobial susceptibility category agreement in each year was ≥91%. Discrepancies in susceptibility categories were generally because the MICs for EQA panel isolates were on or very close to the susceptibility or resistance breakpoints. A high proportion of isolates tested over the 10 years were within one (≥90%) or two (≥97%) MIC log2 dilutions of the modal MIC, respectively. The most common method used was Etest on GC agar base. There was a shift to using breakpoints published by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in the latter 5 years, however overall impact on the validity of results was limited, as the percentage categorical agreement and MIC concordance changed very little between the two five-year periods. Conclusions: The high level of comparability of results in this EQA scheme indicates that high quality data are produced by the Euro-GASP participants and gives confidence in susceptibility and resistance data generated by laboratories performing decentralised testing.