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- ItemAcesso aberto (Open Access)Avaliação das propriedades psicométricas da escala de rastreamento populacional para depressão CES-D em populações clínica e não-clínica de adolescentes e adultos jovens(Universidade Federal de São Paulo (UNIFESP), 1997) Silveira Filho, Dartiu Xavier da [UNIFESP]; Jorge, Miguel Roberto [UNIFESP]Existem evidencias de aumento na prevalencia de transtornos depressivos na populacao geral e de que tem havido incidencia progressivamente mais precoce de depressao no transcorrer deste seculo. A grande maioria dos trabalhos cientificos sobre depressao nao focaliza especificamente populacoes de adolescentes e adultos jovens, sendo a literatura mais escassa ainda quando se trata de populacoes clinicas. Embora exista um grande contingente de estudos a respeito de farmacodependencia nesta faixa etaria, poucos se detem nos aspectos relativos a comorbidade psiquiatrica e as dificuldades diagnosticas nesta populacao. As escalas de rastreamento populacional para depressao tem sido amplamente utilizadas em etapas iniciais de identificacao de casos em levantamentos epidemiologicos, a despeito dos questionamentos sobre a concordancia do desempenho destas escalas com resultados de procedimentos diagnosticos mais complexos realizados em uma segunda etapa. Alem disto, poucos estudos examinaram o desempenho destas escalas em populacoes de adolescentes e adultos jovens, sendo a literatura cientifica extremamente restrita quando se trata de populacoes clinicas. Utilizamos neste estudo a CES-D, escala para depressao do Centro de Estudos Epidemiologicos dos EUA, por ser uma das escalas de rastreamento populacional mais utilizadas nos ultimos vinte anos. Propusemo-nos a estudar as propriedades psicometricas e a estrutura fatorial da escala em duas populacoes de adolescentes e adultos jovens. Uma populacao de 523 estudantes universitarios da cidade de São Paulo e uma amostra de 50 farmacodependentes que procuraram tratamento em um ambulatorio da rede publica assistencial (PROAD) responderam a CES-D. A amostra de farmacodependentes e uma sub-amostra da populacao de estudantes foram tambem submetidas a uma entrevista psiquiatrica. Avaliamos o desempenho da escala de rastreamento comparativamente ao diagnostico psiquiatrico segundo o RDC (Research Diagnostic Criteria) nas duas amostras. Comparando-se os dois grupos, as estimativas de prevalencia entre os estudantes universitarios foram de 7,9 % para transtornos depressivos atuais e de 19 % para transtornos depressivos ao longo da vida, enquanto que entre os farmacodependentes encontramos frequencias de 32 % para transtornos depressivos atuais e de 44 % para transtornos depressivos ao longo da vida. Com relacao a escala de rastreamento, concluimos que entre os estudantes universitarios (populacao nao clinica) a escala apresentou melhor desempenho quando utilizamos o ponto de corte 15, contrastando com a amostra de farmacodependentes (populacao clinica), na qual o ponto de corte 24 correspondeu ao melhor desempenho da escala. Quanto ao estudo da estrutura da escala, duas questoes da CES-D foram excluidas por apresentarem baixa correlacao com a 18 questoes remanescentes. Entretanto, a CES-D apresentou boa consistencia interna (alfa de Cronbach=0,85) e a analise da estrutura fatorial resultou em solucao de quatro dimensoes da escala, demonstrando assim relativa estabilidade quando utilizada em populacoes jovens em nosso meio. Baseando-nos nestes resultados, concluimos que a CES-D pode ser de utilidade em uma primeira etapa de levantamento de casos, desde que sejam consideradas algumas de suas limitacoes. Finalmente, levantamos algumas sugestoes a respeito da utilizacao deste tipo de instrumento em populacoes distintas daquelas para as quais foram concebidos.
- ItemAcesso aberto (Open Access)Dietary patterns and risk of oral cancer: a case-control study in São Paulo, Brazil(Faculdade de Saúde Pública da Universidade de São Paulo, 2007-02-01) Marchioni, Dirce Maria Lobo; Fisberg, Regina Mara; Góis Filho, José Francisco de; Kowalski, Luiz Paulo [UNIFESP]; Carvalho, Marcos Brasilino de; Abrahão, Márcio [UNIFESP]; Latorre, Maria Do Rosário Dias de Oliveira; Eluf-Neto, José; Wünsch Filho, Victor; Universidade de São Paulo (USP); Instituto do Câncer Arnaldo Vieira de Carvalho Departamento de Cabeça e Pescoço; Hospital do Câncer A.C.Camargo Departamento de Cabeça, Pescoço e Otorrinolaringologia; Hospital Heliópolis Departamento de Cabeça e Pescoço; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To analyze the association between dietary patterns and oral cancer. METHODS: The study, part of a Latin American multicenter hospital-based case-control study, was conducted in São Paulo, Southeastern Brazil, between November 1998 and March 2002 and included 366 incident cases of oral cancer and 469 controls, frequency-matched with cases by sex and age. Dietary data were collected using a food frequency questionnaire. The risk associated with the intake of food groups defined a posteriori, through factor analysis (called factors), was assessed. The first factor, labeled prudent, was characterized by the intake of vegetables, fruit, cheese, and poultry. The second factor, traditional, consisted of the intake of rice, pasta, pulses, and meat. The third factor, snacks, was characterized as the intake of bread, butter, salami, cheese, cakes, and desserts. The fourth, monotonous, was inversely associated with the intake of fruit, vegetables and most other food items. Factor scores for each component retained were calculated for cases and controls. After categorization of factor scores into tertiles according to the distribution of controls, odds ratios and 95% confidence intervals were calculated using unconditional multiple logistic regression. RESULTS: Traditional factor showed an inverse association with cancer (OR=0.51; 95% CI: 0.32; 0.81, p-value for trend 0.14), whereas monotonous was positively associated with the outcome (OR=1.78; 95% CI: 1.78; 2.85, p-value for trend <0.001). CONCLUSIONS: The study data suggest that the traditional Brazilian diet, consisting of rice and beans plus moderate amounts of meat, may confer protection against oral cancer, independently of any other risk factors such as alcohol intake and smoking.
- ItemAcesso aberto (Open Access)Estrutura fatorial do questionário de morbidade psiquiátrica de adultos aplicado em amostras populacionais de cidades brasileiras(Faculdade de Saúde Pública da Universidade de São Paulo, 1994-08-01) Andreoli, Sergio Baxter [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Almeida-Filho, Naomar de; Coutinho, Evandro; França, Josimar; Fernandes, Jefferson Gomes; Busnello, Ellis D'Arrigo; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Bahia Departamento de Medicina Preventiva; Escola Nacional de Saúde Pública Departamento de Epidemiologia e Métodos Quantitativos em Saúde; Universidade de Brasília Departamento de Clínica Médica; Pontifícia Universidade Católica do Rio Grande do Sul Faculdade de Medicina Departamento de Medicina Interna; Universidade Federal do Rio Grande do Sul Faculdade de Medicina Departamento de Psiquiatria e Medicina LegalPrincipal Components Analysis is a multivariate statistical technique for the purpose of examining the interdependence among variables. The main characteristic of this technique is the ability to reduce data, and it is currently used as an adjunct for the development of psychiatric research tools and the classification of psychiatric disorders. It has been applied to the study of the Factorial Structure of a Brazilian screening questionnaire, the Adult Psychiatric Morbidity Questionnaire (QMPA). The questionnaire is made up of 45 yes/no items for the identification of psychiatric symptons and the use of psychiatric services and psychotropic drugs. The questionnaire was applied to 6.470 subjects over 15 years old in representative samples from three urban areas: Brasília, Porto Alegre and S. Paulo. Seven factors were found to explain 42.7% of the total variance: Anxiety/Somatization (eigenvalue=3.81, 10.9%); Irritability/Depression (eigenvalue =2.41, 6.9%); Cognitive Impairment (eigenvalue = 2.01, 5.8%); Alcoholism (eigenvalue =1.90, 5.4%); Mood Elation (eigenvalue = 1.62, 4.6%); Hallucinatory/ Delusional Disorders (eigenvalue = 1.60, 4.6%); and Drug/Therapies (eigenvalue = 1.60, 4.5%). A similar pattern of results was found when the analysis was carried out in the three places. It is suggested, on the banis of these findings, that some questions should be modified and some excluded in any future version of the questionnaire.
- ItemSomente MetadadadosFactor analysis of metabolic syndrome components in severely obese girls and boys(Editrice Kurtis S R L, 2009-06-01) Lafortuna, C. L.; Adorni, F.; Agosti, Fiorenza; De Col, Alessandra; Zennaro, R.; Caranti, Danielle Arisa [UNIFESP]; Sartorio, Alessandro; Ist Auxol Italiano; CNR; Universidade Federal de São Paulo (UNIFESP)Aims and methods: Factor analysis is a multivariate correlation technique frequently employed to characterise the aggregation of abnormalities underlying the metabolic syndrome (MS), but scarcely used in obese adolescents. Aim of the study was to investigate the clustering of anthropometric and metabolic variables related to the MS in 487 obese pubertal adolescents (140 boys, 347 girls) in the range of age 11-18 yr employing the factor analysis with exploratory approach. Results: Principal component analysis reduced 11 correlated physiological variables to 4 uncorrelated factors that explained 68.7% of the variance in the original parameters in boys, and 68.4% in girls. in boys, these factors were: obesity/hypertension, insulin resistance, dyslipidemia, and hyperglycemia, with elements related to obesity and fat distribution loaded also in dyslipidemia and insulin resistance. in girls no commonalities were detected, but elements of dyslipidemia and insulin resistance were loaded in a single factor, whereas elements of obesity and hypertension were loaded in separate factors. Conclusions: the identification of 4 independent factors suggests a multiple physiological origin of the MS also in youngsters. the measures of adiposity were correlated with development of hypertension, insulin resistance, and dyslipidemic phenomena in boys only, whereas in girls anthropometric measures were not correlated with any tested component of the MS, possibly disclosing the protective effect of female sex hormones in the juvenile age span. (J. Endocrinol. Invest. 32: 552-558, 2009) (C) 2009, Editrice Kurtis
- ItemAcesso aberto (Open Access)Internal consistency and factor structure of the adherence scale for alcoholics anonymous(Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas, 2011-03-01) Terra, Mauro Barbosa [UNIFESP]; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Athayde, Luciana Dias; Silveira, Dartiu Xavier da [UNIFESP]; Universidade Federal de Ciências da Saúde de Porto Alegre Divisão de Farmacologia Básica e Clínica; Universidade Federal de Ciências da Saúde de Porto Alegre Departamento de Medicina Preventiva; Universidade Federal do Rio de Janeiro Departamento de Psiquiatria; Universidade Federal de São Paulo (UNIFESP)The objective of the article was to estimate the internal consistency and factor structure of the Adherence Scale for Alcoholics Anonymous Groups. The scale was applied to 257 alcoholic patients who had been admitted for treatment in 3 hospitals in Porto Alegre, about 6 months earlier. The scale was produced based on an adaptation of the Drug Attitude Inventory Scale. Internal consistency was measured using Cronbach alpha. Data were subjected to a principal component analysis. The coefficient of internal consistency was 0.71. All items showed corrected item-total correlation coefficients above 0.29. Questionnaire items with factor loading of 0.57 or above were considered in the final factor solution. The factor analysis resulted in 2 dimensions which corresponded to 67.01% of the total variance. This scale appears to be a valid instrument for use in a population of alcoholic patients.
- ItemAcesso aberto (Open Access)Internal consistency and factor structure of the Portuguese version of the Liebowitz Social Anxiety Scale among alcoholic patients(Associação Brasileira de Psiquiatria - ABP, 2006-12-01) Terra, Mauro Barbosa [UNIFESP]; Barros, Helena M T; Stein, Airton T; Figueira, Ivan; Athayde, Luciana D; Gonçalves, Marcelo de S; Tergolina, Letícia P; Rovani, Joana S; Silveira, Dartiu Xavier da [UNIFESP]; FFFCMPA Department of Psychiatry and Forensic Medicine; FFFCMPA Division of Basic and Clinical Pharmacology; FFFCMPA Department of Preventive Medicine; UFRJ Department of Psychiatry; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: Liebowitz Social Anxiety Scale is an instrument used to evaluate the severity of social phobia. It has been widely used in different contexts and cultures, presenting variable psychometric properties. The objective of this article is to investigate the internal consistency and the factor structure of this scale. METHOD: In a sample of 300 alcoholic patients hospitalized in 3 mental clinics in Southern Brazil, 74 of them were social phobics (24.6%). The Structured Clinical Interview for DSM-IV-Axis I Disorders - Patient Edition, a semi-structured clinical interview based on DSM-IV, was used to check for the diagnosis of social phobia. The internal consistency was measured by Cronbach's alpha. Data were subjected to a factor analysis with the principal component method of parameter estimation. Questionnaire items loading at 0.35 or above were considered in the final factor solution. RESULTS: The coefficient of internal consistency was 0.95. All items showed corrected item-total correlation coefficient above 0.15, considered the minimum requested index. The factor analysis resulted in 5 dimensions which corresponded to 52.9% of the total variance. The five factors extracted were: factor I - speaking in a group, factor II - activity in public, factor III - social interaction with unknown person, factor IV - attitude of disagreement or disapproval and factor V - social interaction in leisure activity. CONCLUSIONS: The scale proved to be reliable and structurally valid instrument for use in a population of alcoholic patients. The possibility of screening for social phobia through the use of the instrument may be helpful in identifying probable cases of the disorder among alcoholics.
- ItemAcesso aberto (Open Access)Padrões alimentares de adolescentes na cidade de São Paulo(Pontifícia Universidade Católica de Campinas, 2011-10-01) Salvatti, Aline Giacomelli [UNIFESP]; Schimith Escrivão, Maria Arlete Meil [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Bracco, Mario Maia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Centro Assistencial Cruz de MaltaOBJECTIVE: This study identified the dietary patterns of normal weight and overweight adolescents. METHODS: This was a cross-sectional study of 239 adolescents from a public school in São Paulo, Brazil; of both sexes, aged 14 to 19 years. Anthropometric data and 4-day dietary records were collected. Nutritional status was assessed by body mass index, according to the criteria established by Must et al. Factor analysis was used to identify dietary patterns. RESULTS: This assessment resulted in the identification of four dietary patterns: Traditional, Urban, Healthy, and Junk Food. Normal weight was positively associated with the Traditional and Urban patterns, and overweight was positively associated with the Healthy and Junk Food patterns. Lastly, obesity was negatively associated with the Urban, Healthy and Junk Food patterns. CONCLUSION: The Healthy pattern was found among overweight adolescents who were concerned with weight control and trying to change eating habits. Among the obese, the occurrence of underreporting probably influenced the outcome of the associations.
- ItemAcesso aberto (Open Access)Padrões alimentares de adolescentes obesos e suas repercussões metabólicas(Universidade Federal de São Paulo (UNIFESP), 2009-02-27) Dishchekenian, Vera Regina Mello [UNIFESP]; Lopez, Fábio Ancona [UNIFESP]; Palma, Domingos [UNIFESP]; http://lattes.cnpq.br/7083006802937751; http://lattes.cnpq.br/8225793552223227; http://lattes.cnpq.br/1384892048180457; Universidade Federal de São Paulo (UNIFESP)Objetivo: Avaliar a associação de padrões alimentares com alterações metabólicas em adolescentes obesos. Método: Estudo transversal envolvendo 76 estudantes (ambos os sexos, 14-19 anos, IMC ≥P95 e Tanner ≥4.) de escolas públicas, São Paulo, Brasil. Foram coletados dados antropométricos e bioquímicos, e aplicados questionários com informações sócio-demográficas e registro alimentar de 4 dias, entre 2006 e 2007. Escores fatoriais foram obtidos na análise fatorial e após ajustes três padrões alimentares identificados foram associados a fatores de risco biológico por Regressão linear múltipla. Resultados: O padrão Tradicional (arroz e massas, feijões, carnes vermelhas, embutidos, óleos e doces) foi positivamente associado com insulina, glicemia e triglicérides e negativamente associado com lipoproteína de alta densidade. O padrão Em transição (peixe, aves, ovos, pães, manteiga, leite e derivados, hortaliças, frutas, sucos de frutas e açúcar refinado) apresentou as mesmas associações, além de associação similar com a pressão arterial diastólica. O padrão Fast food (cafeteria, hambúrguer, maionese, bolacha, bolos e tortas, chocolate e refrigerantes) apresentou associação positiva com o colesterol, lipoproteína de baixa densidade e pressão arterial sistólica e diastólica e negativa com a insulina e lipoproteína de alta densidade. Conclusão: Os padrões Tradicional e Em transição apresentaram associações diferentes com o metabolismo lipídico e glicídico quando comparados com o padrão Fast food. Os três padrões podem ser considerados obesogênicos, porém o padrão Fast food pareceu ser o mais aterogênico e promotor de hipertensão arterial.
- ItemAcesso aberto (Open Access)Validation of the structural coherency of the General Health Questionnaire(Associação Brasileira de Psiquiatria - ABP, 2011-03-01) Carvalho, Hudson Wander de [UNIFESP]; Patrick, Christopher John; Jorge, Miguel Roberto [UNIFESP]; Andreoli, Sergio Baxter [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); The Florida State University Department of Clinical Psychology and Psychopatology; Universidade Católica de SantosOBJECTIVE: Investigate the structural coherency of the 60-item version of the General Health Questionnaire via exploratory and confirmatory factor analyses. METHOD: The study design is a cross-sectional survey. A random sample of 146 individuals from the city of Divinópolis-MG volunteered to participate in the present study and responded to the 60-item version of the General Health Questionnaire adapted and validated for use in Brazil. Statistics consisted of exploratory and confirmatory factor analysis. Reliability was estimated using Cronbach's alpha method. RESULTS: Alpha coefficients for all five content scales of the General Health Questionnaire were high (α > 0.8). For four of the five scales, a unifactorial model of constituent items provided a good fit to the data. Items comprising the fifth scale, Psychic Stress, exhibited a two-correlated factor structure. A factor analysis of scores for the five scales yielded strong evidence of coherency, with all scales loading substantially on a single common factor. CONCLUSION: The General Health Questionnaire shows good psychometric coherency as evidenced by high internal consistency and unidimensionality of all but one of its constituent scales, and uniformly high loadings of all scales on a single overarching factor. These results are consistent with prior findings from the General Health Questionnaire developmental study and Brazilian adaptation studies.