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Patient activation is associated with treatment adherence, self-accountability for healthcare and a healthy lifestyle change. Mobile health (m-Health) apps can lead to greater patient treatment adherence and health behaviour change. This study aimed to evaluate the health behaviour change of elderly people through a healthcare programme focused on activation with the support of technology. Three phases were conducted: (1) pre-intervention – design of the intervention protocol and the app, (2) intervention – randomised clinical trial with 41 overweight/obese elderly people. m-Health app-supported group psychotherapy was compared with group psychotherapy only and individual psychotherapy (control) and (3) post-intervention – statistical analysis, intervention's assistant interviews and app heuristics evaluation. By crossing the results, the study has shown that there was no significant difference in the activation level before and after intervention between groups. However, there was a significant increase from the initial mean score to the final one when considering the three groups together. Group therapy, whether with or without the support of the app, was more effective for behaviour change measured by the achievement of the goals, than individual psychotherapy. The lack of impact on group therapy with app support calls into question which and how much technology support is useful. [ABSTRACT FROM AUTHOR]

Smartphone addiction and its excessive use could cause musculoskeletal symptoms such neck and upper limb pain. The purpose of this study was to investigate the association between smartphone use and musculoskeletal pain in the upper limbs and neck, as well as to observe the relationship in between smartphone addiction and musculoskeletal pain and upper limb function in university students. It is a cross-sectional, analytical study. A total of 165 university students participated in the research. Each student had their own smartphone. The students answered a structured questionnaire about pain in the upper limbs and neck; the Smartphone Addiction Inventory (SPAI) and the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH). Prevalence of neck and upper limb pain was 34.0%. Smartphone addiction and its use to play games and listen to music were risk factors to upper limb pain. Moreover, the smartphone addiction and age proved to be risk factors to neck pain. There was correlation between DASH and SPAI scores, and there was association between DASH score and neck and upper limb pain. Being of the female sex and smartphone addiction predicted the risk of incapacity development. We found association between neck and upper limb pain with smartphone addiction. Functional incapacity was associated to neck and upper limb pain. It was predicted by smartphone addiction and being of the female sex. [ABSTRACT FROM AUTHOR]

Self-injurious behavior has been defined as an act directed at oneself that results in tissue damage. The aim of this study was to verify the prevalence of self-injurious behavior and the presence of oral lesions among adolescents in foster care. This is a cross-sectional study that was carried out in the shelters of the city of Recife (Brazil), with adolescents between 10 and 17 years of age, of both genders, by census survey. Data were collected through document analysis, application of the questionnaire (FASM), and physical examination, in the second half of 2021. The data were systematized by SPSS software using descriptive and inferential statistics. A total of 81 adolescents participated of the research. The average age of the patients evaluated was 13.65 years and the majority were male. As for clinical characteristics, 75.3% had one or more self-injurious behavior. Of these, the most frequent were: poking wounds 53.1%, biting oneself 40.7%, and cutting the skin 34.6%. The most observed oral lesion was linea alba 14.8%. In the association between self-injurious behavior and oral lesions, trauma and dental wear, age group, gender, shelter care situation and violence no association was recorded (p > 0.05). Self-injurious behavior may have a high occurrence percentage among adolescents in shelter/foster care. However, the adolescents had a low prevalence of changes in the oral cavity that could suggest self-injurious behavior. No association was recorded between the variables studied. [ABSTRACT FROM AUTHOR]

To analyze the association of autonomic dysfunction symptoms with stress in Brazilian university professors of the Speech Language–Pathology course during the Covid-19 pandemic. Fifty-five Brazilian university professors participated in the study, with a mean age of 42 years and 10 months old (±8.75), 49 female and six male subjects. The evaluated outcomes were the symptoms of stress and self-assessment of autonomic dysfunction symptoms. The results were inferentially analyzed using binary logistic regression and chi-squared tests (p <.05). In 54.54% of the university professors presented stress, with a predominance of psychological symptoms and a higher frequency resistance phase. Stress was a risk factor for the high occurrence of autonomic dysfunction symptoms related (OR 5.841) and unrelated (OR 29.750) to voice. There was an association between the predominance of psychological symptoms and the higher occurrence of autonomic dysfunction symptoms related to voice (p <.001). There was an association between autonomic dysfunction symptoms and stress in Brazilian university professors during the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

The frequent association between mental disorders and HIV infection may be related to several risk factors. The present study aims to determine the prevalence of depression and its associated factors in people living with HIV/AIDS (PLWHA) who attended four outpatient clinics in Fortaleza, Brazil, between September 2014 and April 2015. In addition to the Mini International Neuropsychiatric Interview questionnaire, which was used to identify the prevalence of depressive disorder, the researchers applied a sociodemographic questionnaire, and the Hamilton Depression Scale to classify the severity of depression. In all, 257 participants were included in the analyses. The overall lifetime prevalence of depression was identified to be 29.2% (19.5% in men and 44.9% in women). The prevalence of a current depressive episode was 18.7%. Mild, moderate, and severe depression was identified in 2.1%, 12.5%, and 85.4%, respectively. The factors related to depression were: gender, marital status, income, educational level, current employment status, and family history of depression. This study highlights the importance of lifetime depression as a disorder of high prevalence in PLWHA, and associated with risk factors that are difficult or impossible to be modified. Early diagnosis and treatment of depression may improve quality of life in PLWHA. [ABSTRACT FROM AUTHOR]

Background: The Smoke-free Policy represents a challenge in mental health services. Aim: To compare the stages of a smoke-free policy in a psychiatric hospital, according to the prevalence of smokers, hospital admission acceptance by hospitalized people, psychiatric complications, and the prescription of psychotropic drugs. Methods: Cross-sectional study was conducted with a comparison before and after implementing the Smoke-free Policy in a psychiatric hospital. Secondary data were obtained in 2020 from the medical records of 573 discharged people from psychiatric hospitalizations between September 2017 and August 2018. Fisher's exact test and the Kruskal-Wallis test were applied. Results: In the transition stage, there were more hospitalizations by court order, discharge motivated by the patient's disruptiveness behavior, administration of psychotropic drugs before the schedule time, physical aggression, physical/chemical restraints, length of stay, and dosage of psychotropic drugs. After the ban, there was a reduction in discharges motivated by the patient's disruptiveness behavior and an increase in discharge due to improvement in psychiatric symptoms, less occurrence of anticipation or modification in the use of psychotropic drugs, and fewer attempts to escape, aggressiveness, and physical restraint. Conclusion: The implementation of the Smoke-free Policy has a positive impact on psychiatric hospitalizations, with an increase in discharge due to improvement in psychiatric symptoms and a reduction in discharges due to other reasons. However, the transition stage requires greater attention from the nursing team, as the moment of adaptation to new rules and routines is followed by a momentary worsened behavior of those hospitalized. [ABSTRACT FROM AUTHOR]

To verify the factors associated with the need of tube feeding (TF) during patients post-ischemic stroke hospitalization. This is a retrospective study with 70 adult post-ischemic hemispheric stroke adult patients hospitalized in the Neurology department at a tertiary public hospital in Santa Catarina, Brazil. We investigated associations between the need of a feeding tube during hospitalization and the variables age, gender, admission and discharge NIHSS and FOIS, length of hospital stay in days, presence of thrombolytic therapy, extensive stroke, hemisphere affected, prior stroke, pneumonia during hospitalization, presence of signs of laryngeal penetration and laryngotracheal aspiration and dysphagia in the first and last swallowing clinical evaluation. A total of 33 participants used tube feeding. There was a significant relationship among tube feeding and the following parameters: NIHSS (p value.001), FOIS (p value.001), extensive stroke (p value.034), left hemisphere involvement (p value.035), pneumonia during hospitalization (p value.001), length of hospital stay in days (p value.001), signs of laryngotracheal penetration/aspiration (p value.001) and dysphagia in speech-language assessment (p value.001). Tube feeding during patients hospitalization after ischemic hemispheric stroke was predicted by the severity of stroke and signs of airway permeation. Swallowing difficulty is one of the most common post-stroke consequences. There are few studies on the characterization of post-stroke patients with tube feeding. Tube feeding after ischemic stroke predictors were severity of stroke and signs of airway permeation. [ABSTRACT FROM AUTHOR]

Objective: To relate the socio-demographic profile with access to health services of the population living in environmentally degraded areas in an estuary region. Study design: A sectional field study of 8819 people, evaluating three contaminated areas of São Vicente. Methods: Households were divided by studied area. A structured and pre-tested questionnaire was applied to obtain the data. A probabilistic sample was used. The prevalence of each of the outcomes of interest by area was calculated. To verify the existence of an association between the outcomes of interest and other variables (qualitative), by area, a descriptive analysis and to compare percentages and a comparison test was used between two proportions, a Chi-square test and/or a Fisher's exact test and a Kruska-wallis and Dunn multiple comparison were used as well. The significance level was 5%. Results: Most residents (94%) reported the use of public health services at least once a year (p < 0.001), mainly through the Basic Health Units (BHU) (p < 0.001). Most of the studied population (65%) did not have private health insurance and their schooling was basically restricted to primary education (p < 0.001). The predominant family income (70%) in the three areas was between one and five minimum wages (p < 0.001), with a higher incidence of people receiving one to three minimum wages at the time. The demand for health services was not associated with education or income. Conclusion: The population of the regions analysed heavily rely on the Unified Health System – SUS, but there was no association between income and frequency of health services and there was also no association between education and use of health services. [ABSTRACT FROM AUTHOR]

Anxiety sensitivity (AS) is a multidimensional construct associated with the etiology and maintenance of panic disorder (PD) symptoms. However, only a few studies have evaluated whether cognitive-behavioral group therapy (CBGT) can modify the condition. The objective of this study was to evaluate the impact of CBGT on AS in patients with PD and to analyze AS and its dimensions as predictors of response to CBGT. In the present clinical trial, an intervention group (n = 37) attended 12 CBGT sessions, while a control group (n = 52) did not receive any intervention. The severity of symptoms and of AS were evaluated before and after CBGT in the intervention group and once in the control group. Significant improvement occurred in all specific PD symptoms and in general anxiety and depressive symptoms. Furthermore, AS scores reduced significantly after intervention. This study confirmed that AS is higher in patients with more severe PD. The effectiveness of CBGT for reducing the physical, cognitive, and social dimensions of AS was also observed, supporting the hypothesis of a positive impact of therapy. [ABSTRACT FROM AUTHOR]

Despite the investment in prevention of mother-to-child transmission of HIV, there is still little data about the proportion of women that are retained in treatment after pregnancy in Brazil. Research worldwide shows that a significant proportion of women drop out of treatment after pregnancy. The aim of this study was to identify factors associated with treatment dropout of women that received prenatal care at a federal hospital in Rio de Janeiro between 2016 and 2017 and abandoned treatment after pregnancy. This was a retrospective cohort study using data on prescription refills and hospital medical records. Cross-sectional analysis of data from 454 women showed that 18% were not on cART after pregnancy. Illicit drug use during pregnancy, being less than 35 years old, and being aware of HIV diagnosis before conceiving but not taking cART were factors associated with treatment interruption postpartum. The high prevalence of interruption of HIV treatment after pregnancy suggests that there is a need for better post-natal care to increase adherence in this population. [ABSTRACT FROM AUTHOR]

The purpose of this study was two-step: (1) classify ball possession (BP) according to the duration and number of passes and (2) identify which tactical variables most discriminate the different BP. We obtained 527 BPs from four official matches of the Brazilian Soccer Championship 2016. Forty-one "notational", "space occupation", and "displacement synchronization" predictor variables were used. The BPs were classified into three groups: short (11.07 ± 4.49 s, 1.93 ± 0.99 passes), medium (26.83 ± 7.33 s, 5.41 ± 1.84 passes), long (55.50 ± 14.97 s, 12.11 ± 4.61 passes). Discriminant analysis identified the five most relevant variables to describe each group: coefficient of variation (CV) of the defensive team's synchronization-Y, CV defensive team´s synchronization-X, successful pass last third, CV distance between offensive team's centroid and target, mean of the offensive team's width. The approach highlights important variables and could benefit the description of offensive and defensive game sequences to provide precise knowledge on the process. [ABSTRACT FROM AUTHOR]

Information on occupational health and safety practices in Brazilian aquaculture is limited. This paper reports preliminary results from an online survey based on research questions to identify occupational hazards, risk assessment practices, and prevention measures adopted in Brazilian aquaculture. Data were collected through an online questionnaire, comprising 25 questions, on a voluntary and anonymous basis. Aquaculture stakeholders were invited to participate in the study through email and social media channels. The demographic data demonstrated that the majority of respondents were men (72%) and having a higher education (95%). Most respondents employed administrative controls and personal protective equipment (PPE) rather than substitution and other risk elimination measures to reduce exposure. The most commonly adopted measures were PPE use (87%), adequate handling of chemicals (86%), and imparting knowledge of risks (90%). However, only 12% of participants reported the presence of safety protocols at their workplace, and 17% had some form of immunization of workers. In this study, it was possible to identify a lack of hazard signage in the workplace and lack of occupational health and safety training. The results further indicate that risk management in aquaculture continues to be a challenge in low-income countries. Aquaculture farmers should be encouraged and supported in adopting measures and appropriate technologies to eliminate risks in Brazilian aquaculture. [ABSTRACT FROM AUTHOR]

Pregnant women who are infected with the Human Immunodeficiency Virus (HIV) are particularly vulnerable to severe and recurrent infections with Human Herpesvirus 2 (HHV-2). Neonatal transmission of HHV-2 has been associated with malformations and neurological sequelae in infants, which makes it very important to perform antenatal monitoring for genital herpes. In the study, 134 pregnant women infected with HIV were tested for HHV-2 IgM and IgG using an enzyme-linked immunosorbent assay (ELISA) and had HHV-2 DNA analyzed by Real Time Polymerase Chain Reaction (qPCR). Fisher's exact test was applied to analyze the epidemiological dates (p < 0.05). A total of 59.7% of the pregnant women infected with HIV had HHV-2 IgG and 3.75% of them showed HHV-2 viremia. HHV-2 IgM was found in 6% of the pregnant women and 25% of them had HHV-2 viremia. The risk factors associated with HHV-2 seropositive were age under 20 and a CD4/CD8 ratio > 1. Our study found high HHV-2/HIV coinfection prevalence and HHV-2 viremia among patients with recurrent and primary genital infection, reinforcing the need of prevention and control of HHV-2 infection in order to avoid this virus transmission. [ABSTRACT FROM AUTHOR]

Background: Non-adherence to oral antidiabetics drugs (OADs) has been a common problem and may contribute to poor glycemic control. Aim: To describe an experimental study protocol that aims at implementing and evaluating the effect of the "action planning and coping planning" interventions on medication adherence to OADs in patients with type 2 diabetes mellitus (T2DM) in follow-up at primary care services. Design: A randomized controlled trial. Methods: Two groups (intervention and control) will be followed over a period of 105 days. The intervention group will receive a combination of the "action planning" and "coping planning" intervention strategies. There will be in-person meetings and phone calls to reinforce the intervention. The control group will receive the usual care from the health unit. Conclusions: It is hoped that this study will help health professionals to improve their approach with patients who have T2DM in relation to medication adherence. [ABSTRACT FROM AUTHOR]

Female crack users who sought treatment are a hard to find part of the population. We studied sociodemographic and behavioral characteristics of crack users undergoing treatment in psychosocial care centers for alcohol and other drugs in six Brazilian cities. We carried out a cross-sectional study of 816 crack users and collected data with the Addiction Severity Index. Women were more likely to be in vulnerable situations: had worst levels of education, were not receiving money enough to their basic needs; more likely to be HIV positive (10.1%), to report sexual abuse (34%), and to be separated from their children (20%). [ABSTRACT FROM AUTHOR]

Purpose:To evaluate short-term effects of balance Vestibular Rehabilitation Therapy (VRT) on balance, dizziness symptoms and quality of life of the elderly with chronic Benign Paroxysmal Positional Vertigo (BPPV). Method:In this randomized, single-blind and controlled trial, older adults with chronic BPPV were randomized into two groups, the experimental group (n = 7, age: 69 (65–78) years) and the control group (n = 7, age: 73 (65–76) years). Patients in the experimental group underwent balance VRT (50 min per session, two times a week) and Canalith Repositioning Maneuver (CRM) as required, for 13 weeks. The control group was treated using only CRM as required. Standing and dynamic balance, dizziness symptoms and quality of life were measured at the baseline, and at one, five, nine and thirteen weeks. Results:There were no between-group differences in dizziness, quality of life and standing balance over the 13 weeks. Significant differences were observed in dynamic balance measures between groups (p <  0.05 for most tests) through assessments. In intragroup analysis, both groups showed improvements in all measurements except no improvement was found in majority of the dynamic balance tests in the control group. Conclusions:The patients who received additional balance VRT demonstrated better results in dynamic balance than those who received only CRM. Implications for RehabilitationThe findings that balance VRT in addition to CRM improves dynamic balance in elderly people with BPPV should be useful in guiding rehabilitation professionals’ clinical decision making to design interventions for seniors suffering from BPPV;Improvements in tests of dynamic balance suggest that the risk of adverse consequences of BPPV in the elderly such as falls and fractures can be potentially reduced through implementation of CRM in conjunction with balance VRT;Lack of additional improvement in Visual Analogue Scale of dizziness and Dizziness Handicap Index suggests that addition of balance VRT does not influence dizziness symptomatology, per se, and CRM alone is effective to ameliorate vertiginous symptoms and potentially improve quality of life. [ABSTRACT FROM AUTHOR]

This study investigated the effects of a congested match schedule (7 matches played in 7 days) on steroid hormone concentrations, mucosal immunity, session rating of perceived exertion (S-RPE) and technical performance in 16 elite youth soccer players (14.8 ± 0.4 years; 170.6 ± 9.4 cm; 64.9 ± 7 kg). No change was observed for salivary cortisol concentration across match time points (P = 0.33; effect size [ES] = 0.13–0.48). In contrast, there was a decrease in salivary testosterone and salivary IgA (SIgA) concentrations from the 1st compared with the last time point (P = 0.01 and 0.001, ES = 0.42 and 0.67, respectively). The SIgA concentration varied across time points (P < 0.001) with the highest value observed at the 3rd time point (rest day) (3rd vs all time point; ES = 0.47–0.73). No changes were observed for S-RPE across time points (P > 0.05). A higher number of tackles and interceptions were observed during the 4th match vs 1st and 7th matches (P < 0.001; ES = 2.25 and 1.90, respectively). The present data demonstrate that accumulated fatigue related to participation in a congested match schedule might induce a decrease in testosterone concentration in youth players and negatively affect their mucosal immunity and capacity to perform certain technical actions. [ABSTRACT FROM PUBLISHER]

Background:The recreational use of anabolic-androgenic steroids (AAS) has reached alarming levels among healthy people. However, several complications have been related to consumption of these drugs, including liver disorders.Objective: To evaluate the prevalence of liver injuries in young Brazilian recreational AAS users.Methods:Between February/2007 and May/2012 asymptomatic bodybuilders who were ≥18 years old and reported AAS use for ≥6 months were enrolled. All had clinical evaluations, abdominal ultrasound (AUS), and blood tests.Results:182 individuals were included in the study. The median age (interquartile range) was 26.0 years (22.0–30.0) and all were male. Elevated liver enzyme levels were observed in 38.5% (n= 70) of AAS users, and creatine phosphokinase was normal in 27.1% (n= 19) of them. Hepatic steatosis was observed by AUS in 12.1% of the sample. One individual had focal nodular hyperplasia and another had hepatocellular adenoma. One case each of hepatitis B and C virus infection was found. A diagnosis of toxic liver injury was suggested in 23 (12.6%) AAS users without a history of alcohol or other medications/drugs consumption, or evidence of other liver diseases.Conclusions/Importance: Young Brazilian recreational AAS users presented a wide spectrum of liver injuries that included hepatotoxicity, fatty liver, and liver neoplasm. They also presented risk factors for liver diseases such as alcohol consumption and hepatitis B and C virus infection. The results suggest that the risk of AAS use for the liver may be greater than the esthetic benefits, and demonstrate the importance of screening AAS users for liver injuries. [ABSTRACT FROM PUBLISHER]

Depression is frequent in end-stage renal disease (ESRD) and predicts mortality in dialysis patients. The aim of this study was to investigate the occurrence of depression among patients on hemodialysis. We conducted an observational cross-sectional study at two hemodialysis centres in the metropolitan area of Fortaleza, Ceará, Brazil, between September and October 2010. The occurrence of depression was evaluated according to Beck Depression Inventory II. Among 148 patients interviewed, the mean age was 46?±?13 years and 54% were male. The average time on dialysis was 5.3?±?5.2 years. Depression was found in 101 (68.2%) cases. Depression was classified as mild (49.5%), moderate (41.5%) and severe (9%). Only 15.5% had prior depression diagnosis. Follow-up with Psychologist was being done in only 32.4% of cases. Patients with depression had a higher frequency of antidepressant use (20.7% vs. 4.2%,p?=?.01) and benzodiazepines (33.6% vs. 8.5%,p?=?.001). Among patients using antidepressant, improvement of symptoms was reported by 81.6%. Depression is one potentially modifiable risk factor in ESRD. The investigation and multidisciplinary approach of depression should be part of routine evaluation of patients on dialysis. [ABSTRACT FROM PUBLISHER]

The purpose of the present study was to identify the sociodemographic, clinical, and functional determinants of quality of life in elderly (older than 60 years) patients from a Psychosocial Care Center. The sample was randomly selected patients undergoing treatment at the center during the study period. Quality of life was assessed using the brief version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF) and the World Health Organization Quality of Life Assessment for older adults (WHOQOL-OLD). A total of 50 elderly individuals with a mean age of 67.5 ( SD = 5.72) years were included in the study. A hierarchical linear regression showed that clinical characteristics, such as severe symptoms of depression and a higher number of comorbidities, were related to lower quality of life. Better functional capacity and more frequent visits to the center were determinants of higher quality of life. These findings underscore the importance of assessing quality of life and of taking this variable into account when planning health interventions for elderly patients at a Psychosocial Care Center. [ABSTRACT FROM AUTHOR]

This study explores the relationships between demographic, socioeconomic and health statuses of children whose parents were HIV positive in two cities in Northeast Brazil. We conducted a multisite exploratory study in HIV/AIDS referral services for HIV/AIDS in Fortaleza, the capital of Ceará State, and Salvador, the capital of Bahia State, between June 2008 and March 2009. The study population consisted of 562 HIV+ adults − or caretakers of children of HIV+ adults − who provided information about a single index child under 13 years of age of either sex in their household. A structured questionnaire was used for to the adult parent or caretaker. We used multiple correspondence analysis (MCA), as implemented in the software SPAD (Portable Système pour l'Analyse des données). This analysis enabled us to identify the relationships between a large number of variables simultaneously. Of the 562 children, 311 (55.3%) lived in Fortaleza and 251 (44.7%) lived in Salvador. The proportion of HIV-infected children in Fortaleza was 14.2%, and 61.4% (27/44) of these had progressed to AIDS. In Salvador 34.7% of children were seropositive and 95% (83/87) were diagnosed with AIDS. The most important factors that emerged from the study were city and serostatus of the children. These two active variables accounted for 75.3% of the variance. Results are grouped into four profiles that describe the complex of socioeconomic variables closely associated with these families, and the complex and multiple epidemics of HIV, discrimination and poverty associated with these AIDS-affected families. [ABSTRACT FROM PUBLISHER]

The aim of the current study was to evaluate the effects of a short inspiratory muscle training (IMT) program results in functional capacity, inspiratory muscle strength and quality of life in physically active elderly people. Twenty-six physically active elderly subjects were assigned to either a 6-week IMT program (13 subjects) or a placebo-IMT (P-IMT; 13 subjects). The following parameters were measured before and after intervention: 6-minute walk test (6MWT) distance, inspiratory muscle strength (PImax) and quality of life scores. Between-groups analysis of functional capacity was not statistically significant, but showed a tendency to improvement in the IMT group from 469.4 m (IQR: 418-532 m) at baseline to 516.4 m (IQR: 462.5-560.1 m) during follow-up. The IMT program induced significant improvement in inspiratory strength between the groups from 55 cm H2O (IQR: 45-71.25 cm H2O) at baseline to 90 cm H2O (IQR: 76.25-107.5 cm H2O) during follow-up, whereas the P-IMT group had a slight decrease from 75 cm H2O (IQR: 67.5-95 cm H2O) at baseline to 67.5 cm H2O (IQR: 65-75 cm H2O; p = 0.010). The quality of life questionnaire did not improve after the IMT program. The present study demonstrates that a short-term 6-week IMT program results in improvement in inspiratory muscle strength and a tendency to improvement in functional capacity in physically active elderly people. [ABSTRACT FROM AUTHOR]

HIV infection is a global growing pandemic, and it is considered a public health problem. Treatment advances improved survival rates for HIV-infected individuals, although not always with a good quality of life (QoL). The aim of this study was to assess the QoL of people living with HIV (PLHIV) in the city of São José, Brazil. A cross-sectional study was performed involving a convenience sample of 85 individuals. Self-administered questionnaires were used to collect sociodemographic information, treatment length and period of infection. The WHOQoL-HIV-Bref instrument was used to assess QoL. The collected data were first described in proportions, means, median and percentiles. Chi-square test or Fisher's exact test was used to test association between the perception of poor QoL taking the first quartile of the distribution of values with gender, age, education level, marital status, period of diagnosis, infection status, self-rated health status and believing to be ill or not. The p values were established at <0.05. The found mean score of WHOQoL-HIV-Bref was 14.1 (SD = 2.9). Lower education level (p=0.011) and believing to be ill (p<0.001) were associated with poor QoL. Also lower education level was associated with poor QoL in the psychological (p=0.020) and environment (p=0.047) domains; being diagnosed with HIV infection within the past five years (p=0.029) was found to be associated with poor QoL in the social relationships domain; and believing to be ill was associated with all domains (physical: p<0.001; psychological: p=0.022; level of independence: p=0.009; social relationships: p=0.009; environment: p=0.005; and spirituality/religion/personal beliefs: p=0.021). It could be concluded that in general, PLHIV have a good QoL. A poor QoL was associated mainly with lower education level and when they believe to be ill. [ABSTRACT FROM PUBLISHER]

Despite effectiveness in research, the efficacy of screening and brief intervention (SBI) for risky substance users is not adequately understood in routine clinical practice. Primary healthcare professionals ( n = 103) from three cities in a metropolitan area in Brazil were trained and supervised in SBI and then screened 40 patients. One year later, meetings were held in each city to obtain feedback. Twenty professionals who fulfilled the task (Yes [Y]) and 24 who did not (No [N]) were individually interviewed about their SBI experience. Reports were independently interpreted and codified by two researchers. The Y and N groups reported the same barriers and positive beliefs, but only the Y group reported no negative issues. The present study lasted from 2007 to 2009. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the tolerance to enteral nutrition (EN) and the effects of pro-kinetic drugs in critical traumatic brain injury (TBI) patients. Methods: Transversal observational study. A total of 32 out of 45 TBI patients of both genders receiving EN were evaluated in a trauma referral hospital intensive care unit (ICU). Data from each patient were collected for a period of 10 consecutive days after initiation of enteral feeding: gastric residue, presence of vomiting, abdominal distension, Glasgow coma scale and the use of pro-kinetic agents. Results: In 20 of the 32 patients high levels of gastric residue were found. Of these 20 patients, half could not tolerate the diet within the first 72 hours following infusion. However, no association was found between disease severity and occurrence of gastrointestinal complications ( p > 0.05). Feeding intolerance was observed in 75.0% ( n = 24) of patients, even with the systematic use of metaclopramide from the outset of nutritional therapy. All patients with feeding intolerance who used erythromycin by nasogastric tube showed improvement. Conclusions: The high level of gastric residue was the most common feeding intolerance and the delivery of erythromycin by nasogastric tube seems to control gastrointestinal disorders in TBI patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to verify the impact of an occupational therapy (OT) program on the Quality of Life (QoL) of hemodialysed patients. Sixty patients with chronic renal disease undergoing regular hemodialysis were involved. A study group composed of 20 subjects was submitted to an OT program while a control group with 40 subjects followed conventional treatment. Upon analyzing the group as a whole, the study group showed significant improvement in mental health (p = 0.05) and the control group showed a deterioration in the pain domain (p = 0.04). No significant change was observed when comparing groups. When the group was divided between the genders, female patients in the study group scored improvements in the categories of Pain, Emotional Aspects, and Mental Health, whereas no corresponding significant change was found in the control group. A significant improvement was observed in the pain domain (p < 0.05) when comparing groups. In male patients, no significant changes were observed in the study group whereas a significant deterioration occurred in functional capacity in the control group. No significant changes were observed when comparing groups. The conclusion is that to improve their QoL occupational therapy may be included in the therapeutic approach for patients under hemodialysis. [ABSTRACT FROM AUTHOR]