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In this paper, we measured B cell function in elderly healthy individuals (EH) and in elderly patients with Type-2 Diabetes Mellitus (T2DM, ET2DM), which are treatment-naive, as compared to healthy young (YH) individuals. Results show a higher serum inflammatory status of elderly versus young individuals, and especially of ET2DM versus EH. This status is associated with a reduced response to the seasonal influenza vaccine and with increased frequencies of the circulating pro-inflammatory B cell subset called Double Negative (DN) B cells. B cells from ET2DM patients are not only more inflammatory but also hyper-metabolic as compared to those from EH controls. The results herein are to our knowledge the first to show that T2DM superimposed on aging further increases systemic and B cell intrinsic inflammation, as well as dysfunctional humoral immunity. Our findings confirm and extend our previously published findings showing that inflammatory B cells are metabolically supported. [ABSTRACT FROM AUTHOR]

Background: Changes in the trunk and lower limbs' sagittal movements may cause patellofemoral pain (PFP) because they influence the forces acting on this joint. Objectives: To compare trunk and lower limb sagittal kinematics between women with and without PFP during functional tests and to verify whether sagittal trunk kinematics are correlated with those of the knees and ankles. Methods: A total of 30 women with PFP and 30 asymptomatic women performed single-leg squat (SLS) and step-down (SD) tests and were filmed by a camera in the sagittal plane. The trunk inclination angle, forward knee displacement, and ankle angle were calculated. Results: The PFP group exhibited less trunk flexion (SLS, p =.006; SD, p =.016) and greater forward knee displacement (SLS, p =.001; SD, p =.004) than the asymptomatic group; there was no significant difference in ankle angle (SLS, p =.074; SD, p =.278). Correlation analysis revealed that decreased trunk flexion was associated with increased forward knee displacement (SLS, r = −0.439, p =.000; SD, r = −0.365, p =.004) and ankle dorsiflexion (SLS, r = −0.339, p =.008; SD, r = −0.356, p =.005). Conclusion: Women with PFP present kinematic alterations of the trunk and knee in the sagittal plane during unipodal activities. Furthermore, the trunk and lower limb sagittal movements were interdependent. [ABSTRACT FROM AUTHOR]

Multiple exercises included in strength training involve greater activation of the quadriceps compared to hamstring muscles, which may lead to knee joint imbalances. The aim of this study was to examine the ratio of surface electromyography (sEMG) activity hamstring and quadriceps muscle groups (hamstring-to-quadriceps activation ratio; H:Q EMG), as well as lateral to medial hamstring activation ratio (LH:MH) in parallel squat, Romanian deadlift, hip thrust, lying leg curl and seated knee extension. The H:Q EMG was greater during lying leg curl compared to other exercises during both the concentric and eccentric phase, however the Romanian deadlift and hip thrust also resulted in relatively high H:Q EMG. Pairwise comparisons revealed that LH:MH was greater in the parallel squat compared to the Romanian deadlift and hip thrust in the concentric phase, and compared to the Romanian deadlift and hip thrust during the eccentric phase. Our data suggests that the lying leg curl promotes the greatest hamstring activation and H:Q EMG, amongst the exercises investigated, while also providing relatively homogenous LH:MH. The lying leg curl should be considered as a primary exercise in rehabilitation and training programmes, aiming to proportionally activate LH:MH and increase H:Q EMG, which may improve knee muscle balance. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the immediate effect of Dynamic TapeTM (DT) on hip muscle activation and torque and on lower limb kinematics. Forty-five healthy, recreationally active women were randomly assigned to three groups: 1) submitted to the application of DT in the active form in the gluteus medius (GMed) muscle (BG; n = 15), 2) submitted to the application of DT in the placebo form in the GMed muscle (PG; n = 15), and 3) not submitted to any intervention (CG; n = 15). Participants were evaluated for GMed and gluteus maximus (GMax) muscle activation in a maximal voluntary isometric contraction, simultaneously with the assessment of the hip abductor and extensor torques, as well as during two functional tasks – single leg squat (SLS) and jump landing + maximum vertical jump (VJ) – simultaneously with a 2-D kinematic assessment of the lower limb. After DT application in BG, there was a significant decrease in the hip abductor time to peak torque (P = 0.004), hip extensor torque (P = 0.02), excursion to hip adduction (P = 0.007), and to knee flexion (P = 0.02) during the SLS, as well as in GMed activation during VJ (P < 0.05). DT was able to reduce GMed activation and modify lower limb torque and kinematics. [ABSTRACT FROM AUTHOR]

Background: Hybridization between the local medical systems (LMSs) and biomedicine has been the focus of different studies in ethnobiology, primarily due to the increasing access to biomedicine by indigenous peoples and local communities. Studies on hybridization allow for an understanding of the process of developing and evolving local knowledge systems. In this study, we propose a hybridization score to determine how individuals' socioeconomic characteristics and preference between LMS and biomedicine determine the complementarity of therapeutic options. Methods: We conducted semistructured interviews and applied free listing technique in a rural community in Northeast Brazil to assess the treatments the local population sought and which were preferred. Results: Our analyses showed that the level of schooling was the socioeconomic factor that negatively affected the hybridization process. Individuals with higher levels of schooling tended to prefer LMS strategies less and, consequently, showed a lower probability of hybridizing the two systems. Additionally, older people who preferred LMS strategies showed a greater tendency to adopt hybridization in human health-seeking behavior. Conclusions: Our findings provide further evidence of the complementarity between different medical systems and demonstrate that socioeconomic factors can affect local knowledge and are responsible for differences in individual propensity to hybridize distinct medical systems. [ABSTRACT FROM AUTHOR]

Background: Vestibular Activities and Participation Measure (VAP) subscales assess the effect of vestibular disorders on activity and participation. This study aimed to perform the cross-cultural adaptation and assess the validity, internal consistency, reliability, and measurement error of the Brazilian version of VAP subscales. Methods: The cross-cultural adaptation followed the translation, synthesis, back-translation, review by a committee of experts, and pretesting phases. Structural validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), while Spearman's correlation between VAP subscales and the Dizziness Handicap Inventory (DHI) was used to assess construct validity. Cronbach's alpha measured internal consistency. Intraclass correlation coefficient (ICC) assessed intra- and inter-rater reliability, and measurement error was calculated by using the standard error of measurement (SEM) and minimal detectable change (MDC). Results: Additional information was included in the Brazilian version of the Vestibular Activities and Participation measure (VAP-BR) after approval by one of the developers of the instrument to improve the understanding among individuals. One factor was found in the EFA for each subscale with 50% explained variance. Regarding CFA, the subscales 1 (S1) and 2 (S2) presented, respectively, adequate model fit indices (ie, comparative fit index of 0.99 and 0.97, and standardized root mean square residual of 0.04 for both subscales), but a very low factor load in item 6 of S1 (0.08). Chronbach's alpha was 0.80 (S1) and 0.82 (S2). For intra-rater assessment, the S1 and S2 presented an ICC of 0.87 and 0.90, SEM of 0.01 and 1.16, and MDC of 0.39 and 0.46, respectively. When assessed by 2 different raters, SEM values were 1.03 and 1.53, and MDC values were 2.85 and 4.23 for S1 and S2, respectively; both subscales showed an ICC of 0.92. Correlations between DHI and VAP subscales presented coefficients above 0.57. Conclusion: The Brazilian version of VAP subscales presents good measurement properties and may assist health professionals in identifying activity limitations and participation restrictions in individuals with vestibular disorders. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to test the reliability and structural validity (also called dimensionality) of the online Pittsburgh Sleep Quality Index among college students from low-income regions. Methods: We assessed 195 Brazilian college students from a low-income region (Gini index of 0.56), of whom 117 were reassessed to evaluate the reliability. We collected all data in a self-reported online twice, 2-week apart. We evaluated reliability and structural validity. Results: All questionnaire components showed reliability, correlation coefficient ≥0.49. In the structural validity, the confirmatory analysis showed better global model adjustment for the one-factor (RMSEA = 0.019; SRMR = 0.041; CFI = 0.992; TLI = 0.986) solution compared with two-factor (RMSEA = 0.099; SRMR = 0.070; CFI = 0.764; TLI = 0.619) and three-factor (RMSEA = 0.108; SRMR = 0.066; CFI = 0.763; TLI = 0.548) solutions, respectively. Discussion: The online questionnaire presents acceptable reliability and structural validity in Brazilian low-income regions. [ABSTRACT FROM AUTHOR]

Objective: This case–control study evaluated the association of sociodemographic profile, mental health disorders and oral health‐related quality of life (OHRQoL) with periodontitis. Methods: Patients with periodontitis (PP, n = 50) and control patients (CP, n = 50) were allocated into 2 groups after a complete periodontal examination. Data collection included age, sex, marital status, education and application of 2 questionnaires: Hospital Anxiety and Depression Scale for the diagnosis of anxiety/depression and Impact Profile on Oral Health (OHIP‐14) for classification of well‐being. An adjusted multiple binary logistic regression analysis was performed to assess the effect of all studied covariates on periodontitis. Results: The results show that mean clinical attachment loss and periodontal probing depth were 5.92 (SD = 0.42) and 5.46 (SD = 0.78) in PP and 0.00 (SD = 0.00) and 2.85 (SD = 0.23) in CP, respectively (p < 0.001). The regression analysis demonstrated a significant effect on periodontitis for age (OR = 1.13; p < 0.0001; 95% CI: 1.07–1.20), with the PP having more people aged 50 years or older than CP, anxiety (OR = 1.25; p = 0.020; 95% CI: 1.04–1.50) and OHIP‐14 (OR = 1.17; p < 0.0001; 95% CI: 1.08–1.226). Conclusions: The findings showed a positive association between anxiety, OHRQoL and age with periodontitis. [ABSTRACT FROM AUTHOR]

Objective: To validate the level of agreement between self‐report and clinical examination for oral conditions and evaluate the effect of sociodemographic conditions on the validity of self‐report among women aged 60 and older. Methods: A cross‐sectional study was conducted in a social community center for seniors in Southern Brazil. Sociodemographic data (age, level of education, and income) were measured. Participants were interviewed and clinically examined for the number of teeth (DMF‐T index) and the use of dental prostheses. The self‐reported number of teeth in each arch and the use of dental prostheses were gathered through interviews. The level of agreement was estimated using the observed agreement, Kappa statistics, sensitivity/specificity (edentulism/prostheses) and Lin's concordance correlation coefficient, and related tests (number of teeth). The validity of the oral conditions was estimated according to sociodemographic information. Results: Ninety‐nine women participated in the study. High levels of agreement were observed for edentulism (97.8%; 95%CI 92.8;99.7; Kappa 0.947) and the use of dental prostheses (97.0%; 95%CI 91.3;99.4; Kappa 0.922). In both conditions, despite achieving similar concordance correlation coefficients (ranging from weak to moderate), the mean number of upper teeth was lower in clinical examination (7.1 ± 5.2) compared with self‐reported (8.6 ± 3.6), while the opposite was observed for lower teeth (clinical examination: 9.1 ± 3.4; self‐reported: 6.6 ± 5.3). Larger differences were found among women of low income and educational levels. Conclusions: Our findings suggest that the participants' socio‐economic position might influence their self‐reported number of teeth. [ABSTRACT FROM AUTHOR]

Purpose: Determine if different technology‐based health education interventions can reduce oral health inequalities between the sexes in a sample of adolescents. Methods: A cluster randomized clinical trial was conducted in three phases with an initial sample of 291 male and female adolescents 14–19 years of age. Phase I (n = 288) comprised a clinical examination performed by a calibrated examiner using the simplified oral hygiene index (OHI‐S) and gingival bleeding index (GBI). Phase II involved two educational interventions: video (VD; n = 147) or oral counselling (OR; n = 141) with standardized content. In phase III, an App was made available to half of the clusters (OR + App; n = 66/OR without App; n = 71/VD + App; n = 63/VD without App; n = 63), and the clinical examination was performed a second time. Data were evaluated using descriptive analysis and nonparametric tests. Results: In phase I, boys had a lower standard of oral hygiene compared with girls, with higher mean OHI‐S (p = 0.039) and GBI (p = 0.015). After VD and OR interventions, no significant difference between sexes was found regarding the mean OHI‐S. However, males had a higher mean GBI compared with females in the OR group (p = 0.006). When the App was added to OR and VD groups, males in the 'OR without App' group had a higher mean GBI compared with females (p = 0.007). Conclusion: This clinical trial demonstrated that educational interventions involving information technologies were effective at reducing oral health inequalities between the sexes among adolescents. However, oral counselling alone was not efficient in reducing GBI in male adolescents. [ABSTRACT FROM AUTHOR]

Falls are among the top 10 causes of years lived with disability in people aged 75 and over. Preventive programs like case management (CM) are crucial. Objectives: To evaluate the effects of a multifactorial fall prevention program based on CM on physical performance, the presence of pain, and the risk of falls and fractures in older people who have suffered falls. Methods: This randomized, single-blind clinical trial with parallel groups, Intervention Group (IG) and Control Group (CG), was composed of 55 older people with a history of falling, living in the community. All participants underwent an initial assessment via video call (containing anamnesis, timed up-and-go test, falls risk score, short physical performance battery, and clinical frax). The IG underwent CM, the physical exercise protocol, and the cognitive stimulation protocol. The CG was monitored through telephone calls and received general health and fall guidance. Results: No significant results were found in the physical capacity, the presence of pain, the risk of falls, or the fractures between the Intervention and Control Groups and between assessments. Conclusion: This program was not effective in improving functional performance, but it was important for characterizing pain and the probability of fracture in the next 10 years in this population. [ABSTRACT FROM AUTHOR]

Background: In global health crises, there is a heightened risk to patient and professional safety. Several studies have evaluated the safety climate, revealing different perceptions among healthcare professionals, often influenced by demographic characteristics. This study aimed to assess the percentage of problematic responses (PPR) for the patient safety climate dimensions and... [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the reduction of patients' bed rest time after percutaneous renal biopsy (PRB) from 24 to 8 h using the Nursing Outcomes Classification (NOC). Methods: This was a randomized clinical trial registered with Clinical Trials number NCT04629235. The sample comprised 16 patients in the intervention group and 18 in the control group. In the intervention group, the rest time was modified to 8 h, and afterward, the patients were released to ambulate, whereas the control patients remained at absolute rest for 24 h after PRB according to institutional protocol. All patients were observed for 24 h and evaluated at five time points with the outcomes and indicators of the NOC: before the biopsy, immediately after, at the 8th hour, at the 12th hour, and at the 24th hour after the procedure. Results: In the 170 evaluations performed, statistically significant differences were identified in the outcome Comfort status: physical and the indicators "physical well‐being and comfortable position." None of the complications were related to reduced bed rest time. Conclusions: Reducing patients' bed rest time from 24 to 8 h did not increase complications from PRB, and using the NOC provided a standardized and reliable assessment. Implications for nursing practice: Important evidence was identified for patient care after PRB, demonstrating the positive impact on patient comfort and the possibility of reducing costs to the institution and the workload of the multidisciplinary team. In addition, these findings may contribute to strengthening the use of NOC in clinical practice, teaching, and research. [ABSTRACT FROM AUTHOR]

Some studies have suggested an inflammatory role of the choroid plexus (CP) in the pathophysiology of multiple sclerosis (MS), but mainly in adult patients. We aimed to evaluate clinical and MRI parameters in patients with pediatric-onset multiple sclerosis (POMS). We included 10 patients with POMS and 16 healthy controls (HC), evaluating clinical and neuroimaging variables (cerebral cortex, CP, deep gray matter structures, and demyelinating lesions). Most patients were girls (80%), with a mean age of 15.3 years. POMS individuals had a higher CP volume (p = 0.012) and lower thalamic volume (p = 0.038) compared to HC. This study shows an enlargement of the CP and lower thalamic volume in POMS patients compared to HC. [ABSTRACT FROM AUTHOR]

Objective: Verify the effect of non-periodized and linear periodized combined training on body image perception and body dissatisfaction in adults with obesity. Design: A randomized clinical trial on the effect of two types of combined training periodization was carried out on people with grade I and II obesity. Setting: Participants were allocated into three groups: non-periodized periodization group, linear periodization group, and control group, with 23 participants in each. Subjects: Adults with obesity, with a body mass index between 30 kg/m² and 40 kg/m². Interventions: The intervention lasted 16 weeks (separated into three mesocycles of 4 weeks and 1 week of familiarization), in 3 weekly sessions of 1 hour each, composed of aerobic (30 min) and muscle strength exercises (six exercises) in the same session. The group with non-periodized model maintained uniform intensity, volume, and workload throughout the mesocycles. The group with the linear periodization model started with low initial intensity, subsequently introducing a gradual increase of intensity in the mesocycles. Main measures: Body image perception (current and ideal silhouette) and body dissatisfaction were assessed using the Stunkard silhouette scale. Results: The perception of the current silhouette increased only in the control group (Δ = 1.16; p = 0.04). There was a significant reduction in the ideal silhouette over time (p = 0.001), especially in non-periodized group (Δ = −1.26). Body dissatisfaction increased significantly only over time (p = 0.001), especially for control group (Δ = 1.47). Conclusions: Regardless of periodization, combined training effectively maintained the perception of the current silhouette and reduced the ideal silhouette in adults with obesity. Trial registration: Brazilian Registry of Clinical Trials (RBR-3c7rt3). [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of diadynamic currents administered prior to exercises on pain and disability in patients with osteoarthritis of the knee. Design: A randomized-controlled trial. Setting: Special Rehabilitation Services in Taboão da Serra. Participants: Patients with bilateral knee osteoarthritis. Intervention: Participants were randomly allocated to Group I (diadynamic currents and exercises; n = 30, 60 knees) or Group II (exercises alone; n = 30, 60 knees) and were treated three times a week for 8 weeks. Main outcome measures: The primary outcome measures were change in knee pain evaluated by visual analog scale and disability Index Score (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscle strength (dynamometer), a composite score for pain and disability (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and a drug diary to measure consumption of rescue pain medication (paracetamol). All measurements were collected at baseline, 8 weeks, and 6 months from baseline (follow-up). Results: There were 60 participants with a mean (SD) age of 63.40 (8.20) years. Between-group differences in the follow-up (8 weeks and 6 months) were observed for pain at rest, pain during activities of daily living and disability. There was improvement in Group I that was maintained for the three variables 6 months after treatment. Mean difference for pain at rest was −3.08 points (95% confidence interval −4.13; −2.02), p < 0.01 with an effect size of 1.4; mean difference for pain during activities of daily living was −2.40 points (95% confidence interval −3.34; −1.45), p < 0.01 with an effect size of 1.24; and mean difference for disability was −4.08 points (95% confidence interval −5.89; −2.26), p < 0.01 with an effect size of 1.04. Conclusion: Patients with symptomatic knee osteoarthritis receiving 8 weeks of treatment with diadynamic currents as an adjunct to a program of exercises had significantly greater improvements in pain and disability than those receiving exercises alone. Beneficial effects were sustained for 6 months. [ABSTRACT FROM AUTHOR]

Objective Physical activity is recommended for recipients of a kidney transplant. However, ADHERE BRAZIL study found a high prevalence (69%) of physical inactivity in Brazilian recipients of a kidney transplant. To tackle this behavior, a broad analysis of barriers is needed. This study aimed to identify factors (patient and transplant center levels) associated with physical inactivity among recipients of a kidney transplant. Methods This was a subproject of the ADHERE BRAZIL study, a cross-sectional, multicenter study of 1105 recipients of a kidney transplant from 20 kidney transplant centers. Using a multistage sampling method, patients were proportionally and randomly selected. Applying the Brief Physical Activity Assessment questionnaire, patients were classified as physically active (≥150 min/wk) or physically inactive (<150 min/wk). On the basis of an ecological model, 34 factors associated with physical inactivity were analyzed by sequential logistic regression. Results At the patient level, physical inactivity was associated with smoking (odds ratio = 2.43; 95% CI = 0.97–6.06), obesity (odds ratio = 1.79; 95% CI = 1.26–2.55), peripheral vascular disease (odds ratio = 3.18; 95% CI = 1.20–8.42), >3 posttransplant hospitalizations (odds ratio = 1.58; 95% CI = 1.17–2.13), family income of >1 reference salary ($248.28 per month; odds ratio = 0.66; 95% CI = 0.48–0.90), and student status (odds ratio = 0.58; 95% CI = 0.37–0.92). At the center level, the correlates were having exercise physiologists in the clinical team (odds ratio = 0.54; 95% CI = 0.46–0.64) and being monitored in a teaching hospital (undergraduate students) (odds ratio = 1.47; 95% CI = 1.01–2.13). Conclusions This study identified factors associated with physical inactivity after kidney transplantation that may guide future multilevel behavioral change interventions for physical activity. Impact In a multicenter sample of recipients of a kidney transplant with a prevalence of physical inactivity of 69%, we found associations between this behavior and patient- and center-level factors. At the patient level, the chance of physical inactivity was positively associated with smoking, obesity, and patient morbidity (peripheral vascular disease and hospitalization events after kidney transplantation). Conversely, a high family income and a student status negatively correlated with physical inactivity. At the center level, the presence of a dedicated professional to motivate physical activity resulted in a reduced chance of physical inactivity. A broad knowledge of barriers associated with physical inactivity can allow us to identify patients at a high risk of not adhering to the recommended levels of physical activity. [ABSTRACT FROM AUTHOR]

This quasi-experimental study investigated the preliminary effects of a structured education intervention in a pooled sample of cardiovascular rehabilitation (CR) patients in Brazil. Recently enrolled (RE) and long-term enrolled (LTE) patients attended 12 weekly education sessions in addition to three weekly exercise sessions. Patients completed surveys assessing disease-related knowledge, physical activity, food intake, self-efficacy, and health literacy. Functional capacity was assessed by the 6-minutes walking test. All outcomes were assessed at pre-,post-CR, and 6-months follow-up. Bonferroni correction was applied. In total, 69 (69.7%) patients completed all three assessments. There were significant improvements in knowledge pre-to post-test in both subgroups (p < 0.001), and in functional capacity (p ≤ 0.001) and food intake (p ≤ 0.001) pre-to post-test in the RE subgroup. Post-test knowledge was correlated to physical activity, functional capacity and health literacy. This preliminary study suggests the importance of structured education for CR patients. A larger study using a randomized controlled design is needed to determine efficacy. [ABSTRACT FROM AUTHOR]

Despite advances in neonatology, neonatal mortality from preventable causes remains high in the North and Northeast regions of Brazil. This study aimed to analyze the determinants associated with neonatal and postneonatal mortality in newborns admitted to a neonatal intensive care unit. A cohort study was carried out in a capital in the Brazilian Northeast from 2013 to 2018. The outcome studied was death. Poisson regression was performed in the multivariate analysis of variables. Four hundred and eighty newborns were eligible, and 8.1% (39 newborns) died. Among them, 34 died in the neonatal period. The determinants that remained significantly associated with neonatal and postneonatal mortality in the final adjustment model (p < 0.05) were history of abortion, perinatal asphyxia, early neonatal sepsis and umbilical venous catheterization. All causes of this outcome were preventable. The neonatal mortality rate, although it did not include twins, neonates with malformations incompatible with life and other conditions, was 3.47 deaths per thousand live births (95% CI:1.10−8.03‰), well below the national average. In this study, pregnant women from different social classes had in common a private plan for direct access to health services, which provided them with excellent care throughout pregnancy and postnatal care. These results indicate that reducing neonatal mortality is possible through public policies with strategies that promote improvements in access to health services. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sleep alterations are common in college students, particularly during the COVID-19 pandemic. Sociodemographic factors may predict these alterations in this population. OBJECTIVE: To identify the sociodemographic factors and health characteristics associated with the number of hours of sleep of college students during the COVID-19 pandemic. METHODS: This was a cross-sectional study carried out with 244 university students from a multicampi public university in the State of Bahia, Northeast Brazil. Data collection was performed online and participants answered a specific questionnaire to assess sleep hours, sociodemographic and health variables. RESULTS: Significant associations were observed between hours of sleep and older students (odds ratio adjusted –ORaj: 3.75; 95% Confidence Interval –CI: 1.81–7.75; p < 0.01), attending the final semesters (ORaj: 1.85; 95% CI: 1.05–3.25; p < 0.03), and who reported having some disease (ORaj: 2.18; 95% CI: 1.05–4.50; p < 0.03) with greater chances of getting less sleep. However, those who used tobacco (ORaj: 0.08; 95% CI: 0.01–0.45; p < 0.001) were likely to have more hours of sleep per night. CONCLUSION: Sleep restriction was common among participating college students, which has likely intensified due to the COVID-19 pandemic and its restrictions. This encourages specific public health actions, contemplating the health and hours of sleep of this population. [ABSTRACT FROM AUTHOR]

To verify the psychometric properties of the Brazilian-Portuguese version of the Falls Behavioral (FaB-Brazil) Scale in Parkinson's disease (PD). Participants (n = 96) were assessed by disease-specific, self-report and functional mobility measures. Internal consistency of the FaB-Brazil scale was evaluated using Cronbach's alpha and inter-rater and test–retest reliability using intraclass correlation coefficients (ICC). The standard error of measurement (SEM), minimal detectable change (MDC), ceiling and floor effects, and convergent and discriminative validity were evaluated. Internal consistency was moderate (α = 0.77). Excellent inter-rater (ICC = 0.90; p < 0.001) and test–retest (ICC = 0.91; p < 0.001) reliability were found. The SEM was 0.20 and MDC was 0.38. Ceiling and floor effects were not found. Convergent validity was established by the positive correlations between the FaB-Brazil scale and age, modified Hoehn and Yahr, PD duration, Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Motor Aspects of Experiences of Daily Living, Timed Up & Go and 8-item Parkinson's Disease Questionnaire, and negative correlations between the FaB-Brazil scale and community mobility, Schwab & England, and Activities-specific Balance Confidence scale. Females showed greater protective behaviors than males; recurrent fallers showed greater protective behaviors than non-recurrent fallers (p < 0.05). The FaB-Brazil scale is reliable and valid for assessing people with PD. Fall-related behaviors should be part of the fall risk assessment of community-dwelling people with Parkinson's disease. The Brazilian-Portuguese version of the Fall Behavioral (FaB-Brazil) Scale is reliable and valid for assessing everyday behaviors and actions related to falling in community-dwelling people with Parkinson's disease. The FaB-Brazil scale may be used to tailor individualized fall prevention programs. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the quality of life (QoL) of patients with cervicofacial nonmelanoma skin cancer (NMSC) using the Brazilian Portuguese‐adapted and validated version of the skin cancer index (SCI). After collecting demographic and clinical data from 182 patients with cervicofacial NMSC, the Brazilian versions of the SCI and the Dermatological Life Quality Index (DLQI) were applied preoperatively (T0) and 4 months postoperatively (T1). Assessments were carried out using the Shapiro–Wilk test, Student's t‐test, Mann–Whitney test, Kruskal–Wallis test, and Spearman's correlation. The QoL was evaluated using the Student's t‐test in paired samples at T0 and T1. Significant results were observed, with an increase in scores on the SCI scale in all its dimensions and a decrease in scores on the DLQI scale, demonstrating better postoperative QoL. The variables that presented significant results on the total scale, which indicated better QoL, were men, without children, income above four minimum wages, from the private sector, did not report pruritus, and scalp lesions. The QoL measurement indicated a change from the baseline and improvement after 4 months postoperatively in all subscales, indicating that surgical treatment increased the QoL of these patients from an emotional, social, and physical appearance point of view. The multivariate analysis produced several statistically significant findings in relation to emotional, social, appearance, and total scores. [ABSTRACT FROM AUTHOR]

Learning to descend stairs requires motor and cognitive capacities on the part of infants and opportunities for practice and assurance of safety offered by caregivers. The American Academy of Pediatrics prescribes the age strategy to teach toddlers to safely descend stairs but without much consideration for individual differences in infants' skills or caregivers' techniques. The purpose of this study was to observe the natural ways in which caregivers teach infants to descend stairs at home and the extent to which infants abide. Of particular interest was to examine the dynamic nature of caregivers' teaching and infants' learning over the session with attention to individual differences. Dyads (N = 59) were videorecorded on Zoom for 10 min interacting on stairs at home in the United States, Brazil, Canada, Italy, and Spain. Infants (n = 30 girls, 29 boys; 13-month-olds ± 1 week) were novice walkers (M = 2.04 months walking experience). Caregivers used a variety of teaching strategies and focused on "backing" and "scooting." Infants were more likely to heed caregivers' guidance when caregivers provided hands-on support and verbal encouragement suggesting infants were engaged and responsive to caregivers' overtures. Infants' walking experience predicted change in descent strategy over the session. Although infants did not show evidence of learning over the session, consistent caregiver instruction suggested caregivers were persistent, if not effective, teachers. Teaching and learning motor skills in a potentially risky task creates a unique opportunity for interaction, allowing infants and caregivers to learn from one another. Public Significance Statement: This work contributes to the general body of knowledge regarding infant motor development and problem solving in specific contexts. This study is one of the first to explore the nature of caregiver-infant interaction on stairs and identifies caregiver teaching strategies and infant motor characteristics that are associated with safe infant stair descent. By doing so, we hope to encourage further investigation of infant behavior in this context, upon which recommendations to caregivers for safe infant descent may be based. [ABSTRACT FROM AUTHOR]

The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m2) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21–29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9–8.9) was revealed. A percentage of 19.2% (95% CI: 17.0–21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8–10.1) were obese. A total of 41.5% (95% CI: 38.7–44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4–28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20–7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study. [ABSTRACT FROM AUTHOR]

Objectives: To assess characteristics of hospitalized adolescents facing chronic diseases, correlating the perceptions of their illness, quality of life and the prevalence of risk behaviors, considering gender and the diseases' durations. Methods: The sample consisted of 61 adolescents, aged between 10 and 19 years, with chronic diseases, hospitalized at the University Hospital of the State University of Londrina. They answered a questionnaire and the scales World Health Organization Quality of Life (WHOQOL-BREF) and Illness Perception Questionnaire (IPQ). They were divided in groups, according to the durations of the disease: group 1 (up to 4 years) and group 2 (5 years or more). Results: Group 2 demonstrated higher leisure activity (p = 0.02) and more painful symptoms (p = 0.02). In WHOQOL-BREF, group 2 had a higher quality of life in the domain on environment (p = 0.02) and a higher total score (p = 0.04). Lower scores on the IPQ were associated with higher scores on the WHOQOL-BREF. Positive correlation was found between WHOQOL-BREF total score and years of disease, in which male presented higher scores. Conclusions: These findings may alert to the need for more knowledge about the diseases and the importance of encouraging ways to improve quality of life and care to reduce risky behaviors. [ABSTRACT FROM AUTHOR]

Saliva measurements serve as a noninvasive tool for clinically monitoring newborns (NB) and children, a vulnerable population with promising potential for both research and clinical practice. Saliva acts as a repository for various inflammatory biomarkers involved in diverse biological functions. Particularly for children, it offers numerous advantages when compared to plasma and urine sampling. Nevertheless, there is a significant knowledge gap regarding detectable levels of cytokines in the saliva of newborns and children, as well as studies aiming to assess the relationship of this content with physiological and pathological processes. Objectives: To characterize the levels of 11 inflammatory mediators (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF) in saliva samples from NB on the first and second day of hospitalization in the Neonatal Intensive Care Unit (NICU). Method: Exploratory study, descriptive, nested within a primary clinical, observational, and prospective study, conducted in the NICU of a public hospital in São Paulo, Brazil. Demographic data and vital signs were recorded in the clinical records of 90 NB, and five saliva samples from 5 NB were collected between the first and second day of life (D1–D2) at approximately 8-hr intervals (8–9 am, 4–5 pm, and 11–12 pm). Saliva samples were used for the measurement of 11 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF). Results: Five NBs participated in this exploratory study, and the vital signs showed variability from the first (D1) to the second day (D2) of hospitalization, variability similar to that of the total population of the primary study. The presence and levels of the 11 cytokines were detected in the saliva samples, as well as a statistical correlation between 10 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL10, IL12, IL17, TNF, and VEGF) and vital signs. Conclusions: The novelty of measuring inflammatory mediators in saliva samples from hospitalized NBs in the NICU is highlighted, providing support and new perspectives for the development of clinical and experimental research and an opportunity for developing and implementing new salivary biomarkers in different population segments. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to verify the effects of a 3-mo dual-task training on motor and cognitive functions in community-dwelling older adults. Design: In this prospective, single-blinded, controlled clinical trial, a total of 40 participants were allocated to either the experimental or the control (no-exercise) group. The intervention program consisted of a combination of motor and cognitive exercises conducted twice a week on nonconsecutive days. The main outcome measures were postural stability, mobility, fear of falling, and cognitive functions. Multiple analyses of variancewere used to assess the impact of the dual-task training. Effect sizes (η²p) were reported. Significance was set at 5%. Results: Compared with the control group, participants who underwent the dual-task training showed positive outcomes in terms of postural stability (η²p = 0.298, P = 0.020), mobility (η²p = 0.285, P = 0.003), and cognitive functions (η²p = 0.536, P = 0.001). No significant differences were observed between the groups in terms of the fear of falling (P = 0.566). Conclusions: Three-month dual-task training was beneficial for postural control, mobility, and cognitive functions in community-dwelling older adults. Based on the present findings, healthcare professionals should consider incorporating dual-task training into clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population. Design: A cross‐sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil. Sample: A total of 1452 MSM aged 18 and older. Measurements: Data were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox. Results: The prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high‐risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73–9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31–3.16). Conclusion: There is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives. [ABSTRACT FROM AUTHOR]

Introduction: Studies evaluating smoking and periodontal status show controversial results regarding the impact on oral health‐related quality of life (OHRQol). The aim was to evaluate the association between OHRQol and periodontal status in patients according to their smoking habit. Methods: Cross‐sectional study with a total of 100 patients (31.44 ± 8.50 years, 55% females) answered the short version of Oral Health Impact Profile (OHIP‐14) and underwent a periodontal examination. Associations between periodontal status and total mean OHIP‐14 scores related with smoking habit were analysed with Kruskal–Wallis test. Results: Mean percentage of sites with Bleeding on Probing (BOP), Clinical Attachment Loss (CAL) and Number of Teeth were significantly different between current smokers (n = 53) and never (n = 40) or former smokers (n = 7; p < 0.05). There was no significant difference for Periodontal Probing Depth (PPD) in relation to smoking status. A total mean OHIP‐14 score of 13.07 was observed for the entire sample. The corresponding total mean OHIP‐14 scores, for current smokers, never smokers and former smokers, were 15, 10 and 13 (p = 0.280), respectively. The domains social disability and handicap of the OHIP‐14 were worse in current smokers (p = 0.028 and p = 0.026, respectively). Conclusion: Current smoking was associated with a negative influence on OHRQoL in the domain of social disability and handicap. In addition, smokers have worse periodontal status, related to less BOP, greater CAL and fewer teeth than never and former smokers. [ABSTRACT FROM AUTHOR]

The study focused on examining the relationship between well-being and various psychological factors such as loneliness, anxiety, depression, and stress, whilst also considering changes in lifestyle. A total of 108 elderly participants, with an average age of 70.38 years, were enrolled in this quantitative cross-sectional study. The research employed a battery of assessment tools including a Sociodemographic Data Questionnaire, Mini-Mental State Examination, Positive Mental Health Scale, Stress Perception Scale, Geriatric Anxiety Inventory, Geriatric Depression Scale (reduced version), Loneliness Scale, and International Physical Activity Questionnaire. Descriptive analysis was conducted in order to understand the distribution of scores across these variables, followed by the categorization of participants based on the reported alterations in eating and physical activity behaviors. Correlations between variables were assessed using Spearman correlation and an EBIC-LASSO network analysis. The findings indicated a potential detriment to the well-being of elderly individuals practicing social distancing, evidenced by heightened symptoms of loneliness, depression, anxiety, and stress, alongside the reported changes in dietary patterns and physical activity. The study underscores the importance of understanding the pandemic's impact on the well-being of older adults and advocates for longitudinal investigations to delineate the evolving effects of social distancing measures across different phases of the pandemic. [ABSTRACT FROM AUTHOR]

Background and Objectives: Cardiopulmonary and skeletal muscle impairment and poor physical activity are potential contributors to reduced functional capacity in cystic fibrosis (CF). The Glittre‐ADL test (TGlittre) has great potential for clinical use in adult CF adults, as it meets the need for a comprehensive assessment of physical function using tasks similar to activities of daily living. This study aimed to evaluate the performance of TGlittre in CF adults compared to the 6‐min walk test (6MWT) and, secondarily, to quantify the associations of their results with pulmonary function, muscle strength, and health‐related quality of life (HRQoL). Methods: This cross‐sectional study evaluated 34 CF adults and compared them with 34 subjects from a control group. The participants underwent the following assessments: functional capacity using TGlittre and 6MWT; spirometry; respiratory muscle strength; handgrip strength (HGS); and HRQoL using the Cystic Fibrosis Questionnaire‐Revised (CFQ‐R). Results: While CF patients showed a longer time to perform TGlittre compared to controls (134 (119–150) versus 107 (95–126) % of the predicted time p = 0.0002), no difference between these groups was observed in the 6MWT. When the second TGlittre was compared to the first TGlittre, there was a significant decrease in total time for both CF patients (p < 0.0001) and controls (p = 0.0001). TGlittre time correlated with 6MWT distance (6MWD) (rs = −0.641, p < 0.0001), HGS (rs = −0.364, p = 0.034), peripheral oxygen saturation at the end of the test (rs = −0.463, p = 0.006) and the "digestive symptoms" domain of CFQ‐R (rs = 0.376, p = 0.028). TGlittre time was shorter in patients who engaged in regular physical activity (3.10 (2.49–3.39) min versus 3.28 (2.95–3.53) min, p = 0.016). Conclusions: TGlittre is more effective than the 6MWT in detecting limitations during exercise. There is an important learning effect of TGlittre in adult CF patients. TGlittre time was correlated with 6MWD, HGS, oxygen saturation level, and the patient's level of physical activity. [ABSTRACT FROM AUTHOR]

Despite the high prevalence of sleep disturbances in idiopathic pulmonary fibrosis (IPF), the relationship between physical activity in daily life (PADL) and sleep in this population remains unclear Investigate the impact of sleep on different domains of PADL in IPF and characterize their PADL profile Sixty-seven participants (thirty-three with IPF and thirty-four healthy subjects [control group]) were included. The subjects underwent assessments of pulmonary function, exercise capacity, respiratory and peripheral muscle strength, PADL, sleep, dyspnea, and health-related quality of life. PADL and sleep measures were assessed using an activity monitor (Actigraph®, wGT3x-BT). Associations between sleep and PADL were done using correlation and regression models. In the IPF, sleep duration at night associated significantly with step counts, sedentary, light, and moderate-to-vigorous physical activity (MVPA) (−0.82 ≤ R ≤ 0.43; p <.05 for all). Lung function and sleep partially explained PADL variables (0.19 ≤ R2 ≤ 0.65, p <.05 for all). Compared to controls, the IPF subjects presented lower step counts, less time spent in MVPA, standing position, and more time spent in lying position (p <.05, for all) Sleep duration is associated with PADL in IPF. The PADL profile of patients is worse than in control subjects. [ABSTRACT FROM AUTHOR]

In Cardiovascular Rehabilitation (CR), patient adherence to the maintenance phase is a major challenge. Virtual reality-based therapy (VRBT) promotes acute hemodynamic and autonomic repercussions similar to traditional rehabilitation and can increase patient adherence to the program. However, it is unknown whether the combination of VRBT to a traditional CR manages to maintain or even improve clinical and autonomic variables in long term. To analyze whether VRBT combination in a traditional CR can maintain or improve clinical and autonomic variables in cardiac patients in the maintenance phase of these programs. Twenty-six volunteers (62.04 ± 12.22 years) were evaluated, who underwent an initial assessment and two other assessments (in the sixth and 12th week) of the following outcomes: systolic and diastolic blood pressure, respiratory rate, pulse saturation of oxygen, heart rate, perceived exertion, and cardiac autonomic modulation, using linear and non-linear heart rate variability methods. Except for the apparent lack of clinical significance observed in Shannon Entropy, LF (nu), and HF (nu), the combination of VRBT as routine in a traditional program did not cause significant changes in the analyzed variables. combination of VRBT was able to maintain the chronic hemodynamic and autonomic repercussions caused by traditional CR. [ABSTRACT FROM AUTHOR]

Background: Although dysarthria and respiratory failure are widely described in literature as part of the natural history of Amyotrophic lateral sclerosis (ALS), the specific interaction between them has been little explored. Aim: To investigate the relationship between chronic respiratory failure and the speech of ALS patients. Materials and methods: In this cross-sectional retrospective study we reviewed the medical records of all patients diagnosed with ALS that were accompanied by a tertiary referral center. In order to determine the presence and degree of speech impairment, the Amyotrophic Lateral Sclerosis Functional Rating Scale-revised (ALSFRS-R) speech sub-scale was used. Respiratory function was assessed through spirometry and through venous blood gasometry obtained from a morning peripheral venous sample. To determine whether differences among groups classified by speech function were significant, maximum and mean spirometry values of participants were compared using multivariate analysis of variance (MANOVA) with Tukey's post hoc test. Results: Seventy-five cases were selected, of which 73.3% presented speech impairment and 70.7% respiratory impairment. Respiratory and speech functions were moderately correlated (seated FVC r = 0.64; supine FVC r = 0.60; seated FEV1 r = 0.59 and supine FEV1 r = 0.54, p <.001). Multivariable logistic regression revealed that the following variables were significantly associated with the presence of speech impairment after adjusting for other risk factors: seated FVC (odds ratio [OR] = 0.862) and seated FEV1 (OR = 1.106). The final model was 81.1% predictive of speech impairment. The presence of daytime hypercapnia was not correlated to increasing speech impairment. Conclusion: The restrictive pattern developed by ALS patients negatively influences speech function. Speech is a complex and multifactorial process, and lung volume presents a pivotal role in its function. Thus, we were able to find that lung volumes presented a significant correlation to speech function, especially in those with bulbar onset and respiratory impairment. Neurobiological and physiological aspects of this relationship should be explored in further studies with the ALS population. [ABSTRACT FROM AUTHOR]

Objective. The present study aimed to analyze the variables that could serve as evidence of rhabdomyolysis, such as room temperature, global temperature, rating of perceived exertion (RPE), urine color (myoglobinuria) and urine density, clinical and physical symptoms in a military police operational course conducted in the city of Rio de Janeiro. Methods. Forty-nine male service members were approved to start the Dog Handlers Course for Police Employment II/2019 of the Dog Action Battalion of the Military Police of the State of Rio de Janeiro. A total of 311 urine samples and 311 perceived exertion values were collected. Ambient temperature and moist globe temperature (WBGT) was controlled. Results. During the collections, the ambient temperature was 24.75 °C and the humidity temperature was between 10 and 18.3 °C. Borg's levels of subjective perception (SPE) (CR-10) of exertion increased between Collections 1 and 8 (p < 0.05). There was a positive correlation between urine density and absorbance (rho = 0.561; p < 0.001). Conclusions. Color analysis by spectrophotometry and urine properties was a method with potential efficiency for the detection of myoglobinuria, renal system overload and origin of rhabdomyolysis. [ABSTRACT FROM AUTHOR]

Introduction: Burnout Syndrome (BS) emerges in the context of precarious working conditions, and manifests itself through a set of signs and symptoms that affect the worker's psychology due to exposure to stressors in the work environment. Objective: to analyze the prevalence and factors associated with Burnout Syndrome (BS) in intensive care nurses. Method: cross-sectional and analytical study, carried out with 94 nurses in intensive care units of a public hospital in the state of Bahia. The Maslach Burnout Inventory (MBI) and a questionnaire containing sociodemographic, cultural and occupational issues were used. Results: 62.8% showed high emotional exhaustion; 64.9% high depersonalization and 77.7% high reduction in professional achievement. The factors associated with BS were: age up to 38 years (PR: 2.38; 95% CI: 1.44-3.94), not having a partner (PR: 1.97; 95% CI: 1.17-3.32), job dissatisfaction (PR: 1.78; 95% CI: 1.15-2.75), having back pain (PR: 3.33; 95% CI: 1.72-6.42), anxiety (PR: 2.33; 95% CI: 1.22-4.46) and sleep pattern up to 5 hours (PR: 1.67; 95% CI: 1.08-2.59). It was found that having children is a protective index (PR: 0.55; 95% CI: 0.33-0.90). Conclusion: there is a considered high percentage of nurses with a diagnosis suggestive of the syndrome (43.6%), as well as the existence of associated factors. It is essential that the institution offers a healthy work environment, in which prevention is the best way for these professionals not to become targets of the syndrome. [ABSTRACT FROM AUTHOR]

Introduction: The final step of irrigation has been considered to of increase the bonding strength of filling material to dentin. This study investigated the impact of three final-step irrigation methods on the endodontic sealer bond strength to dentin by using a micro push-out test. Materials and Methods: Palatal roots of human maxillary molars were cleaned and shaped and randomly divided in six groups (n=15) according to the final-step irrigation method and the type of root canal sealer used. The solutions used for the final-step irrigation were 17% ethylenediaminetetraacetic acid and 2.5% sodium hypochlorite, which underwent three methods: 1) syringe-needle irrigation/conventional, 2) passive ultrasonic irrigation, and 3) XP-endo Finisher agitation. The root canal sealers used were: EndoSequence BC Sealer, and AH-Plus sealer. Roots were obturated with the single cone technique and then, cross-sectioned in 2-mm-thick slices (3 slices from each root). Push-out test was performed on the sliced specimens (cervical, middle, and apical thirds) with a universal testing machine. Bond strength values were recorded in megapascal (MPa). Subsequently, each specimen was longitudinally split to verify the type of failure. Data analysis was performed using Johnson transformation, three-way analysis of variance, Tukey's post-hoc tests, and the partial Eta squared test. Results: There were significant differences in bond strength between the sealers [AH: 4.46±2.24 and BC: 3.47±2.19 MPa (P<0.001)]; between final-step irrigation methods [passive ultrasonic irrigation: 4.52±2.25, XP-endo Finisher: 3.93±3.93 and syringe-needle irrigation/conventional: 3.37±2.51 MPa (P<0.001)], and between the root canal thirds represented by the sliced specimens [cervical: 5.45±2.39, middle: 4.14±1.99 and apical: 2.30±1.30 MPa (P<0.001)]. The interaction between the variables had no significance (P>0.05). Conclusion: Agitation of the final irrigating solution may improve the bonding of the sealer to canal walls. AH-Plus sealer had the highest bond strength. The bond strength reduced significantly towards the apical third. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of sociodemographic and working condition variables, as well as the coping strategies used by nurses, on their occupational stress during the COVID-19 pandemic. Methods: A cross-sectional study was conducted with 104 nurses who worked in intensive and emergency care at a public hospital in the state of São Paulo, Brazil. Data collection was performed in person and online using a questionnaire assessing sociodemographic and occupational characteristics, the Nursing Stress Inventory, and the Occupational Coping Scale. Results: The participants had a high level of stress (median = 132), especially in the 'interpersonal relations' domain (median = 63), and made little use of occupational coping strategies (median = 87). Income (p = 0.027), work shift (p = 0.028), being on leave from work (p = 0.020), number of hospitals with employment ties (p = 0.001), and relationship with management were independently associated with the levels of stress among the nurses. Conclusion: In the present study, the high levels of stress among nurses were influenced by financial and work-related factors as well as interpersonal relationships. No significant association was found between stress among the nurses and the use of occupational coping strategies. [ABSTRACT FROM AUTHOR]

This study aims to investigate the fear or failure (FoF) in Brazilian runners of both sex, performance levels and age categories, as well as to verify the relationship between FoF and socioeconomic status (SES). Sample size as composed by 916. Age, sex, body height, body weight, SES, and running pace were self-reported. The Multidimensional Questionnaire of FoF was applied in an online platform. Running pace, and SES were categorized and processed through multivariate analysis and Spearman correlations, with the p-value set at 0.05. Female runners with better performance (2.13 ± 0.74) and younger (2.16 ± 0.80), as a well as male runners with worse performance (2.04 ± 0.69) and older (2.04 ± 0.89) presented the highest values of FoF. Among women, SES was negatively associated with FoF (r = −0.144; p = 0.006), while a positive association between running pace and SES was observed among men (r = 0.290; p < 0.001). Non-professional Brazilian runners presented low values of FoF. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the quality of life (QOL) and adherence to antiretroviral therapy (ART) in people living with HIV (PLWH) in Fortaleza, Ceará, Brazil. A cross-sectional study with a sample of 385 patients followed-up on an outpatient basis. Interviews were conducted using the Sociodemographic, Epidemiological and Clinical Form, the World Health Organization's Quality of Life in PLWH Instrument, the Assessment of Adherence to Antiretroviral Treatment Questionnaire and Pittsburgh Sleep Quality Index. Descriptive statistics and univariate and multivariate logistic regression analysis were performed. The odds ratio and confidence interval were calculated, considering P < 0.05 as statistically significant. Of the 385 PLWH, 134 (34.8%) had unsatisfactory QOL which was associated with unemployment (P = 0.0037), monthly income less than the minimum wage (P < 0.0001), sleep disorders (P = 0.0039) and not doing regular exercise (P = 0.0032). Inadequate adherence to ART occurred in 24 patients (6.23%) and was associated with detectable viral load (P = 0.0001) and unsatisfactory QOL (P = 0.0033). QOL was more unsatisfactory for those unemployed and with low income, sleep disorders and sedentary lifestyle. People with detectable viral load and unsatisfactory QOL had more inadequate adherence to ART. [ABSTRACT FROM AUTHOR]

Individual satisfaction is associated with increased retention in HIV/AIDS care services and adherence to treatment. This study assessed factors associated with individual satisfaction at the initiation of antiretroviral therapy and compared the proportions of satisfaction at the initiation of antiretroviral therapy and after three months of follow-up. Face-to-face interviews were carried out among 398 individuals of three HIV/ AIDS healthcare services in Belo Horizonte, Brazil. Variables included sociodemographic and clinical characteristics, perception about healthcare services, and domains of quality of life. Individuals that rated the quality of healthcare services as good or very good were classified as satisfied. A logistic regression analysis of the association between independent variables and individual satisfaction was performed. The proportion of individual satisfaction with healthcare services was 95.5% at the initiation of antiretroviral therapy and 96.7% after three months and these changes were not statistically significant (p = 0.472). The physical domain of quality of life was found to be associated with satisfaction at the initiation of antiretroviral therapy (OR = 1.38; CI = 1.11–1.71; p = 0.003). Training and supervision of health professionals for addressing the needs of individuals with lower levels of physical domain of quality of life may improve satisfaction with HIV/ AIDS care. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare three-dimensional kinematic of the trunk, pelvis, hip, and knee during the single-leg squat and hip torque in individuals with and without isolated patellofemoral osteoarthritis (PFOA). Patients and methods: This cross-sectional study evaluated trunk, pelvis, hip, and knee kinematics at 30°, 45°, and 60° knee flexion during the single-leg squat using the Vicon motion capture and analysis system, the Nexus System 2.1.1, and 3D Motion Monitor software. Sixteen individuals (8 males, 8 females; mean age: 49.3±6.2 years; range 40 to 61 years) participated in the study, of which eight were PFOA patients and eight were healthy controls. Isometric hip abductor, extensor, and external rotator torques were evaluated using a handheld dynamometer. Results: The PFOA group exhibited greater hip adduction at 30° (p=0.008), 45° (p=0.005), and 60° (p=0.008) knee flexion in the descending phase of the single-leg squat, as well as at 60° (p=0.009) and 45° (p=0.03) knee flexion in the ascending phase. No significant differences were found between groups for other kinematic variables (p>0.05). The PFOA group exhibited lower isometric hip abductor (p=0.02), extensor (p<0.001), and external rotator (p=0.007) torques. Conclusion: Individuals with PFOA exhibited excessive hip adduction that could increase stress on the lateral patellofemoral joint at 30°, 45°, and 60° knee flexion during the single-leg squat and exhibited weakness of the hip abductors, extensors, and external rotators in comparison to healthy controls. [ABSTRACT FROM AUTHOR]

Background: Self-care is essential for minimizing the long-term progression of hypertension (HTN) and improving global health outcomes. However, little is known about the predictors of HTN self-care among adults with HTN in Brazil. Objective: The aimof this study was to evaluate the self-care practices and the association of sociodemographic and clinical factors of adults with HTN in Brazil. Methods: Thiswas a cross-sectional study conducted by telephone with 120 adults with HTN monitored in a specialized outpatient clinic of a teaching hospital. Sociodemographic and clinical information was collected by a questionnaire survey. Self-care was assessed by the Self-care of Hypertension Inventory version 2. Multiple regression and Kendall's correlation analyses were performed to determine possible predictors. Results: Low levels of self-care were observed across maintenance, management, and confidence measures. A weak correlation was observed between self-care maintenance and education (-0.13), the time of diagnosis (0.16), and the number of medications (0.15); self-care management and family income (0.13) and cognitive function (0.17); and self-care confidence and systolic (-0.15) and diastolic (-0.18) blood pressure values and time of diagnosis (0.16). In multiple regression analysis, self-care confidence was a predictor of self-care maintenance (ß = 0.30; 95%confidence interval, 0.10-0.36) and management (ß = 0.20; 95% confidence interval, 0.03-0.46). Conclusion: Confidence was essential in the maintenance and management of self-care and is central to the control of HTN. Self-care interventions must consider the different aspects thatmay affect self-care, highlighting improving self-care confidence as amain goal. [ABSTRACT FROM AUTHOR]

Introduction: The presence of albuminuria is an adverse marker of renal dysfunction progression. Hypertension and diabetes mellitus predispose to albuminuria. However, not all hypertensive and diabetic patients have albuminuria, so it is relevant to identify risk factors associated to this abnormality. The acute effect of intense physical activity may lead to transient albuminuria. On the other hand, physical inactivity is associated with risk factors for albuminuria Objective: To analyze the association between activity levels or physical performance and albuminuria in hypertensive and/or diabetic patients treated at basic health services. Methodology: A prospective cross-sectional study with hypertensives and/or diabetics subjects. The patients were evaluated in regard of albuminuria, clinical, laboratory and physical test performance variables. Results: There was no association between the degree of albuminuria and demographic, anthropometric, laboratory variables, functional capacity and level of physical activity. The degree of albuminuria was associated with systolic blood pressure, as well as the perception of effort, obtained by Borg Scale during the test in univariate analysis (odds ratio 4.11 with 95% confidence interval from 1.18 to 14.37, p = 0.027) and adjusted for systolic blood pressure and diabetes (odds ratio 3.02 with 95% confidence interval from 1.35 to 6.75; p = 0.007). Conclusion: there was association between albuminuria and perceived effort, as well with systolic blood pressure. There was not with association physical performance or level of activity. Further studies are needed to elucidate the association of albuminuria with Borg Scale. [ABSTRACT FROM AUTHOR]

Background: Hyperoxemia, often overlooked in critically ill patients, is common and may have adverse consequences. Objective: To evaluate the incidence of hyperoxemia induced by oxygen therapy in nonsurgical critically ill patients at intensive care unit (ICU) admission and the association of hyperoxemia with hospital mortality. Methods: This prospective cohort study included all consecutive admissions of nonsurgical patients aged 18 years or older who received oxygen therapy on admission to the Hospital Santa Luzia Rede D'Or São Luiz adult ICU from July 2018 through June 2021. Patients were categorized into 3 groups according to Pao2 level at ICU admission: hypoxemia (Pao2<60 mm Hg), normoxemia (Pao2= 60–120 mm Hg), and hyperoxemia (Pao2 >120 mm Hg). Results: Among 3088 patients, hyperoxemia was present in 1174 (38.0%) and was independently associated with hospital mortality (odds ratio [OR], 1.32; 95% CI, 1.04–1.67; P=.02). Age (OR, 1.02; 95% CI, 1.02–1.02; P<.001) and chronic kidney disease (OR, 1.55; 95% CI, 1.02–2.36; P=.04) were associated with a higher rate of hyperoxemia. Factors associated with a lower rate of hyperoxemia were Sequential Organ Failure Assessment score (OR, 0.88; 95% CI, 0.83–0.93; P<.001); late-night admission (OR, 0.80; 95% CI, 0.67–0.96; P=.02); and renal/metabolic (OR, 0.22; 95% CI, 0.13–1.39; P<.001), neurologic (OR, 0.02; 95% CI, 0.01–0.05; P<.001), digestive (OR, 0.23; 95% CI, 0.13–0.41; P<.001), and soft tissue/skin/orthopedic (OR, 0.32; 95% CI, 0.13–0.79; P=.01) primary reasons for hospital admission. Conclusion: Hyperoxemia induced by oxygen therapy was common in critically ill patients and was linked to increased risk of hospital mortality. Health care professionals should be aware of this condition because of its potential risks and unnecessary costs. [ABSTRACT FROM AUTHOR]

BACKGROUND: School servants are professionals involved with cleaning and feeding activities in schools. Exposed to conditions of physical and psychosocial overload at work, they may face situations of morbidity and functional restrictions. OBJECTIVE: To evaluate personal and work characteristics and work ability index (WAI) of school servants in Brazil and test the mediating effect of WAI in the duration of sickness absence. METHODS: 163 Brazilian school servants participated in this cross-sectional study, that including the self-completion of a sociodemographic questionnaire, information about the Work Environment, the Protocol of Psychosocial Risks at Work's Evaluation, and the Work Ability Index. Also was collected, in a secondary health database, information about sickness absence. A linear regression model was constructed to identify the predictors of the duration of absence, followed by the analysis of mediation with the Path Analysis method. RESULTS: The study found that the WAI partially mediates the relation of the personal characteristics and the work conditions with the duration of absence of the school servants. The predictors included the organizational aspects of work, mental exhaustion, physical damage, health self-evaluation, availability of personal protective equipment, and the need to assume inadequate postures at work. These predictors explained 33% of the duration of absence and 53% of the WAI of these workers. CONCLUSION: This study indicated that inadequate working conditions and low WAI impact in the sickness absence, increasing by 33% the length of time off work of school servants. [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]

Background: Medication-related osteonecrosis of the jaw (MRONJ) can cause significant pain and loss of aesthetics and function if not treated properly. However, diagnosis still relies on detailed intraoral examinations and imaging. Prognosis varies even among patients with similar stages or conditions of MRONJ, emphasizing the need for a deeper understanding of its complex mechanisms. Thus, this study aimed to identify the oral microbiota of patients with MRONJ. Methods: This single-center prospective cohort study included patients with confirmed MRONJ who visited the Department of Oral and Maxillofacial Surgery at Yonsei University Dental Hospital between 2021 and 2022. Oral swab samples were collected from the affected and unaffected sides of each patient. The composition and enumeration of the microbial communities were analyzed, and the diversity was compared to verify ecological changes in the groups using a next-generation sequencing-based 16S metagenomic analysis. A statistical analysis was performed using Wilcoxon signed-rank test with SPSS version 22, and values of P less than 0.05 were considered statistically significant. Results: The final study sample included 12 patients. The mean age was 82.67 ± 5.73 (range, 72–90) years. Changes in microbial composition were observed at different taxonomic levels (phylum, genus, and species). The identified microorganisms were commonly associated with periodontitis, gingival disease, and endodontic infection, suggesting a multifactorial etiology of MRONJ. Conclusions: Although this study is based on a small number of cases, it shows that MRONJ is not caused by a specific microorganism but can rather be caused by a variety of factors. By addressing these findings in large-scale studies, the significance of oral microbiome in pathogenesis can be further elucidated and can facilitate the development of effective therapeutic interventions for patients with MRONJ. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID-19 pandemic had direct and indirect impacts on public health, also affecting the mental health of the population. OBJECTIVE: To analyze symptoms of generalized anxiety disorder (GAD) and associated factors, in primary health care (PHC) professionals. METHODS: Cross-sectional and analytical study conducted with professionals who work in the Primary Health Care (PHC) of the Northern health macro-region of the state of Minas Gerais, Brazil. Data collection was carried out through an online, self-administered questionnaire, made available from August 27, 2021, to October 30, 2021 using the Google Forms tool. The questionnaire included sociodemographic questions as well as questions related to the history of anxiety and work during the pandemic. To assess anxiety symptoms, the General Anxiety Disorder-7 (GAD-7) instrument was used. Data treatment consisted of descriptive analysis of the variables, bivariate analysis followed by multivariate Poisson Regression with robust variance. RESULTS: 702 health professionals participated in the study and the general prevalence of GAD was 32.2%. Current anxiety symptoms were self-reported by 37.6% of the participants. In the final model, the associated factors identified were: female sex (PR = 1.82; 95% CI = 1.17–2.84; p = 0.007), previous symptoms (PR = 1.58; 95% CI = 1.19–2.10; p = 0.002) and (PR = 2.68; 95% CI = 2.00–3.62; p < 0.001) current self-reported anxiety. CONCLUSION: The results show the need to implement actions in mental health promotion and anxiety prevention, through the dissemination of information about mental health care, health education activities, encouraging the adoption of healthy habits and professional monitoring when necessary. [ABSTRACT FROM AUTHOR]

Diabetes Mellitus (DM) is a heterogeneous metabolic disorder, characterized by hyperglycemia. It is a vast disease, involving different classifications, signs, symptoms, and treatment approaches, especially pharmacological. With digital technologies, social media, and the Internet have become disseminating agents of health information, which is often incomplete and incorrect. This study aimed to evaluate the information about pharmacological treatments for DM on Brazilian publications' Instagram social media platforms. Data from around 300 publications were collected for this study, which was conducted between 2021 and 2022. The characteristics, engagement, and quality of the information were analyzed using the Discern Questionnaire tool. Content evaluation was applied to categories not included in the quality tool. The type of information presented was classified as information disorder. Data were described using descriptive statistics, and inter-examiner agreement was calculated using the kappa coefficient. It was observed that the profiles publishing the information had an average of 6,263.3 followers. Type 2 DM was mentioned in 46.3% of the publications, and the most cited drugs were metformin (10.3%) and NPH insulin (7%). The quality of the information was classified as very poor in 68.8% of the publications. Regarding analysis of the content and type of information, indication, forms of administration, and non-pharmacological treatment presented misinformation and/or disinformation. It is, therefore, important to reinforce digital literacy, so that people can discern the content they are absorbing. Likewise, public policies aimed at regulating the content circulating in the media, are fundamental tools to ensure better information about DM through the Internet. [ABSTRACT FROM AUTHOR]