Working conditions and illicit psychoactive substance use among truck drivers in Brazil.

BACKGROUND: The aim of this study was to identify the role that working conditions play in predicting the consumption of illicit psychoactive substances (IPS) among truck drivers. METHODS: This cross-sectional study was conducted with truck drivers who transport grains to Paranaguá Port, PR, Brazil. The truck drivers were interviewed, and they completed a self-administered questionnaire regarding their sociodemographics, lifestyles, working conditions, and consumption of IPS over the past 30 days. The statistical analysis included logistic regression models progressively adjusted for sociodemographic and lifestyle variables. RESULTS: A total of 670 male drivers with a mean age of 41.9 (±11.1) years were assessed. The prevalence of IPS consumption over the past 30 days was 10.9% (n=73). The drugs used primarily consisted of amphetamines (n=61). After adjusting for working characteristics, sociodemographic and lifestyle variables, the following working conditions were associated with the consumption of IPS: driving mostly at night (OR=3.91; 95% CI 1.75 to 8.74), driving while tired (OR=2.26; 95% CI 1.31 to 3.89), and earning a higher monthly income (OR=2.08; 95% CI 1.16 to 3.72). Drivers who were 39 years old or younger (OR=2.11; 95% CI 1.05 to 4.25) and not living with a partner (OR=2.22; 95% CI 1.17 to 4.22) were also more likely to consume IPS. CONCLUSIONS: Driving mostly at night, being tired, and earning more increase the use of IPS among truck drivers, regardless of other working characteristics, sociodemographic, and lifestyle variables.

Pharmacoepidemiologic study of warfarin prescription in a Brazilian tertiary hospital.

Warfarin is among the ten drugs most commonly involved in adverse drug reactions, has a narrow therapeutic index and complex dosage regimen, exhibits enormous variability dose-response and high risk drug-drug interactions. To analyze the profile of pharmacoepidemiological drug prescriptions for warfarin in patients admitted to a Brazilian tertiary hospital. In the cross sectional study the electronic prescriptions of the January 01, 2004-December 31, 2010 of patients using warfarin of the Clinical Hospital of the Faculty of Medicine of Ribeirao Preto were analyzed. Sociodemographic characteristics, clinical data, laboratory test results, and drug therapy data were collected. We identified 3,048 patients who received 154,161 drug prescriptions, 42,120 of which contained warfarin. The mean age was 55.8 ± 19.3 years, 48.2% were elderly, and 4.3% had specific cerebrovascular disease diagnoses. The average International Normalized Ratio (INR; 2.4 ± 1.7) and warfarin dose (5.1 ± 1.8 mg/day) were within therapeutic protocol recommendations. However, approximately 14.0 and 8.5% of the patients had mean INR greater than 3.0 and 3.5, respectively. In addition, 66.4 and 6.1% of the patients received polypharmacy and clopidogrel, respectively, which can increase the risk of drug-drug interactions and bleeding. The average number of drugs per prescription was 7.2 ± 3.8, and 31,595 drug prescriptions (74.0%) consisted of five or more drugs. The study found a high prevalence of elderly patients, polypharmacy, and concomitant use of anticoagulant and antiplatelet drugs, which may favor the occurrence of adverse events.

[The mediating role of social media addiction and sleep quality in the association between social media usage and depressive symptoms in university students]. / O papel mediador da dependência de mídia social e da qualidade do sono na associação entre tempo de uso de mídia social e sintomas depressivos em universitários.

Increase in time spent on social media and its association with depressive symptoms, especially among young adults, has generated the need to understand how this association occurs in order to support the development of policies to reduce harm and complications. In view of this fact, this study aimed to assess the mediating effect of social media addiction and sleep quality on the association between time spent on social media and depressive symptoms in Brazilian university students. This is a cross-sectional study conducted with 2,823 university students, who provided information regarding time spent on social media, social media addiction, depressive symptoms and sleep quality. The mediation analysis, adjusted for confounding factors, was performed using the PROCESS macro for SPSS to obtain the total (c), direct (c'), and indirect effects (EI1, EI2, and EI3). The results identified an association between time spent on social media and depressive symptoms, mediated by social media addiction (EI1 = 20%) and sleep quality (EI1 = 40%). These findings help expand knowledge about the mechanisms that mutually influence the relationship between time spent on social media and depressive symptoms, supporting the adoption of strategies to reduce harm resulting from excessive social media use.

O aumento do uso de mídias sociais e sua associação com sintomas depressivos, especialmente em jovens adultos, tem gerado a necessidade do entendimento de como ocorre tal associação para subsidiar políticas de redução de danos e agravos. Nesse sentido, este estudo objetivou verificar o efeito mediador da dependência de mídias sociais e da qualidade do sono na associação entre o tempo de uso de mídias sociais e sintomas depressivos em universitários brasileiros. Trata-se de um estudo transversal, realizado com 2.823 universitários, que forneceram informações referentes ao tempo de uso de mídias sociais, à dependência de mídias sociais, aos sintomas depressivos e à qualidade do sono. A análise de mediação, ajustada por fatores de confusão, foi realizada por meio do software PROCESS para SPSS, para obtenção do efeito total (c), direto (c') e indiretos (EI1, EI2 e EI3). Os resultados identificaram associação entre o tempo de uso de mídias sociais e os sintomas depressivos, mediada pela dependência de mídias sociais (EI1 = 20%) e pela qualidade do sono (EI1 = 40%). Os resultados permitem ampliar o conhecimento acerca dos mecanismos que influenciam mutuamente a relação entre o tempo de uso de mídias sociais e os sintomas depressivos, auxiliando na adoção de estratégias de redução de danos decorrentes do uso excessivo de mídias sociais.

El aumento del uso de las redes sociales y su asociación con síntomas depresivos, especialmente en adultos jóvenes, ha generado la necesidad de comprender cómo se produce esta asociación como una forma de apoyar las políticas de reducción de daños y afecciones. En ese sentido, el presente estudio tuvo como objetivo verificar el efecto mediador de la adicción a las redes sociales y de la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios brasileños. Se trata de un estudio transversal, realizado con 2.823 estudiantes universitarios, quienes brindaron información respecto al tiempo de uso de las redes sociales, adicción a las redes sociales, síntomas depresivos y calidad del sueño. El análisis de mediación, ajustado por factores de confusión, se realizó por medio del software PROCESS para SPSS, para obtener el efecto total (c), directo (c') e indirectos (EI1, EI2 y EI3). Los resultados identificaron una asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos, mediada por adicción a las redes sociales (EI1 = 20%) y la calidad del sueño (EI1 = 40%). Los resultados permiten ampliar el conocimiento acerca de los mecanismos que influyen mutuamente en la relación entre tiempo de uso de las redes sociales y los síntomas depresivos, ayudando a adoptar estrategias para reducir los daños resultantes del uso excesivo de las redes sociales.

Analysis of the dimensional structure of the Patient Health Questionnaire-9 (PHQ-9) in undergraduate students at a public university in Brazil.

BACKGROUND: The prevalence of mental health-related problems has increased in recent years, especially among young adults, such as university students. Several measurement instruments have been developed to identify individuals at risk for depression, such as the Patient Health Questionnaire-9 (PHQ-9). However, different dimensional structures of the PHQ-9 can make it difficult to interpret and compare research results. To analyze the dimensional structure and convergent validity of the PHQ-9 in university students. METHODS: This is a cross-sectional study developed with 3163 students enrolled in different courses at a university in southern Brazil. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to identify the most parsimonious and best-fitting model. Convergent validity was verified through the significant relationship (p < 0.05) between theoretically related constructs (sleep quality, alcohol consumption, and physical activity practice). RESULTS: The EFA resulted in two models (unidimensional and two-dimensional), with better indices for the two-dimensional model. In the CFA, both the unidimensional and the two-dimensional models presented satisfactory fit indices that were higher for the unidimensional model. LIMITATIONS: The analysis of convergent validity is limited by the absence of a gold standard for comparison. CONCLUSIONS: This study provided support for the unidimensional structure of the PHQ-9, with adequate convergent validity, among university students.

Relationship between free-time physical activity and sleep quality in Brazilian university students.

Poor sleep quality and low or no free-time physical activity (FTPA) practice are highly prevalent among university students, but the association between these conditions is still unclear. This cross-sectional study analyzed the relationship between FTPA and sleep quality. An online questionnaire was conducted with university students from a public university in southern Brazil in 2019. The weekly frequency of FTPA was self-reported, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and ANCOVA models were performed and adjusted for confounders. Among the 2,626 students analyzed, 52.2% did not practice the FTPA, and 75.6% had poor sleep quality (PSQI > 5). In the adjusted analysis, practicing FTPA 4-7 times/week was associated with poor sleep quality (odds ratio = 0.71; 95% confidence interval = 0.52, 0.97) compared with not practicing FTPA. In addition, those who practiced FTPA had significantly lower means of the global PSQI, subjective sleep quality and duration, sleep disturbances, and daytime dysfunction scores than those who did not practice FTPA. In conclusion, the FTPA may contribute to better sleep quality among university students.

Adherence to the Mediterranean diet and depression, anxiety, and stress symptoms in Chilean university students: a cross-sectional study.

This study aims to determine the association of adherence to the Mediterranean diet and its food groups with depressive symptoms in Chilean university students. The study design was cross-sectional. A total of 934 first-year students at a Chilean public university completed a self-report questionnaire. To assess adherence to Mediterranean diet, an index validated in Chile (Chilean-MDI) was used, and depression, anxiety, and stress symptoms were assessed using the Depression Anxiety and Stress Scale (DASS-21). Logistic regression models were used to analyze the association of adherence to Mediterranean diet and its food groups with depression, anxiety, and stress symptoms adjusted for the main confounders. Students with moderate and high adherence to Mediterranean diet showed lower odds of depression [DASS-21 > 5, odds ratio (OR) = 0.64; 95% confidence interval (95%CI): 0.47-0.88] than those with low adherence to Mediterranean diet. The consumption of 1-2 servings/day of vegetables (OR = 0.63; 95%CI: 0.43-0.92), > 2 servings/week of nuts (OR = 0.41; 95%CI: 0.21-0.80), 1-2 servings/day of fruits (OR = 0.60; 95%CI: 0.42-0.85), 1-2 servings/week of fish and seafood (OR = 0.67; 95%CI: 0.48-0.94), and 1/2-3 units/week of avocado (OR = 0.67; 95%CI: 0.48-0.93) showed low odds of depressive symptoms. The consumption of whole grains and cereals (> 2 servings/day) (OR = 1.63; 95%CI: 1.02-2.61) showed the opposite association. Adherence to Mediterranean diet and consumption of fruits, vegetables, nuts, avocado, fish, and seafood are associated with a lower likelihood of depression in Chilean university students. New policies and educational strategies are recommended to improve diet quality and the mental health of the entire university community.

Is evening chronotype associated with higher alcohol consumption? A systematic review and meta-analysis.

A broader understanding of whether and to what extent chronotype should be considered a risk factor for alcohol consumption is needed. The aim of this systematic review was to summarize the evidence on the association between evening chronotype and alcohol consumption. A systematic search of observational studies on this association was conducted in the PubMed, Scopus, Web of Science, Cochrane Library and PsycINFO databases up to April 30th, 2023. Random-effect models estimated the pooled odds ratio (OR) of alcohol consumption according to chronotype. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Quality Assessment tool for Observational Cohorts and Cross-sectional Studies from the National Heart, Lung and Blood Institute were followed. A total of 33 studies involving 28 207 individuals (age range: 18-93 years) were included in this review. Overall, most studies indicated a higher volume and frequency of alcohol consumption in evening-type individuals than in individuals with different chronotypes. Additionally, a meta-analysis including 13 studies showed that evening-type individuals were 41% more likely to consume alcohol than those with other chronotypes (OR = 1.41, 95% confidence interval: 1.16-1.66; I2 = 38.0%). Limitations of the present findings are the predominance of cross-sectional studies and varied definitions of alcohol consumption. The available evidence supports an association between the evening chronotype and alcohol consumption. The evening-type population, especially young adults, is a specific target for educational interventions for preventing or reducing alcohol consumption.PROSPERO number: CRD42022343778.

First report of an accident caused by Jaguajir agamemnon (C.L. Koch, 1839) (Scorpiones, Buthidae) in Paraná state, Brazil.

We report the first pediatric case of a Jaguajir agamemnon scorpion sting. This case occurred in the state of Paraná and is the first record of this species in southern Brazil. The patient was admitted within 15 min, with pain, local edema, erythema, whole-body pruritus, and tongue paresthesia within the first two hours, which disappeared thereafter. The patient's condition was considered mild, with a positive outcome, and she recovered completely.

Adverse drug reactions caused by drug-drug interactions in elderly outpatients: a prospective cohort study.

PURPOSE: Although the prevalence of drug-drug interactions (DDIs) in elderly outpatients is high, many potential DDIs do not have any actual clinical effect, and data on the occurrence of DDI-related adverse drug reactions (ADRs) in elderly outpatients are scarce. This study aimed to determine the incidence and characteristics of DDI-related ADRs among elderly outpatients as well as the factors associated with these reactions. METHODS: A prospective cohort study was conducted between 1 November 2010 and 31 November 2011 in the primary public health system of the Ourinhos micro-region, Brazil. Patients aged ≥60 years with at least one potential DDI were eligible for inclusion. Causality, severity, and preventability of the DDI-related ADRs were assessed independently by four clinicians using validated methods; data were analysed using descriptive analysis and multiple logistic regression. RESULTS: A total of 433 patients completed the study. The incidence of DDI-related ADRs was 6 % (n = 30). Warfarin was the most commonly involved drug (37 % cases), followed by acetylsalicylic acid (17 %), digoxin (17 %), and spironolactone (17 %). Gastrointestinal bleeding occurred in 37 % of the DDI-related ADR cases, followed by hyperkalemia (17 %) and myopathy (13 %). The multiple logistic regression showed that age ≥80 years [odds ratio (OR) 4.4; 95 % confidence interval (CI) 3.0-6.1, p < 0.01], a Charlson comorbidity index ≥4 (OR 1.3; 95 % CI 1.1-1.8, p < 0.01), consumption of five or more drugs (OR 2.7; 95 % CI 1.9-3.1, p < 0.01), and the use of warfarin (OR 1.7; 95 % CI1.1-1.9, p < 0.01) were associated with the occurrence of DDI-related ADRs. With regard to severity, approximately 37 % of the DDI-related ADRs detected in our cohort necessitated hospital admission. All DDI-related ADRs could have been avoided (87 % were ameliorable and 13 % were preventable). The incidence of ADRs not related to DDIs was 10 % (n = 44). CONCLUSIONS: The incidence of DDI-related ADRs in elderly outpatients is high; most events presented important clinical consequences and were preventable or ameliorable.

Prevalence and predictors of potential drug-drug interactions in the elderly: a cross-sectional study in the brazilian primary public health system.

PURPOSE: The primary objective of this study was to investigate the prevalence of clinically important potential drug-drug interactions (DDIs) in elderly patients attending the public primary health care system in Brazil. The secondary objective was to investigate possible predictors of potential DDIs. METHODS: A cross-sectional study was carried out in 5 Brazilian cities located in the Ourinhos Micro-region, Sao Paulo State, between November 2010 and April 2011. The selected sample was divided according to the presence (exposed) or absence (unexposed) of one or more potential DDIs (defined as the presence of a minimum 5-day overlap in supply of an interacting drug pair). Data were collected from medical prescriptions and patients' medical records. Potential DDIs (rated major or moderate) were identified using 4 DDI-checker programs. Logistic regression analysis was used to study potential DDI predictors. RESULTS: The prevalence of clinically important potential DDIs found during the study period was 47.4%. Female sex (OR = 2.49 [95% CI 2.29-2.75]), diagnosis of ≥ 3 diseases (OR = 6.43 [95% CI 3.25-12.44]), and diagnosis of hypertension (OR = 1.68 [95% CI 1.23-2.41]) were associated with potential DDIs. The adjusted OR increased from 0.90 [95% CI 0.82-1.03] in patients aged 60 - 64 years to 4.03 [95% CI 3.79 - 4.28] in those aged 75 years or older. Drug therapy regimens involving ≥ 2 prescribers (OR = 1.39 [95% CI 1.17-1.67]), ≥ 3 drugs (OR = 3.21 [95% CI 2.78-3.59]), ≥ 2 ATC codes (OR = 1.19 [95% CI 1.12-1.29]), ≥ 2 drugs acting on cytochrome P450 (OR = 2.24 [95% CI 2.07-2.46]), and ATC codes B (OR = 1.89 [95% CI 1.05-2.08]) and C (OR = 4.01 [95% CI 3.55-4.57]) were associated with potential DDIs. CONCLUSION: Special care should be taken with the prescription and therapeutic follow-up of patients who present characteristics identified as predictors. Knowledge of potential DDI predictors could aid in developing preventive practices and policies that allow public health services to better manage this situation.

Incidence and predictors of adverse drug reactions caused by drug-drug interactions in elderly outpatients: a prospective cohort study.

PURPOSE: The primary objective of this study was to investigate the incidence of drug-drug interactions (DDIs) related to adverse drug reactions (ADRs) in elderly outpatients who attended public primary healthcare units in a southeastern region of Brazil. The secondary objective was to investigate the possible predictors of DDI-related ADRs. METHODS: A prospective cohort study was conducted between November 1, 2010, and November 31, 2011, in the primary public healthcare system in the Ourinhos micro-region in Brazil. Patients who were at least 60 years old, with at least one potential DDI, were eligible for inclusion in the study. Eligible patients were assessed by clinical pharmacists for DDI-related ADRs for 4 months. The causality of DDI-related ADRs was assessed independently by four clinicians using three decisional algorithms. The incidence of DDI-related ADRs during the study period was calculated. Logistic regression analysis was used to study DDI-related ADR predictors. RESULTS: A total of 433 patients completed the study. The incidence of DDI-related ADRs was 6.5%. A multivariate analysis indicated that the adjusted odds ratios (ORs) rose from 0.91 (95% confidence interval [CI] = 0.75-1.12, p = 0.06) in patients aged 65-69 years to 4.40 (95% CI = 3.00-6.12, p < 0.01) in patients aged 80 years or older. Patients who presented two to three diagnosed diseases presented lower adjusted ORs (OR = 0.93 [95% CI = 0.68-1.18, p = 0.08]) than patients who presented six or more diseases (OR = 1.12 [95% CI = 1.02-2.01, p < 0.01]). Elderly patients who took five or more drugs had a significantly higher risk of DDI-related ADRs (OR = 2.72 [95% CI = 1.92-3.12, p < 0.01]) than patients who took three to four drugs (OR = 0.93 [95% CI = 0.74-1.11, p = 0.06]). No significant difference was found with regard to sex (OR = 1.08 [95% CI 0.48-2.02, p = 0.44]). CONCLUSION: The incidence of DDI-related ADRs in elderly outpatients was significant, and most of the events presented important clinical consequences. Because clinicians still have difficulty managing this problem, highlighting the factors that increase the risk of DDI-related ADRs is essential. Polypharmacy was found to be a significant predictor of DDI-related ADRs in our sample.

Free-time physical activity and pain perception: An analysis of daily records from Brazilian teachers.

The sensation of pain is frequent in teachers and its relationship with the practice of free-time physical activity still needs more scientific evidence. This study analyzed the association between free-time physical activity and pain symptoms experienced by teachers during the day and at bedtime. In this cross-sectional study, data were obtained through individual interviews and the fulfillment of an activity diary by teachers from a city located in southern Brazil. Statistical analysis was performed using logistic regression adjusted for sociodemographic, lifestyle and health variables. Among the 141 teachers included, pain perception was reported during the day by 66.7% and at bedtime by 66.0%. Analyses adjusted for sex, age, body mass index and time spent watching television indicated that practicing more than 240 minutes/week of free-time physical activity was associated with a lower likelihood of reported pain during the day (odds ratio, OR=0.18; 95% confidence interval, CI: 0.06-0.54) and at bedtime (OR=0.28; 95% CI: 0.10-0.79) compared to practicing ≤60 minutes/week of free-time physical activity. These associations lost statistical significance after the additional adjustment for depressive symptoms. In summary, this study showed that teachers who practiced more than 240 minutes/week of physical activity in free-time were less likely to report pain during the day and at bedtime. Depressive symptoms had an important confounding effect on this association. A multidisciplinary approach can optimize preventive strategies for pain prevention and management through health education programs in the workplace.

The Association Between Alcohol-Related Problems and Sleep Quality and Duration Among College Students: a Multicountry Pooled Analysis.

Alcohol consumption and sleep disorders are both prevalent and relevant problems among college students, but the relationship between these conditions is unclear. This study aimed to analyze the association between alcohol-related problems and sleep in first-year college students from Brazil, Chile, and Spain. Cross-sectional analyses were performed with data from three independent studies with first-year college students from each country. The risk of alcohol-related problems (RARP) and sleep quality and duration were self-reported using mixed methods. Pooled odds ratios (p-OR) and 95% confidence intervals (95% CI) of suboptimal sleep quality and of short (< 7 h) and long (> 8 h) sleep duration were estimated according to RARP adjusting for the main confounders. Of the 1830 students included (31.2% Brazilian, 42.2% Chilean, and 26.6% Spanish), 61.6% were female, and the mean age was 20.0 ± 3.6 years. Overall, 25.0% and 9.9% of the students were classified as intermediate and high RARP, respectively. In the combined results for the three countries, intermediate-to-high RARP was associated with a higher likelihood of suboptimal sleep quality (p-OR: 1.24; 95% CI: 1.00 to 1.52; I2 heterogeneity statistics: 43.0%), regardless of sociodemographic and lifestyle covariates and of self-rated health. The frequency of alcohol consumption was not associated with sleep quality or sleep duration. In this multicountry pooled analysis, first-year college students at risk of alcohol-related problems were more likely to report worse sleep quality. The coexistence of alcohol-related problems and sleep disorders could potentiate its adverse health effects among these young adults. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-022-00763-8.

The pharmaceutical care of patients with type 2 diabetes mellitus.

OBJECTIVE: To evaluate the efficiency of pharmaceutical care on the control of clinical parameters, such as fasting glycaemia and glycosylated haemoglobin in patients with Type 2 Diabetes mellitus. SETTING: This study was conducted at the Training and Community Health Centre of the College of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil. METHODS: A prospective and experimental study was conducted with 71 participants divided in two groups: (i) pharmaceutical care group (n=40), and (ii) the control group (n=31). The distribution of patients within these groups was made casually, and the patients were monitored for 12 months. MAIN OUTCOME MEASURE: Values for fasting glycaemia and glycosylated haemoglobin were collected. RESULTS: Mean values of fasting glycaemia in the pharmaceutical care group were significantly reduced whilst a small reduction was detected in the control group at the same time. A significant reduction in the levels of glycosylated haemoglobin was detected in patients in the pharmaceutical care group, and an average increase was observed in the control group. Furthermore, the follow-up of the intervention group by a pharmacist contributed to the resolution of 62.7% of 142 drug therapy problems identified. CONCLUSION: In Brazil, the information provided by a pharmacist to patients with Type 2 Diabetes mellitus increases compliance to treatment, solving or reducing the Drug Therapy Problem and, consequently, improving glycaemic control.

CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF SUICIDE ATTEMPTS IN CHILDREN ASSISTED BY A POISON CONTROL CENTER.

OBJECTIVE: To assess suicide attempts in children seeking care at a Poison Control Center. METHODS: Cross-sectional study with children (<12 years old) that attempted suicide and were cared at the Poison Control Center in Londrina, Paraná, Southern Brazil, from April 1985 to December 2018. RESULTS: We identified 59 children, most of them females (74.6%), who used only one product (77.9%). Among the products involved, medications were the most important ones (88.1%). Neurological/psychiatric/muscular manifestations (61.0%) were the main symptoms presented. The main reason identified for the suicide attempt was conflicts with family and/or friends (27.1%). Suicide attempts were more frequent in 2001-2003 and 2016-2018. CONCLUSIONS: Suicide attempts occurred mainly in female children with a single agent (mainly medications), and the main reason was family conflicts..

[Unhealthy eating habits and associated risk factors among truck drivers]. / Comportamentos alimentares de risco à saúde e fatores associados entre motoristas de caminhão.

The scope of this article is to identify risk factors associated with unhealthy eating habits among truck drivers. It involved a cross-sectional study carried out with truck drivers individually interviewed at the Port of Paranaguá in the State of Paraná, Brazil. Information was obtained on the consumption of fruit, vegetables, fried salted food, sweetened beverages, and the removal of visible fat from red meat and of skin from chicken meat. Hierarchical Poisson regression models were applied to identify factors associated with unhealthy eating habits. Of those interviewed (n = 670), 53.1% had four or more unhealthy eating habits. This condition was associated with age less than 40 years (prevalence ratio, PR = 1.49; 95% confidence interval, CI = 1.28-1.73), moderate, low or very low ability to exercise the profession (PR 1.28; 95% CI 1.08-1.52), not taking physical exercise in free time (PR = 1.66; 95%CI = 1.38- 2.00), overall self-reported eating habits as poor or very poor (RP = 1.25; IC95% = 1.05-1.49) and body mass index < 25 Kg/m2 (PR = 1.22; 95% CI = 1.05-1.43). More than half of the truck drivers revealed unhealthy eating habits, highlighting the need for strategies to rectify these habits.

O objetivo deste artigo é identificar fatores associados aos comportamentos alimentares de risco à saúde entre motoristas de caminhão. Trata-se de um estudo transversal realizado com motoristas de caminhão entrevistados no Porto de Paranaguá. Foram obtidas informações sobre o consumo de frutas, verduras e legumes, salgados fritos, bebidas açucaradas industrializadas e doces, e retirada de gordura visível de carne vermelha e da pele de carne de frango. Modelos hierarquizados foram construídos para identificar fatores associados aos comportamentos alimentares de risco à saúde. Dos entrevistados (n = 670), 53,1% apresentaram quatro ou mais comportamentos alimentares de risco à saúde. Tal condição associou-se com idade inferior a 40 anos (RP = 1,49; IC95% = 1,28-1,73), capacidade para exercer a profissão referida como moderada/baixa/muito baixa (RP 1,28; IC 95% 1,08-1,52), não praticar atividade física no tempo livre (RP = 1,66; IC95% = 1,38-2,00), qualidade da alimentação referida como ruim/muito ruim (RP = 1,25; IC95% = 1,05-1,49) e índice de massa corporal (IMC) < 25 Kg/m2 (RP = 1,22; IC95% = 1,05-1,43). Mais da metade dos motoristas de caminhão apresentaram comportamentos alimentares de risco à saúde, reforçando a necessidade de estratégias de incentivo à redução desses hábitos.

Trends of drug-related poisoning cases attended to at a poison control center. / Tendências de eventos toxicológicos relacionados a medicamentos atendidos por um Centro de Informações Toxicológicas.

INTRODUCTION: Drug-related poisonings have a high impact on morbidity and mortality, representing the first cause of intoxication in Brazil. OBJECTIVE: To describe the trends of cases of drug-related poisonings attended to by a poison control center. METHOD: A quantitative approach (cross-sectional trend study) with data analysis of cases of drug-related poisonings attended to at the Poison Control Center of University Hospital of the State University of Londrina. Data were collected from service notification records for the period 1985 to 2014. For statistical analysis, a simple linear regression model was used. RESULTS: Of the 36,707 cases attended to by the service, 22.5% (n = 8,608) were drug-related poisonings. There was an increase in the proportion of cases for both sexes (R2 = 0.195, p = 0.014) and males (R2 = 0.403, p < 0.001). There was a trend towards a higher proportion of cases involving the analgesic, anti-inflammatory and immunosuppressive drug classes (R2 = 0.521, p = 0.018), antidepressants (R2 = 0.923, p < 0.001) and antipsychotics (R2 = 0.869; p < 0.001). Antibiotics showed a trend toward a lower proportion of cases (R2 = 0.773, p = 0.001). CONCLUSIONS: There was a trend for a higher proportion of cases of drug-related poisonings in males. Also, there was an increased trend towards cases involving analgesics/anti-inflammatories/immunosuppressants, antidepressants and antipsychotics.

INTRODUÇÃO: Os eventos toxicológicos relacionados a medicamentos têm alto impacto na morbimortalidade, representando a primeira causa de intoxicação no Brasil. OBJETIVO: Descrever as tendências de casos de eventos toxicológicos relacionados a medicamentos atendidos por um Centro de Informações Toxicológicas. MÉTODO: Estudo com abordagem quantitativa (transversal e de tendência), com análise dos dados referentes aos casos de eventos toxicológicos relacionados a medicamentos atendidos pelo Centro de Informações Toxicológicas do Hospital Universitário da Universidade Estadual de Londrina. Os dados foram coletados das fichas de atendimento, referentes ao período de 1985 a 2014. Para a análise estatística, utilizou-se um modelo de regressão linear simples. RESULTADOS: Dos 36.707 casos atendidos pelo serviço, 22,5% (n = 8.608) foram eventos toxicológicos relacionados a medicamentos. Houve um aumento da proporção de casos em ambos os sexos (R2 = 0,195; p = 0,014) e no sexo masculino (R2 = 0,403; p < 0,001). Detectou-se tendência de elevação da proporção de casos envolvendo a classe de analgésicos, anti-inflamatórios e imunossupressores (R2 = 0,521; p = 0,018), antidepressivos (R2 = 0,923; p < 001) e antipsicóticos (R2 = 0,869; p < 0,001). Os antimicrobianos apresentaram tendência de redução da proporção de casos (R2 = 0,773; p = 0,001). CONCLUSÕES: Observou-se tendência de aumento da proporção de casos de eventos toxicológicos relacionados a medicamentos no sexo masculino. Também houve aumento nas tendências envolvendo analgésicos/anti-inflamatórios/imunossupressores, antidepressivos e antipsicóticos.

O papel mediador da dependência de mídia social e da qualidade do sono na associação entre tempo de uso de mídia social e sintomas depressivos em universitários / The mediating role of social media addiction and sleep quality in the association between social media usage and depressive symptoms in university students / El papel mediador de la adicción a las redes sociales y la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios

Resumo: O aumento do uso de mídias sociais e sua associação com sintomas depressivos, especialmente em jovens adultos, tem gerado a necessidade do entendimento de como ocorre tal associação para subsidiar políticas de redução de danos e agravos. Nesse sentido, este estudo objetivou verificar o efeito mediador da dependência de mídias sociais e da qualidade do sono na associação entre o tempo de uso de mídias sociais e sintomas depressivos em universitários brasileiros. Trata-se de um estudo transversal, realizado com 2.823 universitários, que forneceram informações referentes ao tempo de uso de mídias sociais, à dependência de mídias sociais, aos sintomas depressivos e à qualidade do sono. A análise de mediação, ajustada por fatores de confusão, foi realizada por meio do software PROCESS para SPSS, para obtenção do efeito total (c), direto (c') e indiretos (EI1, EI2 e EI3). Os resultados identificaram associação entre o tempo de uso de mídias sociais e os sintomas depressivos, mediada pela dependência de mídias sociais (EI1 = 20%) e pela qualidade do sono (EI1 = 40%). Os resultados permitem ampliar o conhecimento acerca dos mecanismos que influenciam mutuamente a relação entre o tempo de uso de mídias sociais e os sintomas depressivos, auxiliando na adoção de estratégias de redução de danos decorrentes do uso excessivo de mídias sociais.

Abstract: Increase in time spent on social media and its association with depressive symptoms, especially among young adults, has generated the need to understand how this association occurs in order to support the development of policies to reduce harm and complications. In view of this fact, this study aimed to assess the mediating effect of social media addiction and sleep quality on the association between time spent on social media and depressive symptoms in Brazilian university students. This is a cross-sectional study conducted with 2,823 university students, who provided information regarding time spent on social media, social media addiction, depressive symptoms and sleep quality. The mediation analysis, adjusted for confounding factors, was performed using the PROCESS macro for SPSS to obtain the total (c), direct (c'), and indirect effects (EI1, EI2, and EI3). The results identified an association between time spent on social media and depressive symptoms, mediated by social media addiction (EI1 = 20%) and sleep quality (EI1 = 40%). These findings help expand knowledge about the mechanisms that mutually influence the relationship between time spent on social media and depressive symptoms, supporting the adoption of strategies to reduce harm resulting from excessive social media use.

Resumen: El aumento del uso de las redes sociales y su asociación con síntomas depresivos, especialmente en adultos jóvenes, ha generado la necesidad de comprender cómo se produce esta asociación como una forma de apoyar las políticas de reducción de daños y afecciones. En ese sentido, el presente estudio tuvo como objetivo verificar el efecto mediador de la adicción a las redes sociales y de la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios brasileños. Se trata de un estudio transversal, realizado con 2.823 estudiantes universitarios, quienes brindaron información respecto al tiempo de uso de las redes sociales, adicción a las redes sociales, síntomas depresivos y calidad del sueño. El análisis de mediación, ajustado por factores de confusión, se realizó por medio del software PROCESS para SPSS, para obtener el efecto total (c), directo (c') e indirectos (EI1, EI2 y EI3). Los resultados identificaron una asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos, mediada por adicción a las redes sociales (EI1 = 20%) y la calidad del sueño (EI1 = 40%). Los resultados permiten ampliar el conocimiento acerca de los mecanismos que influyen mutuamente en la relación entre tiempo de uso de las redes sociales y los síntomas depresivos, ayudando a adoptar estrategias para reducir los daños resultantes del uso excesivo de las redes sociales.

A Distance-Learning Course to Improve Drug-Dispensing Behaviors Among Brazilian Community Pharmacists.

Objective. To evaluate the effectiveness of a distance-learning course in the training of pharmacists in drug dispensing. Methods. This interventional study was carried out with community pharmacists throughout Brazil. A 12-week distance-learning course was conducted. Pharmacists' knowledge and performance during drug dispensing were evaluated before and after completion of the course. Results. Community pharmacists' knowledge of drug dispensing was greater after completing the distance-learning course than before (mean=5.7, SD=2.8 points vs mean=3.8, SD=1.9 points, respectively). However, no improvement was observed in pharmacists' drug-dispensing practice. Almost all participants (96.5%) considered that they were more qualified to perform the drug dispensing after the course. There were 1492 pharmacists enrolled in the course, of which 1061 were included in the study, and 472 completed the surveys. Only pharmacists from Ribeirão Preto, Brazil, were invited to take the mytery shopper evaluation (n=26). However, 10 pharmacists completed the mystery shopper encounter. Conclusion. A distance-learning course was effective in improving community pharmacists' knowledge. However, the course did not seem to improve overall drug-dispensing performance. Additional educational strategies should be adopted in future studies to address this gap.

Working conditions and sleepiness while driving among truck drivers.

Objective: The objective of this study is to identify the role of working conditions as predictors of sleepiness while driving among truck drivers. Methods: This was a cross-sectional study carried out among truck drivers who transported grains to Paranaguá Port, Paraná, Brazil. The truck drivers were interviewed and completed a self-administered questionnaire to collect data on sociodemographic and behavioral variables, working conditions, consumption of illicit psychoactive substances, and sleep patterns. Drivers were considered to be sleepy while driving if they reported a medium or high probability of napping while driving at night, during the daytime, or while stopped in traffic. The statistical analysis used logistic regression models progressively adjusted for age, behavioral variables, sleep duration, and other working conditions. Results: In total, 670 male drivers, with a mean age of 41.9 (±11.1) years, were enrolled. The prevalence of sleepiness while driving was 31.5%. After model adjustments, the following working conditions were associated with sleepiness while driving: Distance from the last shipment of more than 1,000 km (odds ratio [OR] = 1.54; 95% confidence interval [CI], 1.07-2.23) and a formal labor contract with a productivity-based salary (OR = 2.65; 95% CI, 1.86-3.78). Consumption of illicit psychoactive substances (OR = 1.99; 95% CI, 1.14-3.47) was also associated with sleepiness while driving. Conclusions: Distance traveled and a formal labor contract with productivity-based earnings were the working conditions associated with sleepiness while driving, regardless of other working or behavioral characteristics, age, consumption of illicit psychoactive substances, and sleep duration.