Health literacy of people with spinal cord injury: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVE: To systematically review the evidence on health literacy (HL) of people diagnosed with spinal cord injury (SCI). METHODS: PubMed, Cochrane Library, Web of Science and Embase databases were used to identify studies published from 1974 to 2021. Two reviewers independently carried out the study selection process and assessed the methodological quality of the studies. The risk of bias in the studies was classified according to the Joanna Briggs Institute (JBI). RESULTS: In total, 1398 studies were identified from the initial search, and 11 were selected for reading thoroughly. After screening, five studies were included. All had a cross-sectional design, and most scientific production was from the United States. In the studies, people with SCI received assistance in rehabilitation services. The results were heterogeneous compared to the HL: reasonable HL; suitable HL; Inadequate HL. Better HL was identified in individuals from the white population compared to the black population with SCI. CONCLUSION: Studies on HL in the SCI population are limited. Guidance and personalized education provided in rehabilitation programs seem to have an influence on HL levels in this population. More research is needed to broaden the understanding of HL in the rehabilitation process of people diagnosed with SCI.

Associated Factors of Quality of Life in Prison Officers, Brazil.

This study analyzed factors associated with the quality of life (QoL) of prison officers (POs) in the Midwest Region of Brazil. POs in five penitentiary units participated in this cross-sectional study. Sociodemographic data were obtained through face to face interview and a World Health Organization Quality of Life abbreviated version (WHOQOL-BREF) questionnaire was applied to assess QoL. Student's t-test or ANOVA were used for bivariate analysis and multiple linear regression was applied for adjusted analysis. The domains used for outcomes were: physical, psychological, social relations, and the environment. The lowest score among WHOQOL-BREF domains was environment (59.9; 95%CI 58.0-61.5). After adjustment, the factors associated with the physical domain were 'female sex' and 'no history of workplace PO-PO violence'; factors associated with the psychological domain were 'female sex', 'without spouse', and 'no history of inmate-PO violence'; factors associated with the social relationships domain were 'female sex', 'work experience in years', 'no higher education', 'no private health insurance', and 'no history of inmate-PO violence'; and factors associated with environment domain were 'female sex', 'work experience in years', 'no private health insurance', and 'no history of PO-PO violence'. This study showed that female workers and those with a history of violence at work had worse QoL scores. This investigation highlights the importance of prison management in promoting QoL of POs, as well as support and development of strategies to prevent workplace violence.

Bilateral but not unilateral tubal obstruction is associated with positive chlamydia serology.

OBJECTIVE: To assess the association between positive Chlamydia trachomatis (C. trachomatis) serology and unilateral or bilateral tubal obstruction. METHODS: This was a cross sectional study that evaluated the association of positive C. trachomatis serology (Immunofluorescence Indirect Serology, IIF or Enzyme Immune Essay, EIE), in two infertile groups: A. 243 patients (27 with unilateral obstruction and 216 without it). B. 247 patients (31 with bilateral obstruction and 216 without it). The exclusion criteria were tubal ligation (tubectomy) and tubal surgery. The statistical test (SPSS 17.0) was the Chi-Square with a p=5%. Tubal obstruction was diagnosed through hysterosalpingography (HSG). RESULTS: The mean age of the patients without obstruction was 33.6 years, SD 4.9. The mean age of the patients with unilateral obstruction was 33.7 years SD 4.9. The mean age of the patients with bilateral obstruction was 33.6 years, SD 4.9. There was no statistically significant difference between the age groups. In group A (unilateral obstruction versus serology) the Chi-Square was 0.02 (p=n.s.) and the Attributable Risk (AR) = 0.7%. In Group B (bilateral obstruction versus serology) the Chi-Square test was 9.87 (p<0.005) and the AR = 14.8%. CONCLUSION: This study found a strong and statistically significant association between bilateral tubal obstruction and C. trachomatis positive serology. The power of the test was 86%. There was no association between unilateral obstruction and positive serology.

Prognostic Significance of Apoptosis-related Markers in Patients With Soft-Tissue Sarcomas of Extremities.

Bcl-2 and Bax proteins are key regulators of apoptosis, a process that is deregulated in many human diseases, particularly cancer. Overexpression of antiapoptotic Bcl-2 protein is associated with drug resistance and poor clinical outcome in cancer patients, whereas the expression of proapoptotic Bax protein, commonly detected in soft-tissue sarcoma (STS), is often associated with chemiosensitivity in different tumors. Studies on the clinical implications of apoptosis-related markers Bcl-2 and Bax in STS are limited. In this study, immunohistochemistry for Bcl-2 and Bax was performed on tissue microarrays of 86 multiple types of adult STS of the extremities. Bcl-2 and Bax positive expression was detected in 25.9% and 66.7% of the sarcomas, respectively. Overexpression of both, Bcl-2 and Bax, was directly associated with histologic grade and clinical stage. A significant association between Bax and Bcl-2 expression was also observed (P=0.007). The 5-year overall survival for the group was 57%, and it was lower for cases that overexpressed Bcl-2 (47.6% vs. 58.3%) and Bax (50% vs. 66.7%), although not statistically significant. After multivariate analysis, only the high histologic grade appeared as an independent prognostic factor for the patients (P=0.043; HR=8.0; 95% CI, 1.1-60.1). In our study, Bcl-2 and Bax expression was significantly associated with histologic grade and clinical stage, which are classic factors of poor prognosis. We suggest the use of these proteins as potential prognostic markers in STS of extremities.

O perfil da Fonoaudiologia em hospitais universitários federais brasileiros / The profile of speech therapy in Brazilian federal university hospitals

Introdução: Os Hospitais Universitários são importantes centros e ocupam papel de destaque na comunidade onde estão inseridos. Nestes locais há um conjunto diversificado de profissionais de saúde. Objetivo: Descrever a atuação da Fonoaudiologia nos Hospitais Universitários das Universidades Federais Brasileiras - HUs. Métodos: Estudo descritivo exploratório realizado nos Serviços de Fonoaudiologia dos HUs. A população constituiu-se de fonoaudiólogos responsáveis pelos serviços. No site do MEC- Ministério da Educação, foi obtida a relação de todos os Hospitais Universitários Federais, com seus respectivos contatos (e-mail/ endereço/ telefone). Os dados foram coletados por meio da aplicação de questionário contendo questões objetivas que avaliou a atuação fonoaudiológica dentro do HU, sendo aplicado via e-mail. Resultado: Entre os 45 HUs, 25 participaram do estudo e 16 possuem serviços de fonoaudiologia há 2 a 13 anos. Os atendimentos são ambulatoriais, entretanto, há serviços de fonoaudiologia atuando em ambulatório, clínicas, UTIs neonatal e de adultos e pronto socorro. Doutorado, Mestrado e a docência fazem parte do currículo de vários profissionais. Conclusão: A atuação da fonoaudiologia em unidades hospitalares, assim como a atuação conjunta precisa ser ampliada, pois o trabalho em equipe faz com que a profissão seja cada vez mais reconhecida e solicitada por outros profissionais, além de contribuir para melhor efeito na assistência ao paciente.

Introduction: The University Hospitals are very important centers and represent a relevant role in the community where they are inserted. In these places there is a diverse range of health professionals.Objective: To describe the performance of Speech-Language Pathology in University Hospitals of Federal Brazilian Universities ­ UH. Methods: Exploratory descriptive study developed by the Speech-Language Pathology services of the UHs. The population was constituted by the Speech-Language Pathology therapists responsible for the services. In MEC site, the relation of all the Federal University Hospitals and its respective contacts (e-mail/address/telephone) were obtained. The data were collected by the application of a questionnaire with objective questions, which evaluated the performance of Speech-Language Pathology inside the UH, and that was sent by e-mail. Results: Among the 45 UHs, 25 have participated of the study and 16 posses Speech-Language Pathology Services from 2 to 13 years. The attendance is the ambulatory, but there are also services developed in clinic, neonatal and adult ITUs and in first-aid clinics. Doctorship, Mastership and teaching are part of the résumé of many professionals. Conclusions: The performance of Speech-Languege Pathology in hospital unities should be amplified, since joint work makes the profession to be better recognized and therefore requested by other professionals, beyond contributing to a better assistance for the patient.

Introducción: Los Hospitales Univesitários son importantes centros y ocupan un papel relevante en la comunidad donde se insertan. En estos lugares hay una amplia gama de profesionales de la salud. Objetivo: Describir la actuación de la Fonoaudiologia en los Hospitales Universitários de las Universidades Federales Brasileñas. Métodos: Estudio exploratorio descriptivo llevada a cabo en servicios de Fonoaudiologia de los HUs. La población se constituió de fonoaudiologos responsable de los servicios. En la pagina web del MEC ­ Ministério de la Educación, fue encontrada la relación de todos los Hospitales Universitários Federales, con sus correspondientes contactos (correo electrónico / dirección / teléfono). Los datos fueron recolectados a través de la aplicación de un cuestionario con preguntas objetivas que evaluó el desempeño fonoaudiológico dentro de HU, aplicado a través del correo electrónico. Resultados: Entre los 45 HUs, 25 participaron del estudio y 16 tienen servicios de Fonoaudiologia hace 2 a 13 años. La atención ambulatoria, sin embargo, está trabajando en los servicios ambulatorios, clínicas, UCI neonatal y de adultos y la sala de emergencia. Doctorado, máster y la enseñanza son parte del currículum de varios profesionales. Conclusión: La actuación de la Fonoaudiología en unidades hospitalares, así como la acción conjunta necesita ser ampliada porque el trabajo en equipo hace que la profesión sea cada vez más reconocida y buscada por otros profesionales, mas allá de contribuir a un mejor efecto en el cuidado al paciente.

Riscos ocupacionais em fonoaudiólogos de uma unidade hospitalar: um estudo-piloto / Occupational risks faced by speech-pathologists and audiologists in a hospital setting

Este estudo-piloto teve como objetivo investigar os riscos ocupacionais a que estão sujeitos os fonoaudiólogos que atuam em unidade hospitalar. Trata-se de pesquisa transversal, realizada em um hospital-escola integrante da rede pública da região centro-oeste do Brasil. A população constituiu-se de 4 fonoaudiólogos que atuam em variados locais do hospital: na realização de exames em ambulatórios, clínicas, maternidade e UTIs neonatal e de adultos. Os fonoaudiólogos entrevistados trabalham na unidade há mais de 7 anos, com formação profissional especializada em sua área de atuação. O instrumento utilizado para a coleta dos dados foi o questionário que investigava a ocorrência de acidentes e doenças ocupacionais entre os participantes do estudo. Detectou-se a existência de riscos químicos tais como os radioativos físicos a exemplo da lesão por esforço repetitivo (LER), biológicos por meio do contato com fluidos corpóreos, além da violência ocupacional. As enfermidades infecto-contagiosas e a LER foram consideradas as doenças com maior probabilidade de ocorrência entre os participantes. Concluiu-se que assim como outros profissionais, os fonoaudiólogos estão expostos a riscos, sendo prevalentes a LER e a violência ocupacional. Este estudo confirma a necessidade da implantação de medidas preventivas como a adoção de exercícios intercalados nos horários de trabalho e estudos no sentido de se buscarem alternativas capazes de reduzir as agressões sofridas pelos profissionais na instituição

Fatores associados ao uso do preservativo em adolescentes do gênero feminino no Município de Goiânia / Factors assocated with Condom use by female adolescents in Goiânia city

Estudo transversal de base populacional, com seleção aleatória sistemática de adolescentes do gênero feminino, sexualmente ativas, com idade entre 15 e 19 anos. Os dados foram obtidos por meio de entrevista confidencial

AVALIAÇÃO DA ADOÇÃO DAS MEDIDAS DE PRECAUÇÕES PADRÃO EM CATEGORIAS ESPECÍFICAS DE PROFISSIONAIS DE SAÚDE

Uma pesquisa em profissionais da área da saúde que provavelmente tem intensa e freqüente exposição a sangue e outros fluídos orgânicos (anestesiologistas) foi conduzida para avaliar a freqüência de relatos de exposição ocupacional a sangue e/ou outros fluídos orgânicos e o conhecimento e aderência destes profissionais as medidas de precauções padrão. De todos os profissionais entrevistados, 62,8% relataram acidentes ocupacionais com sangue e/ou outros fluídos orgânicos, seja através de lesão percutânea e/ou contato em membrana mucosa, todos relataram conhecimento acerca das medidas de precauções padrão e a maioria referirou a adoção de tais medidas e vacinação contra hepatite B. No entanto, observou-se na prática desses profissionais uma pobre aderência às medidas de precaução, principalmente, em relação ao uso de máscaras, óculos protetores e lavagem das mãos. Esse estudo enfatiza a importância do desenvolvimento de novas estratégias para o treinamento em precauções padrão.

A survey of health care workers who were thought likely have frequent and intensive exposures to blood and other body fluids, anaesthetists, was carried out to asses the frequency of self-reported occupational exposures to blood and other body fluids, the knowledge and the compliance with regard standard precautions. Of all interviewed profissionals, 62.8% reported occupational exposures to blood and/or other body fluids by percutaneous injuries and/or mucous membranes contacts. All profissionals reported knowledge about standard precautions and the most of them assumed the use of these precautions, and hepatitis B vaccination. Nevertheless was observed a poor adherence to standard precautions in their practices, principally, concerning the use of masks, protective eyeglasses and handwashings. This study emphasizes the importance of developing new strategies for precautions standards training.