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.

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.

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.

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 / Adesão à dieta mediterrânea e sintomas de depressão, ansiedade e estresse em universitários chilenos: um estudo transversal / Adherencia a la dieta mediterránea y síntomas de depresión, ansiedad y estrés en universitarios chilenos: un estudio transversal

Abstract: 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.

Resumen: El objetivo de este estudio fue determinar la asociación entre la adherencia a la dieta mediterránea y sus grupos de alimentos y los síntomas depresivos en estudiantes universitarios chilenos. El diseño del estudio fue el transversal. Un total de 934 estudiantes de primer año de una universidad pública chilena completaron una encuesta de autoevaluación sobre la adherencia a la DM -utilizando un índice validado en Chile (IDM chileno)- y los síntomas de depresión, ansiedad y estrés, mediante el uso de la Escala de Depresión, Ansiedad y Estrés (DASS-21). Se utilizaron los modelos de regresión logística para analizar la asociación entre la adherencia a la dieta mediterránea y sus grupos alimenticios y los síntomas de depresión, ansiedad y estrés, ajustados por los principales factores de confusión. Los estudiantes con moderada o alta adherencia a la dieta mediterránea tenían menos probabilidades de presentar depresión [DASS-21 > 5, odds ratio (OR) = 0,64; intervalo de 95% de confianza (IC95%): 0,47-0,88] que aquellos con baja adherencia a la dieta mediterránea. Un consumo de 1-2 porciones por día de verduras (OR = 0,63; IC95%: 0,43-0,92), > 2 porciones por semana de nueces (OR = 0,41; IC95%: 0,21-0,80), 1-2 porciones por día de frutas (OR = 0,60; IC95%: 0,42-0,85), 1-2 porciones por semana de pescado y marisco (OR = 0,67; IC95%: 0,48-0,94) y 1/2-3 unidades por semana de aguacate (OR = 0,67; IC95%: 0,48-0,93) resultó en bajas probabilidades de síntomas depresivos. El consumo de cereales integrales (> 2 porciones por día) (OR = 1,63; IC95%: 1,02-2,61) tuvo una asociación opuesta. La adhesión a la dieta mediterránea y el consumo de frutas, verduras, nueces, aguacate, pescados y mariscos se asocian con una menor probabilidad de depresión en los estudiantes universitarios chilenos. Se sugiere la adopción de nuevas políticas y estrategias educativas para mejorar la calidad de la alimentación y promover la salud mental de toda la comunidad universitaria.

Resumo: O objetivo do estudo foi determinar a associação da adesão à dieta mediterrânea e seus grupos alimentares com sintomas depressivos em estudantes universitários chilenos. O desenho do estudo foi transversal. Um total de 934 estudantes do primeiro ano de uma universidade pública chilena responderam a uma pesquisa de autoavaliação para analisar a adesão à dieta mediterrânea - por meio de um índice validado no Chile (IDM-chileno) - e sintomas de depressão, ansiedade e estresse, utilizando a Escala de Depressão, Ansiedade e Estresse (DASS-21). Modelos de regressão logística foram utilizados para examinar a associação entre a adesão à dieta mediterrânea e seus grupos alimentares com sintomas de depressão, ansiedade e estresse, ajustados para os principais fatores de confusão. Estudantes com adesão moderada ou alta à dieta mediterrânea apresentaram chances menores de ter depressão [DASS-21 > 5, odds ratio (OR) = 0,64; intervalo de 95% de confiança (IC95%): 0,47-0,88] do que aqueles com baixa adesão à dieta mediterrânea. Um consumo de 1-2 porções por dia de verduras (OR = 0,63; IC95%: 0,43-0,92), > 2 porções por semana de nozes (OR = 0,41; IC95%: 0,21-0,80), 1-2 porções por dia de frutas (OR = 0,60; IC95%: 0,42-0,85), 1-2 porções por semana de peixes e frutos do mar (OR = 0,67; IC95%: 0,48-0,94) e 1/2-3 unidades por semana de abacate (OR = 0,67; IC95%: 0,48-0,93) resultou em chances baixas de sintomas depressivos. O consumo de cereais integrais (> 2 porções por dia) (OR = 1,63; IC95%: 1,02-2,61) resultou na associação oposta. A adesão à dieta mediterrânea e o consumo de frutas, verduras, nozes, abacate, peixes e frutos do mar estão associados a uma menor probabilidade de depressão em estudantes universitários chilenos. Recomendamos a adoção de novas políticas e estratégias educacionais para melhorar a qualidade da alimentação e promover a saúde mental de toda a comunidade universitária.

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

ABSTRACT 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.

An analysis of pharmaceutical care for critical patients of an adult Intensive Care Unit

Abstract This work analyzed the pharmacotherapeutic problems identified by the clinical pharmacist in an intensive care unit (ICU) and the acceptance of pharmaceutical interventions in solving these problems. This is a descriptive cross-sectional retrospective study, carried out in the adult ICU of a public hospital. All patients hospitalized during the study period had their pharmacotherapy monitored and those whose stay at the ICU lasted less than 24 hours were excluded. The pharmacotherapeutic problems were classified according to type, cause, acceptability/implementation, mode of intervention, outcome and related pharmacotherapeutic group. 302 patients were followed up and 350 pharmacotherapeutic problems were identified. Most of them were classified as unnecessary drug-treatment (n=186; 53.1%). The most frequent causes were excessive drug administration (n=181; 97.3%), and antimicrobials was the main group of drugs associated to that type of problem. 350 pharmaceutical interventions were performed, highlighting "prescriber informed only" (n=178; 50.9%), with an average acceptability of 90.7%, with those carried out on site being more effective (93.4%). The number of pharmacotherapeutic problems that were totally solved was 282 (80.6%). Clinical pharmacy activities in the ICU identified, prevented and corrected pharmacotherapeutic problems, contributing to the optimization of pharmacotherapy in aspects related to the need, efficacy and safety of treatments.

Relação entre o peso corporal e a insatisfação com a imagem corporal entre estudantes universitários / Relationship between body weight and body image dissatisfaction among college students / Relación entre el peso corporal y la insatisfacción con la imagen corporal en estudiantes universitarios

O Brasil vive uma epidemia de obesidade há muitos anos, situação que leva ao aumento do risco de doenças cardiovasculares. Entre os jovens, observa-se elevação de distúrbios da imagem corporal, sendo que um terço está insatisfeito com a própria aparência. Dessa forma, foi analisada a relação entre o peso corporal e a insatisfação com a imagem corporal entre estudantes universitários. Este é um estudo transversal realizado com 3.168 estudantes de uma universidade pública paranaense. Para avaliação da satisfação corporal, foi utilizado o Body Shape Questionnaire (BSQ) adaptado e validado para o Brasil. Para o peso corporal, foi utilizado o Índice de Massa Corpórea (IMC). Na análise de associação, foi utilizada Regressão de Poisson com variância robusta com cálculo da razão de prevalência (RP) e intervalo de confiança 95% (IC95%). Os resultados alcançados mostram que estudantes com sobrepeso (RP: 1,56; IC95% 1,46-1,67) e obesidade (RP: 1,68; IC95% 1,55-1,81) apresentaram maior insatisfação com a imagem corporal, independentemente das variáveis de ajuste. Já entre estudantes com baixo peso (RP: 0,42; IC95% 0,34-0,53), a insatisfação com a imagem corporal é menor. Independentemente de variáveis sociodemográficas e de saúde mental, estudantes universitários com excesso de peso constituem um grupo com maior prevalência para a insatisfação corporal.

Brazil has experienced an obesity epidemic for many years, a situation which increases the risk of cardiovascular diseases. Research has found an increase in body image disorders among young people. About one third of this group feels dissatisfied with their body appearance. Thus, we analyzed the relation between college students' body weight and dissatisfaction with their body image. This is cross-sectional study was conducted with 3,168 students from a public university in Paraná. To evaluate body satisfaction, we used the Body Shape Questionnaire (BSQ), which was adapted and validated for Brazil. To assess body weight, the Body Mass Index (BMI) was used. A Poisson regression with robust variance and calculation of its prevalence ratio (PR) and 95% confidence interval (95%CI) was used in our association analysis. Students with overweight (PR 1.56; 95%CI 1.46-1.67) and obesity (PR 1.68; 95%CI 1.55-1.81) showed greater dissatisfaction with their body image, regardless of our adjustment variables. Conversely, we found underweight students (PR 0.42; 95%CI 0.34 - 0.53) had lower body image dissatisfaction. Regardless of sociodemographic and mental health variables, overweight college students constitute a group with a high prevalence of body dissatisfaction.

Brasil vive desde hace años una epidemia de obesidad, situación que resulta en el aumento del riesgo de enfermedades cardiovasculares. Entre los jóvenes, se ha notado un aumento de los trastornos de la imagen corporal, con cerca de un tercio de este grupo insatisfecho con su apariencia corporal, en este sentido analizamos la relación entre el peso corporal y la insatisfacción con la imagen corporal entre los estudiantes universitarios. Se trata de un estudio transversal realizado con 3.168 estudiantes de una universidad pública de Paraná. Para evaluar la satisfacción corporal se utilizó el Body Shape Questionnaire (BSQ) adaptado y validado para Brasil. Para el peso corporal se utilizó el Índice de Masa Corporal (IMC). En el análisis de asociación se utilizó la regresión de Poisson con varianza robusta con cálculo de la razón de prevalencia (RP) y el intervalo de confianza del 95% (IC 95%). Los resultados obtenidos muestran que los estudiantes con sobrepeso (PR 1,56; IC 95% 1,46-1,67) y los estudiantes obesos (PR 1,68; IC 95% 1,55-1,81) mostraron una mayor insatisfacción con la imagen corporal, independientemente de las variables de ajuste. Por el contrario, los estudiantes con bajo peso (PR 0,42; IC95% 0,34 - 0,53) mostraron una menor insatisfacción con la imagen corporal. Independientemente de las variables sociodemográficas y de salud mental, los estudiantes universitarios con sobrepeso constituyen un grupo con mayor prevalencia de insatisfacción corporal.

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.

Consumo de anticoncepcionais e fatores associados entre estudantes universitários / Contraceptive use and associated factors among university students

Introdução: o uso de anticoncepcionais vem crescendo a cada ano, sendo um dos principais motivos para a redução das taxas de fecundidade total, inclusive na população mais jovem, como a universitária. Objetivo: identificar o consumo de anticoncepcionais hormonais e fatores associados entre estudantes universitárias. Métodos: a população de estudo foi composta por estudantes universitárias matriculadas nos cursos de graduação da Universidade Estadual de Londrina (UEL), em Londrina, estado do Paraná, Brasil, no ano de 2019, integrantes do projeto maior denominado GraduaUEL. As estudantes responderam um instrumento construído em uma plataforma digital on-line. A variável dependente foi o consumo de contraceptivos hormonais, e as variáveis independentes foram aspectos sociodemográficos e hábitos de vida e de saúde. As associações medidas foram verificadas por meio de Regressão de Poisson, com cálculo da Razão de Prevalência (RP) e intervalo de confiança de 95% (IC 95%). Resultados: das 2.221 estudantes avaliadas, identificou-se o consumo de contraceptivos por 13,0%, maior entre mulheres brancas/amarelas, que relataram serem heterossexuais, que apresentavam pais com maior escolaridade, que referiram possuir plano privado de saúde e companheiro, e que praticavam atividade física pelo menos duas vezes na semana. Entretanto, apenas o fato de serem heterossexuais mostrou-se associação significativa após a análise ajustada (RP: 1,865; IC 95%: 1,308-2,659). Conclusões: diante do exposto, fica clara a necessidade de preparar os profissionais de saúde sobre os contraceptivos e seus efeitos adversos; ainda, que questões sociais devem ser consideradas no processo de uso dos contraceptivos, para combater a discriminação e as desigualdades social e econômica quanto ao acesso e uso destes medicamentos.

Introduction: the use of contraceptives has been growing every year, being one of the main reasons for the reduction in total fertility rates, including in the younger population, such as university students. Objective: identify the consumption of hormonal contraceptives and associated factors among university students. Methods: the study population consisted of university students enrolled in undergraduate courses at the Universidade Estadual de Londrina (UEL), in Londrina, Paraná state, Brazil, in 2019, members of the larger project called GraduaUEL. The students answered an instrument built on an on-line digital platform. The dependent variable was the consumption of hormonal contraceptives, and the independent variables were sociodemographic aspects, lifestyle and health. Measured associations were verified using Poisson Regression, with calculation of the Prevalence Ratio (PR) and 95% confidence interval (95% CI). Results: of the 2,221 students evaluated, the consumption of contraceptives was identified by 13.0%, higher among white/yellow women, who reported being heterosexual, who had parents with higher education, who reported having a private health plan and partner, and who practiced physical activity at least twice a week. However, only the fact of being heterosexual showed a significant association after the adjusted analysis (PR: 1.865; 95% CI: 1.308-2.659). Conclusions: in light of the above, the need to prepare health professionals about contraceptives and their adverse effects is clear, as well as what social issues should be considered in the process of using contraceptives, to combat discrimination, social and economic inequality regarding access and the use of these medications.

Sodium alendronate: proposal and reliability of indicators

Abstract The present study proposes and evaluates the test-retest reliability of indicators of the correct use of sodium alendronate in elderly patients. This is a test-retest reliability study for use of sodium alendronate. Six questions to evaluate the correct use of this medicine were elaborated after analysis of information in the literature. Data collection was performed through questionnaires in face-to-face in-home interviews by previously trained interviewers. The participants were initially interviewed (test) when they agreed to participate in the study, and secondly (retest), after a period of 7 to 14 days from the first interview. The reliability of the questions was evaluated by means of the agreement percentage and the Kappa coefficient. Fifty-seven pairs (test-retest) were obtained. The mean age was 69.3 (SD = 6.9) years, the majority (92.5%) completed elementary education, and declared themselves white (50.9%). All the questions presented high concordance ranging from 79.0% to 98.3%. The Kappa values ranged from 0.1 (low) to 0.83 (very good). The agreement percentage and the Kappa values suggest adequate reliability of the proposed questions. We suggest that they can be used as a simple and quick way to evaluate the quality of sodium alendronate use among the elderly.

Direct-acting antivirals for chronic Hepatitis C are effective and safe: an observational study in Londrina/PR

Abstract This study aimed to evaluate the effectiveness and safety of direct-acting antivirals in a Unified Health System pharmacy of Londrina, Brazil. A descriptive observational study was performed from June 2017 to June 2018. Sociodemographic, clinical, and therapeutic variables of patients were collected from secondary data sources. Effectiveness was evaluated by sustained virologic response (SVR) and safety was evaluated by adverse events (AEs) and drug interactions (DIs). The mean population (N=30) was 56.6±11.3 years old and almost all patients had comorbidities (93.3%) and concomitant drugs (96.7%). Effectiveness evaluation was possible in 17 patients, and all of them (100.0%) achieved SVR. Eighteen patients (60.0%) reported 38 AEs, mostly mild, such as stomach symptoms and headache. No statistical relation was found between AE occurrence and treatment duration, Ribavirin use, number of comorbidities or number of concomitant drugs. A total of 48 DIs were reported, 18 being severe, and were managed by the pharmacist. The study indicates that the treatment was effective and safe.

Clinical and epidemiological analysis of suicide attempts in children assisted by a poison control center / Análise clínica e epidemiológica das tentativas de suicídio em crianças atendidas em um centro de informação e assistência toxicológica

ABSTRACT 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..

RESUMO Objetivo: Analisar as tentativas de suicídio em crianças atendidas em um Centro de Informação e Assistência Toxicológica (CIATox-Londrina). Métodos: Estudo transversal com crianças (<12 anos) atendidas no CIATox-Londrina, Paraná, de abril/1985 a dezembro/2018, com tentativa de suicídio. Resultados: Identificaram-se 59 crianças, com predomínio do sexo feminino (74,6%) e com o uso de apenas um produto (77,9%). Entre os produtos envolvidos, destacaram-se os medicamentos (88,1%). As manifestações neurológicas/psíquicas/musculares (61,0%) foram os principais sintomas apresentados. O principal motivo identificado da tentativa de suicídio foram os conflitos com familiares e/ou amigos (27,1%). Houve maior frequência de tentativas de suicídio nos triênios 2001-2003 e 2016-2018. Conclusões: As tentativas de suicídio ocorreram predominantemente nas crianças do sexo feminino, com um único agente (em geral, medicamentos), em que o principal motivo foram os conflitos familiares, observando-se um aumento ao longo dos anos.

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..

Eventos toxicológicos em idosos atendidos por centro de informação e assistência toxicológica: análise de tendência / Toxicological events in older adults attended by toxicological information center: a trend analysis / Eventos toxicológicos en ancianos atendidos por centro de información y asistencia toxicológica: análisis de tendencia

Por produzir elevado impacto socioeconômico, promovendo custos e danos evitáveis, além de ter efeitos nocivos ao organismo humano, a intoxicação humana é considerada um problema importante em saúde pública. Com o envelhecimento, os indivíduos ficam suscetíveis a diversas doenças e agravos em saúde, e dentre eles, é importante notar-se os eventos toxicológicos ocorridos por várias circunstâncias, como o uso de polifarmácia, tentativa de suicídio, erro de prescrição médica, erro na administração do medicamento, entre outros, causas cada vez mais presente nessa população. Dessa forma, este artigo tem o objetivo de determinar o perfil e a tendência dos eventos toxicológicos ocorridos em idosos. Trata-se de estudo de tendência, realizado com indivíduos com 60 anos ou mais, notificados por um Centro de Informação e Assistência Toxicológica de Londrina (CIATox-Londrina), de 1985 a 2014. As variáveis foram coletadas através do banco de dados do CIATox-Londrina, e a análise de tendência realizada por meio de modelos de regressão linear simples. Identificou-se 2.042 casos de eventos toxicológicos em idosos, predominando a faixa etária de 60 a 69 anos (61,9%). A maioria (69,1%) foram casos de evento acidental, de forma aguda (98,2%), envolvendo animais (64,6%), pesticidas (16,5%) e medicamentos (10,8%) como principais agentes. Casos com animais apresentaram tendências de aumento significativas (R2 = 0,682; p = 0,03; ß1 = 1,542). Tal tendência também foi observada no sexo masculino (R2 = 0,766; p = 0,001; ß1 = 1,855). Observou-se predominância de eventos envolvendo animais, pesticidas e medicamentos, com tendência de aumento significativo em casos com animais, tanto em toda população avaliada como no sexo masculino.

Human intoxication is considered an important public health problem because it produces a high socioeconomic impact, promoting avoidable costs and damages, in addition to having harmful effects on the human body. With aging, individuals are susceptible to various diseases and health problems. Among several health problems, it is important to note the toxicological events that occurred due to various circumstances, such as polypharmacy, suicide attempt, wrong medical prescription, wrong medication administration, among others, causes increasingly present in this population. This study aims at determining the profile and trend of toxicological events among older adults. A trend study was conducted with individuals aged 60 years or older that were notified by a Center for Information and Toxicological Assistance of Londrina CIATox, from 1985 to 2014. Variables were obtained from the CIATox database. Trend analysis performed using simple linear regression models. In total, 2042 cases of toxicological events were identified, predominating from 60 to 69 years (61.9%). The events were mostly accidental (69.1%) and acute (98.2%), involving animals (64.6%), pesticides (16.5%) and drugs (10.8%) as main agents. Cases with animals showed significant increase tendencies (R2 = 0.682, p = 0.03, ß1 = 1.542). This trend was also observed in males (R2 = 0.766, p = 0.001, ß1 = 1.855). There was predominance of events involving animals, pesticides and drugs, with tendency to increase in cases with animals, both among the total population and among males.

Dado que la intoxicación humana produce un alto impacto socioeconómico, con costos y daños evitables, además de tener efectos nocivos sobre el cuerpo humano, se considera este trastorno un importante problema de salud pública. Con el envejecimiento, las personas son susceptibles a diversas enfermedades y problemas de salud; entre los cuales es importante tener en cuenta los eventos toxicológicos que ocurrieron debido a diversas circunstancias, como el uso de polifarmacia, intento de suicidio, error de prescripción médica, error en la administración de medicamentos, entre otros, causas cada vez más presentes en esta población. Este estudio tuvo como objetivo determinar el perfil y la tendencia de eventos toxicológicos que ocurrieron con los ancianos. Este es un estudio de tendencias, realizado con individuos de 60 años o más, notificados por un Centro de Información y Asistencia Toxicológica (CIATox) en Londrina, de 1985 a 2014. Las variables fueron recopiladas por la base de datos CIATox; y el análisis de tendencias se realizó con el uso de modelos de regresión lineal simple. Se identificaron 2.042 casos de eventos toxicológicos en ancianos, con una predominancia de edad de 60 a 69 años (61,9%). La mayoría (69,1%) fueron casos accidentales, agudos (98,2%), involucrando animales (64,6%), pesticidas (16,5%) y medicamentos (10,8%) como principales agentes. Los eventos con animales mostraron tendencias significativas al alza (R2 = 0,682; p = 0,03; ß1 = 1,542). Esta tendencia también se observó en varones (R2 = 0,766; p = 0,001; ß1 = 1,855). Hubo un predominio de eventos que involucraron animales, pesticidas y medicamentos, con una tendencia a un aumento significativo en los casos con animales, tanto en toda la población evaluada como en el sexo masculino.

[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.

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

Resumo 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.

Abstract 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.

Irrational use of alendronate sodium by the elderly / Uso irracional de alendronato de sódio por idosos / Uso irracional de alendronato de sodio en los ancianos

Introduction: The effectiveness and safety of alendronate sodium are dependent on patient adherence to very specific guidelines regarding use. This study aims to estimate the rational use of alendronate sodium in the elderly. Methods: This is a cross-sectional study carried out with a structured questionnaire containing form of use and occurrence of adverse events related to alendronate sodium. The patients were recruited in their own homes. Rational use was considered as being the participants who: a) took the tablet in the morning; b) were fasting; c) waited at least 30 minutes before eating; d) ingested with a full glass of water; e) ingested the whole tablet; f) and remained in the orthostatic position for at least 30 minutes after use. Additionally, the odds ratio (OR) was used to analyze the association between the irrational use of alendronate sodium and the independent variables. Results and Discussion: Of the 248 participants in the study, most of the participants administered the medication in the morning (95.2%), with fasting (89.1%), waited at least 30 minutes to eat the first meal of the day (87.9%), and were in the orthostatic position until the time of the first meal (78.6%), but less than half ingested the tablet with a full glass of water (43.6%). Rational use of the medication was observed in only 30.7% of the participants. Regarding possible adverse events, 13.3% of the participants reported some event. Among the most prevalent were dry cough (6.5%), stomach pain (5.2%) and some throat discomfort (4.8%). The irrational use of this medication is associated with age and education level. Conclusion: The prevalence of irrational use of alendronate sodium in the elderly is high, and this use is associated with patients' sociodemographic factors.

Introdução: A efetividade e segurança do alendronato de sódio são dependentes da adesão dos pacientes em relação às orientações específicas sobre o uso. Assim, este trabalho, tem como objetivo estimar a racionalidade de uso do alendronato de sódio em idosos. Metodologia: Trata-se de um estudo transversal realizado através de um questionário estruturado contendo a forma de utilização e a ocorrência de eventos adversos relacionados ao uso do medicamento. Os pacientes foram recrutados em suas próprias casas. Considerou-se uso racional os participantes que: a) tomaram o comprimido pela manhã; b) em jejum; c) esperaram pelo menos 30 minutos para se alimentar; d) ingeriu com um copo cheio de água; e) ingeriu o comprimido inteiro; f) e permaneceu na posição ortostática por pelo menos 30 minutos após o uso. Adicionalmente, o odds ratio (OR) foi utilizado para analisar associação entre o uso irracional do alendronato de sódio e as variáveis independentes. Resultados e Discussão: Dos 248 participantes do estudo a maioria administravam o medicamento pela manhã (95,2%), em jejum (89,1%), aguardavam pelo menos 30 minutos para realizar a primeira refeição do dia (87,9%), ficavam em posição ortostática até o horário da primeira refeição (78,6%), porém menos da metade ingeria o comprimido com um copo cheio de água (43,6%). O uso racional do medicamento foi observado em apenas 30,7% dos participantes. Em relação aos possíveis eventos adversos, 13,3% dos participantes relataram algum evento. Dentre os mais prevalentes, destacaram-se a tosse seca (6,5%), dor de estômago (5,2%) e algum desconforto na garganta (4,8%). O uso irracional deste medicamento está associado à idade e ao nível de escolaridade. Conclusão: É elevada a prevalência de uso irracional do alendronato de sódio em idosos e este uso está associado a fatores sociodemográficos dos pacientes.

Introducción: La eficacia y seguridad del alendronato sódico dependen de la adherencia de los pacientes en relación con directrices específicas sobre el uso. Por lo tanto, este trabajo tiene como objetivo estimar la racionalidad del uso del alendronato sódico en los ancianos. Metodos: Este es un estudio transversal realizado a través de un cuestionario estructurado que contiene la forma de uso y la ocurrencia de eventos adversos relacionados con el uso de la droga. Los pacientes fueron reclutados en sus propios habitación. Se consideró el uso racional como los participantes que: a) tomaron la tableta por la mañana, b) en ayuno, c) esperaron al menos 30 minutos antes de comer; d) Ingerido con un vaso lleno de agua; e) ingirió toda la tableta, f) y permaneció en la posición ortostática durante al menos 30 minutos después de su uso. Además, el odds ratio (OR) se utilizó para analizar la asociación entre el uso irracional de alendronato de sodio y las variables independientes. Resultados y Discusión: De los 248 participantes en el estudio, la mayoría administró el medicamento por la mañana (95,2%), em ayuno (89,1%), esperó al menos 30 minutos para realizar la primera comida del día (87,9%), estaban en posición ortostática hasta el momento de La primera comida (78,6%), pero menos de la mitad ingeriría el comprimido con un vaso lleno de agua (43,6%). El uso racional de la droga se observó en sólo 30.7% de los participantes. En cuanto a los posibles acontecimientos adversos, el 13,3% de los participantes informaron de algún evento. Entre los más frecuentes, tos seca (6,5%), dolor de estómago (5,2%) Y algunas molestias en la garganta (4,8%). El uso irracional del medicamento está asociado a la ida y al nivel de escolaridad. Conclusión: La prevalencia del uso irracional del alendronato de sodio en los ancianos es alta, y este uso está asociado a factores sociodemográficos de los pacientes.