Free-running circadian rhythms of muscle strength, reaction time, and body temperature in totally blind people.

Light is the major synchronizer of circadian rhythms. In the absence of light, as for totally blind people, some variables, such as body temperature, have an endogenous period that is longer than 24 h and tend to be free running. However, the circadian rhythm of muscle strength and reaction time in totally blind people has not been defined in the literature. The objective of this study was to determine the period of the endogenous circadian rhythm of the isometric and isokinetic contraction strength and simple reaction time of totally blind people. The study included six totally blind people with free-running circadian rhythms and four sighted people (control group). Although the control group required only a single session to determine the circadian rhythm, the blind people required three sessions to determine the endogenous period. In each session, isometric strength, isokinetic strength, reaction time, and body temperature were collected six different times a day with an interval of at least 8 h. The control group had better performance for strength and reaction time in the afternoon. For the blind, this performance became delayed throughout the day. Therefore, we conclude that the circadian rhythms of strength and simple reaction time of totally blind people are within their free-running periods. For some professionals, like the blind paralympic athletes, activities that require large physiological capacities in which the maximum stimulus should match the ideal time of competition may result in the blind athletes falling short of their expected performance under this free-running condition.

Actigraphic characterization of sleep and circadian phenotypes of PER3 gene VNTR genotypes.

The molecular circadian timing system involves genes known as "clock genes," such as the PER3 gene. Studies have demonstrated associations among a repeat polymorphism (VNTR) of the PER3 gene with chronotypes, with the occurrence of circadian rhythm disorders and with sleep homeostasis phenotypes. The aim of this study was to investigate, by actigraphy, sleep and circadian rhythm profiles of people with different genotypes for the VNTR polymorphism of the PER3 gene. We genotyped 467 individuals (46,39% male) for the PER3 VNTR polymorphism. The mean age of the participants was 21.84 ± 2.64, ranging from 18 to 30 y old. Actigraphy data were collected from a subsample of 81 subjects with PER3 4-repeats homozygous (PER34/4) or 5-repeats homozygous (PER35/5) genotypes from April to June of 2021. From this sample, 48 PER34/4 and 33 PER35/5 subjects wore a wrist actigraph between 12 and 19 d. The sleep onset (weekdays, p = 0.015; weekend, p = 0.022) and offset (weekdays, p = 0.004; weekend, p = 0.041) of the PER35/5 group occurred later than the PER34/4 group. Similar results were observed for the mid-sleep phase of weekdays (MSW) (p = 0.008) and free days (MSF) (p = 0.019), and for the mid-sleep phase corrected for sleep debt accumulated over the week (MSFsc) (p = 0.024). Despite the phase differences found between the PER34/4 and PER35/5 groups, no differences were found in sleep duration and social jet lag. However, the PER34/4 group presented, on average, a longer sleep rebound on the days off when compared to the PER35/5 (p = 0.002). The PER35/5 group showed lower interdaily stability (IS) (p = 0.032) and higher daily activity rhythm variability (IV) (p = 0.035). The findings of the present study revealed associations between the PER3 gene, sleep, and circadian rhythms. In general, we found that the gene is associated with the expression of sleep timing and duration and to the phase of the activity rhythm. The experiments carried out here occurred in the COVID-19 pandemic scenario, which should be considered as an environmental element with potential effects on the results obtained.

Isokinetic hamstrings-to-quadriceps peak torque ratio: the influence of sport modality, gender, and angular velocity.

The purpose of this study was to determine differences in hamstrings-to-quadriceps (H/Q) peak torque ratios evaluated at different angular velocities between men and women who participate in judo, handball or soccer. A total of 166 athletes, including 58 judokas (26 females and 32 males), 39 handball players (22 females and 17 males), and 69 soccer players (17 females and 52 males), were evaluated using an isokinetic dynamometer. The H/Q isokinetic peak torque ratios were calculated at angular velocities of 1.05 rad · s⁻¹ and 5.23 rad · s⁻¹. In the analysis by gender, female soccer players produced lower H/Q peak torque ratios at 1.05 rad · s⁻¹ than males involved in the same sport. However, when H/Q peak torque ratio was assessed at 5.23 rad · s⁻¹, there were no significant differences between the sexes. In the analysis by sport, there were no differences among females at 1.05 rad · s⁻¹. In contrast, male soccer players had significantly higher H/Q peak torque ratios than judokas (66 ± 12% vs. 57 ± 14%, respectively). Female handball players produced significantly lower peak torque ratios at 5.23 rad · s⁻¹ than judokas or soccer players, whereas males presented no ratio differences among sports At 5.23 rad · s⁻¹. In the analysis by velocity, women's muscular ratios assessed at 1.05 rad · s⁻¹ were significantly lower than at 5.23 rad · s⁻¹ for all sports; among men, only judokas presented lower ratios at 1.05 rad · s⁻¹ than at 5.23 rad · s⁻¹. The present results suggest that sport modality and angular velocity influence the isokinetic strength profiles of men and women.

Association between light exposure and metabolic syndrome in a rural Brazilian town.

CONTEXT: Metabolic syndrome (MetS) is a complex condition comprising a 'clustering' of components representing cardiometabolic risk factors for heart disease and diabetes; its prevalence rate is high and consequences serious. Evidence suggests that light exposure patterns and misalignment of circadian rhythms might contribute to MetS etiology by impacting energy metabolism and glucose regulation. OBJECTIVE: We hypothesised that individuals with MetS would show disrupted circadian and sleep parameters alongside differences in light exposure profiles. We investigated this using data from a cohort study in Brazil. METHODS: Data from 103 individuals from the Baependi Heart Cohort Study aged between 50 and 70 were analysed. Motor activity and light exposure were measured using wrist-worn actigraphy devices. Cardiometabolic data were used to calculate the number of MetS components present in each participant, and participants grouped as MetS/non-MetS according to standard guidelines. Between-group comparisons were made for the actigraphy measures; additionally, correlation analyses were conducted. RESULTS: Motor activity and circadian profiles showed no differences between groups. However, the MetS group presented lower light exposure during the day and higher light exposure at night. Correlation analyses, including all participants, showed that greater daytime light exposure and greater light exposure difference between day and night were associated with reduced MetS risk (a lower number of MetS components). Also, the light exposure difference between day and night correlated with body mass index across all participants. CONCLUSIONS: The observed results suggest a direct association between light exposure and MetS which appears to not be attributable to disruptions in circadian activity rhythm nor to sleep parameters. This link between light exposure patterns and MetS risk could inform possible prevention strategies.

Evaluation of Siddha Samadhi Yoga for anxiety and depression symptoms: a preliminary study.

Siddha Samadhi Yoga is a program in which meditation is associated with pranayama (breathing exercises). 22 volunteers with anxiety complaints (M age = 42.8 yr., SD = 10.3) were assigned to two groups: 14 attended the yoga group, and 8 attended a waiting-list or control group. They were evaluated before the intervention and 1 month after it on the State-Trait Anxiety Inventory, the Beck Depression Inventory, Tension Feelings Self-evaluation Scales, and the Well-being Self-evaluation Scales. A significant reduction in scores on anxiety, depression, and tension was found in yoga group, as well as an increase in well-being in comparison with the control group.

Seasonal variation of suicide in Brazil.

Most of what is known about the seasonal variation in suicide rate originates from studies conducted in the northern hemisphere; very few studies have been done in the southern hemisphere. The purpose of the present study was to explore the possibility that in Brazil, the seasonal variation of suicides is a function of photoperiod. This was accomplished by analyzing monthly suicide data for a 12 yr period (1979 to 1990), within latitudes ranging from 2 degrees N to 33 degrees S. Single cosinor analyses with periods of 12 or 6 months were applied to time series of monthly total and suicidal deaths, separated by gender and state. Significant spring or early summer peaks of suicide were found only in the south of Brazil for both men and women, except for the latter in one state. These peaks did not coincide with those found for total deaths, which occurred in the autumn or winter in all areas. No significant six-month period was found. In the present study, the chance of a suicide was typically 10-17% higher during the peak period than during the other months of the year. Although this moderate seasonal effect might not be sufficient to justify planning large scale prophylactic interventions, those dealing with patients who have suicide ideation should be aware of this high risk time.

Clock polymorphisms and circadian rhythms phenotypes in a sample of the Brazilian population.

A Clock polymorphism T to C situated in the 3' untranslated region (3'-UTR) has been associated with human diurnal preference. At first, Clock 3111C had been reported as a marker for evening preference. However these data are controversial, and data both corroborating and denying them have been reported. This study hypothesizes that differences in Clock genotypes could be observed if extreme morning-type subjects were compared with extreme evening-type subjects, and the T3111C and T257G polymorphisms were studied. The possible relationship between both polymorphisms and delayed sleep phase syndrome (DSPS) was also investigated. An interesting and almost complete linkage disequilibrium between the polymorphisms T257G in the 5' UTR region and the T3111C in the 3' UTR region of the Clock gene is described. Almost always, a G in position 257 corresponds to a C in position 3111, and a T in position 257 corresponds to a T in position 3111. The possibility of an interaction of these two regions in the Clock messenger RNA structure that could affect gene expression was analyzed using computer software. The analyses did not reveal an interaction between those two regions, and it is unlikely that this full allele correspondence affects Clock gene expression. These results show that there is no association between either polymorphism T3111C or T257G in the Clock gene with diurnal preference or delayed sleep phase syndrome (DSPS). These controversial data could result from the possible effects of latitude and clock genes interaction on circadian phenotypes.

Sleep on the job partially compensates for sleep loss in night-shift nurses.

Nursing personnel in Brazil are usually submitted to fixed 12 h shifts with no consecutive working days or nights. Moonlighting is common in this group, with a consequent increase in the number of working hours. The possibility of sleeping on the job during the night shift in the studied hospitals had already been described. The present study aims to analyze whether the time devoted to daily activities (sleep, rest, leisure, housework, commuting, personal needs, care of children or other people, non-paid work, and study) is related to the number of worked hours and to nap-taking during the night shift. The field study took place at two public hospitals in Rio de Janeiro, Brazil. Workers filled out a structured form on time devoted to the above-mentioned activities for at least four consecutive days. The time devoted to sleep was analyzed according to its occurrence at home or on the job. Workers were classified according to the number of jobs (one job/two jobs) and the time dedicated to work according to the median of the whole series (below the median/above the median). All workers who had at least one working night were analyzed as to nap-taking on the job. They were classified according to the sleep occurrence during the night shift-the sleep group and the non-sleep group, both of which were compared to daytime workers. Statistical treatment of data included non-parametrical procedures. The study group comprised 144 workers (mean age: 35.7+/-10.5 years old; 91% women; 78% nurse assistants, the remainder registered nurses). They recorded their daily activities for 4-11 days; 829 cumulative days were analyzed for the whole group. A total of 165 working nights were analyzed; sleep or rest occurred during 112 (68%) of them, with mean sleep/rest duration of 141+/-86 min. Time devoted to sleep and leisure varied according to the number of working hours, being significantly reduced in those submitted to longer work hours (p < 0.001 and p = 0.002, respectively). Results close to significance point to a reduction in the time dedicated to housework among workers with long work hours (p = 0.053). The time spent on sleep/rest per working night did not differ according to the number of worked hours (p = 0.490). A tendency was observed for those who have two jobs to devote more time to sleep/rest on the job (p = 0.058). The time of personal needs was significantly lower among those who did not sleep on the job as compared to day workers (p = 0.036). The total sleep time was significantly lower among those who did not sleep on the job, as compared to day workers and to those who slept on the job (p = 0.004 and p = 0.05, respectively). As to home sleep length, workers who slept and those who did not sleep on the job were similar and slept significantly less than exclusively daytime workers (p < 0.001 and p = 0.002, respectively). Sleeping on the job during the night shift seems to partially compensate for the shorter sleep at home among night workers and may play a beneficial effect in coping with two jobs.

Effect of fatigue caused by a simulated handball game on ball throwing velocity, shoulder muscle strength and balance ratio: a prospective study.

BACKGROUND: Arm throwing represents a deciding element in handball. Ball velocity, aim accuracy, and dynamic stability of the shoulder are factors that influence throwing effectiveness. The purpose of this study was to examine the influence of muscle fatigue caused by simulated game activities (SGA) on shoulder rotational isokinetic muscle strength, muscle balance and throwing performance, and to examine the relationship between muscle strength and throwing performance. METHODS: Ten national elite adult handball athletes were evaluated. Isokinetic internal (IR), external (ER) rotators peak torque, and balance ratio were measured before and after SGA. Ball throwing velocity was assessed by radar gun. RESULTS: Both internal (IR) and external (ER) rotators peak torque were significantly lower after SGA (p = 0.0003 and p = 0.02, respectively). However, the deleterious effect was more evident for IR than ER muscles (effect size r = 0.39 and r = 0.18, respectively). Balance ratio before and after SGA did not differ (p = 0.06). Ball throwing velocity was not impaired by SGA. Moreover, isokinetic variables correlated positively with ball velocity (r ≥ 0.67). CONCLUSIONS: SGA affected the muscle strength of IR more than ER, predisposing the shoulder joint to muscular imbalance. The muscular impairment after SGA was insufficient to impair ball throwing velocity.

Physiological variation in plasma total homocysteine concentrations in rats.

Hyperhomocysteinemia was initially related to cardiovascular diseases; but homocysteine (Hcy) metabolism disturbances have more recently associated with a wide range of pathophysiological conditions including age-related diseases, disrupted circadian rhythms and gynaecological disorders. Since in many cases we do not know to what extent animal models are physiologically similar to human ones, this study aimed to track spontaneous variations in rat plasma Hcy concentrations during different physiological processes such as life cycle, 24 hours and estrous cycle. Plasma total Hcy concentrations were accessed by HPLC. Plasma Hcy concentration varied with age and newborns had the lowest values (2.94 +/- 0.47 micromol/L). Rats aged 10 days presented concentration similar to 3 month old animals (6.87 +/- 0.67 and 8.29 +/- 1.55 micromol/L respectively). Values decreased to 6.42 +/- 1.65 micromol/L at 6 months and 4.87 +/- 0.81 micromol/L at 28 months. Concerning circadian variations in Hcy concentration cosinor analysis showed acrophase in young rats at 1:09 pm, but no plasma Hcy circadian variations in aged rats. Female rats showed changes in Hcy concentration during the estrous cycle with higher values during the diestrous I (10.61 +/- 1.81 micromol/L) compared with the estrous (8.47 +/- 1.86 micromol/L) and diestrous II (7.68 +/- 1.58 micromol/L) phases. In conclusion, plasma Hcy concentration varied spontaneously with ontogenic development and during the estrous cycle and presented a circadian rhythm variation in young rats.

Workplace exercise and educational program for improving fitness outcomes related to health in workers: a randomized controlled trial.

OBJECTIVE: To investigate the effects of a workplace fitness and education program intervention on physical fitness of workers. METHODS: Employees from a chemical plant (n = 60) participated in a 4-month longitudinal study. They were randomly distributed in control and experimental groups. The experimental group had 4 months of exercise training in 15-minute sessions. The following evaluations were performed before and after the training period: body composition, localized muscle strength, and flexibility. RESULTS: The experimental group showed a significant decrease in body fat (24.7%) and a significant increase in lean mass (6.1%), flexibility (17.9%), sit-up test performance (39.8%), and push-up test performance (29.8%) after the workplace fitness and education program compared with initial values. CONCLUSIONS: A structured program of physical exercise was effective in improving body composition, abdominal strength, upper limb strength, and flexibility in workers.

The effect of combined therapy (ultrasound and interferential current) on pain and sleep in fibromyalgia.

Multidisciplinary treatment has proven to be the best therapeutic option to fibromyalgia (FM) and physiotherapy has an important role in this approach. Considering the controversial results of electrotherapy in this condition, the aim of this study was to assess the effects of combined therapy with pulsed ultrasound and interferential current (CTPI) on pain and sleep in FM. Seventeen patients fulfilling FM criteria were divided into two groups, CTPI and SHAM, and submitted to pain and sleep evaluations. Pain was evaluated by body map (BM) of the painful areas; quantification of pain intensity by visual analog scale (VAS); tender point (TP) count and tenderness threshold (TT). Sleep was assessed by inventory and polysomnography (PSG). After 12 sessions of CTPI or SHAM procedure, patients were evaluated by the same initial protocol. After treatment, CTPI group showed, before and after sleep, subjective improvement of pain in terms of number (BM) and intensity (VAS) of painful areas (P<0.001, both); as well as objective improvement, with decrease in TP count and increase in TT (P<0.001, both). Subjective sleep improvements observed after CTPI treatment included decrease in morning fatigue and in non-refreshing sleep complaint (P<0.001, both). Objectively, PSG in this group showed decrease in sleep latency (P<0.001) and in the percentage of stage 1 (P<0.001), increase in the percentage of slow wave sleep (P<0.001) and in sleep cycle count (P<0.001). Decrease in arousal index (P<0.001), number of sleep stage changes (P<0.05) and wake time after sleep onset (P<0.05), were also observed and no difference regarding pain or sleep parameters were verified after SHAM procedure. This study shows that CTPI can be an effective therapeutic approach for pain and sleep manifestations in FM.

Further validation of actigraphy for sleep studies.

STUDY OBJECTIVES: Actigraphy is generally compared to polysomnography (PSG), which has been considered the gold standard for sleep studies. The objective of the present study was to evaluate the concordance between PSG and two previously proposed algorithms (Cole et al, 1992; Sadeh et al, 1994) to analyze actigraphic recordings. The minute-by-minute agreement rate was evaluated through calculation of sensitivity, specificity, and accuracy. Regarding the sleep parameters, the concordance was performed through the Bland and Altman technique. DESIGN: A night of adaptation to the sleep laboratory followed by simultaneous polysomnographic and actigraphic recordings throughout the night. PARTICIPANTS: 21 healthy volunteers. SETTING: A sleep laboratory INTERVENTIONS: None. RESULTS: Ninety-one percent of all PSG epochs were correctly identified by both algorithms, and this accuracy is reasonably satisfactory. The actigraphy was a sensitive method, with values of 99% and 97% for Cole's and Sadeh's algorithms, respectively. However, actigraphy had a low specificity: 34% and 44% for Cole's and Sadeh's algorithms, respectively. The Bland and Altman technique showed that actigraphy systematically overestimated Sleep Latency, Total Sleep Time and Sleep Efficiency while it underestimated Intermittent Awakenings. CONCLUSIONS: The results of this study show the utility of actigraphy as a useful method for assessment of sleep, despite its limitations regarding identification of waking epochs during sleep. The Bland and Altman concordance technique was revealed to be a powerful tool to evaluate how well actigraphy agreed with polysomnography. This technique, combined with calculations of sensitivity and specificity, appears to be the most adequate procedure for the assessment of concordance.

Sleep deprivation induced by the modified multiple platform technique: quantification of sleep loss and recovery.

Vigilance status was continually monitored in socially stable groups of rats exposed to the modified multiple platform (MMP) technique for sleep deprivation. For comparison, sleep parameters were also monitored in socially isolated rats deprived of sleep by the single platform (SP) method. In all cases, sleep was continuously recorded during baseline, during 96 h of sleep deprivation and during 4 days of recovery. Both multiple- and single-platform techniques completely abolished paradoxical sleep (PS) during the deprivation period, but also resulted in significant decreases in slow wave sleep (SWS) (-31% and -37%, respectively). Unexpectedly, animals on large platforms, which are normally intended as controls, also showed significant reductions in PS and SWS, and these effects were more pronounced in rats deprived in groups than in animals deprived in isolation. Another control preparation, rats placed on wire-mesh grids in the deprivation tank, also showed PS reduction (-39%) but no loss of SWS during the 4 test days. Paradoxical sleep rebound was observed in the first 24 h in all groups, except for grid controls. Overall, no significant differences were found between single- and multiple-platform procedures during the 4 days of deprivation. However, sleep rebound was more pronounced in MMP-deprived rats than in SP-deprived rats. Sleep loss in both control groups may reflect residual effect of stress that remain in the platform technique. These findings indicate that the MMP technique is effective in inducing PS deprivation (PSD). However, the fact that SWS is also affected may have implications for conclusions on paradoxical sleep function based upon paradoxical sleep deprivation.

The influence of acute hypoxic exposure on isokinetic muscle force production.

To investigated whether an acute hypoxic stimulus affects muscle strength development assessed by isokinetic dynamometry during maximal knee extension. A total of 15 healthy young men participated in this study (61.9 ± 6.1 kg; 1.72 ± 0.08 m; 20.9 ± 2.6 years). We evaluated knee extension and flexion isokinetic dynamometer performance in normoxic and hypoxic conditions. The analyzed parameters, for concentric contraction, were peak torque and total work measured at 1.05 and 5.23 rad/s; and fatigue index measured at 5.23 rad/s. During isokinetic testing, heart rate and oxygen saturation (SpO2) were monitored. Hypoxic conditions (3,600 m) were simulated, via a mixing chamber, with the dilution being constantly controlled by a PO2 probe. Test reproducibility results (test-retest) for all isokinetic knee parameters were classified as moderate to almost perfect (ICC = 0.694 to 0.932). SpO2 was 88.4 ± 3.4% in the hypoxic condition and 97.1 ± 0.7% in the normoxic condition (p = 0.000, effect size = 0.87). Heart rate was not significantly different between normoxic and hypoxic conditions at the end of the test. There were no significant differences in isokinetic variables evaluated for the extensor and flexor muscles at concentric contraction between the normoxic and hypoxic conditions. Our findings indicate that reduced arterial oxygenation per se has no effect on the muscular isokinetic strength of the knee extensors.

Influence of maternal height and weight on low birth weight: a cross-sectional study in poor communities of northeastern Brazil.

BACKGROUND: Low birth weight (LBW) is associated with an increased risk of mortality, adverse metabolic conditions, and long-term chronic morbidities. The relationship between LWB and short maternal stature coupled with nutritional status was investigated in poor communities. METHODS/PRINCIPAL FINDINGS: A cross-sectional population-based study involving 2226 mother-child pairs was conducted during the period 2009-2010 in shantytowns of Maceió, Alagoas, Brazil. Associations between LBW and maternal sociodemographics, stature and nutritional status were investigated. The outcome variable was birth weight (< 2500 g and ≥ 2500 g). The independent variables were the age, income, educational background, stature and nutritional status (eutrophic, underweight, overweight and obese) of the mother. The frequency of LBW was 10%. Short-statured mothers (1(st) quartile of stature ≤ 152 cm) showed a tendency of increased risk of LBW children compared to mothers in the 4(th) quartile of stature (>160.4 cm) (OR: 1.42, 95% CI: 0.96 - 1.09, p = 0.078). Children from short-statured mothers weighed an average of 125 g less than those from taller mothers (3.18 ± 0.56 kg vs. 3.30 ± 0.58 kg, respectively p = 0.002). Multivariate analyses showed that short stature, age < 20 y (OR: 3.05, 95% CI:1.44 - 6.47) or were underweight (OR: 2.26, 95% CI:0.92 - 5.95) increased the risk of LBW, while overweight (OR: 0.38, 95% CI:0.16 - 0.95) and obesity (OR: 0.39, 95% CI:0.11 - 1.31) had lower risk for LBW. In taller mothers, lower income and underweight were associated with LBW (OR: 1.88, 95% CI: 1.07 - 3.29 and 2.85, 95% CI:1.09 - 7.47, respectively), and obese mothers showed a trend of increased risk of LBW (OR: 1.66, 95% CI:0.84 - 3.25). CONCLUSIONS/SIGNIFICANCE: Overweight was found to have a protective effect in short-statured mothers, indicating that a surplus of energy may diminish the risk of LBW. Short-statured younger mothers, but not taller ones, showed higher risk of LBW. The mother being underweight, regardless of stature, was associated with LBW.

Profiling the isokinetic shoulder rotator muscle strength in 13- to 36-year-old male and female handball players.

OBJECTIVES: To evaluate the external (ER) and internal rotator (IR) muscles' isokinetic peak torque and conventional and functional strength ratios in handball players and controls of different ages. DESIGN: Cross-sectional and descriptive analysis. SETTING: Exercise Physiology Laboratory. PARTICIPANTS: A total of 228 participants (108 athletes and 120 controls) were divided into five groups according to age, ranging from 13 to 36 years old. MAIN OUTCOME MEASURES: Isokinetic tests were performed concentrically at 60 and 300 deg s(-1) and eccentrically at 300 deg s(-1). RESULTS: The differences between the athletes and controls regarding the peak torque of the ER and IR muscles were significant in males older than 18 years. The peak torque of the IR and ER muscles increased significantly across age in male athletes, but not in female athletes, except in the case of ER peak torque, which differed significantly between 13 and 16 years old. The female athletes presented higher conventional ratios (0.81 ± 0.07) than males (0.66 ± 0.08). Values represent means and standard deviations. Athletes and controls showed mean functional strength ratios below 1.0. CONCLUSIONS: Although there were no muscular ratio differences between the athletes and the controls, their ratio values were below the literature-recommended reference values to prevent shoulder injuries.

Knowledge about epilepsy among health professionals: a cross-sectional survey in Sao Paulo, Brazil.

OBJECTIVE: To evaluate the epilepsy knowledge among health professionals in São Paulo, Brazil. DESIGN: This is a cross-sectional study. PARTICIPANTS: Professionals with academic degrees in physical education (n=134), nutrition (n=116), medicine (n=100), psychology (n=53), nursing (n=122) and physiotherapy (n=99) who lived in São Paulo City, Brazil. PRIMARY AND SECONDARY OUTCOME MEASURES: Knowledge of health professionals about epilepsy. METHODS: Professionals with academic degrees in physical education (n=134), nutrition (n=116), medicine (n=100), psychology (n=53), nursing (n=122) and physiotherapy (n=99) who lived in São Paulo City, Brazil, were invited to participate in the study. The subjects (n=624) answered a questionnaire composed of 25 simple closed-ended questions from three areas: personal, educational and knowledge. RESULTS: Out of all subjects, 88.5% (n=552) had a postgraduate education, while 11.5% (n=72) had only an undergraduate degree. The authors found that physical educators, nutritionists and physiotherapists received lower scores on their epilepsy knowledge than other health professionals. CONCLUSIONS: Health professionals are considered better-educated group inside the society, especially with regards to healthcare issues. Thus, it is important they also have an accurate and correct knowledge about epilepsy. The findings of the present study indicate an imperative improvement in education about epilepsy, as well as an inclusion of formal programmes for epilepsy education especially for non-medical professionals. An improvement in epilepsy education might contribute to an improvement in epilepsy care and management.

Mild stunting is associated with higher body fat: study of a low-income population.

OBJECTIVE: To test if individuals having height-for-age z scores between -2 and -1 present higher body fat percentage and, therefore, should not be categorized as having normal nutritional status. METHODS: The study involved 96 individuals (52 boys and 44 girls); 57% of whom had already attained puberty. Body composition was analyzed by dual energy X-ray absorptiometry. RESULTS: The percentage of abdominal body fat in pre-pubertal stunted girls was higher (27.4%; p = 0.01) in comparison with their non-stunted counterparts (20.6%). Similar differences in abdominal fat content (%) were observed for pubertal stunted and non-stunted girls and boys (37.6 and 29.8%, respectively, p = 0.01; 24.6 and 15.7%, p = 0.01, respectively). The percentages of total body fat percent in pre-pubertal stunted girls and pubertal stunted boys (29.9 and 24.5%, p = 0.03; 26.3 and 18.1%, p = 0.01, respectively) were higher than those of their non-stunted counterparts. Non-stunted groups showed lower waist circumferences. CONCLUSION: Adolescents with mild stunting exhibit alterations in body composition indicating increased risk of metabolic diseases.

Increasing trends of sleep complaints in the city of Sao Paulo, Brazil.

OBJECTIVE: The aim of this study was to compare the prevalence of sleep habits and complaints and to estimate the secular trends through three population-based surveys carried out in 1987, 1995, and 2007 in the general adult population of the city of Sao Paulo, Brazil. METHODS: Surveys were performed using the same three-stage cluster-sampling technique in three consecutive decades to obtain representative samples of the inhabitants of Sao Paulo with respect to gender, age (20-80 years), and socio-economic status. Sample sizes were 1000 volunteers in 1987 and 1995 surveys and 1101 in a 2007 survey. In each survey, the UNIFESP Sleep Questionnaire was administered face-to-face in each household selected. RESULTS: For 1987, 1995, and 2007, respectively, difficulty initiating sleep (weighted frequency %; 95% CI) [(13.9; 11.9-16.2), (19.15; 16.8-21.6), and (25.0; 22.5-27.8)], difficulty maintaining sleep [(15.8; 13.7-18.2), (27.6; 24.9-30.4), and (36.5; 33.5-39.5)], and early morning awakening [(10.6; 8.8-12.7), (14.2; 12.2-16.5), and (26.7; 24-29.6)] increased in the general population over time, mostly in women. Habitual snoring was the most commonly reported complaint across decades and was more prevalent in men. There was no statistically significant difference in snoring complaints between 1987 (21.5; 19.1-24.2) and 1995 (19.0; 16.7-21.6), but a significant increase was noted in 2007 (41.7; 38.6-44.8). Nightmares, bruxism, leg cramps, and somnambulism complaints were significantly higher in 2007 compared to 1987 and 1995. All were more frequent in women. CONCLUSIONS: This is the first study comparing sleep complaints in probabilistic population-based samples from the same metropolitan area, using the same methodology across three consecutive decades. Clear trends of increasing sleep complaints were observed, which increased faster between 1995 and 2007 than from 1987 to 1995. These secular trends should be considered a relevant public health issue and support the need for development of health care and educational strategies to supply the population's increased need for information on sleep disorders and their consequences.