Tuberculosis Containment among the Homeless in Metropolitan Jackson, Mississippi.

IMPORTANCE: Preventing tuberculosis among the homeless has emerged as an especially difficult challenge. OBJECTIVES: We assessed a 2008-2009 tuberculosis (TB) outbreak ad subsequent prevention strategies among homeless persons in metropolitan Jackson, Hinds County, Mississippi. DESIGN, SETTING AND PARTICIPANTS: We compared data about cases and subclinical TB infections (LTBI) among homeless persons during the outbreak and post-outbreak years, interviewed involved homeless persons, compiled observations from visits to Jackson homeless shelters and conducted literature reviews on homelessness and infectious diseases. We reviewed homeless shelter TB prevention methods adopted by other municipalities, guidelines developed by the Centers for Disease Control and Prevention (CDC), and recommendations from other official and ad hoc groups and considered their applicability to metropolitan Jackson. MAIN OUTCOMES AND MEASURES: The Mississippi State Department of Health TB Program assisted by the CDC and other agencies, contained the Jackson-area outbreak by the end of 2009 as reflected by progressively lower TB rates among homeless persons thereafter. However, some follow-up activities and enforcement of shelter preventive measures have not been consistently maintained. Resources to prevent further outbreaks continue to be inadequate, and over-reliance on private organizations has continued. In the process, appreciation of the dynamic interaction enhancing TB risk among the homeless and incarcerated persons has emerged. RESULTS: Major outbreak contributors were lack of periodic TB screening among homeless shelter clients, preventive treatment compliance and follow-up difficulties among those with subclinical tuberculosis infections, interrupted preventive measures among infected persons incarcerated in local correctional facilities who disproportionately re-join Jackson's homeless community when released, inadequate attention to shelter environmental preventive strategies such as ultraviolet light germicidal irradiators and proper air-exchange/ventilation, costs of isolation housing for homeless people with full-blown tuberculosis (especially those co-infected with HIV and other infections and those with alcohol and/or other chemical dependencies), lack of adequate transportation which impacts access to evaluation and care, lack of mandated ongoing training among shelter and correctional facility staff, and inadequate attention to the societal problem of homelessness itself. CONCLUSIONS: Sustained adherence to local shelter and correctional facility TB prevention measures based on standards and policies proved effective in other settings is most crucial. These include requirements for periodic tuberculosis prevention and awareness training for shelter and correctional facility staff, ongoing tuberculosis screening and follow-up among homeless shelter clients and inmates of local correctional facilities, and attention to shelter and correctional facility environmental sanitation, proper ventilation, ultraviolet light fixtures and capacity/bed alignment standards.

Leisure-Time Physical Activity in a Southern Brazilian City (2004-2021): Applying an Equity Lens to Time-Trend Analyses.

BACKGROUND: This study aimed to verify leisure-time physical activity trends over 15 years and monitor inequalities according to gender, self-reported skin color, and socioeconomic position in a Southern Brazilian city. A secondary aim is to evaluate intersectionalities in physical activity. METHODS: Trend analysis using 3 population-based surveys carried out in 2004, 2010, and 2021. Main outcome assessed was the prevalence of physical activity according to recommendations (150 min/wk). Inequalities dimensions measured were sex, self-reported skin color, and wealth. Intersectionalities were evaluated using Jeopardy index combining all inequality dimensions. Trend analysis was performed using least-squares weighted regression. RESULTS: We included data from 3090, 2656, and 5696 adults in 2004, 2010, and 2021, respectively. Prevalence of physical activity remains stable around 25% in the 3 years. In the 3 periods evaluated, men presented a prevalence in average 10 percentage points higher than women (SII2004 = -11.1 [95% confidence interval, CI, -14.4 to -7.8], SII2021 = -10.7 [95% CI, -13.7 to -7.7]). Skin color inequalities did not present a clear pattern. Richest individuals, in general presented a prevalence of leisure-time physical activity level 20pp higher than poorest ones (SII2004 = 20.5 [95% CI, 13.7 to 27.4]; SII2021 = 16.7 [95% CI, 11.3 to 22.0]). Inequalities were widely marked, comparing the most privileged group (represented by men, the wealthiest, and White) and the most socially vulnerable group (represented by women, the poorest, and Black/Brown). The Slope Index of Inequality for intersectionalities was -24.5 (95% CI, -31.1 to -17.9) in 2004 and -18.8 in 2021 (95% CI, -24.2 to -13.4). CONCLUSIONS: Our analysis shows that women, Black/Brown, and poor present lower leisure-time physical activity level. This group is often neglected regarding other health and social outcomes.

Examining motivation factors for African American students' use of consumer wearables.

Purpose: This study was initiated to examine factors that motivate African American students who use wearable devices at an HBCU in Mississippi. Method: We conducted a correlational research study on undergraduate and graduate students from a southern USA university. The stratified random sample comprised a total of 239 students. The responses of the students were analyzed using the Fisher exact test to determine whether or not there was a significant association between the categorical demographic variables (age, gender, ethnicity, and student classification) and the students' motivation for using a wearable device. Results: Students used wearables for one main reason, to help them increase their awareness of their health status because they understand the importance of tracking their health metrics to boost their health status and reduce risk factors for developing chronic diseases. Students also demonstrated that they understand the value of tracking health information, such as heart rate and blood pressure, as a way to reduce the prevalence and impact of risk factors that can lead to chronic diseases. Conclusions: Wearables enable individuals to regularly observe, measure, and record their physical status and physiological measures, and facilitate medication adherence by enabling individuals to maintain their prescribed medication regimen adequately. The data collected and stored through these wearables can provide data that will be useful for medical personnel in their treatment of patients and in developing strategies for prevention and intervention for the larger community.

Mississippi church leaders' perceptions of challenges and barriers to the use of consumer wearables among community members.

Background: Wearables have begun to play a transformative role in health management and disease prevention. Objective: This study examined the use of wearable devices in African American communities in Mississippi, USA, through the lens of church leaders. Methods: We conducted focus groups with church leaders to record their perceptions about the use of wearables of their community members. We conducted six focus groups with a total of 89 church leaders from across the state of Mississippi. The focus groups were designed to contextualize and explain the socio-cognitive processes that provided an understanding of wearable device adoption practices among community members. Participants were male and female church leaders who were recruited from the three Mississippi Districts. The church leaders' perceptions of barriers and challenges to the adoption of consumer wearables in their communities were thoroughly analyzed using thematic analysis. Results: There was great apprehension on the part of community members about the security of the information they entered into the wearable devices and about how that information could be used by other parties. Many community members who understood the value of proactive health behaviors could not afford the high cost of purchasing wearable devices, while others displayed a low level of comfort with technology, believing that wearable use was for younger people. Conclusion: More expansive adoption of wearable devices in Mississippi will depend on the ability of the public health professionals, policy-makers and manufacturers to address the barriers that were identified by this study, thereby enabling the community to have full access to the potential benefits of these technologies.

Evaluation of dry eye signs and symptoms in patients with systemic sclerosis.

BACKGROUND: One of the most frequent ocular features of systemic sclerosis (SSc) is dry eye disease (DED), which has been identified to occur in 37-79% of patients. Although several studies have found weak or no correlations between symptoms and signs of dry eye, symptoms are often the motivation for seeking eye care, and are therefore a critical outcome measure when assessing treatment effect. The aim of this study is to evaluate the impact of symptoms of dry eye on vision-related quality of life in patients with systemic sclerosis, and to investigate the relation between clinical tests and symptoms of dry eye in these patients. METHODS: In this cross-sectional study, 45 consecutive patients with SSc were enrolled. For evaluation of the symptoms the "Ocular Surface Disease Index (OSDI)" questionnaire was applied to all patients. After that, all individuals were submitted to a full ophthalmic examination, including the following tests: tear break-up time, Schirmer I, rose bengal staining. Patients were then grouped into dry eye and non-dry eye groups with regard to the diagnosis of dry eye. Mann-Whitney test was used to compare continuous variables, whereas the Fisher exact test was used to compare categorical data between groups. Spearman's correlation test was used to analyze the correlations between clinical tests and OSDI scores. P values <0.05 were considered significant. RESULTS: Dry eye disease was diagnosed in 22 patients (48.9%). Other ocular surface abnormalities found were: blepharitis (40% of the patients), pterygium (15.6%), pinguecula (82.2%), and superficial punctate keratitis (26.7%). Among the 45 patients, 29 patients (64.4%) had symptoms of ocular surface disease. The mean OSDI score was 26.8 ± 25.8 (SD). There were no statistically significant differences in OSDI scores between DED and non-DED patients. No substantive correlations were found between OSDI scores and TBUT, Schirmer I, or rose bengal staining score, and none of the observed correlations reached statistical significance. CONCLUSION: Symptoms of dry eye have a moderate impact on vision-related quality of life in patients with systemic sclerosis and do not correlate well with clinical findings.

Use of 99mTc-anti-CD3 scintigraphy in the differential diagnosis of rheumatic diseases.

OBJECTIVES: The aim of this study was to assess the use of anti-CD3, labelled with technetium-99m scintigraphy, for evaluating the joints of patients with RA, juvenile idiopathic arthritis (JIA), OA and gouty arthritis, and to establish the diagnosis parameters for each disease. METHODS: We evaluated 2044 joints from 77 patients with rheumatic diseases. The clinical evaluation consisted of laboratory assays; examination for joint inflammation (pain and/or oedema); and for patients with RA, the disease activity score of 28 joints. To evaluate the sensitivity and specificity of 99mTc-anti-CD3 in detecting disease activity, patients received an injection of the radiopharmaceutical compound 99mTc-anti-CD3, and underwent a scintigraphy scan 1 h later. Scanning was repeated 3 h later. As a control, after 2 days, the patient was injected with 99mTc-non-specific human immunoglobulins, and scintigraphy scanning performed at 1 and 3 h after the injection. The intensity of uptake and the pattern of activity were defined, and Spearman's correlation and analysis of variance used for statistical evaluation. RESULTS: Diagnosis criteria were established for 99mTc-anti-CD3 uptake in different diseases. RA and JIA showed joint uptake with progressive increase in late images. Gouty arthritis showed joint uptake with decrease during the late images. Joint uptake was low or absent in patients with OA, although when present the joint uptake decreased during the examination. CONCLUSION: 99mTc-anti-CD3 scintigraphy is a useful method in the differential diagnosis of rheumatic diseases.

Evaluation of multi-starter S. cerevisiae/ D. bruxellensis cultures for mimicking and accelerating transformations occurring during barrel ageing of beer.

During beer ageing, endogenous barrel microbes grow spontaneously and transform wort/beer composition, being Dekkera bruxellensis and Saccharomyces cerevisiae among the main contributors to the chemical and sensory profile of aged beer. This work aims at the application of multi-starter cultures to mimic and accelerate biological modifications occurring during barrel ageing of beer, in controlled fermentation processes. Co-cultures of D.bruxellensis/S.cerevisiae were conducted under conditions commonly found in barrel aged beer production: different pitching rates, high glucose concentration and presence of ethanol and wood extracts. Selective pressures and competition between yeasts influenced microbial growth and metabolite production, namely ethanol, acetic acid and target volatile compounds (esters, alcohols, terpenols, volatile acids and volatile phenols). Metabolic profiles of co-cultures combined traits of both species, and differed from those of pure cultures. Lastly, multi-starters were successfully applied in combination with wood in a controlled and accelerated fermentation process for mimicking barrel ageing transformations.

Efficacy testing of the SAVOR (Sisters Adding Fruits and Vegetables for Optimal Results) intervention among African American women: A randomized controlled trial.

Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a SistersAdding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks).SAVOR (n=26) was compared to an equivalent knowledge-based intervention (n=28). Process evaluation was done for program fidelity and satisfaction. A validated 38-item self-reported questionnaire was used to measure changes in MTM constructs and past 24-hour consumption of fruits and vegetables. Results: The SAVOR intervention resulted in improvement of mean consumption of fruits and vegetables in the experimental group from pre-test (2.78) to posttest (4.77) to recommended levels at follow-up (5.04) while in the comparison group they remained at around 3 (P<0.0001)Statistically significant changes (P<0.05) were noted for all MTM constructs except for participatory dialogue. Conclusion: The SAVOR intervention was found to be efficacious and established the robustness of MTM. SAVOR can be replicated for future effectiveness trials.

Physical activity and prevalence of hypertension in a population-based sample of Brazilian adults and elderly.

OBJECTIVES: a) To determine the prevalence of hypertension and its associated factors and b) to establish the impact of past (i.e. adolescence) and current physical activity on hypertension. METHODS: A cross-sectional study of people aged 40 years or more living in the urban area of Pelotas - Brazil (2003). Hypertension was assessed by self-report of medical diagnosis. Individuals were considered active in adolescence if they reported regular physical activity practice between the ages 10 and 19 years. In adulthood, individuals who performed > or =150 min/week of leisure-time physical activities were considered active. Other variables studied included skin color, age, smoking, body mass index and socioeconomic status. RESULTS: 1696 individuals were interviewed (response rate >95%). Prevalence of hypertension was 34.4% (CI(95%) 32.1-36.7) and varied considerably among population subgroups. Current physical activity showed no association with hypertension. Physical activity in adolescence was associated with a decreased risk of adulthood hypertension in the crude analyses for women (p<0.001). However, after adjusting for potential confounders and mediators, this protection was no longer significant 1.20 (CI(95%) 0.93-1.55). CONCLUSIONS: Prevalence of hypertension is high among Brazilians and markedly different among population subgroups. There was no robust evidence of association between adolescence physical activity practice and hypertension in later life.

Bone mineral density at 45 years of age, before menopause.

OBJECTIVE: The objectives of this study were to investigate variations in bone mineral density values in 45-year-old women from a community sample in the City of Rio de Janeiro, in the same-name Brazilian state, and to compare them with US norms and international standards. DESIGN: In this cohort study, the age of 45 years is significant for the design, since clinical observation in this community indicates that it is approximately 5 years before menopause can be confirmed, thus preceding the typical postmenopause acceleration of the rate of bone loss. Nine hundred fifty-nine such women volunteered to participate in the investigation, conducted in 2 Rio de Janeiro teaching hospitals. Informed of procedures, potential risks, and benefits, they were screened for the inclusion criteria: (a) being 45-years-old: (b) being healthy (without obvious or diagnosed systemic disease, metabolic disease, endocrine disease, liver disease, cardiac disease, infectious disease, pulmonary disease, neurologic disease, dermatologic disease, inflammatory bowel disease, kidney disease, hereditary, or congenital conditions); (c) having regular and intact menstrual cycles; (d) having had normal healthy development to date; (e) having had high protein intake from birth to date; (f) having at least completed high school; (g) living in a dwelling equipped with running water, electricity, and public sewer; (h) being nonsmoking and non-drug abusing. Racial distinction was not among the inclusion criteria. After further informed consent, the 146 women who met all inclusion criteria had bone mineral density quantified--using the dual energy x-ray absorptionmetry method--and compared with US-born density norms for L2-L4 and the neck of the femur for young adults and the sample age group, which are endorsed by the World Health Organization and by the International Osteoporosis Foundation. RESULTS: About three-quarters of the sample had normal bone mineral density values, 22.61% had osteopenia, and 2.73% had osteoporosis. CONCLUSION: These findings, obtained from women whose regular and intact menstrual cycles demonstrated premenopausal hormonal levels, seem to attest to the importance of genetic predisposition, yet they warrant the authors' recommendation that interventions be instituted before age 45, specifically aimed at increasing the chances of all women, especially those genetically predisposed, of avoiding osteoporosis and its deleterious consequences.

[Food intake according to the type of food consumed in schools in a rural area in southern Brazil]. / Consumo alimentar conforme o tipo de alimentação consumida em escolas de zona rural no Sul do Brasil.

The scope of the article was to evaluate food consumption according to the type of food consumed in rural schools. A cross-sectional descriptive study was conducted among adolescents enrolled in 12 rural public schools in Canguçu in the state of Rio Grande do Sul, Brazil. The research was linked to the intervention named "Physical Education +: Practicing Health in School." Dietary intake was evaluated using consumption markers from the Brazilian Food and Nutrition Surveillance System. The main independent variable was the type of food consumed at school (brought from home, provided by the school free of charge and/or purchased at school). Descriptive statistics and the Chi-square test were used and the significance level was p<0.05. The study enlisted 526 students, 51.3% female and 88.0% consuming food free of charge. From 15% to 31% of adolescents consumed foods considered unhealthy for more than three days in the preceding week. Students who reported taking a snack to school consumed raw salad, fresh fruit or fruit salad, biscuits/crackers and packet snacks and soft drinks more frequently. It was concluded that the consumption of healthy foods among schoolchildren in rural areas was low and interventions are needed to improve the current situation of inadequate feeding practices.

Objetivou-se avaliar o consumo alimentar de escolares conforme o tipo de alimentação consumida em escolas de zona rural. Trata-se de um estudo transversal realizado com adolescentes de 12 escolas públicas rurais de Canguçu/RS. A investigação está vinculada à intervenção "Educação Física +: Praticando Saúde na Escola". O consumo alimentar foi avaliado pelos marcadores do Sistema de Vigilância Alimentar e Nutricional. A variável independente principal foi o tipo de alimentação consumida (trazida de casa, fornecida gratuitamente e/ou comprada na escola). Foi utilizada a estatística descritiva e o teste de Qui-quadrado com nível de significância de p < 0,05. Participaram do estudo 526 escolares, 51,3% do sexo feminino e 88,0% que consumiram a alimentação gratuita. Entre 15-31% dos adolescentes consumiram mais de três dias na semana anterior alimentos considerados não saudáveis. Os escolares que relataram levar lanche de casa para a escola consumiram com maior frequência salada crua, frutas frescas ou salada de frutas, bolachas/biscoitos salgados e salgadinhos de pacote e refrigerante. Concluiu-se que o consumo de alimentos saudáveis entre os escolares da zona rural foi baixo e intervenções são necessárias a fim de melhorar o quadro atual de práticas inadequadas de alimentação.

Physical activity and health: a historical and conceptual approach / A relação entre atividade física e saúde: uma abordagem histórica e conceitual

This theoretical essay reflects on physical activity (PA) and health and the development of this study area, particularly in Brazil. A historical review is presented based on major research themes in the area since the 1950s and the evolution of PA recommendations for health. Crucial conceptual and operational definitions in the area that have gone through recent updates are addressed. The pa-per highlights relevant institutions and documents, as well as reflects on future perspectives and challenges in the field. Finally, this essay highlights the need to reduce the gap between the robust scientific knowledge already produced about the health benefits of PA and the real action in the field, especially in the primary health care setting

A partir de uma abordagem histórica, conceitual, crítica e didática, este ensaio teórico propõe uma reflexão sobre a relação entre atividade física (AF) e saúde e o desenvolvimento desta área de estudo, com um olhar especial sobre o Brasil. Apresenta-se revisão histórica a partir de grandes temas de pesquisa na área desde os anos 1950 e da evolução das recomendações de AF para a saúde. São abordadas definições conceituais e operacionais que passaram por atualizações recentes e que são cruciais na área. Faz-se destaque a instituições e documentos relevantes, além de reflexões sobre perspectivas e desafios futuros para a área. Por fim, destaca a necessidade da redução na distância entre a solidez do conhecimento já produzido sobre os benefícios da AF para a saúde e os desejados avanços no contexto da promoção da saúde, em especial na atenção primária à saúde

Tracking of physical activity from adolescence to adulthood: a population-based study.

OBJECTIVE: To assess the association between regular physical activity in adolescence and leisure-time physical activity in adulthood, with emphasis on gender differences. METHODS: A population-based cross-sectional study was carried out in Pelotas, Southern Brazil, in 2003. A representative sample of households was selected in multiple stages and subjects aged 20-59 years were interviewed. Leisure-time physical activity was evaluated using the International Physical Activity Questionnaire. Data on adolescent physical activity were based on subjects' recall. RESULTS: Of 2,577 subjects interviewed, 27.5% were classified as adequately active, and 54.9% reported regular physical activity in adolescence. Subjects who engaged in regular physical activity during adolescence were more likely to be adequately active in adulthood (adjusted prevalence ratio 1.42; 95% CI: 1.23; 1.65). This effect was stronger in women (adjusted prevalence ratio: 1.51; 95% CI: 1.22; 1.86) than men (adjusted prevalence ratio: 1.35; 95% CI: 1.10; 1.67). CONCLUSIONS: Promoting physical activity in school age may be a successful intervention against the epidemic of adult inactivity. Although women were less likely to report regular physical activity in adolescence, the effect of this experience on adult behavior was stronger than in men.

[Evolution of the epidemiological research on physical activity in Brazil: a systematic review]. / Evolução da pesquisa epidemiológica em atividade física no Brasil: revisão sistemática.

OBJECTIVE: To describe the evolution of the epidemiological research on physical activity in Brazil. METHODS: A systematic review of the literature was carried out in electronic databases (Medline/PubMed, Lilacs, Ovid, Science Direct, BioMed Central and High Wire), non-indexed Brazilian journals, query by specific authors, and contact with other researchers. The inclusion criteria were: the sample should be representative of a defined population; sample size equal to or greater than 500 individuals; data collection in Brazil; measurement of physical activity; and report of data on this variable. RESULTS: A total of 42 studies were reviewed. The first study was published in 1990, and there has been a clear growth in the number of publications since 2000. Great regional disparities were seen and most studies were carried out in the Southeast and South regions. Almost all studies (93%) used questionnaires but operational definitions of sedentary lifestyle and questionnaires used varied markedly across studies preventing result comparisons. CONCLUSIONS: Although the literature on physical activity in Brazil has quantitatively increased, methodological limitations make it difficult to compare study results. Therefore, standardization of instruments and definitions is essential for the improvement of scientific knowledge in the area.

Modelo Lógico do Programa Tribunal Superior do Trabalho em Movimento: uma construção de 15 anos de experiência / Logic Model of the Tribunal Superior do Trabalho em Movimento Program: a construction of 15 years of experience

Na perspectiva de promover saúde no local de trabalho, com ênfase na atividade física (AF), em 2004 o Tribunal Superior do Trabalho (TST), em Brasília, Distrito Federal, criou o Programa TST em Movimento. O objetivo deste estudo foi descrever o modelo lógico (ML) do Programa, a partir de sua construção histórica. O ML foi desenvolvido seguindo as diretrizes do Centers of Disease Control and Prevention, descrevendo objetivo, recursos, atividades, produtos, metas, fatores influenciadores e público-alvo. Sua construção incluiu a análise de documentos do Programa, como o relatório de resultados de 2019. O Programa é composto por profissionais de educação física, fisioterapia e estagiários, oferecendo atividades como educação em saúde, práticas de AF, eventos e monitoramento de indicadores em saúde. O ML apresentado é fruto de 15 anos de experiência e passa a compor os processos avaliativos e o acompanhamento das metas, iluminando a sustentabilidade do Programa em bases sólidas

From the perspective of promoting health in the workplace, with an emphasis on physical activity (PA), in 2004 the Tribunal Superior do Trabalho (TST), in Brasília, Distrito Federal, created the TST em Mo­vimento Program. The aim of this study was to describe the logical model (LM) of the Program, based on its historical construction. The LM was developed following the Centers of Disease Control and Prevention guidelines, describing objective, resources, activities, products, goals, influencing factors, and target audience. Its construction included the analysis of Program documents, such as the 2019 results report. The Program is composed of physical education professionals, physiotherapy, and trainees, offering activities such as health education, PA practices, events, and monitoring of health indicators. The LM presented is the result of 15 years of experience and becomes part of the evaluation processes and monitoring of goals, illuminating the Program's sustainability on solid foundations

Adolescent physical activity and health: a systematic review.

Physical activity in adolescence may contribute to the development of healthy adult lifestyles, helping reduce chronic disease incidence. However, definition of the optimal amount of physical activity in adolescence requires addressing a number of scientific challenges. This article reviews the evidence on short- and long-term health effects of adolescent physical activity. Systematic reviews of the literature were undertaken using a reference period between 2000 and 2004, based primarily on the MEDLINE/PubMed database. Relevant studies were identified by examination of titles, abstracts and full papers, according to inclusion criteria defined a priori. A conceptual framework is proposed to outline how adolescent physical activity may contribute to adult health, including the following pathways: (i) pathway A--tracking of physical activity from adolescence to adulthood; (ii) pathway B--direct influence of adolescent physical activity on adult morbidity; (iii) pathway C--role of physical activity in treating adolescent morbidity; and (iv) pathway D - short-term benefits of physical activity in adolescence on health. The literature reviews showed consistent evidence supporting pathway 'A', although the magnitude of the association appears to be moderate. Thus, there is an indirect effect on all health benefits resulting from adult physical activity. Regarding pathway 'B', adolescent physical activity seems to provide long-term benefits on bone health, breast cancer and sedentary behaviours. In terms of pathway 'C', water physical activities in adolescence are effective in the treatment of asthma, and exercise is recommended in the treatment of cystic fibrosis. Self-esteem is also positively affected by adolescent physical activity. Regarding pathway 'D', adolescent physical activity provides short-term benefits; the strongest evidence refers to bone and mental health. Appreciation of different mechanisms through which adolescent physical activity may influence adult health is essential for drawing recommendations; however, the amount of exercise needed for achieving different benefits may vary. Physical activity promotion must start in early life; although the 'how much' remains unknown and needs further research, the lifelong benefits of adolescent physical activity on adult health are unequivocal.

[Prevalence of sedentary behavior and its correlates among primary and secondary school students]. / Prevalência de comportamento sedentário de escolares e fatores associados.

OBJECTIVE: To determine the students' exposure to four different sedentary behavior (SB) indi-cators and their associations with gender, grade, age, economic status and physical activity level. METHODS: A cross-sectional study was conducted in 2013. The SB was collected using the HELENA instrument, composed by screen time questions (TV, video games and internet) and sitting activ-ities on school opposite shift. The cut point of ≥2h/day was used to categorize the outcome. The Poisson regression was used for associations between the outcome and the independent variables (95% significance level), controlling for confounding variables and the possible design effect. RESULTS: The sample was composed by 8661 students. The overall prevalence of SB was 69.2% (CI95% 68.1-70.2) on weekdays, and 79.6% (CI95% 78.7-80.5) on weekends. Females were more associated with the outcome, except to electronic games. Advanced grades students were more involved in sitting tasks when compared to the early grades. Older students were more likely to surf on net for ≥2h/day. Higher economic level students were more likely to engage in video games and internet. Active individuals were less likely to engage in SB on weekdays. CONCLUSIONS: The prevalence of SB was high, mainly on weekends. The associations with sex, age, grade and physical activity level should be considered into elaboration of more efficient interventions on SB control.

The prevalence of physical activity and its associated effects among students in the São Paulo public school network, Brazil.

The current study evaluated physical activity (PA) level and its associated effects among students in the public network of São Paulo, Brazil. A cross-sectional study was taken using a representative sample of students in São Paulo public school system. International Physical Activity Questionnaire determined PA level. Students who reported at least 300 minutes/week of PA were considered active. The independente variables were: gender, age, body mass index, education, region, recognition of the Agita São Paulo program. The prevalence of regular PA was 71.7%. Males (PR = 1.09, 95% CIs = 1.04 -1.15) at least 17 years old (PR = 1.16, 95% CIs 1.09-1.24) in their 3rd year of high school (PR = 1.20, 95% CIs = 1.12-1.29) who resided in the Midwest region (PR = 1.27, 95% CIs 1.16-1.38) were most likely to be active. Males at least 17 years old in their 3rd year of high school who lived in the Midwest and recognized the Agita São Paulo/Agita Galera program had higher levels of PA. São Paulo students presented a high level of PA. Moreover, males older than 17 years, attending their 3rd year of high school, who lived in the Midwest region, and recognized the Agita São Paulo/Agita Galera program were the most likely to be more active.

Assessment of Central Corneal Thickness in Different Subtypes of Systemic Sclerosis.

PURPOSE: To compare central corneal thickness between patients with diffuse cutaneous systemic sclerosis and limited cutaneous systemic sclerosis. METHODS: A total of 53 consecutive patients with systemic sclerosis were enrolled in this study. All subjects were screened for age, gender, classification of disease subtype, autoantibody profile, duration of disease, organ involvement, current treatment, tear break-up time, Schirmer test, and measurement of the central corneal thickness with an ultrasonic pachymeter. RESULTS: No statistically significant differences were found in terms of age, sex, and duration of the disease, and dry eye evaluation between systemic sclerosis subsets. The mean central corneal thickness was 535.3 ± 37.6 µm (range, 471-619 µm) in diffuse cutaneous systemic sclerosis patients, and 539.3 ± 37.1 µm (range, 484-651 µm) in limited cutaneous systemic sclerosis (p = 0.71). CONCLUSIONS: Central corneal thickness in patients with diffuse cutaneous systemic sclerosis is not different from the one in limited cutaneous systemic sclerosis.

Drugs or disease: evaluating salivary function in RA patients.

Oral complications of RA may include temporomandibular joint disorders, mucosa alterations and symptoms of dry mouth. The aim of this study was to evaluate the salivary gland function of subjects with rheumatoid arthritis (RA) comparing it to healthy controls. Subjects with other systemic conditions known to affect salivary functions were excluded. A questionnaire was applied for the evaluation of xerostomia. Resting and chewing-stimulated salivary flow rates (SFR) were obtained under standard conditions. There were 145 subjects included of the study (104 RA and 38 controls). About 66.7% of the RA subjects and 2.4% in control group presented xerostomia. The median resting SFR were 0.24 ml/min for RA subjects and 0.40 mL/min for controls (p = 0.04). The median stimulated SFR were 1.31 mL/min for RA subjects and 1.52 ml/min for controls (p = 0.33). No significant differences were found between resting and stimulated SFR of RA subjects not using xerogenic medications and controls. There was significantly higher number of subjects presenting hyposalivation in the RA group than among controls, even when subjects using xerogenic medications were eliminated from the analysis. In conclusion, hyposalivation and xerostomia were more frequent among RA subjects not using xerogenic medication than among controls, although there were no significant differences in the median SFR between groups.