Características sociodemográficas, de trabalho e saúde de homens e mulheres deficientes residentes em contexto rural / Características sociodemográficas, de trabajo y salud de hombres y mujeres discapacitados residentes en un contexto rural / Sociodemographic characteristics of work and health of disabled men and women living in a rural setting

RESUMO Objetivo: Comparar as características sociodemográficas, de saúde e de trabalho de homens e mulheres com deficiência que residem em contexto rural. Método: Estudo transversal analítico, com 276 pessoas com deficiência residentes em cenário rural de oito municípios da região noroeste do Estado do Rio Grande do Sul, Brasil. Os dados foram coletados por meio de um questionário fechado, com variáveis sociodemográficas, de trabalho e saúde, aplicado na residência dos participantes nos meses de setembro de 2018 a julho de 2019. Esses foram digitados e analisados no programa estatístico software Statistical Package for the Social Sciences for Windows, versão 18.0 por meio de estatística analítica descritiva (comparação de frequência). Para comparar os dois grupos (homens e mulheres) empregou-se o teste Qui-Quadrado. Resultados: Dos homens, 27,8% apresentaram deficiência física e a deficiência múltipla foi mais frequente na mulher (p<0,001). O trabalho na agricultura e do lar eram mais frequentes no sexo feminino e as atividades autônomas e empregatícias, no sexo masculino. Ambos recebiam BPC, ainda que 18% não tivessem nenhum tipo de benefício. Homens tinham duas vezes mais chance de serem tabagistas e quase três vezes maior risco de etilismo que as mulheres (p<0,001). Conclusão: As características de pessoas com deficiência que residem em contexto rural se diferenciam entre os sexos, no que se refere à deficiência, trabalho e hábitos que vulnerabilizam a saúde.

RESUMEN Objetivo: comparar las características sociodemográficas, de salud y de trabajo de hombres y mujeres con discapacidad que residen en contexto rural. Método: estudio transversal analítico, con 276 personas con discapacidad residentes en escenario rural de ocho municipios de la región noroeste del Estado de Rio Grande do Sul, Brasil. Los datos fueron recogidos a través de un cuestionario cerrado, con variables sociodemográficas, de trabajo y salud, aplicado en la residencia de los participantes en los meses de septiembre de 2018 a julio de 2019. Estos fueron introducidos y analizados en el programa estadístico software StatisticalPackageforthe Social Sciencesfor Windows, versión 18.0. por medio de estadística analítica descriptiva (comparación de frecuencia). Para comparar los dos grupos (hombres y mujeres) se empleó la Prueba de chi-cuadrado. Resultados: de los hombres, el 27,8% presentó discapacidad física y la discapacidad múltiple fue más frecuente en la mujer (p<0,001). El trabajo en la agricultura y en el hogar eran más frecuentes en el sexo femenino y las actividades autónomas y de empleo, en el sexo masculino. Ambos recibían BPC, aunque el 18% no tenía ningún tipo de beneficio. Los hombres tenían dos veces más probabilidades de ser fumadores y casi tres veces mayor riesgo de etilismo que las mujeres (p<0,001). Conclusión: las características de las personas con discapacidad que residen en un contexto rural se diferencian entre los sexos, en lo que se refiere a la discapacidad, trabajo y hábitos que vulneran la salud.

ABSTRACT Objective: Comparing the sociodemographic characteristics of health and work of men and women with disabilities living in a rural context. Method: A cross-sectional analytical study with 276 people with disabilities living in a rural setting in eight cities in the Northwest Region of the State of Rio Grande do Sul, Brazil. Data were collected through a closed questionnaire with sociodemographic, work and health variables applied at the participants' residence from September 2018 to July 2019. These were typed and analyzed in the software Statistical Package for the Social Sciences for Windows, version 18.0 by means of descriptive analytical statistics (frequency comparison). To compare the two groups (men and women) the Chi-Square test was used. Results: Of the men, 27.8% had physical disabilities and multiple disability was more frequent in women (p<0.001). Work in agriculture and home was more frequent in females and autonomous and employment activities in males. Both received PB, although 18% did not have any kind of benefit. Men were twice as likely to be smokers and almost three times higher risk of alcohol than women (p<0.001). Conclusion: The characteristics of people with disabilities living in a rural setting differ between the genders, with regard to disability, work and habits that make health vulnerable.

The prevalence of current smokers and alcohol drinkers among cancer survivors and subjects with no history of cancer among participants in a community-based cardiometabolic screening program in Miyagi prefecture, Japan: a comparison with nationally representative surveys in other countries.

BACKGROUND: We determined the prevalence of current cigarette smokers and alcohol drinkers among cancer survivors and subjects with no history of cancer in Japan and compared the findings with nationally representative studies in other countries. METHODS: We conducted a cross-sectional study of baseline data from a prospective cohort study. A self-administered questionnaire was surveyed during 2013-2015 with residents aged ≥20 years attending a community-based cardiometabolic screening program in Miyagi prefecture in north-eastern Japan. Subjects with past cancer histories were classified as cancer survivors. Sex-specific, age-standardized prevalence of current smokers, and drinkers were calculated. Age-adjusted prevalence ratios (PRs: the cancer survivors' rate divided by the rate of subjects with no history of cancer) and 95% confidence intervals (CIs) were estimated with log-binomial regressions. RESULTS: 36,786 subjects, including 2760 cancer survivors, responded and provided usable information (58.9% of recruited subjects). For men, the age-standardized prevalence of current smokers and drinkers among survivors was 18.8% and 74.4%, respectively, with an age-adjusted PR (95%CI) of 0.76 (0.66-0.86, p < 0.001) and 0.95 (0.91-0.98, p = 0.002), respectively. For women, the figures were 6.1%, 37.9%, 0.84 (0.67-1.06, p = 0.138) and 0.96 (0.90-1.03, p = 0.313), respectively. The U.S., the U.K, and Australian studies generally showed no substantially lower prevalence of current smokers or drinkers in survivors than in subjects with no history of cancer (PR ≥ 0.75), while Korean studies did (PR < 0.75). CONCLUSIONS: A considerable proportion of Japanese cancer survivors, especially men, remained currently smoking and drinking. Consistent with Western studies, the rates were not substantially lower than those among subjects with no history of cancer.

Condição bucal e qualidade de vida em pacientes alcoolistas e não alcoolistas ­ estudo caso-controle / Buccal condition and quality of life in alcoholic and non-alcoholic patients ­ case-control study

Objetivo: estudar as concepções dos pacientes alcoolistas, alcoolistas cirróticos e cirróticos não alcoolistas quanto à percepção de qualidade de vida, condição periodontal, perda dentária e uso ou não de prótese dentária. Material e métodos: estudo caso-controle com 194 pacientes, com idades entre 25 e 73 anos, atendidos no Serviço de Gastroenterologia do Hospital Universitário Cassiano Antônio de Moraes (Hucam/Ufes), quanto aos parâmetros: profundidade de sondagem, nível de inserção clínica, índice de placa visível, sangramento gengival, sangramento a sondagem, supuração, mobilidade dentária, lesões de furca e questionário OHIP-14. Resultados: a condição clínica dos pacientes mostrou predomínio de má qualidade de vida marcada por perda dentária extrema. Foram observadas perdas de inserção periodontais, predominância de placa dentária (p=0,002) e bolsas periodontais profundas (< 6 mm) no grupo-caso (p=0,035). Alguns parâmetros do OHIP-14 com significância (p < 0,001) foram observados com a condição clínica médica, especialmente nas categorias dos problemas ao falar, sentimento de constrangimento social e mastigação. Uma comparação foi realizada para avaliar a percepção dos pacientes alcoolistas e desdentados em relação ao OHIP-14, utilizando apenas as primeiras (nunca) e as últimas (sempre) respostas. A resposta "nunca" apresentou maiores percentuais nas questões 1 (91,8%); 2 (82,7%); 6 (69,4%); 7 (70,7%); 8 (88,3%); 9 (80,0%); 12 (90,4%); 13 (69,2%); e 14 (89,8%). A pergunta 5 obteve a resposta "sempre" como a maior porcentagem (73,3%) para o mesmo grupo. Conclusão: a condição clínica dos pacientes mostra efeitos significativos ao se correlacionar os parâmetros do OHIP-14 com a condição periodontal deteriorada e ausência considerável de próteses dentárias.

Objective: in the present study we studied the conceptions of alcoholic, cirrhotic alcoholic and non-alcoholic cirrhotic patients regarding perception of quality of life, periodontal condition, tooth loss and use of dental prosthesis. Material and methods: we evaluated 194 patients aged 25-73 years, attending the Gastroenterology Department of the University Hospital Cassiano Antônio de Moraes (Hucam/Ufes), regarding the parameters: probing pocket depth, clinical attachment loss, visible plaque, marginal gingival bleeding, bleeding on probing, suppuration, dental mobility, furcation lesions, and OHIP-14 questionnaire. Results: the clinical condition of the patients showed a predominance of poor quality of life marked by extreme dental loss. Periodontal attachment losses, predominance of dental plaque (p=0.002) and signifi cant deep pockets ( 6 mm) were observed in the case group (p=0.035). Some OHIP-14 parameters with signifi cance (p < 0.001) were also observed with the medical clinical condition, especially in the categories of speech problems, feeling of social embarrassment and chewing. A comparison was made to evaluate the perception of alcoholic and edentulous patients in relation to OHIP-14 using the fi rst (never) and the last (always) answers. The answer "never" presented higher percentages in questions 1 (91.8%); 2 (82.7%); 6 (69.4%); 7 (70.7%); 8 (88.3%); 9 (80.0%); 12 (90.4%); 13 (69.2%); and 14 (89.8%). Question 5 obtained the answer "always" as the highest percentage (73.3%) for the same group. Conclusion: the clinical condition of patients shows signifi cant effects when correlating with OHIP-14 parameters with the medical clinical condition, deteriorated periodontal condition and considerable absence of dental prostheses.

Assessment of genotoxicity amongst smokers, alcoholics, and tobacco chewers of North India using micronucleus assay and urinary 8-hydroxyl-2'-deoxyguanosine, as biomarkers.

The main objective of the present study was to screen the genotoxicity caused by individual and combined habits of smoking, tobacco chewing, and alcohol consumption in human population of North India. Study recruited 67 male subjects aged 25 to 65 years. Buccal mucosal cells were subjected to micronucleus (MN) assay, and 8-hydroxyl-2-deoxyguanosine (8-OHdG) was estimated in their urine samples. Number and shape of the MN cells varied in the buccal epithelium of different groups. Maximum number of MN (0.47%) were found in tobacco chewers followed by smokers (0.45%) and alcoholics (0.44%) (P < 0.05). These results reciprocated the concentration of urinary 8-OHdG. Maximum value for 8-OHdG was also recorded in tobacco chewers (21.07 ± 5.51 mg/mg creatinine) followed by smokers (20.25 ± 3.96 mg/mg creatinine) and alcoholics (19.06 ± 3.41 mg/mg creatinine) (P < 0.05). Combined effects of these agents were found to be statistically different from individual effects. Carcinogenic compounds present in cigarette smoke, nitrosamines found in solid tobacco, and acetaldehyde, a metabolic product of alcohol, induce oxidative stress that manifests into genotoxicity. In conclusion, demographical differences occur in the genotoxicity caused by these three habits. MN assay and urinary 8-OHdG are simple, noninvasive, and reliable biomarkers of genotoxicity.

Tackling TB in low-incidence countries: improving diagnosis and management in vulnerable populations.

In low tuberculosis incidence regions, tuberculosis is mainly concentrated among hard-to-reach populations like migrants, homeless people, drug or alcohol abusers, prisoners and people living with HIV. To be able to eliminate tuberculosis from these low incidence regions tuberculosis screening and treatment programs should focus on these hard-to-reach populations. Here we discuss the barriers and facilitators of health care-seeking, interventions improving tuberculosis screening uptake and interventions improving treatment adherence in these hard-to-reach populations.

Uso de enxaguatórios bucais em pacientes portadores de câncer de boca e orofaringe / Mouthrinse use in patients with oral and oropharyngeal cancer

O câncer de boca é atualmente um grave problema de saúde mundial. A incidência varia amplamente todo o mundo. Vários fatores de risco têm sido associados com cânceres da cavidade oral, tais como o fumo, consumo de bebidas alcoólicas, pobre saúde bucal e infecção pelo papiloma vírus humano. O mecanismo pelo qual bebidas alcoólicas provocam câncer oral é desconhecido, mas provavelmente envolve exposição tópica. Diferentes estudos têm sido conduzidos por muitos anos, a fim de esclarecer a possível relação entre o uso crônico de enxaguatórios bucais com álcool e câncer oral. O objetivo desse estudo foi avaliar o uso de enxaguatórios bucais em pacientes com câncer de boca e orofaringe. Foram entrevistados 53 pacientes por meio de um questionário específico de dois centros de referência para o diagnóstico e tratamento do câncer. O grupo caso foi constituído por 33 pacientes, com diagnóstico final de carcinoma epidermóide de boca e orofaringe com sítios nas seguintes localizações anatômicas: face interna dos lábios, língua, gengiva, assoalho da boca, palato e úvula, mucosa oral, vestíbulo da boca, área retromolar, outras partes e partes não especificadas da boca, amígdala e orofaringe. O grupo controle foi constituído por 20 pacientes atendidos em outros ambulatórios dos mesmos hospitais e serviços não ligados a oncologia...

Oral cancer is a major problem worldwide nowadays. The incidence varies widely throughout the world. A great variety of risks have been associated with oral and oropharyngeal cancers,such as tobacco and alcohol consumption, poor oral health, and human papilloma virus infection. The mechanism through which alcohol contributes to oral cancer is unknown, but it probably involves topical and systemic exposition. Different studies aiming to clarify a possible association between alcoholic mouthwashes and oral cancer have been conducted for many years. The objective of this study was to evaluate oral hygiene habits and the use of mouthwashes in oral and oropharyngeal cancer patients. Fifty-three patients from two cancer centers were interviewed by means of a specific questionnaire. The case group comprised 33 patients diagnosed with squamous cell carcinoma located at the following anatomical sites: lips, tongue, gingiva, floor of the mouth, buccal mucosa, palate, uvula, pharyngeal tonsil, oropharynx, and other non-specified parts. The control group comprised 20 patients with non-neoplastic treatments. The results showed that 42.4% the of case group patients presented tongue lesions, 16 patients were classified at stageIV...

Epidemiology of drug use among biracial/ethnic youth and young adults: results from a U.S. population-based survey.

This study estimates the prevalence of cigarette, alcohol, and marijuana use in a nationally representative sample of monoracial/ethnic and biracial/ethnic youth and young adults. The authors consider 16 racial/ethnic categories and used four waves of data from the National Longitudinal Study of Adolescent Health. The analysis sample consists of 20,745 individuals in Wave 1. The primary statistical methodology used in the present study is logistic regression with sample weights. Findings suggest that participants who self-report two races/ethnicities have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates. For example, Black-American Indians reported cigarette smoking rates that were significantly lower than rates reported by American Indians but significantly higher than rates reported by Blacks. Groups with the highest prevalence of cigarette smoking at Wave 1 were American Indian, White-American Indian, White, and Multiracial (people reporting three or more races/ethnicities). Groups with the highest prevalence of alcohol drinking at Wave 1 were White-American Indian, Multiracial, Hispanic, White, and White-Hispanic. Groups with the highest prevalence of marijuana smoking at Wave 1 were Black-Asian and American Indian. The authors found an interaction effect between race/ethnicity and socioeconomic status. Lower-class SES status may serve as a risk factor for biracial/ethnic adolescents while upper-class SES may serve as a protective factor for these youth. In general, biracial/ethnic individuals have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates.

Active case finding for tuberculosis among high-risk groups in low-incidence countries.

In low-incidence countries, tuberculosis (TB) is now largely concentrated in high-risk groups such as migrants, homeless people, illicit drug users, alcoholics and prisoners. This has led to increased efforts to implement targeted active case finding for TB among specific populations. This review examines the evidence supporting active case finding in migrants and social risk groups, as well as the cost-effectiveness of interventions. While data from observational studies support active case finding in defined high-risk groups, further research to determine the effectiveness of specific tools and the cost-effectiveness of screening strategies is needed to inform evidence-based control methods in low-incidence countries. Inevitably, addressing TB in low-incidence countries will depend on effective disease control in high-burden countries.