Military Nursing in "Operation Return to Brazil": aeromedical evacuation in the coronavirus pandemic / Enfermería militar en la "Operación Regreso a Brasil": evacuación aeromédica en la pandemia de coronavirus / Enfermagem Militar na "Operação Regresso ao Brasil": evacuação aeromédica na pandemia do coronavirus

ABSTRACT Objective: to describe the experience of military nursing in "Operation Return to Brazil" in an aeromedical evacuation. Method: this is an experience report of the nursing staff in the Aeromedical Evacuation of potentially-contaminated Brazilians who were in Wuhan, China, after the outbreak of the new coronavirus. Results: the report was constructed from nursing care performed in three stages: pre-flight, screening, and flight. Pre-flight care would include aircraft configuration and material prediction. In screening, the staff was concerned with being properly attired. In the health assessment of returnees, in-flight, attention was focused on Personal Protective Equipment handling to minimize the risk of contamination by prolonged contact with potentially-contaminated passengers. Final considerations: nursing was committed to planning all the actions of this mission, which was one of the longest, strenuous and unprecedented in the history of aeromedical transport in Brazil.

RESUMEN Objetivo: describir la experiencia de enfermería militar en la "Operación Regreso a Brasil" en una evacuación aeromédica. Método: este es un informe de experiencia del equipo de enfermería, en la evacuación aeromédica de brasileños potencialmente contaminados que se encontraban en Wuhan, China, después del brote del nuevo coronavirus. Resultado: el informe se construyó a partir de la atención de enfermería realizada en tres etapas: pre-vuelo, detección y vuelo. En el prevuelo, el cuidado incluyó la configuración de la aeronave y el pronóstico del material. En la evaluación, al equipo le preocupaba estar bien preparado. En la evaluación de la salud de los retornados, durante el vuelo, la atención se centró en el manejo de equipos de protección personal para minimizar el riesgo de contaminación por contacto prolongado con pasajeros potencialmente contaminados. Consideraciones finales: la enfermería se comprometió a planificar todas las acciones de esta misión, que fue una de las más largas, extenuantes y sin precedentes en la historia del transporte aeromédico en Brasil.

RESUMO Objetivo: descrever a experiência da enfermagem militar na Operação Regresso ao Brasil em uma evacuação aeromédica. Método: trata-se de um relato de experiência da equipe de enfermagem, na evacuação aeromédica dos brasileiros potencialmente contaminados que estavam em Wuhan, China, após o surto do novo coronavírus. Resultado: o relato foi construído a partir de cuidados de enfermagem realizados em três etapas: pré-voo, triagem e voo. No pré-voo, os cuidados incluíram a configuração da aeronave e a previsão do material. Na triagem, a equipe preocupou-se em estar devidamente aparamentada. Na avaliação de saúde dos repatriados, durante voo, concentrou-se a atenção no manejo dos Equipamentos de Proteção Individual para minimizar o risco de contaminação pelo contato prolongado, com passageiros potencialmente contaminados. Considerações finais: a enfermagem empenhou-se no planejamento de todas as ações dessa missão, que foi uma das mais longas, extenuantes e inéditas da história do transporte aeromédico do Brasil.

Epidemiological study of metabolic syndrome in Brazilian soldiers

ABSTRACT Objective: The aim of this study was to carry out an epidemiological analysis of metabolic syndrome among Brazilian Army soldiers. Subjects and methods: Two thousand seven hundred and nineteen male soldiers of the Brazilian Army were evaluated from 2014 to 2016. Characteristics: age = 27.77 (± 8.59) years and BMI = 25.15 (± 3.41) kg/m2. Blood tests and anthropometric measures were performed following the criteria of the International Diabetes Federation Task Force on MS Epidemiology and Prevention, 2009. The epidemiological analysis was based on Odds ratio (OR) with confidence interval (CI). Results: The prevalence of MS found was 12.21%. Both WC and BMI proved to be good predictors of changes in MS physiological markers. Increased WC and BMI were strongly associated with all physiological markers. Soldiers with WC ≥ 90 were more likely to present MS with OR = 33.37 (24.37-45.7). Soldiers with WC ≥ 90 also presented high risk of: high triglycerides with OR = 5.98 (4.69-7.61); low HLD-c with OR = 1.78 (1.47-2.16); and increased systolic blood pressure OR = 3.10 (2.55-3.76). Soldiers with BMI ≥ 30 had a high risk of: increased glucose with OR = 2.69 (1.93-3.75); and increased diastolic blood pressure with OR = 3.02 (2.22-4.10). Conclusion: Both WC and BMI can be considered as good predictors of changes in MS physiological markers. We believe that WC and BMI should be used as screening tools to indicate the soldiers that must undergo blood tests to monitor MS prevalence.

Association of bruxism and anxiety symptoms among military firefighters with frequent episodic tension type headache and temporomandibular disorders / Associação de bruxismo e sintomas de ansiedade em bombeiros militares com cefaleia do tipo tensional episódica frequente e desordens temporomandibulares

ABSTRACT Objective To assess the presence of bruxism and anxiety among military firefighters with frequent episodic tension-type headache and painful temporomandibular disorders (TMDs). Methods The sample consisted of 162 individuals aged 18 to 55 years divided into four groups. Headache was diagnosed in accordance with the International Classification of Headache Disorders-III. The Research Diagnostic Criteria for Temporomandibular Disorders questionnaire was used to classify TMDs and awake bruxism; sleep bruxism was diagnosed in accordance with the International Classification of Sleep Disorders-3; and anxiety was classified using the Beck Anxiety Inventory. In statistical models, a significance level of 95% was used. The chi-square test was used to assess anxiety. Results Associations were found among frequent episodic tension-type headache, painful TMDs, awake bruxism and anxiety (p < 0.0005). Sleep bruxism was not a risk factor (p = 0.119) except when associated with awake bruxism (p = 0.011). Conclusion Anxiety and awake bruxism were independent risk factors for developing frequent episodic tension-type headache associated with painful TMDs; only awake bruxism was a risk factor for frequent episodic tension-type headache with non-painful TMDs.

RESUMO Objetivo Avaliar a presença de bruxismo e sintomas de ansiedade entre bombeiros militares com cefaleia do tipo tensional episódica frequente (CTTEF) e desordens temporomandibulares Dolorosas (DTMs). Métodos A amostra foi composta por 162 indivíduos com idade entre 18 e 55 anos divididos em quatro grupos. A CTTEF foi diagnosticada de acordo com o ICHD-III. O RDC / TMD foi usado para classificar as DTMs e o bruxismo acordado; o bruxismo do sono foi diagnosticado de acordo com o ICSD-3; e a ansiedade foi classificada usando o Inventário de Ansiedade de Beck. Nos modelos estatísticos, utilizou-se um nível de significância de 95%. O teste Qui-quadrado avaliou a ansiedade. Resultados Associações foram encontradas entre CTTEF, DTMs dolorosas, bruxismo diurno e ansiedade (p < 0,0005). O bruxismo do sono não foi fator de risco (p = 0,119), mas quando associado à atividade diurna (p = 0,011). Conclusão Ansiedade e bruxismo diurno foram fatores de risco independentes para o desenvolvimento de CTTEF associado a DTMs dolorosas. Apenas o bruxismo diurno foi fator de risco para CTTEF com DTMs não dolorosas.

The Brazilian Army nurses' uniforms: visual identity in World War II / Uniformes de enfermeras del Ejército Brasileño: identidad visual en la Segunda Guerra Mundial / Uniformes de enfermeiras do Exército Brasileiro: identidade visual na II Guerra Mundial

ABSTRACT Objective: To analyze the symbolic effects of the official military uniform of the nurses from Brazilian Army in World War II. Method: This research was developed using the historical method, with iconographic sources. The data were discussed based on the concepts of the social world theory, by Pierre Bourdieu. Results: The images selected demonstrate the own meaning of the uniforms, evidencing the functions and the social position of those who wear it, being private and obligatory to use it in the military field. Final considerations: In the case of the nurses from the Brazilian Expeditionary Force, the appropriation of uniforms promoted the visual communication representing military nurse in the context of war, at the same time it served for distinction purposes in the army, but not necessarily in the nursing field. Symbolically, they remained amongst the walls of the barracks even after the end of the war and, thus, they remained unknown and marked by the symbols of forgetfulness.

RESUMEN Objetivo: Analizar los efectos simbólicos de la vestimenta militar oficial de las enfermeras del Ejército Brasileño en la II Guerra Mundial. Método: La investigación fue desarrollada usando el método histórico con fuentes de imágenes. Los datos fueron discutidos a la luz de conceptos de la teoría del mundo social, de Pierre Bourdieu. Resultados: Las imágenes seleccionadas demuestran el significado propio de los uniformes, explicitando las funciones y la posición social de quien los porta, siendo de uso privativo y obligatorio en el campo militar. Consideraciones finales: En el caso de las enfermeras de la Fuerza Expedicionaria Brasileña, la apropiación de uniformes promovió la comunicación visual de la figura-tipo de la enfermera militar en el contexto de la guerra, al tiempo que confería distinción en el ámbito del ejército, pero no necesariamente en el campo de la enfermería. Simbólicamente, permanecieron entre los muros de los cuarteles incluso después del término de la guerra, y, por consiguiente, se mantuvieron desconocidas y marcadas por los signos del olvido.

RESUMO Objetivo: Analisar os efeitos simbólicos do vestuário militar oficial das enfermeiras do Exército Brasileiro na II Guerra Mundial. Método: A pesquisa foi desenvolvida usando o método histórico, com fontes imagéticas. Os dados foram discutidos à luz de conceitos da teoria do mundo social, de Pierre Bourdieu. Resultados: As imagens selecionadas demonstram o significado próprio dos uniformes, explicitando as funções e a posição social de quem os porta, sendo de uso privativo e obrigatório no campo militar. Considerações finais: No caso das enfermeiras da Força Expedicionária Brasileira, a apropriação de uniformes promoveu a comunicação visual da figura-tipo da enfermeira militar no contexto da guerra, ao mesmo tempo que conferiu distinção no âmbito do exército, mas não necessariamente no campo da enfermagem. Simbolicamente, elas permaneceram entre os muros dos quartéis mesmo após o término da guerra e, por conseguinte, mantiveram-se desconhecidas e marcadas pelos signos do esquecimento.

A portrait of risk behavior towards HIV infection among Brazilian Army conscripts by geographic regions, 2016 / Retrato do comportamento de risco dos conscritos do Exército brasileiro à infecção pelo HIV por macrorregiões brasileiras, 2016

ABSTRACT Introduction: Knowledge about risky sexual behavior among young people has been widely acknowledged as a key tool to controlling the spread of HIV. This article aimed at presenting the risk behavior of Brazilian Army conscripts toward HIV infection according to the country's geographic regions. . Method: We collected data from 37,282 conscripts, aged 17 to 22, during enlistment in the Brazilian Army in 2016. The prevalence of HIV infection, both self-reported and measured through laboratory results, and risk behavior factors were estimated by region. Results: 75% of the sample of conscripts reported to have already started sexual activity, and the average age of their sexual initiation was 15. Condom use varied according to the type of sexual relationship, being lower among steady partners and greater among less stable relationships. HIV prevalence assessed by laboratory tests was 0.12% across the country and the highest prevalence was observed in the North region (0.24%). Alcohol and illicit drug usage was higher in the South region. Discussion: The study allowed the observation of risk behavior monitoring for HIV infection among young Brazilians. Lower condom usage among steady partners may be contributing to an increase in the number of HIV-infected individuals. Conclusion: Results suggest the need to intensify prevention campaigns to disseminate safe sex practices among young people, in addition to the expansion of testing offer to this population.

RESUMO Introdução: O conhecimento do comportamento sexual de risco entre jovens tem sido amplamente reconhecido como ferramenta-chave para controlar a propagação do HIV. Este artigo tem o objetivo de retratar o comportamento de risco dos conscritos do Exército brasileiro à infecção pelo HIV segundo as macrorregiões brasileiras. Métodos: Foram utilizados dados de 37.282 conscritos, entre 17 e 22 anos, durante apresentação ao Exército em 2016. Estimaram-se as prevalências de HIV autorreferida e medida por exame laboratorial, além de indicadores de comportamento de risco, por macrorregiões geográficas. Resultados: Dos conscritos que compuseram a amostra, 75% relatou já ter iniciado atividade sexual, e a média de idade de início foi de aproximadamente 15 anos. O uso do preservativo variou de acordo com o tipo de parceria sexual, sendo menor na relação com parceiros(as) fixos(as) e maior nas parcerias menos estáveis. A prevalência da infecção pelo HIV medida através do diagnóstico laboratorial foi de 0,12% no Brasil, sendo mais prevalente na região Norte (0,24%). O consumo de álcool e drogas ilícitas foi maior na região Sul. Discussão: O estudo permitiu observar o monitoramento do comportamento de risco à infecção pelo HIV entre os jovens brasileiros. O menor uso de preservativo quando a parceria sexual é considerada estável pode estar contribuindo para aumentar o número de indivíduos infectados pelo HIV. Conclusão: Os resultados sugerem a necessidade de campanhas de divulgação para os jovens sobre práticas de sexo seguro, além da ampliação da oferta de testagem nessa população.

Analysis of combat casualties admitted to the emergency department during the negotiation of the comprehensive Colombian process of peace / Análisis de los soldados heridos en combate admitidos al departamento de emergencias durante la negociación del proceso de paz en Colombia

Abstract Aim: Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016. Methods: A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period). Variables were compared with respect to periods Results: A total of 448 hostile casualties were registered. There was a gradual decline in the number of admissions to the emergency department during the negotiation period. The number of soldiers suffering blast and rifle injuries also decreased over this period. In 2012 there were nearly 150 hostile casualties' admissions to the ER. This number decreased to 84, 63, 32 and 6 in 2013, 2014, 2015 and 2016 respectively. Both, the proportion of patients with an ISS ≥9 and admitted to the intensive care unit were significantly higher in the period before peace negotiation. From August to December/2016 no admissions of war casualties were registered. Conclusion: We describe a series of soldiers wounded in combat that were admitted to the emergency department before and during the negotiation of the Colombian process of peace. Overall, we found a trend toward a decrease in the number of casualties admitted to the emergency department possibly in part, as a result of the period of peace negotiation.

Resumen Objetivo: Describir las variaciones en los soldados heridos en combate admitidos al departamento de emergencias durante el periodo de negociación del proceso de paz colombiano entre el 2011 y el 2016. Métodos: Estudio retrospectivo de todos los soldados heridos en combate que fueron manejados en un centro de trauma desde Enero del 2011 a Diciembre del 2016. Los pacientes se dividieron en dos grupos: aquellos que ingresaron al departamento de emergencias antes de la tregua del proceso de paz (Noviembre 2012) y aquellos que ingresaron durante la negociación. Los grupos se compararon con respecto a los periodos de tiempo. Resultados: Un total de 448 soldados heridos en combate fueron incluidos. Hubo una disminución gradual en el número de admisiones durante el periodo de negociación. Además, el número de soldados que sufrieron heridas por explosiones y fusiles disminuyó durante este periodo. En el 2012 se registraron 150 soldados heridos en combate. Este número disminuyó a 84, 63, 32 y 6 en los años 2013, 2014, 2015 y 2016 respectivamente. La proporción de pacientes con un ISS ≥9 y la proporción de admitidos a la unidad de cuidado intensivo fueron significativamente mayores en el periodo antes de la negociación. Desde Agosto a Diciembre/2016 no se registraron admisiones. Conclusión: Este estudio describe una disminución gradual en el número de soldados heridos en combate admitidos al departamento de emergencia en un periodo de 6 años. Este fenómeno pudo deberse al periodo de negociación del proceso de paz.

Mulheres da segurança pública do litoral do Paraná, Brasil: intersecções entre gênero, trabalho, violência(s) e saúde / Public security female workers at the coast of Paraná, Brazil: intersections of gender, work, violence(s), and health

Resumo Este artigo busca compreender as relações entre gênero, violências e o processo saúde-doença de mulheres que trabalham na área de segurança pública no litoral do estado do Paraná. A metodologia foi qualitativa, por meio de pesquisa etnográfica com 50 mulheres (policiais civis e militares, e agentes penitenciárias), realizada em três municípios balneários da região entre março de 2014 e março de 2015. A análise dos resultados revelou: 1) dilemas concernentes às sobrecargas de trabalho impostas pela conjuntura local, marcada pela sazonalidade; 2) exposição às violências (principalmente institucional e de gênero) e repercussão na saúde dessas mulheres; 3) relações de poder, assinaladas pelas hierarquias das corporações e assimetrias de gênero entre profissionais homens e mulheres. Esta pesquisa evidenciou: como as profissionais femininas nas instituições de segurança pública sofrem diretamente o impacto das violências e desigualdades de gênero em suas vidas pessoais e profissionais; e as resistências e rearranjos dessas mulheres nas instituições, suas reinvenções em meio a um ambiente de hegemonia tradicionalmente masculina.

Abstract This study aimed to promote visibility of women working in public security along the Parana coast, articulating issues of gender, violence(s), and the health-disease process. The methodology was qualitative, through an ethnographic research which included 50 women (civilians, military policewomen, and prison officers) from municipalities along the Parana coast, between March 2014 and March 2015. Results revealed: 1) the dilemmas that these women are subjected to, facing the seasonal dynamics in the field of public security in the region; 2) exposure to violence (mainly institutional and gender-based) and its impact on these women's health; 3) power relations, marked by corporations' hierarchies and gender asymmetries between men and women in professional settings. In summary, this research highlighted the need to promote visibility of women working in public security institutions, considering the impact of violence and gender inequalities in their personal and professional lives, including the resistance and rearrangements promoted by these women in the institutions in response to their presence in a hegemonic and traditionally male environment.

Análisis comparativo de las pruebas físicas del personal naval, región costa y sierra / Comparative analysis of physical evidence of naval, coastal region and sierra personnel

Introducción: las pruebas de condición física, desde el punto de vista biológico, son un procedimiento científico realizado bajo condiciones estandarizadas que miden diversas características de forma empírica, especificándose las mediciones médico-biológicas como indicadores fundamentales del rendimiento profesional de militares del ejército. Objetivo: comparar el rendimiento de los evaluados en la región costa y sierra utilizando cuatro test (carrera, flexiones de cadera, natación y trepar cabo) correspondientes a las pruebas físicas del personal Naval en el primer semestre del año 2015. Métodos: estudio de tipo observacional, retrospectivo, analítico y transversal, en el cual se evaluó a hombres y mujeres de edades comprendidas entre 18 y 30 años. Resultados: se observó que en el grupo masculino de la sierra comparado con el de la costa, hubo diferencia significativa en las disciplinas que evalúan fuerza (flexiones de cadera y trepar cabo). Conclusiones: el estudio evidenció que los factores ambientales (ej. presión barométrica, temperatura, humedad) no ejercen influencia en las pruebas físicas de fuerza realizadas en la región sierra. Además, es importante señalar que el rendimiento masculino y femenino de las dos regiones en las pruebas de natación sobrepasó las expectativas de las tablas de evaluación. Por tal motivo, como recomendación se debe realizar un nuevo estudio para estandarizar y determinar los puntos de corte adecuados para las respectivas pruebas físicas(AU)

Introduction: The physical fitness tests, from the biological point of view, are a scientific procedure performed under standard conditions that measure several characteristics in an empirical way, specifying the medical-biological measurements as essential indicators of the professional performance of army militaries. Objective: This paper is aimed at comparing the performance of the militaries evaluated in the coast and mountain regions using four tests (race, hip flexion, swimming and rope climbing) corresponding to the physical tests of the Navy staff in the first semester of 2015. Methods: The study was observational, retrospective, analytic and transversal, in which were evaluated men and women aged 18-30. Results: The statistical analysis reported that the male group of the mountain compared to the one of the coast showed a significant difference in the disciplines that evaluate strength (hip flexion and rope climbing). Conclusions: The study showed that the environmental factors (e.g: barometric pressure, temperature, humidity) have no influence in the physical tests of strength performed in the mountains. In addition, it is important to note that the male and female performance of the two regions in the swimming tests overcame the expectation of the evaluation charts. For that reason, as a recommendation, it is necessary to carry out a new study to standardize and determine the adequate cut off points for the respective physical tests(AU)

Validación del test de 6 minutos de carrera como predictor del consumo máximo de oxígeno en el personal naval / Validation of the 6-minute race test as a predictor of maximum oxygen consumption in naval personnel

Introducción: las altas demandas físicas requeridas para el desarrollo de las tareas propias del personal naval, exige un alto desarrollo del consumo máximo de oxígeno (VO2max) en dicha población. Encontrar pruebas que midan el VO2max en el personal naval de forma confiable y válida, además de que sean de fácil aplicación y con poca infraestructura es una labor pendiente. Objetivo: validar el test de 6 minutos de carrera (t-6 min) en el personal naval. Métodos: estudio correlacional, con una muestra de 224 cadetes de la Escuela Naval pertenecientes a la Armada de Chile. Las variables medidas fueron: VO 2max y distancia evaluada a través del t-6 min y el test de 12 minutos (t-12 min). Para el análisis estadístico se utilizó una correlación de Pearson y la técnica Bland-Altman. En el análisis Post hoc se utilizó la prueba t de Student, mientras el tamaño del efecto (TE) fue calculado con una d de Cohen. Resultados: la correlación del VO2max estimado entre el t-6 min y el t-12 min fue de 0,60. El análisis Post hoc mostró diferencias significativas en el VO2max estimado de ambas pruebas de campo (p < 0,0001; TE = 1,016). En el análisis de Bland-Altman se observó la relación entre los valores medios y las diferencias del VO2max estimado entre el t-12 min y el t-6 min, estuvieron en torno a -3,03. Conclusión: los resultados del estudio mostraron una correlación buena entre el t-6 min y el t-12 min. Por tal razón, el t-6 min es una prueba válida para ser aplicada en el personal naval(AU)

Introduction: The high physical demands that Navy personnel face in order to perform their day-to-day tasks entail a high development in peak oxygen uptake (VO 2max). Therefore, finding tests to measure VO2max in Navy personnel in a reliable and valid fashion requiring minor infrastructure and are easily performed is a pending matter. Objective: To validate a 6- minute run test (6WRT) in Navy personnel. Methods: correlational study, while the sample were 224 cadets of the Chilean Navy School. The variables to be measured were: VO2max and distance measured through a 6WRT and 12- minute test (12- min test). The statistical analysis was performed through the Pearson correlation test and the Bland-Altman technique. The post hoc analysis was performed with Student's t test and the size of the effect (SE) was measured using Cohen's d test. Results: The connection of the estimated VO2max between 6WRT and 12- min test was 0.06. The Post hoc analysis showed a significant difference between the estimated VO2max of both field tests (p < 0.0001; SE = 1.016). The Bland-Altman analysis evidenced a relation between media values and the differences of VO2max between 12- min test and 6WRT were approximately -3.03. Conclusion: The results of the study showed a positive connection between 6WRT test and 12- min test. Consequently, 6WRT test is a valid test to be applied in Navy personnel(AU)

Prevalence of hepatitis B and C virus infections among military personnel

Background: Data regarding Hepatitis B and C viruses (HBV and HCV) prevalence among military personnel in Brazil are lacking, but the work-related risk of exposure can be high. The objective of this study was to estimate the seroprevalence of HBV and HCV and the risk factors associated to HBV exposure among Brazilian military personnel. Methods: A cross-sectional study was conducted and included 433 male military adults aged 18-25 years old working in Rio de Janeiro during October 2013. All individuals completed a questionnaire to assess their risk of exposure and provided a blood sample to HBV and HCV testing. Results: None of the participants presented HBsAg or anti-HBc IgM, 18 (4.1%) were positive for total anti-HBc, 247 (57.0%) were positive for anti-HBs, and 3 (0.7%) were anti-HCV reactive. The majority of military personnel with past HBV infection (anti-HBc reactive) and HBV immunity (anti-HBs reactive) had a history of prior dental procedures (88.9% and 77.3%), consumption of alcohol at least once a week (50% and 55.9%), and practiced oral sex (61.1% and 58.3%, respectively). In addition, anti-HBc positivity was common among individuals with a history of surgery (44.4%) and practice of anal sex (50%). At univariate analysis, age group was associated to anti-HBc and anti-HBs positivity. Conclusions: Low rates of HBV and HCV infection were observed among Brazilian military personnel in comparison to the general Brazilian population. HBV immunity rates were relatively low indicating the need for vaccination campaigns in this group. .

Tobacco and alcohol use, sexual behavior and common mental disorders among military students at the Police Academy, São Paulo, Brazil. A cross-sectional study / Tabagismo e consumo de álcool, comportamento sexual e transtornos mentais comuns em estudantes militares da Academia de Polícia, São Paulo, Brasil. Um estudo transversal

CONTEXT AND OBJECTIVE: The lifestyle of military personnel has been little studied in Brazil. This study evaluated the frequencies of tobacco and alcohol use, sexual behavior and mental health among military students. DESIGN AND SETTING: Cross-sectional study at the Police Academy, in São Paulo. METHODS: Students answered a questionnaire about tobacco use, alcohol consumption, sexual behavior and common mental disorders (CMDs). To analyze associations among the frequencies of smoking and alcohol use, sexually transmitted diseases (STDs) and CMDs during the undergraduate years, we built a multinomial logistic regression model adjusted for age and sex. RESULTS: All 473 students were invited to participate and 430 (90.9%) agreed (10.5% were women). Most were white (76.6%), aged < 30 years, from the upper middle class (78.1%). The frequency of smoking was 6.5%, alcohol consumption 69.3%, STDs 14% and CMDs 15.6%. The use of condoms was low. Fourth-year students presented a lower odds ratio (OR) for STDs than the first-year students: 0.44 (95% confidence interval: 0.22-0.90). Third-year students presented a lower OR for CMDs than the first-year students. CONCLUSION: The frequencies of smoking and CMDs were low, while the frequency of alcohol consumption was similar to that of the Brazilian population. The use of condoms was low, in comparison with previous studies with similar samples. The results suggest that there was a certain degree of protection against CMDs and STDs during the undergraduate years. .

CONTEXTO E OBJETIVOS: O estilo de vida dos militares foi pouco estudado no Brasil. Este estudo avaliou frequência de tabagismo, consumo de álcool, comportamento sexual e saúde mental em estudantes militares. TIPO DE ESTUDO E LOCAL: Estudo transversal na Academia de Polícia, São Paulo. MÉTODOS: Alunos responderam questionário sobre tabagismo, uso de álcool, comportamento sexual e transtornos mentais comuns (TMC). Para analisar a associação das frequências de tabagismo, uso de álcool, doenças sexualmente transmissíveis (DST) e TMC durante a graduação, realizou-se regressão logística multinomial ajustada por idade e sexo. RESULTADOS: Todos os 473 estudantes foram convidados e 430 (90,9%) aceitaram participar (10,5% mulheres). A amostra foi composta majoritariamente de brancos (76,6%), com menos de 30 anos, de classe média alta (78,1%). A frequência de fumo foi de 6,5%, de consumo de álcool, 69,3, de DST, 14% e de TMC, 15,6%. O uso de preservativos foi baixo. Estudantes do quarto ano apresentaram uma menor razão de chances (RC) de DST comparados aos do primeiro ano: 0,44 (intervalo de confiança 95%, 0,22-0,90). Estudantes do terceiro ano apresentaram RC menores de ter um TMC comparados aos do primeiro ano. CONCLUSÃO: As frequências de tabagismo e de TMC foram baixas e a de álcool foi similar à da população brasileira. O uso de preservativos foi baixo comparado a estudos anteriores em amostras semelhantes. Os resultados sugerem uma certa proteção para TMC e DST ao longo da graduação. .

Analysis of the Change of Health Status Among the Republic of Korea Air Force Soldiers During Military Service / 예방의학회지

OBJECTIVES: The aim of this study was to investigate whether the health status of Republic of Korea Air Force (ROKAF) soldiers changed after one year of military service. METHODS: We selected 483 ROKAF soldiers from the 11 749 recruits who participated in the 2011 physical examination. The selected soldiers underwent another physical examination in 2012 for advancement to senior airman. Data from 2011 and 2012 were merged. To collect data on lifestyle, a questionnaire was sent to all included subjects via the military intranet e-mail service. RESULTS: The percentage of recruits with an abnormal alanine transaminase level (normal range or =25 kg/m2) decreased from recruitment (20.5%) to the following year (10.4%). There was a significant change in mean duration of exercise carried out each day before (0.8+/-1.3 hours) and after (1.0+/-0.7 hours) joining the ROKAF service. CONCLUSIONS: These ROKAF soldiers were generally in good health before and after joining the armed service. After one year of military service, the health status of most soldiers improved, especially with respect to body mass index and alanine transaminase level.

Tattoos on 18-year-old male adolescents - Characteristics and associated factors / Tatuagens em Adolescentes Masculinos de 18 anos - Caracteristicas e fatores associados

BACKGROUND: Prevalence of tattoos is around 10-26% in men and 10-22% in women, and can involve negative effects such as: regret, removal attempts, physical and biological changes of the skin and association with some viral diseases. OBJECTIVE: to determine the prevalence, characteristics and factors associated with tattoos in recruiters joining the military. METHODS: the recruiters were examined by dermatologists that documented the presence or absence of tattoos, as well as their sizes, colors, designs and patterns, and whether they needed a parent's consent to get a tattoo. RESULTS: 1,968 recruiters were examined and the prevalence of tattoos was 10.82% (213), 141 (66.20%) had a single tattoo, 44 (20.66%) two tattoos, 15 (7.04%) three tattoos, 9 (4.23%) four tattoos, and 4 (1.88%) had more than four. Of the total sample, 168 (80.77%) reported getting the first tattoo before the age of 18. 158 (74.53%) were monochromatic. In relation to size, 108 (50.70%) had tattoos of up to 10 cm, 75 (35.21%) had tattoos measuring between 11-20cm, while 30 had ones over 21cm (14.09%). CONCLUSIONS: The population studied had a high prevalence of tattoos for their age, the percentage of complex (large and polychromatic) tattoos was also high. .

FUNDAMENTOS: Estima-se que a prevalência de tatuagens seja por volta de 10-26% em homens e 10-22% em mulheres, e estas trazem como consequência desdobramentos como: arrependimento, tentativas de remoção, alterações físicas e biológicas da pele e associação com soro positividade para doenças virais. OBJETIVOS: determinar a prevalência, características e fatores associados a tatuagens em alistandos do exército. MÉTODOS: Os alistandos foram entrevistados e examinados por dermatologistas, os quais anotaram a presença ou não de tatuagem , seus tamanhos, suas cores, padrões de desenhos e se havia permissão dos responsáveis para sua execução. RESULTADOS: Foram examinados 1.968 alistandos e a prevalência de tatuagens foi de 10,82% (213), 141 (66,20%) tinham tatuagem única, 44 (20,66%) tinham duas tatuagens, 15 (7,04%) tinham três tatuagens, 9 (4,23%) tinham quatro tatuagens e 4 (1,88%) tinham mais que quatro tatuagens; 168 (80.77%) informaram ter feito a primeira tatuagem antes de completar 18 anos de idade. 158 (74,53%) eram monocromáticas. Em relação ao tamanho no seu maior eixo temos que 108 (50,70%) tinham tatuagens com até 10 cm, 75 (35,21%) tinham entre 11 e 20 cm e com mais de 21 centimetros 30 (14,09%). CONCLUSÕES: a população estudada apresenta uma prevalência alta de tatuagens para a idade, e o percentual de tatuagens complexas (grandes e policromáticas) também é alto. .

Triagem pré-participação com ECG em recrutas militares / Pre-participation ECG screening in military recruits

FUNDAMENTO: Os achados e investigações adicionais necessários com base na triagem pré-participação com eletrocardiograma (ECG) entre os recrutas militares estão mal definidos na literatura. OBJETIVOS: Este estudo foi elaborado para avaliar a taxa de achados anormais na triagem pré-participação com ECG em adultos jovens e as avaliações adicionais necessárias com base nestes resultados. MÉTODOS: Um estudo de coorte retrospectivo foi realizado no centro aero-médico da Força Aérea de Israel (IAF), para candidatos das unidades das academias de voo e de tropa s de elite. Os candidatos das unidades das Academias de voo e de elite passam por uma triagem pré-participação com ECG antes do alistamento nas Forças de Defesa de Israel (IDF). Desde 2010, todos os ECGs são realizados no centro aero-médico da IAF. Todos os ECGs realizados desde janeiro de 2010 foram analisados por um de três cardiologistas e todos aqueles nos quais resultados significativos foram identificados foram encaminhados para uma avaliação mais detalhada, a pedido do cardiologista. As causas de encaminhamento para avaliação posterior, as avaliações realizadas e os resultados dessas avaliações são notificados para a população de estudo. RESULTADOS: 1.455 ECGs foram realizados nos anos 2010-2011. Desses, 1.388 (95,39%) foram interpretadas como normais. 67 indivíduos foram encaminhados para uma avaliação mais detalhada com base nos achados do ECG. Os achados mais comuns levando a uma avaliação mais detalhada foram alterações da onda T (16 casos, 23,88%), padrão de pré-excitação (14, 20,89%) e critérios de voltagem para hipertrofia ventricular esquerda (11; 16,41%). Apenas 7 indivíduos (10,44%) tinham resultados anormais que foram considerados clinicamente significativos no final da avaliação médica. CONCLUSÕES: A taxa de achados significantes levando à desqualificação para a atividade militar é extremamente baixa e o encaminhamento para investigações adicionais baseado nos achados do ECG de 12 derivações deve ser criterioso.

BACKGROUND:The findings and additional investigations required based on pre-participation electrocardiography (ECG) among military recruits are poorly defined in the literature. OBJECTIVES: This study was designed to evaluate the rate of abnormal findings on pre-participation ECG in young adults and the additional evaluations required based on these findings. METHODS: A retrospective cohort study was performed in the Israeli Air Force (IAF) aero medical screening center for flight academy and elite units' candidates. Flight academy and elite units' candidates undergo pre-participation ECG prior to enlistment to the Israeli Defense Forces (IDF). Since 2010, all ECGS have been performed at the IAF aero medical center. All ECGs performed since January 2010 were analyzed by one of three cardiologists and all those in which significant findings were identified were referred to further evaluation upon the cardiologist's request. Causes of referral for further evaluation, the evaluations performed and the results of these evaluations are reported for the study population. RESULTS: 1455 ECGS were performed in the years 2010-2011. Of these, 1388 (95.39%) were interpreted as normal. 67 subjects were referred to further evaluation based on ECG findings. The most common findings leading to further evaluation were T wave changes (16 cases, 23.88%), pre-excitation pattern (14, 20.89%) and voltage criteria for left ventricular hypertrophy (11, 16.41%). Only 7 subjects (10.44%) had abnormal findings which were considered clinically significant at the end of the medical evaluation. CONCLUSIONS: The rate of significant findings leading to disqualification from military activity is extremely low and referral to continued investigations based on 12-lead ECG findings should be judicious.

Seroprevalence of hepatitis B surface antigen and its correlation with risk factors among new recruits in Turkey

OBJECTIVES: The objective of this cross-sectional study was to determine seroprevalence of hepatitis B surface antigen and related risk factors among new recruits in a military unit in Turkey. METHODS: Eight thousand five hundred eighty-nine newly-recruited soldiers were enrolled in the study. Blood samples were drawn from them between January 2006 and December 2006 and ELISA technique was applied to the samples. In addition, questions on the risk factors of hepatitis B exposure were asked to the participants in the survey. RESULTS: The results demonstrated that HBsAg seroprevalence was 2.8%. Further survey results indicated that seropositivity increased depending on certain risk factors. In multiple regression analysis, significant correlations were determined between HBsAg positivity and certain risk factors such as living in the Southeast Anatolia region (p < 0.01), having a history of living with a hepatitis B carrier (p < 0.001), and presence of a hepatitis B carrier in the neighborhood or at work (p < 0.05). CONCLUSIONS: The HBsAg seropositivity found in this study supports the fact that Turkey remains in the medium endemicity zone, and that horizontal transmission is predominant.

South Korean Military Service Promotes Smoking: A Quasi-Experimental Design

PURPOSE: The South Korean (SK) government monopolizes the tobacco industry and is accused of pushing smoking on captive military personnel. However, estimating the association between military service and smoking is difficult, since military service is required for all SK men and the few civilian waivers are usually based on smoking determinants, e.g., social status. MATERIALS AND METHODS: Using a quasi-experimental design we validly estimate the association between military service and smoking. Military service was assigned by immigration patterns to the United States, instead of an experimenter, by comparing Korean Americans who happened to immigrate before or after the age(s) of mandated service. Smoking promotion in the military was also described among SK veterans, to identify the probable mechanisms for veterans' smoking tendencies. RESULTS: Veterans were 15% [95% confidence interval (CI), 4 to 27] more likely to ever-puff and 10% (95% CI, 0 to 23) more likely to ever-smoke cigarettes, compared to a similar group of civilians. Among veterans, 92% (95% CI, 89 to 95) recalled cigarettes were free, 30% (95% CI, 25 to 35) recalled smokers were given more work breaks and 38% (95% CI, 32 to 43) felt explicit "social pressure" to smoke. Free cigarettes was the strongest mechanism for veterans' smoking tendencies, e.g., veterans recalling free cigarette distribution were 16% (95% CI, 1 to 37) more likely to ever-smoke than veterans not recalling. CONCLUSION: These patterns suggest military service is strongly associated with smoking, and differences between veterans and civilians smoking may carry over long after military service. Given military service remains entirely in government purview, actively changing military smoking policies may prove most efficacious. This highlights the importance of recent bans on military cigarette distribution, but policies eliminating other smoking encouragements described by veterans are necessary and could effectively reduce the smoking prevalence by as much as 10% in SK.

Combinação de fatores de risco relacionados à síndrome metabólica em militares da Marinha do Brasil / Combination of risk factors for metabolic syndrome in the military personnel of the Brazilian Navy

FUNDAMENTO: As doenças cardiovasculares representam a principal causa de morte na população, e a síndrome metabólica (SM) é uma condição clínica significativamente associada ao aumento da morbimortalidade. OBJETIVO: Descrever o padrão de combinação dos fatores de risco relacionados ao diagnóstico de SM em militares da Marinha do Brasil e identificar eventuais variáveis associadas à presença da referida síndrome nessa população. MÉTODOS: Estudo transversal envolvendo 1.383 homens (18-62 anos) lotados nas organizações militares da Grande Natal-RN. O critério utilizado para diagnóstico de SM foi o proposto pela International Diabetes Association. A razão entre a prevalência observada e a esperada e os respectivos intervalos de confiança foram utilizados para identificar as combinações de fatores de risco que excediam o esperado para a população. A análise de regressão logística foi utilizada para identificar variáveis associadas à SM. RESULTADOS: A prevalência de SM foi de 17,6 por cento. Aproximadamente um terço dos militares apresentou dois ou mais fatores de risco para SM. Todas as combinações específicas dos fatores de risco para SM que excederam a prevalência esperada apresentaram a obesidade abdominal como um de seus componentes. Nas análises ajustadas, idade, tabagismo e nível de atividade física mantiveram-se associados à SM. CONCLUSÃO: Nossos achados reforçam a constante presença da obesidade abdominal no fenótipo da SM. Além disso, nossos dados também suportam a ideia de que idade, tabagismo e baixo nível de atividade física são variáveis independentes para a ocorrência de SM.

BACKGROUND: Cardiovascular diseases are the major cause of death in the population, and metabolic syndrome (MS) is a clinical condition significantly associated with the increase in morbidity and mortality. OBJECTIVE: To describe the pattern of combination of the risk factors related to the diagnosis of MS in the military personnel of the Brazilian Navy and to identify variables associated with the presence of MS in that population. METHODS: Cross-sectional study involving 1,383 men (18-62 years) assigned to military organizations in the city of Natal, state of Rio Grande do Norte. The criterion proposed by the International Diabetes Association was used for the diagnosis of MS. The ratio between observed and expected prevalence and the respective confidence intervals were used to identify the combinations of risk factors that exceeded that expected for the population. Logistic regression was used to identify variables associated with MS. RESULTS: The prevalence of MS was 17.6 percent. Approximately one third of the military personnel studied had two or more risk factors for MS. All specific combinations of risk factors for MS that exceeded the expected prevalence had abdominal obesity as one of its components. In the adjusted analyses, age, smoking and physical activity level remained associated with MS. CONCLUSION: Our findings reinforce the constant presence of abdominal obesity in the phenotype of MS. In addition, our data also support the idea that age, smoking and low level of physical activity are independent variables for the occurrence of MS.

Efeitos do ruído de impacto na audição de militares / Effects of impact noise on the hearing of military personnel

A prática de tiro é uma atividade que expõe o policial militar ao ruído de impacto, o que pode causar efeitos irreversíveis na audição. OBJETIVO: Avaliar o conhecimento sobre o ruído e os efeitos do ruído de impacto entre policiais militares que fazem prática de tiro. FORMA DE ESTUDO: Caso controle retrospectivo. MATERIAL E MÉTODO: Participaram 115 militares, sendo 65 expostos ao ruído de impacto e 50 não expostos. Foi realizada a avaliação do nível de ruído das armas de fogo, aplicado um questionário, realizada audiometria tonal limiar e teste de emissões otoacústicas transiente e produto de distorção. RESULTADOS: O nível médio de ruído foi de 125Db (C), a maioria (78 por cento) acredita que o ruído pode causar perda auditiva, 92,3 por cento utilizam protetor auricular nas práticas de tiro, mas grande parte (32,3 por cento) nunca recebeu orientação quanto ao seu uso, o sintoma mais referido foi o zumbido (23 por cento) e 25 por cento dos expostos apresenta perda auditiva sugestiva de induzida por ruído. Houve diferença significativa entre os grupos em relação às alterações auditivas. CONCLUSÃO: Os militares expostos ao tiro são mais suscetíveis a desenvolver perdas auditivas. Há necessidade do desenvolvimento de Programas de Preservação Auditiva nesta população.

Shooting is an activity that exposes military personnel to noise impact, which may cause irreversible effects on hearing. OBJECTIVE: To evaluate impact noise on the hearing of military personnel that practice shooting. STUDY DESIGN: A case-control retrospective study. METHODS: 115 military personnel were enrolled; 65 had been exposed to impact noise and 50 were non-exposed. Firearm noise levels were evaluated, subjects answered a questionnaire and underwent threshold tonal audiometry and otoacoustic emissions testing. RESULTS: The average noise level was 125dB(C). Most subjects (78 percent) believe that noise may cause hearing loss; nearly all (92.3 percent) used ear noise protectors while shooting, but most (32.3 percent) had never received guidance for using this equipment. There were significant differences between the two groups in relation to changes suggesting impact noise-induced hearing loss. CONCLUSION: The differences between groups show that noise-exposed military personnel are more likely to develop hearing loss. The goal of a hearing conservation program for this population should be to preserve hearing and educate these individuals about the importance of using hearing protection correctly.

Prevalence of prehypertension in young military adults & its association with overweight & dyslipidaemia.

Background & objectives: Estimation of prevalence of prehypertension in a population and its association with risk factors of cardiovascular disease is important to design preventive programmes. This cross-sectional study was carried out in a healthy military population to assess the prevalence of prehypertension and its association with risk factors such as overweight, abdominal adiposity and dyslipidaemia. Methods: The study included 767 participants (130 officers and 637 from other ranks). The blood pressure, serum triglycerides and serum cholesterol (total, HDL and LDL) were assessed along with anthropometric measurements such as height, weight, waist-hip ratio in apparently healthy military personnel. Information on smoking, alcohol intake, dietary habits and physical activity was collected using pretested questionnaire. Prehypertension was defined as systolic blood pressure (SBP) 120-139 mm Hg and diastolic blood pressure (DBP) 80-89 mm Hg. Results: The overall prevalence of prehypertension was high (about 80%). The prevalence of other risk factors such as overweight (BMI>23 kg/m2), serum total cholesterol > 200 mg/dl, serum LDL cholesterol > 130 mg/dl, serum HDL cholesterol <40 mg/dl, serum triglyceride > 150 mg/dl in the total group was 30, 22, 22, 67, and 14 per cent, respectively. Most of the personnel undertook moderate or heavy exercise. A significantly higher proportion of individuals with prehypertension had clinical and behavioural risk factors such as overweight, dyslipidaemia and adverse dietary practices like saturated fat and added salt intake. On multivariate logistic regression analysis, prehypertension had significant positive association with BMI>23 kg/m2 (OR 1.75), age (OR 1.89), serum triglyceride >150 mg/dl (OR 2.25)and serum HDL cholesterol <40 mg/dl (OR 1.51). Interpretation & conclusions: The high prevalence of prehypertension and its association with overweight and dyslipidaemia in this young, physically active military population indicates an urgent need for targeted interventions to reduce the cardiovascular risk.