Determinants of quality of life decrease in family caregivers of care-dependent patients: a longitudinal study.

PURPOSE: Family caregivers of care-dependent patients experience a decline in their Quality of Life (QoL). However, the determinants contributing to this decrease in QoL are still not fully understood. Therefore, this study aimed to estimate prospectively the determinants contributing to decreased QoL among family caregivers of care-dependent patients. METHODS: This longitudinal study involved 135 family caregivers in Brazil. Data were collected at baseline from October 2016 to August 2017, and at follow-up from December 2021 to July 2022. During both periods, we administered a questionnaire that covered sociodemographic, health, and lifestyle characteristics of the participants; the Barthel Index to assess the dependency level of the patients; and the WHOQOL-bref to assess the caregivers' QoL. RESULTS: Both caregivers and care-dependent patients were more frequently elderly (44.4% versus 74.6%), female (79.3% versus 61.5%), and had non-communicable disease (60.0% versus 94.3%) at baseline. Most patients experienced a worsening in their level of dependency (59.8%), while over a third of family caregivers (34.8%) reported a decline in their General Quality of Life Index. Eight determinants of decreased QoL were identified: four protective factors (religious faith, physical activity, sharing caregiving responsibilities, and sufficient sleep) and four risk factors (patient hospitalization in the past year, patient increased care dependency, older family caregiver age, and longer caregiving duration). CONCLUSION: Many factors influencing caregiver QoL are modifiable through intervention, underscoring the need for public policies to support family caregivers. Healthcare professionals can play a vital role in promoting protective factors and addressing risk factors to enhance caregiver QoL.

Total dietary antioxidant capacity and food groups and their relationship with the sleep time of Brazilian graduates (CUME Study).

To investigate the association between the Dietary Total Antioxidant Capacity (dTAC) and the Total Antioxidant Capacity of food groups (fgTAC) with the sleep time of Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). This cross-sectional study analyzed 6,387 graduates (2,052 men, 4,335 women, 35.3 ± 9.3 years old) from the CUME Study. Data was collected online, and dTAC was obtained by the Ferric Reduction Antioxidant Power (FRAP) method. Daily sleep time was classified as short sleep, normal sleep, and long sleep (≤6, 7-8, and ≥9 h, respectively). Multinomial logistic regression models were used to estimate the Odds Ratio (OR) and its 95% Confidence Interval (95% CI) between short sleep and long sleep with quartiles of dTAC and the fgTAC. Lower odds of short sleep was observed for the third quartile of dTAC and for fourth quartile of fgTAC of fruits, beans, and lentils, and for the third quartile of fgTAC of vegetables and oils and fats. Higher odds of short sleep for the fourth quartile of fgTAC of teas and coffees. For long sleep, inverse associations were observed for the fourth quartile of fgTAC of oilseeds and the third quartile of fgTAC of teas and coffees. Higher odds of long sleep were observed for the third quartile of artificial juices and sodas. We cannot independently assert an association between higher dTAC and sleep time. In turn, the associations between sleep time and fgTAC show the importance of the food matrix that antioxidants are inserted, requiring longitudinal studies to observe the direction of associations.

Risk and protective factors for Long COVID in Brazilian adults (CUME Study).

Background: Most people recover from COVID-19, however, between 5 to 20% have experienced new, recurring, or continuous health problems four or more weeks after being infected, a phenomenon called Long COVID, and whose reasons for its manifestation are incipient. Our objective was to analyse the risk and protective factors for Long COVID in Brazilian adults participating in the CUME Study. Methods: The CUME Study is a prospective cohort conducted with graduates from federal universities in the State of Minas Gerais, Brazil. In this study, 390 participants who answered the baseline questionnaire in 2016 and the third follow-up questionnaire in 2022 (which contained a block of questions about occurrence of COVID-19 and Long COVID) were included. The diagnosis of Long COVID was based on self-reporting of persistence of signs and symptoms of COVID-19 between 30 days and 6 months after remission of the disease. To estimate the risk and protective factors for Long COVID, a hierarchical multivariate statistical analysis was conducted using the Poisson regression technique. Results: Long COVID was observed in 48.9% of the participants. The following characteristics were identified as risk factors for the outcome: female sex (RR = 1.56; 95% CI = 1.22-1.99); prior diagnosis of hypertension (RR = 1.46; 95% CI = 1.19-1.80); having contracted COVID-19 in the first (RR =1.38; 95% CI = 1.07-1.79) or in the second waves (RR = 1.33; 95% CI = 1.07-1.65) of the pandemic period; and having presented three or more signs and symptoms during the acute phase of COVID-19 (RR = 2.99; 95% CI = 1.08-8.24). On the other hand, having a doctoral/postdoctoral educational level (RR = 0.69; 95% CI = 0.50-0.94) was identified as a protective factor for the outcome. Conclusion: Health system managers and healthcare professionals should be aware of the socioeconomic profile and disease history of patients who have had COVID-19 because women, people with a prior diagnosis of hypertension, and those who manifested multiple signs and symptoms of COVID-19 during the acute phase of the disease were at greater risk of developing Long COVID.

Toxicidad financiera y calidad de vida relacionada con la salud en pacientes con cáncer: un estudio correlacional / Financial Toxicity and Health-Related Quality of Life Among Cancer Patients: A Correlational Study / Toxicidade financeira e qualidade de vida relacionada à saúde de pacientes com câncer: estudo correlacional

Introducción: la toxicidad financiera puede aumentar los costes en salud, así como impactar negativamente en la adherencia terapéutica y en la calidad de vida relacionada con la salud de los pacientes con cáncer en el sistema público de salud. Objetivo: correlacionar la toxicidad financiera con la calidad de vida relacionada con la salud de adultos con cáncer durante la pandemia covid-19. Materiales y método: estudio observacional, transversal y correlacional con 179 pacientes atendidos por el Sistema Único de Salud en una capital del sur de Brasil. La recolección de datos se realizó de septiembre de 2021 a diciembre de 2022, utilizando cuestionarios con datos sociodemográficos y clínicos, y el COmprehensive Score for Financial Toxicity y la Functional Assessment of Cancer Therapy-General. La correlación entre la toxicidad financiera y la calidad de vida relacionada con la salud se evaluó mediante el coeficiente de correlación de Spearman a un nivel de significación del 5 %. Resultados: la correlación entre la toxicidad financiera y la calidad de vida relacionada con la salud fue de 0,41 (valor p < 0,001). Las puntuaciones de toxicidad económica y calidad de vida relacionada con la salud fueron 20,1/44 y 73,3/108, respectivamente. Conclusión: este estudio reveló que cuanto menor era la toxicidad financiera, mejor era la calidad de vida relacionada con la salud de los pacientes. En este sentido, reconocer la presencia de toxicidad financiera en el itinerario terapéutico podría ayudar a mejorar la adherencia al tratamiento y la calidad de vida relacionada con la salud.

Introdução: a toxicidade financeira pode elevar os custos com cuidados em saúde, além de impactar negativamente a adesão terapêutica e a qualidade de vida relacionada à saúde dos pacientes com câncer no âmbito do sistema público de saúde. Objetivo: correlacionar a toxicidade financeira com a qualidade de vida relacionada à saúde de adultos com câncer durante a pandemia da covid-19. Materiais e método: estudo observacional, transversal, correlacional com 179 pacientes atendidos pelo Sistema Único de Saúde, em uma capital do sul do Brasil. A coleta de dados ocorreu de setembro de 2021 a dezembro de 2022, utilizando questionários com dados sociodemográficos e clínicos, e o COmprehensive Score for Financial Toxicity e o Functional Assessment of Cancer Therapy-General. A correlação entre toxicidade financeira e qualidade de vida relacionada à saúde foi avaliada com o coeficiente de correlação de Spearman a um nível de significância de 5 %. Resultados: a correlação entre a toxicidade financeira e a qualidade de vida relacionada à saúde foi de 0,41 (p-valor < 0,001). O escore de toxicidade financeira e de qualidade de vida relacionada à saúde foi de 20,1/44 e 73,3/108, respectivamente. Conclusão: este estudo revelou que, quanto menor a toxicidade financeira, melhor a qualidade de vida relacionada à saúde dos pacientes. Nesse sentido, reconhecer a presença da toxicidade financeira no itinerário terapêutico poderá contribuir para melhorar a adesão ao tratamento e a qualidade de vida relacionada à saúde.

Introduction: Financial toxicity can increase healthcare costs, in addition to negatively impacting the therapeutic adherence and health- related quality of life of cancer patients within the public healthcare system. Objective: To correlate financial toxicity with the adults living with cancer health-related quality of life during the COVID-19 pandemic. Materials and Methods: This is an observational, cross-sectional, correlational study conducted with 179 patients receiving care from the Unified Health System in a capital city in southern Brazil. Data collection was performed from September 2021 to December 2022, using questionnaires containing sociodemographic and clinical data, and the Comprehensive Score for Financial Toxicity and the Functional Assessment of Cancer Therapy-General. The correlation between financial toxicity and health-related quality of life was assessed using Spearman's correlation coefficient at a 5 % significance level. Results: The correlation between financial toxicity and health-related quality of life was 0.41 (p-value < 0.001). The financial toxicity and health-related quality of life scores were 20.1/44 and 73.3/108, respectively. Conclusion: This study has found that the lower the financial toxicity, the better the patients' health-related quality of life. In this sense, recognizing the presence of financial toxicity in the treatment course could help improve adherence to treatment and health-related quality of life.

Fatty acid intake and prevalence of depression among Brazilian graduates and postgraduates (CUME Study).

BACKGROUND: Dietary fatty acids are related to the development of several inflammatory-related diseases, which may include depression. So, the association between fatty acids, culinary oils and fat intake and depression in highly educated Brazilians was evaluated. METHODS: Multicenter cross-sectional study using baseline data from the Cohort of Universities of Minas Gerais. The diagnosis of depression was self-reported, and the daily intake of fatty acids was assessed using a 144-item food frequency questionnaire (FFQ). RESULTS: A total of 7157 participants (68.83 % women) with a median age of 33 years were included. The prevalence of depression was 12.60 % (N = 902). In the adjusted analyses, it was observed that individuals with the highest intake of omega-6 fatty acids (n-6) (OR: 1.36, 95 % CI 1.11-1.67) had a higher prevalence of depression. This increased n-6 intake was identified as a risk factor for depression only among male participants, while among overweight participants, higher n-6 intake was also positively associated with depression. Conversely, a higher ratio of polyunsaturated to monounsaturated and saturated fatty acids (PM/S) was also found to be positively associated with depression, but this association was observed only among non-overweight participants. No associations were found between the consumption of culinary oils or fats and depression. LIMITATIONS: Cross-sectional design limits the assessment of causality. The use of the FFQ can make estimates more difficult. CONCLUSION: Higher consumption of n-6, and higher PM/S ratios were associated with depression, and individual factors can interfere. The mental health care policies should include specific nutritional strategies.

Food consumption according to the degree of industrial food processing in Brazilian graduates (CUME Project): A hierarchical analysis of associated factors / Consumo alimentar segundo o grau de processamento industrial dos alimentos em brasileiros graduados (Projeto CUME): uma análise hierarquizada dos fatores associados

ABSTRACT Objective Evaluate the food consumption of the participants of the Cohort of Universities of Minas Gerais, according to the degree of processing, and its relationship with socioeconomic, behavioral, and individual factors. Methods A total of 4,124 individuals from the baseline of the Cohort of Universities of Minas Gerais (2016 and 2018) participated in this study. Food consumption was self-reported by completing an online Food Frequency Questionnaire. The foods were divided into 3 groups: Group 1, in natura, minimally processed foods, culinary ingredients and culinary preparations; Group 2, processed foods; Group 3, ultra-processed foods. A hierarchical multiple linear regression model was used to verify the associated factors. Results Regarding the factors associated with food consumption, it is noteworthy that Group 1 was positively associated with the practice of physical activity, female gender, age, "non-white" skin color, and the presence of diabetes Mellitus; and negatively with "not married/without stable union" marital status, alcohol abuse, tobacco use, obesity, and depression. Considering Group 2, it was positively associated with alcohol abuse, tobacco use, and age; and negatively with physical activity, female gender, and "non-white" skin color. As for Group 3 it was positively associated with a marital status of "not married/without stable union", obesity, and depression; and negatively with physical activity, age, "non-white" skin color, and presence of diabetes Mellitus. Conclusion The factors that are in at least one of the final hierarchical linear regression models stand out: marital status, physical activity, alcohol abuse, tobacco use, sex, age, skin color, obesity, diabetes mellitus, and depression.

RESUMO Objetivo Avaliar o consumo alimentar dos participantes da Coorte de Universidades Mineiras, de acordo com grau de processamento, e sua relação, com fatores socioeconômicos, comportamentais e individuais. Método Participaram desse estudo 4.124 indivíduos da linha de base da Coorte de Universidades Mineiras (2016 e 2018). O consumo alimentar foi autorrelatado por um questionário online de frequência de consumo alimentar. Os alimentos foram divididos em: Grupo 1: alimentos in natura, minimamente processados, ingredientes culinários e preparações culinárias; Grupo 2: alimentos processados; e Grupo 3: alimentos ultraprocessados. Foi utilizado modelo de regressão linear múltipla hierarquizada para verificar os fatores associados. Resultados O Grupo 1 se associou positivamente à prática de atividade física, sexo feminino, idade, cor da pele "não branca" e presença de diabetes Mellitus; e negativamente ao estado civil "não casado/sem união estável", consumo abusivo de álcool, uso do tabaco, obesidade e depressão. O Grupo 2 se associou positivamente ao consumo abusivo de álcool, uso do tabaco e idade; e negativamente à prática de atividade física, sexo feminino e cor da pele "não branca". O Grupo 3 se associou positivamente ao estado civil "não casado/sem união estável", obesidade e depressão; e negativamente à prática de atividade física, idade, cor da pele "não branca" e presença de diabetes Mellitus. Conclusão Destacam-se os fatores que estão em pelo menos um dos modelos de regressão linear hierarquizada final: estado civil, atividade física, consumo abusivo de álcool, uso do tabaco, sexo, idade, cor da pele, obesidade, diabetes mellitus e depressão.

30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study.

OBJECTIVE: Estimate the incidence of the 30-year high cardiovascular risk and its determinants among graduates of federal universities in Minas Gerais. METHODS: This is a prospective cohort of 2,854 adults aged 20 to 59. The incidence of the outcome was calculated using the Framingham equation and its determinants were determined through multivariate Cox regression. RESULTS: After an average of 2.62 years, the incidence of high cardiovascular risk was 8.09 and 20.1 cases per 1,000 person-years, for females and males respectively. Being male (HR: 2.34; 95% CI: 1.58 - 3.46), employment (HR: 2.13; 95% CI: 1.13 - 3.99), high consumption of processed foods (HR: 2.44; 95% CI: 1.21 - 4.90), and being physically active (HR: 0.63; 95% CI: 0.41 - 0.98) were associated with high cardiovascular risk. CONCLUSIONS: Among highly educated adults, being male, employment, and high consumption of processed foods are predictors of high cardiovascular risk, while being physically active acts as a protective factor.

Trait and state anxiety in healthcare professionals of intensive care unit.

OBJECTIVE: To estimate trait and state anxiety levels among intensivecare professionals during the Covid-19 pandemic. METHOD: Cross-sectional, analytical study, conducted from April to July 2022, in a teaching hospital in southern Brazil, using the State-Trait Anxiety Inventory scale. RESULTS: Trait and state anxiety were present in more than half of the sample, being associated with gender, age group, having children, weekly workload, time working in the hospital and ICU (p<0.05) for the state; and associated with gender, having children, profession, daily and weekly workload, and time working in the hospital (p<0.05) for the trait. CONCLUSION: Trait and state anxiety were medium to high level for women, young, without children, non-nurses, with a daily shift of 9 to 18 working hours, a weekly workload of more than 40 hours, with less than five years of experience in intensive care and with more than five years of experience working in the institution.

The 30-year cardiovascular risk trajectories and their independently associated factors in participants of a Brazilian cohort (CUME Study).

We aimed to analyze the different trajectories of 30-year cardiovascular risk (CVR) and its independently associated factors in participants of the CUME Study, a prospective study with alumni from federal universities of Minas Gerais State, Brazil. In this study, 1,286 participants who answered the baseline (2016) and follow-up (2018 and 2020) questionnaires were included. Trajectories of CVR, according to the Framingham score, were identified with the latent class growth modelling technique with the use of the censored normal model. Analysis of the factors independently associated with each of the trajectories was conducted with multinomial logistic regression technique. Three CVR trajectories were identified: Low-Low (68.3%), Medium-Medium (26.2%), and High-High (5.5%). Male sex, living in a stable union, and having moderate and high intakes of ultra-processed foods were positively associated with the Medium-Medium and High-High CVR trajectories. Having non-healthcare professional training and working were positively associated with the Medium-Medium CVR trajectory, whereas being physically active was negatively associated with the High-High CVR trajectory. In conclusion, more than one-third of participants had CVR trajectories in the Medium-Medium and High-High categories. Food consumption and physical activity are modifiable factors that were associated with these trajectories; thus, implementing health promotion measures could help prevent the persistence or worsen of CVR. On the other hand, sociodemographic and labor characteristics are non-modifiable factors that were associated with Medium-Medium and High-High trajectories, which could help identify people who should be monitored with more caution by health services.

Spatial clusters of diabetes: individual and neighborhood characteristics in the ELSA-Brasil cohort study.

This study identified spatial clusters of type 2 diabetes mellitus among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two cities and verified individual and neighborhood socioeconomic environmental characteristics associated with the spatial clusters. A cross-sectional study was conducted with 4,335 participants. Type 2 diabetes mellitus was defined as fasting blood glucose ≥ 126mg/dL (7.0mmol/L), oral glucose tolerance test ≥ 200mg/dL (11.1mmol/L), or glycated hemoglobin ≥ 6.5% (48mmol/L); by antidiabetic drug use; or by the self-reported medical diagnosis of type 2 diabetes mellitus. Neighborhood socioeconomic characteristics were obtained from the 2011 Brazilian census. A spatial data analysis was conducted with the SaTScan method to detect spatial clusters. Logistic regression models were fitted to estimate the magnitude of associations. In total, 336 and 343 participants had type 2 diabetes mellitus in Belo Horizonte, Minas Gerais State (13.5%) and Salvador, Bahia State (18.5%), respectively. Two cluster areas showing a high chance of type 2 diabetes mellitus were identified in Belo Horizonte and Salvador. In both cities, participants living in the high type 2 diabetes mellitus cluster area were more likely to be mixed-race or black and have a low schooling level and manual work; these were also considered low-income areas. On the other hand, participants in the low type 2 diabetes mellitus cluster area of Salvador were less likely to be black and have low schooling level (university degree) and live in a low-income area. More vulnerable individual and neighborhood socioeconomic characteristics were associated with living in clusters of higher type 2 diabetes mellitus occurrence , whereas better contextual profiles were associated with clusters of lower prevalence.

Habitual polyphenol intake of foods according to NOVA classification: implications of ultra-processed foods intake (CUME study).

We aimed to evaluate the intake of dietary total polyphenols and their classes according to NOVA classification among adults of a Brazilian cohort study. This is a cross-sectional study, in which food consumption was assessed using an Food Frequency Questionnaire (FFQ) and polyphenol content (total and their classes) was estimated at Phenol-Explorer for each food category and presented as mean and 95% confidence interval. Adjusted linear regression was used to describe the trend of the association between the quintiles of polyphenols intake (dependent variable) and NOVA group of food consumption (independent variable). The higher consumption of fresh/minimally processed foods is accompanied by a higher intake of total polyphenols and all their classes, while the higher consumption of ultra-processed foods represented the lower intake of total polyphenols and their classes. Fresh foods are the greatest sources of polyphenols, and their daily consumption should be encouraged, while ultra-processed foods are deficient in such bioactive compounds.

Association between total dietary antioxidant capacity and food groups and incidence of depression in a cohort of Brazilian graduates (CUME Project).

This study aims to evaluate the association between Dietary Total Antioxidant Capacity (dTAC) and Total Antioxidant Capacity of food groups (fgTAC) with the incidence of depression in Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). The sample consisted of 2572 participants without a medical diagnosis of depression at baseline who responded to at least one follow-up questionnaire from the CUME Project. The Ferric Reducing Antioxidant Power assay was used to determine dTAC. Incidence of depression was estimated by self-reported medical diagnosis of depression during the years of cohort follow-up. Cox regression models were used to relate dTAC and fgTAC to the incidence of depression. The mean follow-up time was 2·96 (1·00) years, and 246 cases of depression were observed (32·3/1000 person-years). The mean dTAC was 11·03 (4·84) mmol/d. We found no associations between higher dTAC and lower risk of developing depression after adjusting for possible confounders. The incidence of depression was inversely associated with fgTAC of the beans and lentils group (hazard ratio (HR): 0·61; 95 % CI 0·41, 0·90). The fgTAC of the junk food group was positively associated with higher incidence of depression after all adjustments (HR: 1·57; 95 % CI 1·08, 2·26). Our findings do not support an association between dTAC and the incidence of depression in a highly educated Brazilian population. However, associations of fgTAC show the importance of analysing the food matrix in which these antioxidants are inserted. We highlight the need for more prospective studies with different nationalities to confirm these results.

Ultra-processed food consumption is positively associated with the incidence of depression in Brazilian adults (CUME project).

OBJECTIVE: To evaluate the association between the consumption of ultra-processed food and the incidence of depression in Brazilian adults. METHODS: This longitudinal study included 2572 participants (M = 936 and F = 1636, mean age of 36.1 years) from the Cohort of Universities of Minas Gerais - CUME Project, Brazil. Ultra-processed food (UPF) consumption (in % of daily energy intake, DEI), as defined by the NOVA food classification system, was assessed at baseline using a validated semi-quantitative 144-item food frequency questionnaire. Participants were classified as incident cases of depression if they reported a medical diagnosis of depression in at least one of the follow-up questionnaires. Crude and adjusted cox regression models were used to assess the relationship between UPF consumption and the incidence of depression. RESULTS: After a mean of follow-up of 2,96 years, a total of 246 incident cases of depression were identified. The mean consumption of UPF was 44 g/d or 24 % of DEI. Participants in the highest quartile of UPF consumption (31 to 72 % of DEI) had a higher risk of developing depression (HR = 1.82 95 % CI = 1.15-2.88) than those in the lowest quartile (0 to 16 % of DEI) after adjusting for potential confounders. CONCLUSION: Higher UPF consumption is a risk factor of depression incidence in Brazilian adults with high education level.

Consumption of sweetened beverages is associated with the incidence of type 2 diabetes in Brazilian adults (CUME project).

BACKGROUND AND AIM: To evaluate the association between the energy consumption of sweetened beverages (SBs) adjusted for daily energy intake and the incidence of type 2 diabetes. METHODS AND RESULTS: This was a prospective study with 2480 type 2 diabetes mellitus (T2DM)-free Cohort of Universities of Minas Gerais (CUME) participants at baseline and 2-4 years of follow-up. A longitudinal analysis was performed with generalized equation estimation to verify the effect of SB consumption, adjusted for sociodemographic and lifestyle variables, on the incidence of T2DM. The incidence of T2DM was 2.78%. The median calorie intake of daily SB consumption adjusted for energy was 47.7 kcal/day. Participants with the highest consumption of SBs (≥47.7 kcal/day) were 63% (odds ratio [OR] = 1.63; p value-0.049) more likely to acquire T2DM over time compared to the lowest consumption (<47.7 kcal/day). CONCLUSIONS: Higher energy consumption from SBs favored a higher incidence of T2DM among CUME participants. The results reinforce the need for marketing restrictions on these foods and taxation to reduce the consumption of these beverages to prevent T2DM and other chronic noncommunicable diseases.

Effects of minimally and ultra-processed foods on blood pressure in Brazilian adults: a two-year follow up of the CUME Project.

AIM: To assess the association of food consumption according to degree of processing with changes in systolic (SBP) and diastolic (DBP) blood pressure in adult participants of a Brazilian cohort. METHODS: Longitudinal study with 2496 adult participants of the Cohort of Universities of Minas Gerais (CUME Project). Food consumption was categorized by food groups according to degree of processing following the NOVA grading system: unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). Changes in SBP and DBP were categorized (decreased, maintained, increased). Independent associations between exposure and outcomes were verified using multiple generalized ordered logistic models adjusted for potential confounders. RESULTS: After a two-year follow-up, the consumption of U/MPF&CI (% daily caloric intake) reduced the chance of increasing DBP (P for trend = 0.014), with a more evident effect among participants within the 5th quintile of this food group (odds ratio (OR) = 0.55; 95% confidence interval (CI): 0.34-0.97]. On the other hand, the consumption of UPFs (% daily caloric intake) raised the chance of increasing DBP (P for trend = 0.005) and was more evident among participants within the quintiles of higher consumption (4th quintile - OR = 1.97; 95% CI: 1.25-3.10; 5th quintile - OR = 1.79; 95% CI = 1.12-2.86). No associations were found between food consumption according to degree of processing and changes in SBP. CONCLUSION: Higher consumption of U/MPF&CI and UPFs were independently associated to lower and greater chances of increased DBP in adult participants from CUME Project.

Total Polyphenol Intake, Polyphenol Subtypes, and Prevalence of Hypertension in the CUME Cohort.

Objective:Epidemiological studies have shown associations between polyphenol consumption and reduced risk of cardiovascular diseases. This study aimed to assess the association between polyphenol intake and the prevalence of hypertension.Methods:This cross-sectional study was performed on data from the Cohort of Universities of Minas Gerais (CUME) project. Participants completed an online food frequency questionnaire, and polyphenol intake was assessed using the Phenol-Explorer database and articles. Hypertension was determined by a medical diagnosis, having a blood pressure ≥ 130 mmHg/80 mmHg, or using antihypertensive drugs. Adjusted logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the prevalence of hypertension.Results:The prevalence of hypertension was 39.57%, and the average intake of total polyphenols was 860.79 mg/day. The highest (5th quintile) intake of flavonoids (mean: 368.46mg/day; OR: 0.83; 95%CI 0.70; 0.97), hydroxybenzoic acids (mean: 379.38mg/day; OR: 0.77; 95%CI: 0.66;0.91), and flavonols (mean: 44.13mg/day; OR: 0.79; 95%CI: 0.67; 0.93) was inversely associated with hypertension prevalence, compared to the lowest intake (1st quintile).Conclusions:Our findings demonstrate that the intake of flavonoids, hydroxybenzoic acids, and flavonols is associated with a lower prevalence of hypertension.

Low polyphenol intake among highly scholarity population: CUME cohort.

In the absence of a recommendation for daily intake of phenolic compounds, to compare the intake of the main dietary polyphenols between populations is a really challenge. This study aimed to estimate the total dietary intake of polyphenols, classes and their food sources among Brazilian graduates and postgraduates. This was a cross-sectional study using baseline data from the Cohort of Universities of Minas Gerais (CUME project). Food consumption was assessed using a quantitative food frequency questionnaire with 144 food items. Polyphenol intake was estimated from the Phenol-Explorer and US Department of Agriculture database, and previous studies that evaluated the phenolic content of specific foods. A total of 4130 individuals of both sexes with a median age of 34 (18-86) years old were finally included. The median intake of total polyphenols adjusted for energy was 753.41 mg/day (interquartile range - IQR=461.80; p<0.001), and the most consumed classes were phenolic acids and flavonoids, with median intakes of 552.30 mg/d (IQR=429.78; p<0.001) and 154.70 mg/day (IQR=108.70; p<0.001), respectively. The main food sources of polyphenols were coffee, peanuts, beans, and fruits. A lower intake of total polyphenols and their classes was observed in a population with similar characteristics to those from developed countries. The results demonstrate the importance of disseminating nutritional information about foods, so that the consumption of natural foods is prioritized. New studies that evaluate the consumption of polyphenols and their impact on human health are recommended to establish a daily recommendation for the consumption of such compounds.

The 30-year cardiovascular risk trajectories and their independently associated factors in participants of a Brazilian cohort (CUME Study) / As trajetórias de risco cardiovascular de 30 anos e seus fatores independentemente associados em participantes de uma coorte brasileira (Estudo CUME) / Las trayectorias de riesgo cardiovascular de 30 años y sus factores asociados de forma independiente en participantes de una cohorte brasileña (Estudio CUME)

Abstract: We aimed to analyze the different trajectories of 30-year cardiovascular risk (CVR) and its independently associated factors in participants of the CUME Study, a prospective study with alumni from federal universities of Minas Gerais State, Brazil. In this study, 1,286 participants who answered the baseline (2016) and follow-up (2018 and 2020) questionnaires were included. Trajectories of CVR, according to the Framingham score, were identified with the latent class growth modelling technique with the use of the censored normal model. Analysis of the factors independently associated with each of the trajectories was conducted with multinomial logistic regression technique. Three CVR trajectories were identified: Low-Low (68.3%), Medium-Medium (26.2%), and High-High (5.5%). Male sex, living in a stable union, and having moderate and high intakes of ultra-processed foods were positively associated with the Medium-Medium and High-High CVR trajectories. Having non-healthcare professional training and working were positively associated with the Medium-Medium CVR trajectory, whereas being physically active was negatively associated with the High-High CVR trajectory. In conclusion, more than one-third of participants had CVR trajectories in the Medium-Medium and High-High categories. Food consumption and physical activity are modifiable factors that were associated with these trajectories; thus, implementing health promotion measures could help prevent the persistence or worsen of CVR. On the other hand, sociodemographic and labor characteristics are non-modifiable factors that were associated with Medium-Medium and High-High trajectories, which could help identify people who should be monitored with more caution by health services.

Resumo: Nosso objetivo foi analisar as diferentes trajetórias de risco cardiovascular (RCV) de 30 anos e seus fatores independentemente associados em participantes do Estudo CUME, um estudo prospectivo com ex-alunos de universidades federais de Minas Gerais, Brasil. Este estudo incluiu 1.286 participantes que responderam aos questionários de linha de base (2016) e acompanhamento (2018 e 2020). As trajetórias de RCV, de acordo com o escore de Framingham, foram identificadas por modelagem de crescimento de classe latente com o uso do modelo normal censurado. A análise dos fatores independentemente associados a cada uma das trajetórias foi realizada por regressão logística multinomial. Foram identificadas três trajetórias de RCV: Baixo-Baixo (68,3%), Médio-Médio (26,2%) e Alto-Alto (5,5%). Sexo masculino, união estável e consumo moderado e alto de alimentos ultraprocessados foram positivamente associados às trajetórias de RCV Médio-Médio e Alto-Alto. Formação profissional e trabalhar em áreas não relacionadas à saúde foram positivamente associados à trajetória de RCV Médio-Médio, enquanto ser fisicamente ativo foi negativamente associado à trajetória de RCV Alto-Alto. Em conclusão, mais de um terço dos participantes apresentou trajetórias de RCV nas categorias Médio-Médio e Alto-Alto. Fatores modificáveis foram associados a essas trajetórias (consumo de alimentos e atividade física); assim, medidas de promoção da saúde podem evitar a manutenção ou a piora do RCV. Por outro lado, os fatores não modificáveis associados às trajetórias Médio-Médio e Alto-Alto (características sociodemográficas e laborais) permitem traçar o perfil das pessoas que devem ser monitoradas com mais cautela pelos serviços de saúde.

Resumen: Nuestro objetivo fue analizar las diferentes trayectorias de riesgo cardiovascular (RCV) de 30 años y sus factores asociados de forma independiente en participantes del Estudio CUME, un estudio prospectivo con exalumnos de universidades federales de Minas Gerais, Brasil. Este estudio incluyó a 1.286 participantes que completaron los cuestionarios de referencia (2016) y de seguimiento (2018 y 2020). Las trayectorias de RCV, según el índice de Framingham, se identificaron mediante el modelado de crecimiento de clase latente utilizando el modelo normal censurado. El análisis de los factores asociados de forma independiente a cada una de las trayectorias se realizó mediante regresión logística multinomial. Se identificaron tres trayectorias de RCV: Bajo-Bajo (68,3%), Medio-Medio (26,2%) y Alto-Alto (5,5%). El género masculino, la unión estable y el consumo moderado y alto de alimentos ultraprocesados se asociaron positivamente con las trayectorias de RCV Medio-Medio y Alto-Alto. La formación profesional y el trabajo en áreas no relacionadas con la salud se asociaron positivamente con la trayectoria de RCV Medio-Medio, mientras que la actividad física se asoció negativamente con la trayectoria de RCV Alto-Alto. En conclusión, más de la tercera parte de los participantes presentó trayectorias de RCV en las categorías Medio-Medio y Alto-Alto. A estas trayectorias se asociaron factores modificables (consumo de alimentos y actividad física); por lo tanto, las medidas de promoción de la salud pueden prevenir el mantenimiento o el empeoramiento del RCV. Por otra parte, los factores no modificables asociados a las trayectorias Medio-Medio y Alto-Alto (características sociodemográficas y laborales) permiten delinear el perfil de las personas que deben ser monitoreadas con más atención por los servicios de salud.

Mortalidade infantil por causas evitáveis: perfil epidemiológico e tendencial em um município de médio porte da região oeste do Paraná, 2011-2021 / Infant mortality from preventable causes: epidemiological and trend profile in a medium-sized municipality in the western Paraná region, 2011-2021 / Mortalidad infantil por causas prevenibles: perfil epidemiológico y tendencia en un municipio de tamaño medio de la región oeste del Paraná, 2011-2021

Objetivo: analisar o perfil epidemiológico e a tendência da mortalidade infantil por causas evitáveis em Fazenda Rio Grande/PR, de 2011 a 2021. Método: realizou-se um estudo de série temporal com dados obtidos dos Sistemas de Informações de Mortalidade e Nascidos Vivos. As taxas de mortalidade foram calculadas segundo categorias: neonatal precoce; tardia e pós-neonatal; evitáveis e não evitáveis; e reduzíveis por adequada atenção à mãe e neonato, com avaliação de tendência por regressão linear de Prais-Winsten. Resultados: As maiores proporções de óbitos evitáveis, foram por inadequada atenção à mulher no parto (36,5%), à mulher na gestação (26,8%), e ao recém- nascido (16%). Observou-se redução percentual nos coeficientes de óbitos gerais (ß = - 0,32; IC95% -0,91;0,68) e por causas evitáveis (ß = -0,74; IC95% -0,98;0,50), mesmo não havendo significância estatística nos resultados relativos às tendências (p ≥ 0,05). Conclusão: A partir dos resultados obtidos, Constatou-se a necessidade de intervenções voltadas ao cuidado materno-infantil, essencialmente na atenção à mulher no pré-natal e no parto e ao neonato, visto que constituem percentuais expressivos dentre as causas de morte evitáveis. A redução da mortalidade infantil é um desafio global para os serviços de saúde e sociedade como um todo. Sua análise permite incorporar o uso de informação qualificada no planejamento e avaliação de ações e políticas públicas voltadas à saúde materno-infantil, tal como, embasar novos estudos, fundamentais para alicerçar a avaliação crítica da prática em relação aos achados de pesquisa e promover mudanças baseadas em evidências.

Objective: to analyze the epidemiological profile and the trend of infant mortality from preventable causes in Fazenda Rio Grande/PR, from 2011 to 2021. Method: a time-series study was conducted with data obtained from the Mortality and Live Births Information Systems. Mortality rates were calculated according to categories: early neonatal; late and post-neonatal; preventable and non-preventable; and reduceable by adequate attention to the mother and neonate, with trend evaluation by Prais-Winsten linear regression. Results: The highest proportions of avoidable deaths, were due to inadequate care of the woman in childbirth (36.5%), the woman in pregnancy (26.8%), and the newborn (16%). There was a percentage reduction in the coefficients of general deaths (ß = -0.32; 95%CI -0.91;0.68) and by preventable causes (ß = -0.74; 95%CI - 0.98;0.50), even though there was no statistical significance in the results regarding trends (p ≥ 0.05). Conclusion: From the results obtained, there was a need for interventions aimed at maternal and child care, especially in the care of women in prenatal and childbirth and neonates, since they constitute significant percentages among the causes of preventable death. The reduction of infant mortality is a global challenge for health services and society as a whole. Its analysis allows us to incorporate the use of qualified information in the planning and evaluation of actions and public policies aimed at maternal and child health, as well as to support new studies, which are essential to support the critical evaluation of the practice in relation to research findings and to promote evidence-based changes.

Objetivo: analizar el perfil epidemiológico y la tendencia de la mortalidad infantil por causas evitables en Fazenda Rio Grande/PR, de 2011 a 2021. Material y método: se realizó un estudio de series temporales con datos obtenidos de los Sistemas de Información de Mortalidad y Nacidos Vivos. Se calcularon las tasas de mortalidad según las categorías: neonatal precoz; neonatal tardía y posneonatal; prevenible y no prevenible; y reducible por atención adecuada a la madre y al neonato, con evaluación de la tendencia por regresión lineal de Prais-Winsten. Resultados: Las mayores proporciones de muertes evitables, se debieron a la inadecuada atención a la mujer en el parto (36,5%), a la mujer en el embarazo (26,8%) y al recién nacido (16%). Hubo una reducción porcentual en los coeficientes de muertes generales (ß = -0,32; IC 95% -0,91;0,68) y por causas evitables (ß = -0,74; IC 95% -0,98;0,50), aunque no hubo significación estadística en los resultados en cuanto a tendencias (p ≥ 0,05). Conclusiones: De los resultados obtenidos se desprende la necesidad de intervenciones dirigidas a la atención materno- infantil, especialmente en la atención de la mujer en el prenatal y parto y de los neonatos, ya que constituyen porcentajes significativos entre las causas de muerte prevenible. La reducción de la mortalidad infantil es un reto global para los servicios de salud y la sociedad en su conjunto. Su análisis permite incorporar el uso de información cualificada en la planificación y evaluación de acciones y políticas públicas dirigidas a la salud materno-infantil, así como apoyar nuevos estudios, que son esenciales para apoyar la evaluación crítica de la práctica en relación con los resultados de la investigación y promover cambios basados en la evidencia.

Trait and state anxiety in healthcare professionals of intensive care unit / Rasgo y estado de ansiedad en profesionales de salud de unidad de cuidados intensivos / Ansiedade traço e estado em profissionais da saúde de unidade de terapia intensiva

ABSTRACT Objective: To estimate trait and state anxiety levels among intensivecare professionals during the Covid-19 pandemic. Method: Cross-sectional, analytical study, conducted from April to July 2022, in a teaching hospital in southern Brazil, using the State-Trait Anxiety Inventory scale. Results: Trait and state anxiety were present in more than half of the sample, being associated with gender, age group, having children, weekly workload, time working in the hospital and ICU (p<0.05) for the state; and associated with gender, having children, profession, daily and weekly workload, and time working in the hospital (p<0.05) for the trait. Conclusion: Trait and state anxiety were medium to high level for women, young, without children, non-nurses, with a daily shift of 9 to 18 working hours, a weekly workload of more than 40 hours, with less than five years of experience in intensive care and with more than five years of experience working in the institution.

RESUMEN Objetivo: Estimar los niveles de ansiedad rasgo y estado entre los profesionales de salud de cuidados intensivos durante la pandemia de Covid-19. Método: Estudio transversal, analítico, realizado de abril a julio de 2022, en un hospital escuela del sur de Brasil, utilizando la escala Inventario de Ansiedad Estado-Rasgo. Resultados: La ansiedad rasgo y estado estuvo presente en más de la mitad de la muestra, asociándose con el género, grupo etario, tener hijos, carga horaria semanal, tiempo de trabajo en el hospital y UCI (p<0,05) para el estado; y asociado al género, tener hijos, profesión, carga diaria y semanal y tiempo de trabajo en el hospital (p<0,05) para el rasgo. Conclusión: La ansiedad rasgo y estado fue media a alta para mujeres, jóvenes, sin hijos, no enfermeras, con jornada diaria de 9 a 18 horas, carga laboral semanal de más de 40 horas, con menos de cinco años de experiencia en terapia cuidados intensivos y tiempo de trabajo en la institución por más de cinco años.

RESUMO Objetivo: Estimar os níveis de ansiedade traço e estado entre profissionais da saúde daterapia intensiva durante a pandemia Covid-19. Método: Estudo transversal, analítico, realizado de abril-julho de 2022, num hospital de ensino do sul do Brasil, utilizando a escala Inventário de Ansiedade Traço-Estado. Resultados: A ansiedade traço e estado estiveram presentes em mais da metade da amostra, sendo associada ao sexo, faixa etária, ter filhos, carga horária semanal, tempo de trabalho no hospital e na UTI (p<0,05) para o estado; e associada ao sexo, ter filhos, profissão, carga horária diária e semanal, e tempo de trabalho no hospital (p<0,05) para o traço. Conclusão: A ansiedade traço e estado foram de nível médio a alto para mulheres, jovens, sem filhos, não enfermeiras, com jornada diária de 9 a 18 horas trabalhadas, carga horária semanal acima de 40 horas, com experiência menor de cinco anos em terapia intensiva e quanto ao tempo de atuação na instituição maior que cinco anos.