Prion protein is associated with a worse prognosis of head and neck squamous cell carcinoma.

BACKGROUND: Head and neck squamous cell carcinoma (HNSC) etiopathogenesis remains unclear, and the biological changes with the activation of heat shock proteins (HSPs) and prion protein (PRNP) promoted by hypoxia in HNSC are undetermined. This study investigates hypoxia's effect in lymph node metastasis by PRNP expression changes and its main partners. METHODS: The study combined a theoretical/cell culture study with a case-control study. First, bioinformatics and cell culture were performed. A case-control study was performed in a second step by comparing HNSC patients with and without lymph node metastasis. ANALYSES: The Cancer Genome Atlas (TCGA) data source validates the theory in the global population study. RESULTS: Bioinformatics analysis suggests that hypoxia-inducible factor-1α (HIF1A) is associated with HSPA4, HSP90AA1 and PRNP expression. TCGA data validate the hypothesis that higher HSP90AA1, HSPA4 and PRNP are related to metastases and low survival. Herein, the cell study demonstrated that muted PRNP did not respond to hypoxia. DISCUSSION: Our results collectively provide the first evidence that PRNP promotes HNSC lymph node metastasis progression through the upregulation of HSPA4, HSP90AA1 and HIF1A. Our findings may provide a molecular basis for the promoting Role of PRNP in HNSC progression.

Factors associated with survival in patients with visceral leishmaniasis treated at a reference hospital in northern Minas Gerais - Brazil.

BACKGROUND: Visceral leishmaniasis (VL) is a public health problem and is a relevant cause of death in developing countries. This study aimed to evaluate the 20-year survival and predictors of worse prognosis in patients with VL admitted to a reference hospital for the treatment of infectious diseases between 1995 and 2016 in northern Minas Gerais, an area of high endemicity for VL. METHODS: This retrospective cohort study was conducted at a hospital in northern Minas Gerais, Brazil. All patients with VL were evaluated over a 20-year period. The medical records were thoroughly analyzed. Cox regression analysis was performed to estimate factors associated with the probability of survival. RESULTS: The cohort included 972 individuals, mostly male children <10 years old, from urban areas who presented at admission with the classic triad of fever, hepatosplenomegaly, and skin pallor. The mean hemoglobin level was 7.53 mg/dl. The mean interval between symptom onset and hospital admission was 40 days. The instituted therapies ranged from pentavalent antimonates to amphotericin, or both. The probability of survival was reduced to 78% one year after symptom onset. Hemoglobin levels and age were strongly associated with the probability of survival. CONCLUSIONS: Regardless of the mechanism underlying the reduction in hemoglobin and the non-modifiable factors of age, early initiation of drug treatment is the most appropriate strategy for increasing survival in patients with VL, which challenges health systems to reduce the interval between the onset of symptoms and hospital admission.

Interrelationships between dissatisfaction with teaching work and depressive symptoms: Structural equation modelling. / Inter-relações entre insatisfação com o trabalho docente e sintomas depressivos: modelagem com equações estruturais.

The objective of this article is to evaluate the interrelationships of factors associated with depressive symptoms (DS) in teachers, considering dissatisfaction with the teaching job as a possible mediator. This was a cross-sectional study using data from 700 teachers from the public school system of a Brazilian municipality. The outcome of interest was DS, as assessed using the Beck Depression Inventory (BDI). Direct and indirect interrelationships between the outcome and dissatisfaction with work, age, income, lifestyle and adiposity were tested. These variables composed the operational model tested by structural equation modelling. Older age (ß=0.12) and greater dissatisfaction with work (ß=0.12) were directly associated with DS. A more favourable lifestyle (ß=-0.60) and adiposity (ß=-0.10) were associated with a lower occurrence of DS. The variables lifestyle (ß=-0.06) and adiposity (ß=-0.02) also had negative indirect effects on DS, mediated by job dissatisfaction. The structural equation model tested identified interrelationships that influenced DS. Dissatisfaction with teaching work was associated with DS and mediated the relationship of other factors with such symptoms.

O objetivo deste artigo é avaliar inter-relações de fatores associados a sintomas depressivos (SD) em professores, considerando a insatisfação com o trabalho docente como possível mediador. Estudo transversal utilizando dados de 700 professores da rede pública de ensino de um município brasileiro. O desfecho de interesse foi SD aferido pelo Inventário de Depressão de Beck (BDI). Foram testadas inter-relações diretas e indiretas entre o desfecho e insatisfação com o trabalho, idade, renda, estilo de vida e adiposidade. Essas variáveis compuseram modelo operacional testado por meio de modelagem de equações estruturais. A maior idade (ß=0,12) e a maior insatisfação com o trabalho (ß=0,12) associaram-se diretamente aos SD. Já o estilo de vida mais favorável (ß=-0,60) e a adiposidade (ß=-0,10), associaram-se a menor ocorrência de SD. As variáveis estilo de vida (ß=-0,06) e adiposidade (ß=-0,02) também apresentaram efeitos indiretos negativos nos SD, mediados pela insatisfação com o trabalho. O modelo de equação estrutural testado identificou inter-relações que influenciaram os SD. A insatisfação com o trabalho docente associou-se aos SD e mediou a relação de outros fatores sobre tais sintomas.

DNMT3B (C46359T) polymorphisms and immunoexpression of DNMT3b and DNMT1 proteins in oral lichen planus.

OBJECTIVE: To investigate the DNMT3B (C46359T) polymorphism and immunoexpression of DNMT3b and DNMT1 in oral lichen planus (OLP) compared to a control group. METHODS: We aimed to investigate the DNMT3B (C46359T) polymorphism and immunoexpression of DNMT3b and DNMT1 in OLP (n = 32), comparing it with oral mucosa (control; n = 24). The DNMT3B (C46359T) polymorphism was analyzed using the RFLP-PCR and DNMT1, and DNMT3a proteins were identified using immunohistochemistry. We also compared the DNMT3B expression in OLP and oral inflammatory fibrous hyperplasia (OIFH), another oral inflammatory disease. Differences between the groups were determined by specific statistical analyses. RESULTS: The CT genotype of DNMT3B was associated with OLP development (p = 0.012). Increased expression of DNMT3B and DNMT1 was observed in OLP compared to the control group (p = 0.014 and p = 0.001, respectively). A significant increase in DNMT3B protein levels was observed in the genotype CT in DNMT3B (C46359T) polymorphisms (p = 0.045). No DNMT3B expression differences between OLP and OIFH were observed. CONCLUSIONS: Our data show that the DNMT3B (C46359T) polymorphism is associated with OLP development. Furthermore, increased expression of the enzyme DNMT3B, an epigenetic-associated protein, is present in OLP.

Sexually transmitted infection and HIV/AIDS counseling practice in primary health care in the city of Montes Claros, Minas Gerais, Brazil, 2015-2016. / Prática de aconselhamento em infecções sexualmente transmissíveis, HIV e aids, realizada por profissionais da atenção primária à saúde de Montes Claros, Minas Gerais, 2015-2016.

OBJECTIVE: to investigate self-reported counseling practice of primary health care (PHC) professionals on sexually transmitted infections (STI) and HIV/AIDS in Montes Claros, MG, Brazil, 2015-2016. METHODS: this was a cross-sectional study using a questionnaire answered by PHC physicians and nurses; their practice was classified as being adequate/inadequate based on the recommendations of Ministry of Health manuals; four thematic areas were investigated - counseling provision; prevention measures; risk behavior and vulnerability assessment; serological testing. RESULTS: 146 professionals participated (41.1% physicians; 58.9% nurses); only 25.7% of professionals reported adequate practices; the area with the highest proportion of inadequate self-reported practice was 'risk behavior and vulnerability assessment' (69.9%); physicians overall practice was more likely to be appropriate than that of nurses (OR=3.48 - 95%CI 1.57;7.70), especially for 'serological testing'. CONCLUSION: self-reported STI and HIV/AIDS counseling practices in PHC were found to be inadequate, revealing the need to intensify health professional awareness-raising/training.

[Arterial Hypertension and work among teachers of basic education in the public-school system]. / Hipertensão Arterial e trabalho entre docentes da educação básica da rede pública de ensino.

The scope of this paper was to investigate the relationship between Arterial Hypertension (AH) and the occupational profile of teachers of basic public education and present a theoretical model. A probabilistic sample was adopted by clusters, with AH as the dependent variable. The independent variables were grouped in thematic blocks (Sociodemographic Characteristics, Occupational Profile, Behaviors and Health Outcomes) that composed the theoretical model. The analyses were corrected by the sample design. Hierarchical logistic regression was conducted. The prevalence of AH was 25%, and 58% reported dissatisfaction with the work. There was a higher probability of AH among older teachers (OR = 3.7), without postgraduate qualification (OR = 1.4), who also worked in the private network (OR = 2.6), who had a higher salt intake (OR = 1.7), with a high waist-hip ratio (OR = 1.9) and hypercholesterolemia / hypertriglyceridemia (OR = 1, 5) and a lower chance among females (OR = 0.5), who had other work activity (OR = 0.6) and were dissatisfied with the work (OR = 0.6). Thus, the occupational profile of teachers had an influence on AH. The relationship between work and teacher health demands attention and care, with measures that preserve and promote the health and well-being of teachers.

Objetivou-se investigar a relação entre Hipertensão Arterial (HA) e perfil ocupacional de docentes da educação básica pública e apresentar modelo teórico. Adotou-se amostra probabilística por conglomerados. A HA foi a variável dependente. As variáveis independentes foram agrupadas em blocos temáticos (Características Sociodemográficas, Perfil Ocupacional, Comportamentos e Desfechos em Saúde), que compuseram o modelo teórico. As análises foram corrigidas pelo desenho amostral. Foi conduzida regressão logística hierarquizada. A prevalência de HA foi de 25%, enquanto que 58% apresentaram insatisfação com o trabalho. Houve maior chance de HA entre os docentes mais velhos (OR = 3,7), sem pós-graduação (OR = 1,4), que atuavam também na rede privada (OR = 2,6), que apresentavam maior consumo de sal (OR = 1,7), com sobrepeso (OR = 2,1) / obesidade (OR = 7,2), com relação cintura-quadril elevada (OR = 1,9) e com hipercolesterolemia/hipertrigliceridemia (OR = 1,5) e menor chance entre os do sexo feminino (OR = 0,5), que exerciam outra atividade de trabalho (OR = 0,6) e insatisfeitos com o trabalho (OR = 0,6). Assim, o perfil ocupacional docente apresentou influência sobre a HA. A relação trabalho e saúde docente carece de atenção e cuidado, com adoção de medidas que preservem e promovam sua saúde e seu bem-estar.

Factors associated with survival in patients with visceral leishmaniasis treated at a reference hospital in northern Minas Gerais - Brazil

ABSTRACT Background: Visceral leishmaniasis (VL) is a public health problem and is a relevant cause of death in developing countries. This study aimed to evaluate the 20-year survival and predictors of worse prognosis in patients with VL admitted to a reference hospital for the treatment of infectious diseases between 1995 and 2016 in northern Minas Gerais, an area of high endemicity for VL. Methods: This retrospective cohort study was conducted at a hospital in northern Minas Gerais, Brazil. All patients with VL were evaluated over a 20-year period. The medical records were thoroughly analyzed. Cox regression analysis was performed to estimate factors associated with the probability of survival. Results: The cohort included 972 individuals, mostly male children <10 years old, from urban areas who presented at admission with the classic triad of fever, hepatosplenomegaly, and skin pallor. The mean hemoglobin level was 7.53 mg/dl. The mean interval between symptom onset and hospital admission was 40 days. The instituted therapies ranged from pentavalent antimonates to amphotericin, or both. The probability of survival was reduced to 78% one year after symptom onset. Hemoglobin levels and age were strongly associated with the probability of survival. Conclusions: Regardless of the mechanism underlying the reduction in hemoglobin and the non-modifiable factors of age, early initiation of drug treatment is the most appropriate strategy for increasing survival in patients with VL, which challenges health systems to reduce the interval between the onset of symptoms and hospital admission.

Avaliação de indicadores sociais e de saúde em municípios de Minas Gerais conforme tipologia rural-urbano / Assessment of social and health indicators in municipalities of Minas Gerais according to the rural-urban typology

RESUMO O presente artigo tem o objetivo de avaliar indicadores sociais e de saúde de municípios conforme a tipologia rural-urbano. Trata-se de estudo ecológico que utilizou dados oficiais de acesso público dos 853 municípios do estado de Minas Gerais, Brasil. Foram conduzidas análises descritivas e bivariadas através da Regressão de Poisson e Teste de Kruskal-Wallis. Do total de municípios, 547 (64,12%) são rurais. A maior média do Índice de Desenvolvimento Humano Municipal (IDH-M) foi observada entre os municípios urbanos. A maior média de cobertura da Estratégia Saúde da Família (ESF) foi verificada entre os municípios rurais, nos quais também foram demonstrados os melhores resultados para os indicadores de mortalidades infantil, prematura e por causas evitáveis, homogeneidade vacinal e prevalência de desnutrição. Os achados deste estudo evidenciam que uma maior cobertura da ESF está associada à ocorrência de melhores condições gerais de vida e de saúde das populações atendidas em municípios de tipologia rural. Recomenda-se aos gestores de saúde o fomento à consolidação da ESF em comunidades com contextos socioeconômicos e culturais desfavoráveis, como localidades rurais remotas e aglomerados urbanos, e o estabelecimento de ações intersetoriais com impacto positivo na saúde.

ABSTRACT This article aims to evaluate social and health indicators of municipalities according to the rural-urban typology. This is an ecological study that used official publicly accessible data from the 853 municipalities in the state of Minas Gerais, Brazil. Descriptive and bivariate analysis were carried out using Poisson Regression and Kruskal-Wallis Test. 547 (64.12%) are rural municipalities. The highest average of the Municipal Human Development Index (MHDI) was observed among urban municipalities. The highest average coverage of the Family Health Strategy (FHS) was found among rural municipalities. In these municipalities, the best results were shown for the indicators of infant mortality, premature mortality and mortality from preventable causes, vaccine homogeneity and prevalence of malnutrition. The findings of this study show that greater FHS coverage is associated with the occurrence of better general living and health conditions in the populations served in rural municipalities. It is recommended that health managers encourage the consolidation of the FHS in communities with unfavorable socioeconomic and cultural contexts, such as remote rural locations and urban agglomerations, and the establishment of intersectoral actions with a positive impact on health.

Inter-relações entre insatisfação com o trabalho docente e sintomas depressivos: modelagem com equações estruturais / Interrelationships between dissatisfaction with teaching work and depressive symptoms: Structural equation modelling

Resumo O objetivo deste artigo é avaliar inter-relações de fatores associados a sintomas depressivos (SD) em professores, considerando a insatisfação com o trabalho docente como possível mediador. Estudo transversal utilizando dados de 700 professores da rede pública de ensino de um município brasileiro. O desfecho de interesse foi SD aferido pelo Inventário de Depressão de Beck (BDI). Foram testadas inter-relações diretas e indiretas entre o desfecho e insatisfação com o trabalho, idade, renda, estilo de vida e adiposidade. Essas variáveis compuseram modelo operacional testado por meio de modelagem de equações estruturais. A maior idade (β=0,12) e a maior insatisfação com o trabalho (β=0,12) associaram-se diretamente aos SD. Já o estilo de vida mais favorável (β=-0,60) e a adiposidade (β=-0,10), associaram-se a menor ocorrência de SD. As variáveis estilo de vida (β=-0,06) e adiposidade (β=-0,02) também apresentaram efeitos indiretos negativos nos SD, mediados pela insatisfação com o trabalho. O modelo de equação estrutural testado identificou inter-relações que influenciaram os SD. A insatisfação com o trabalho docente associou-se aos SD e mediou a relação de outros fatores sobre tais sintomas.

Abstract The objective of this article is to evaluate the interrelationships of factors associated with depressive symptoms (DS) in teachers, considering dissatisfaction with the teaching job as a possible mediator. This was a cross-sectional study using data from 700 teachers from the public school system of a Brazilian municipality. The outcome of interest was DS, as assessed using the Beck Depression Inventory (BDI). Direct and indirect interrelationships between the outcome and dissatisfaction with work, age, income, lifestyle and adiposity were tested. These variables composed the operational model tested by structural equation modelling. Older age (β=0.12) and greater dissatisfaction with work (β=0.12) were directly associated with DS. A more favourable lifestyle (β=-0.60) and adiposity (β=-0.10) were associated with a lower occurrence of DS. The variables lifestyle (β=-0.06) and adiposity (β=-0.02) also had negative indirect effects on DS, mediated by job dissatisfaction. The structural equation model tested identified interrelationships that influenced DS. Dissatisfaction with teaching work was associated with DS and mediated the relationship of other factors with such symptoms.

Floor Maze Test is capable of differentiating spatial navigation between frail and pre-frail institutionalized older persons / Floor Maze Test é capaz de diferenciar a navegação espacial entre idosos institucionalizados frágeis e pré-frágeis

ABSTRACT. Investigation of the association between physical frailty and cognitive performance through spatial navigation is important to enable the identification of individuals with cognitive impairment and physical comorbidity. Objective: To analyze the association between spatial navigation and frailty in frail and pre-frail institutionalized older adults. Methods: Forty older people of both sexes, aged 60 years or over, residing in four Brazilian Long-Term Care Facilities (LTCFs) participated in this study. The following tests were applied: Mini-Mental State Examination (MMSE), 2.44m Timed Up and Go, Floor Maze Test (FMT), and Fried's frailty criteria. For data analysis, the Mann-Whitney and independent t-tests were used to compare the groups (frail x pre-frail), principal component analysis was used to explore the main variables related to the data variance, and binary logistic regression to estimate associations. Results: There was a significant difference in performance in the FMT immediate maze time (IMT) (p=0.02) and in the delayed maze time (DMT) (p=0.009) between the pre-frail and frail older adults. An association between FMT DMT performance and frailty was found, showing that older people with shorter times on the DMT (better performance) had approximately four times the chance of not being frail (odds ratio - OR=4.219, 95% confidence interval - 95%CI 1.084-16.426, p=0.038). Conclusion: Frailty is associated with impaired spatial navigation ability in institutionalized older adults, regardless of gait speed performance.

RESUMO. A investigação da associação entre fragilidade física e desempenho cognitivo por meio da navegação espacial é importante para possibilitar a identificação de indivíduos com déficit cognitivo e comorbidade física. Objetivo: Analisar a associação entre navegação espacial e fragilidade em idosos institucionalizados frágeis e pré-frágeis. Métodos: Participaram deste estudo 40 idosos de ambos os sexos, com idade igual ou superior a 60 anos, residentes em quatro instituições de longa permanência (ILPI) brasileiras. Foram aplicados os seguintes testes: Miniexame do Estado Mental (MEEM), 2,44m Timed Up and Go, Floor Maze Test (FMT) e os critérios de fragilidade de Fried. Para a análise dos dados, foram utilizados os testes t independente e de Mann-Whitney para comparar os grupos (frágeis x pré-frágeis), foi feita análise de componentes principais para explorar as principais variáveis relacionadas à variância dos dados e regressão logística binária para estimar associações. Resultados: Houve diferença significativa no desempenho do FMT no tempo imediato do labirinto (TIL) (p=0,02) e no tempo posterior do labirinto (TPL) (p=0,009) entre os idosos pré-frágeis e frágeis. Encontrou-se associação entre o desempenho no FMT TPL e fragilidade, mostrando que idosos com menor tempo de TPL (melhor desempenho) tiveram aproximadamente quatro vezes mais chance de não serem frágeis (odds ratio - OR=4,219, intervalo de confiança de 95% - IC95% 1,084-16,426, p=0,038). Conclusão: A fragilidade está associada à habilidade de navegação espacial prejudicada em idosos institucionalizados, independentemente do desempenho da velocidade da marcha.

Fatores de risco e proteção para doenças crônicas não transmissíveis entre professores da educação básica / Risk and protective factors for noncommunicable chronic diseases among primary education teachers

Resumo Objetivo: descrever as prevalências de fatores de risco e de proteção para doenças crônicas não transmissíveis (DCNT) e testar associações desses fatores com sexo, idade e satisfação com o trabalho entre professores da educação básica. Métodos: estudo transversal analítico realizado em Montes Claros, MG, Brasil, em 2016. Amostra probabilística por conglomerados. Utilizou-se questionário autoaplicável e avaliações físicas. Estimaram-se razões de prevalências (RP) e intervalos de confiança de 95% (IC95%) pela Regressão de Poisson. Resultados: dos 745 participantes, 83% eram mulheres, 81% tinham até 49 anos e 60% estavam insatisfeitos com o trabalho. Houve maior prevalência de fumantes entre homens (RP: 2,33; IC95%: 1,13;4,81), bem como consumo abusivo de álcool (RP: 7,24; IC95%: 2,19;23,91), excesso de peso (RP:1,48; IC95%: 1,04;2,13), menor prevalência de sintomas depressivos (RP:0,93; IC95%: 0,88;0,98) e de estresse (RP:0,88; IC95%: 0,82;0,95). Professores mais velhos apresentaram menor prevalência de Burnout (RP:0,87; IC95%: 0,81;0,94) e maior prevalência de comportamentos de proteção, apesar de terem maior comprometimento da saúde física. Professores insatisfeitos apresentaram maior prevalência de sintomas depressivos (RP:2,52; IC95%: 1,61;3,93), estresse (RP:1,76; IC95%: 1,33;2,32) e Burnout (RP:9,20; IC95%: 4,46;18,99). Conclusões: tabagismo, etilismo, excesso de peso e comprometimento da saúde mental foram fatores de risco frequentes para DCNT entre professores. Observaram-se diferenças nas prevalências de fatores de risco e de proteção para DCNT segundo sexo, idade e satisfação com o trabalho.

Abstract Objective: to describe the prevalence of risk and protective factors for noncomunicable chronic diseases (NCD) and test the association of these factors with sex, age, and job satisfaction among public primary and secondary schools teachers. Methods: analytical cross-sectional study in Montes Claros, MG, Brazil, carried out in 2016. We applied the probability cluster sampling technique. We used a self-applicable questionnaire and physical evaluations. We estimated Prevalence ratios (PR) and 95% Confidence Intervals (95%CI) using Poisson's regression. Results: of the 745 participants, 83% were women, 81% were 49 years old or younger, and 60% were unsatisfied with work. Smoking was more prevalent among men (PR: 2.33; 95%CI: 1.13;4.81), as well as alcohol abuse (PR: 7.24; 95%CI: 2.19;23.91), overweight (PR:1.48; 95%CI: 1.04;2.13), lower prevalence of depressive symptoms (PR: 0.93; 95%CI: 0.88;0.98) and stress (PR: 0.88; 95%CI: 0.82;0.95). Older teachers had a lower prevalence of burnout (PR: 0.87; 95%CI: 0.81;0.94) and a higher prevalence of protective behaviors, despite having a greater impairment of physical health. Unsatisfied teachers showed higher prevalence of depressive symptoms (PR: 2.52; 95%CI: 1.61;3.93), stress (PR: 1.76; 95%CI: 1.33;2.32), and burnout (PR: 9.20; 95%CI: 4.46;18.99). Conclusions: smoking, alcoholism, overweight, and mental health impairment were frequent risk factors for NCD among teachers. Differences were observed in the prevalence of risk and protection factors for NCD according to sex, age, and job satisfaction.

Fatores associados ao não uso dos serviços odontológicos durante o isolamento social na pandemia de Covid-19 entre professores da educação básica da rede Estadual de Minas Gerais / Factors associated with non-use of dental services during social isolation in the Covid- 19 pandemic among teachers of basic education in the state network of Minas Gerais

Objetivo: Analisar fatores associados ao não uso dos serviços odontológicos durante o isolamento social na pandemia da Covid-19 entre professores da educação básica pública do estado de Minas Gerais (MG).Métodos: Estudo transversal analítico do tipo websurvey realizado entre professores da educação básica das escolas estaduais de MG. O estudo contou com o apoio da Secretaria de Estado de Educação (SEE-MG) que enviou o formulário aos e-mails institucionais dos professores. A variável dependente adotada foi o não uso dos serviços odontológicos durante o período de isolamento social (2020 e 2021) na pandemia da Covid-19. As variáveis independentes foram organizadas segundo modelo teórico de ANDERSEN & DAVIDSON. Foi conduzida Regressão Logística Binária. Resultados: Dos 1.907 professores participantes, 15,3% não utilizaram o serviço odontológico durante o período de isolamento social. A chance de não uso dos serviços odontológicos foi maior entre indivíduos do sexo masculino, com pior padrão alimentar, com autopercepção regular e negativa da saúde bucal, que relataram necessitar de tratamento odontológico e menor chance de não uso entre aqueles que relataram dor. Conclusão: A maioria dos professores investigados fez uso dos serviços odontológicos durante o período. O não uso foi maior entre homens e esteve associado a hábitos, condições clínicas e subjetivas mais negativas.

Aim: To analyze factors associated with the non-use of dental services during social isolation in the Covid-19 pandemic among teachers of public basic education in the state of Minas Gerais. Methods: Analytical cross-sectional web survey study carried out among basic education teachers in state schools in Minas Gerais. The study was supported by the State Department of Education (SEE-MG), which sent the form to the teachers' institutional email. The dependent variable adopted was the non-use of dental services during the period of social isolation (2020 and 2021) in the Covid-19 pandemic. Independent variables were organized according to ANDERSEN & DAVIDSON's theoretical model. Binary Logistic Regression was conducted. Results:Of the 1,907 participating teachers, 15.26% did not use the dental service during the isolation period. The chance of not using dental services was higher among males, with a worse dietary pattern, with regular and negative self-perception of oral health, who reported needing dental treatment, and a lower chance of not using it among those who reported pain. Conclusion: Most of the investigated teachers made use of dental services during the period. Non-use was higher among men and was associated with more negative habits, clinical, and subjective conditions.

[Lack of access to information on oral health problems among adults: an approach based on the theoretical model for literacy in health]. / Falta de acesso a informações sobre problemas bucais entre adultos: abordagem baseada no modelo teórico de alfabetização em saúde.

This study sought to investigate factors associated with the lack of access to information on oral health among adults. It is a cross-sectional study, carried out among 831 adults (35-44 years of age). The dependent variable was access to information on how to avoid oral problems, and the independent variables were gathered into subgroups according to the theoretical model for literacy in health. Binary logistic regression was carried out, and results were corrected by the design effect. It was observed that 37.5% had no access to information about dental problems. The lack of access was higher among adults who had lower per capita income, were dissatisfied with the dental services provided, did not use dental floss, had unsatisfactory physical control of the quality of life, and self-perceived their oral health as fair/poor/very poor. The likelihood of not having access to information about dental problems among those dissatisfied with the dental services used was 3.28 times higher than for those satisfied with the dental services used. Thus, decreased access to information was related to unfavorable conditions among adults. Health services should ensure appropriate information to their users in order to increase health literacy levels and improve satisfaction and equity.

Objetivou-se investigar os fatores associados à falta de acesso à informação em saúde bucal entre adultos. Trata-se de um estudo transversal, conduzido entre 831 adultos (35-44 anos). A variável dependente foi o acesso a informações sobre como evitar problemas bucais e as independentes foram reunidas em subgrupos conforme modelo teórico de Alfabetização em saúde. Conduziu-se Regressão Logística Binária com correção pelo efeito de desenho. Observou-se que 37,5% não tiveram acesso a informações sobre problemas bucais. A falta de acesso foi maior entre os adultos que possuíam renda per capita menor, estavam insatisfeitos com os serviços odontológicos utilizados, não utilizavam fio dental, apresentavam o domínio físico da qualidade de vida insatisfatório e que autopercebiam a saúde bucal como regular/ruim/péssima. A chance de não ter recebido informações sobre com evitar problemas bucais entre os insatisfeitos com os serviços odontológicos utilizados foi 3,28 vezes aquela observada entre os satisfeitos com os serviços odontológicos utilizados. Assim, o menor acesso esteve relacionado a condições desfavoráveis entre adultos. Os serviços de saúde devem garantir informações adequadas a seus usuários, a fim de aumentar os níveis de Alfabetização em saúde, maior satisfação e equidade.

Physical activity on anxiety symptoms during the COVID-19 pandemic: a systematic review / Atividade física nos sintomas de ansiedade durante a pandemia de COVID-19: uma revisão sistemática

Abstract This systematic review aimed to investigate the effect of physical activity on anxiety symptoms during the COVID-19 pandemic. Three databases (PubMed; Scopus and Web of Science) were searched in the period from 2020 to 2022 the following base terms were used: "Physical Activity", Exercise, Anxiety and COVID-19. Peer-reviewed, primary studies published in English, Portuguese and Spanish using valid and reliable measures were included. Eighteen studies met the eligibility criteria, of which 17 were cross-sectional, 2 were cohort studies. The number of participants ranged from 43 to 2,301, aged between 18 and 65 years or older. A decrease in PA practice or an increase in sitting time were associated with higher levels of anxiety symptoms. Additionally, participants who did not meet PA recommendations were more likely to experience moderate to severe anxiety symptoms. The results showed that physical activity is associated with the alleviation of anxiety symptoms during confinement in the COVID-19 pandemic.

Resumo Esta revisão sistemática teve como objetivo investigar o efeito da atividade física nos sintomas de ansiedade durante a pandemia de COVID-19. Foram pesquisadas três bases de dados (PubMed; Scopus e Web of Science) no período de 2020 a 2022 foram utilizados os seguintes termos base: "Physical Activity", Exercise, Anxiety e COVID-19. Foram incluídos estudos primários, revisados ​​por pares, publicados em inglês, português e espanhol usando medidas válidas e confiáveis. Dezoito estudos preencheram os critérios de elegibilidade, sendo 17 transversais, 2 estudos de coorte. O número de participantes variou de 43 a 2.301, com idade entre 18 e 65 anos ou mais. Uma diminuição na prática de AF ou um aumento no tempo sentado foram associados a níveis mais elevados de sintomas de ansiedade. Além disso, os participantes que não atendiam às recomendações de AF eram mais propensos a apresentar sintomas de ansiedade moderados a graves. Os resultados mostraram que a atividade física está associada ao alívio dos sintomas de ansiedade durante o confinamento na pandemia de COVID-19.

Dissatisfaction with the dental services and associated factors among adults. / Insatisfação com os serviços odontológicos e fatores associados entre adultos.

This study aimed to identify factors associated with dissatisfaction with dental services among adults. It analyzed 830 adult participants of an epidemiological survey of oral health. The dependent variable was dissatisfaction with the dental service, and the independent ones were selected according to the theoretical model set forth by Andersen and Davidson (1997). Estimates were corrected by the sample design effect, and Binary Logistic Regression was carried out. It was found that about 11% of adults were dissatisfied with the dental service. In the final model, dissatisfaction with dental services was lower among older adults (OR = 0.559) and among smokers (OR = 0.332). On the other hand, it was higher among adults who self-perceived their chewing as negative (OR = 2,804), who self-perceived some discomfort in the mouth and head and neck region (OR = 2.065), and among those who did not have access to information on how to avoid oral problems (OR = 3.020). Therefore, the services need to access the perceptions and expectations expressed by users, and provide information in appropriate quantity and quality, in the context of "health literacy" in order to achieve greater satisfaction among its users.

[Validity of self-perceived dental caries as a diagnostic test and associated factors in adults]. / Validade da autopercepção da presença de cárie dentária como teste diagnóstico e fatores associados entre adultos.

This study aimed to analyze the validity of self-perceived dental caries and associated factors in a sample of 795 adults (35-44 years). The dependent variable was self-perceived dental caries, and the independent variables were combined in blocks. Three logistic models were performed: (1) all adults; (2) adults with a formal diagnosis of caries; and (3) adults without such caries. Self-perceived dental caries showed 77.7% sensitivity, 58% specificity, 65% accuracy, 52% positive predictive value, and 81% negative predictive value. In Model 1, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, formal diagnosis of caries, self-perceived need for treatment, toothache, and dissatisfaction with oral health and general health. In Model 2, self-perceived dental caries was associated with time of use of dental services, self-perceived need for treatment, and dissatisfaction with oral health and general health. In Model 3, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, self-perceived need for treatment, and dissatisfaction with oral health. Self-perceived dental caries showed limited utility as a diagnostic method.

Cognitive abilities of institutionalized older persons with depressive symptoms / Habilidades cognitivas de idosos institucionalizados com sintomas depressivos

ABSTRACT Objective To determine the level of association between depressive symptoms and cognitive abilities of institutionalized older adults. Methods This is a cross-sectional study that enrolled 69 older adults, living in a long-term care facility. Investigation of depressive symptoms in all individuals was performed using the geriatric depression scale. Cognitive verbal fluency, digit span forward (DSF) and backward (DSB) tests, and two-minute stationary gait, sit-to-stand test, and six-minute walk test were performed to assess their association with depressive symptoms. Results Depressive symptoms were identified in 35 individuals. Worse cognition and physical performances were associated with the presence of depressive symptoms - Mini-Mental State Examination [t (61) = 2.36; p < 0.05] and Stationary gait test of two minutes [t (53) = 3.12; p < 0.05]. Short-term memory and working memory tests presented worse results in individuals with depressive symptoms (DSF: U = 402.00; p < 0.05 e DSB: U = 341,00; p < 0.05). Older adults with scores below normal in DSF were 5 times more likely to exhibit depressive symptoms. Conclusion The importance of physical, cognitive and social intervention strategies in long-term care facilities for the older adults is highlighted, in order to privilege autonomy. Notably, there is an association between deficits in short-term memory and the presence of depressive symptoms in older adults. Therefore, prospective studies are suggested to investigate the cause-effect relationship of this association with the institutionalization of older adults.

RESUMO Objetivo Determinar o nível de associação entre sintomas depressivos e habilidades cognitivas de idosos institucionalizados. Métodos Trata-se de um estudo transversal que envolveu 69 idosos residentes em uma instituição de longa permanência. A investigação dos sintomas depressivos em todos os indivíduos foi realizada por meio da escala de depressão geriátrica. Os testes cognitivos de fluência verbal, digit span forward (DSF) e backward (DSB)e os testes físicos de marcha estacionária de dois minutos, de sentar e levantar e o teste de caminhada de seis minutos foram realizados para avaliar sua associação com sintomas depressivos. Resultados Sintomas depressivos foram identificados em 35 indivíduos. Baixos desempenhos cognitivo e físico foram associados à presença de sintomas depressivos - Miniexame do Estado Mental [t (61) = 2,36; p < 0,05] e Teste de marcha estacionária de dois minutos [t (53) = 3,12; p < 0,05]. A memória de curto prazo e os testes de memória operacional mostraram piores resultados em indivíduos com sintomas depressivos (DSF: U = 402,00; p < 0,05 e DSB: U = 341,00; p < 0,05). Idosos com escores abaixo do normal no DSF tiveram 5 vezes mais chance de apresentar sintomas depressivos. Conclusão Destaca-se a importância de estratégias de intervenção físicas, cognitivas e sociais em instituições de longa permanência para idosos, a fim de privilegiar a autonomia. Notavelmente, apresenta-se uma associação entre déficit na capacidade de memória de curto prazo e a presença de sintomas depressivos em adultos mais velhos. Sugerem-se, então, estudos prospectivos que investiguem a relação de causa-efeito dessa associação com a institucionalização de idosos.

Dementia among older adults living in long-term care facilities: an epidemiological study / Demência em idosos residentes em instituições de longa permanência: um estudo epidemiológico

ABSTRACT Institutionalization has been associated with social isolation, psychological and cognitive changes, and decreased levels of physical activity in older adults. Objectives: The aim of this study was to estimate the prevalence of dementia, mild cognitive impairment (MCI), and functional dependence in older adults dwelling in two different Brazilian long-term care facilities (LTCFs). Methods: This is a cross-sectional study with 185 older people of both sexes, aged 60 years or over, residing in two LTCFs in the city of Montes Claros-MG, Brazil. The diagnosis of MCI and dementia was performed using the Diagnostic and Statistical Manual of Mental Disorders. Results: Prevalence rates of dementia, MCI, and functional dependence in institutionalized older participants were 62.3, 15.1, and 78.9%, respectively. There was a significant reduction of the Mini-Mental State Examination scores according to the increase of the institutionalization period in LCTFs and the age of older adults (p<0.001). Conclusions: Prevalence of dementia and functional dependence of older adults residing in LTCFs exhibited higher rates compared to the other older population worldwide. A higher institutionalization period is related to a greater cognitive decline.

RESUMO A institucionalização tem sido associada ao isolamento social, a alterações psicológicas e cognitivas e à diminuição dos níveis de atividade física em idosos. Objetivos: Estimar a prevalência de demência, declínio cognitivo leve (DCL) e dependência funcional em idosos residentes em duas instituições de longa permanência (ILPI) brasileiras. Métodos: Estudo transversal com 185 idosos de ambos os sexos, com 60 anos ou mais, residentes em duas ILPI. O diagnóstico de DCL e demência foi realizado por meio do Manual Diagnóstico e Estatístico de Transtornos Mentais. Resultados: As taxas de prevalência de demência, DCL e dependência funcional em participantes idosos institucionalizados foram 62,3, 15,1 e 78,9%, respectivamente. Houve redução significativa dos escores do miniexame do estado mental de acordo com o aumento do período de institucionalização nas ILPI e a idade dos idosos (p<0,001). Conclusões: A prevalência de demência e dependência funcional de idosos residentes em ILPI foi mais elevada em comparação com outras populações idosas em todo o mundo. Um período maior de institucionalização está relacionado a maior declínio cognitivo.

Prática de aconselhamento em infecções sexualmente transmissíveis, HIV e aids, realizada por profissionais da atenção primária à saúde de Montes Claros, Minas Gerais, 2015-2016 / Practica en aconsejar sobre enfermedades transmisibles sexualmente y VIH/SIDA en la atención primaria de salud en Montes Claros, Minas Gerais, Brasil, 2015-2016 / Sexually transmitted infection and HIV/AIDS counseling practice in primary health care in the city of Montes Claros, Minas Gerais, Brazil, 2015-2016

Resumo Objetivo: investigar a prática autorreferida dos profissionais da atenção primária à saúde (APS) sobre aconselhamento em infecções sexualmente transmissíveis (ISTs) e HIV/aids em Montes Claros, MG, Brasil, 2015-2016. Métodos: estudo transversal, mediante aplicação de questionário a médicos e enfermeiros da APS; a prática desses profissionais foi classificada, segundo manuais do Ministério da Saúde, como adequada/inadequada; foram investigadas quatro unidades temáticas - realização do aconselhamento; medidas de prevenção; avaliação de comportamento de risco e vulnerabilidade; e testagem sorológica. Resultados: participaram 146 profissionais (41,1% médicos; 58,9% enfermeiros); apenas 25,7% referiram práticas adequadas; o domínio com maior proporção de prática autorreferida inadequada foi 'avaliação de comportamento de risco e vulnerabilidade' (69,9%); médicos referiram prática global com maior chance de ser adequada que enfermeiros (OR=3,48 - IC95% 1,57;7,70), especialmente na unidade temática 'testagem sorológica'. Conclusão: as práticas autorreferidas de aconselhamento em ISTs e HIV/aids na APS mostraram-se inadequadas, indicando a necessidade de intensificar a sensibilização/capacitação dos profissionais.

Resumen Objetivo: describir investigar la práctica auto-referida de los profesionales de la atención primaria de salud (APS) sobre aconsejar en enfermedades transmisibles sexualmente (ETS) y VIH/SIDA en Montes Claros, MG, Brasil, 2015-2016. Métodos: estudio transversal por cuestionario aplicado a médicos y enfermeros; la práctica fue clasificada según los manuales del Ministerio de Salud, en adecuada/inadecuada; se investigaron dominios - realización del asesoramiento; medidas de prevención; evaluación de comportamiento de riesgo y vulnerabilidad; pruebas serológicas. Resultados: participaron 146 profesionales (41,1% médicos; 58,9% enfermeros); sólo el 25,7% de los profesionales reportaron prácticas adecuadas; el dominio con mayor proporción de práctica auto-referida inadecuada fue la 'evaluación del comportamiento de riesgo y vulnerabilidad (69,9%); los médicos tuvieron una práctica global con mayor probabilidad de ser adecuada que los enfermeros (OR=3,48 - IC95% 1,57;7,70), especialmente en la unidad temática 'pruebas serológicas'. Conclusión: las prácticas de asesoramiento en ITS y VIH/SIDA en la APS se mostraron inadecuadas, revelando la necesidad de intensificar la sensibilización/capacitación de los profesionales.

Abstract Objective: to investigate self-reported counseling practice of primary health care (PHC) professionals on sexually transmitted infections (STI) and HIV/AIDS in Montes Claros, MG, Brazil, 2015-2016. Methods: this was a cross-sectional study using a questionnaire answered by PHC physicians and nurses; their practice was classified as being adequate/inadequate based on the recommendations of Ministry of Health manuals; four thematic areas were investigated - counseling provision; prevention measures; risk behavior and vulnerability assessment; serological testing. Results: 146 professionals participated (41.1% physicians; 58.9% nurses); only 25.7% of professionals reported adequate practices; the area with the highest proportion of inadequate self-reported practice was 'risk behavior and vulnerability assessment' (69.9%); physicians overall practice was more likely to be appropriate than that of nurses (OR=3.48 - 95%CI 1.57;7.70), especially for 'serological testing'. Conclusion: self-reported STI and HIV/AIDS counseling practices in PHC were found to be inadequate, revealing the need to intensify health professional awareness-raising/training.

Salário de médicos contratados da Estratégia Saúde da Família e contexto municipal: estudo ecológico / Salary of physicians hired by the Family Health Strategy Program and the municipalities context: an ecological study

RESUMO O salário é um importante fator de atração, fixação e satisfação de profissionais médicos na Atenção Primária à Saúde (APS), sobretudo nas regiões mais remotas ou carentes. Este estudo tem o objetivo de identificar características contextuais municipais que estejam associadas ao valor do salário pago a médicos contratados da Estratégia Saúde da Família (ESF). Realizou-se um estudo ecológico e transversal com 78 municípios da Macrorregião de Saúde Norte, Minas Gerais, Brasil. A variável dependente referiu-se ao valor pago aos médicos contratados da ESF. Foram consideradas 22 variáveis independentes contextuais incluindo características sociodemográficas, de localização e indicadores assistenciais e de saúde de cada município, coletados de bases de dados oficiais. Conduziu-se Regressão Linear Múltipla. A média salarial encontrada foi de R$11.188,61 (±R$2.093,71), variando de R$6.388,20 até R$17.000,00. Após ajuste do modelo, somente a Distância ao Centro Regional manteve-se positivamente associada ao desfecho (R2=6,4%). O salário dos médicos não foi determinado por características municipais contextuais mensuráveis. Outros fatores mais subjetivos, de difícil mensuração, podem estar envolvidos na questão. Observa-se a necessidade do estabelecimento de parâmetros claros para definição do valor do salário de médicos contratados para atuação na ESF.

ABSTRACT Salary is an important factor of attraction, fixation and satisfaction of physicians in Primary Health Care (PHC), mainly in the most remote or poor regions. This study aims to identify characteristics related to municipalities that are associated to salaries paid to physicians hired from the Family Health Strategy (FHS) Program. An ecological and cross-sectional study was conducted with 78 municipalities of the Northern Health Macro-region of Minas Gerais State, Brazil. The dependent variable referred to the amount paid to the physicians hired from FHS. Twenty-two contextual independent variables were applied, including sociodemographic characteristics, location and health and care indicators of each municipality, all collected from public databases. Multiple Linear Regression was conducted. The outcome average salary was R$11,188.61 (±R$2,093.71), ranging from R$6,388.20 to R$17,000.00. After adjusting the model, only the variable 'Distance from Regional Center' remained positively associated to the outcome (R2=6.4%). The conclusion is that the salaries of physicians were not determined by measurable contextual municipal characteristics. Other more subjective and difficult to measure factors may be involved in the issue. Therefore, there is need to establish clear parameters so to define the salaries of physicians hired to work for FHS.