All things considered, my risk for diabetes is medium: A risk personalization process of familial risk for type 2 diabetes.

BACKGROUND: A positive family history of type 2 diabetes (T2D) has been associated with risk awareness and risk-reducing behaviours among the unaffected relatives. Yet, little is known about how people with a positive family history for diabetes develop and manage their personal sense of risk. OBJECTIVE: To characterize two key concepts, salience and vulnerability, within the familial risk perception (FRP) model among unaffected individuals, at increased familial risk for T2D. DESIGN: We conducted a mixed method study. Descriptions of salience and vulnerability were collected through semi-structured interviews. Participant's perception of self-reported risk factors (family history, age, race/ethnicity, medical history, weight and exercise) was measured using the Perceived Risk Factors for T2D Tool and was compared to a clinical evaluation of the same risk factors. RESULTS: We identified two components of salience: (a) concern for developing T2D and (b) risk awareness triggers, and two features of vulnerability: (a) statement of risk and (b) risk assessment devices. Although few participants (26%) were concordant between their perceived and clinical overall T2D risk, concordance for individual risk factors was higher, ranging from 42% (medical history) to 90% (family history). DISCUSSION AND CONCLUSION: Both familial and non-familial events lead people to contemplate their T2D risk, even among people who have a positive family history. Participants often downplayed their overall risk and underestimated their overall risk compared to a clinical risk assessment of the same self-reported risk factors. Clinicians could leverage key components of the FRP process as way to engage patients in risk reduction strategies earlier.

Active Circulation of Madariaga Virus, a Member of the Eastern Equine Encephalitis Virus Complex, in Northeast Brazil.

Madariaga virus (MADV) is a member of the eastern equine encephalitis virus (EEEV) complex that circulates in Central and South America. It is a zoonotic, mosquito-borne pathogen, belonging to the family Togaviridae. Disturbances in the natural transmission cycle of this virus result in outbreaks in equines and humans, leading to high case fatality in the former and acute febrile illness or neurological disease in the latter. Although a considerable amount of knowledge exists on the eco-epidemiology of North American EEEV strains, little is known about MADV. In Brazil, the most recent isolations of MADV occurred in 2009 in the States of Paraíba and Ceará, northeast Brazil. Because of that, health authorities have recommended vaccination of animals in these regions. However, in 2019 an equine encephalitis outbreak was reported in a municipality in Ceará. Here, we present the isolation of MADV from two horses that died in this outbreak. The full-length genome of these viruses was sequenced, and phylogenetic analyses performed. Pathological findings from postmortem examination are also discussed. We conclude that MADV is actively circulating in northeast Brazil despite vaccination programs, and call attention to this arbovirus that likely represents an emerging pathogen in Latin America.

Evaluation on the information about absolute and relative indications of cesarean sections available on popular websites / Avaliação das informações sobre indicações absolutas e relativas de cesarianas disponíveis em sites populares

Abstract Objectives: to evaluate the reliability of information available on popular websites, in other words, websites aimed lay pregnant women, about absolute and relative indications for cesarean sections. Methods: this was a descriptive/comparative study based on the popular websites most likely to be visited by lay pregnant women and that contained information about indications for absolute and relative cesarean sections. Cohen's Kappa index of agreement was used to analyze the reliability degree on the indications for cesarean sections presented on the websites and the scientific evidence. Results: there was a higher prevalence (62.63%) of information on the indications for cesarean sections that did not mention whether the indication was absolute or relative, and of these indications, 40.74% were not indications for cesarean sections. Low agreement was also observed among websites and the scientific evidence when the website mentioned the indication for cesarean section was absolute or relative. Conclusion: this study showed that the reliability of the information on absolute and relative indications for cesarean sections available in popular websites is questionable.

Resumo Objetivos: avaliar a confiabilidade das informações disponíveis em sites populares, ou seja, sites voltados para gestantes leigas, sobre indicações absolutas e relativas de cesarianas. Métodos: estudo descritivo/comparativo, baseado nos sites populares mais prováveis de serem visitados por gestantes leigas e que traziam informações sobre as indicações de cesarianas absolutas e relativas. Para analisar o grau de confiabilidade das indicações de cesarianas apresentadas pelos sites e a evidência cientifica, foi realizado o índice de concordância de Kappa de Cohen. Resultados: houve maior prevalência (62,63%) de informações de indicações de cesarianas que não mencionavam se a indicação apresentada era absoluta ou relativa, sendo que destas, 40,74% não eram indicações de cesarianas. Observou-se, concordância baixa entre os sites e a evidência cientifica quando o site mencionava que a indicação de cesariana era absoluta ou relativa. Conclusão: este estudo demonstrou que a confiabilidade das informações acerca das indicações absolutas e relativas de cesarianas disponíveis em sites populares é questionável

Factors associated with the practice of physical activity among university students in social isolation during the covid-19 pandemic / Fatores associados à prática de atividade física entre universitários durante o isolamento social- pandemia covid-19

Abstract This study sought to analyze the practice of physical activity (PA) among university students, during the COVID-19 pandemic, and associated factors. This is a cross-sectional study with an analytical approach, carried out with 857 university students enrolled in higher education institutions in Montes Claros, in the state of Minas Gerais. Data collection was carried out using the Google forms, which was shared via social networks, containing questions regarding sociodemographic profile, physical activity, clinical factors, and behavioral and health habits. A descriptive exploratory analysis of the data was carried out, with frequency distribution of the study variables. Subsequently, bivariate analyses were performed and the associated variables with up to a level of 20% (p ≤ 0.20) were selected for multiple analysis using Poisson Regression. The prevalence non-practice of PA during the pandemic was of 56.8% among college students. Variables, such as being with a partner (PR=1.28), presence of respiratory diseases (PR=1.17), negative self-perception of health (PR=1.37), increased consumption of ultra-processed foods (PR=1.29), and presence of depression (PR=1.21), showed statistically significant associations with the practice of physical activity. We concluded that the non-practice of PA in university students during the social isolation caused by the COVID-19 pandemic is associated with marital status, presence of respiratory diseases, negative self-perception of health, increased consumption of ultra-processed foods, and presence of depression.

Resumo Este estudo buscou analisar a prática de atividade física entre universitários durante a pandemia de COVID19, e os fatores associados. Trata-se de estudo transversal de abordagem analítica, realizado com 857 universitários matriculados em instituições de ensino superior de Montes Claros-Minas Gerais. A coleta de dados foi realizada através do formulário Google forms, divulgado por redes sociais, contendo perguntas referentes ao perfil sociodemográfico, prática de atividade física, fatores clínicos, hábitos comportamentais e de saúde. Realizou-se análise descritiva exploratória dos dados, com distribuição de frequências das variáveis do estudo. Em seguida foram realizadas análises bivariadas e as variáveis associadas até o nível de 20% (p ≤ 0,20) foram selecionadas para a análise múltipla através da Regressão de Poisson. A prevalência de ausência da prática de AF durante a pandemia foi de 56,8% entre os universitários. Variáveis como estar com companheiro (RP=1,28), presença de doenças respiratórias (RP=1,17), autopercepção negativa da saúde (RP=1,37), aumento do consumo de alimentos ultraprocessados (RP=1,29) e presença de depressão (RP=1,21) demonstraram associações estatisticamente significativas com a prática de atividade física. Neste estudo, observou-se elevada prevalência de universitários que não praticam AF durante o isolamento social, sendo associado a diversos fatores, como o estado conjugal, à presença de doenças, hábitos alimentares e a autopercepção do estado de saúde. Dessa forma, tais características podem subsidiar intervenções com o intuito de incentivar hábitos saudáveis e sobretudo, promover a prática de AF como promoção a saúde física e mental.

Perfil epidemiológico das gestações não planejadas em um hospital de referência no oeste do Paraná / Epidemiological profile of unplanned pregnancies in a reference hospital in the west of Paraná

Objetivo: Delinear o perfil epidemiológico das gestações não planejadas em um hospital na cidade de Toledo-PR, comparando características socioeconômicas, uso de métodos contraceptivos, adesão ao pré-natal e desfechos maternos e fetais, entre as gestações planejadas e não planejadas. Métodos: Foram realizadas entrevistas com puérperas, por meio da aplicação de questionário criado especificamente para este estudo. Realizaram-se análise descritiva e comparação por análise bivariada. Foi considerado o nível de significância de 5%. Resultados: O total de participantes entrevistadas foi de 327. A prevalência de gestações não planejadas foi de 51,6% (n = 169). Do total, 10,3% (n = 34) eram adolescentes. As partic ipantes com gestações não planejadas apresentaram 0,4 gestação a mais (p = 0,004); 68% (n = 98) desse grupo era não branca (p = 0,009); 60,9% (n = 103) eram casadas ou em união estável; 17,2% (n = 29) possuíam renda até um salário mínimo (p = 0,007); 50,3% (n = 85) não utilizavam métodos contraceptivos. A proporção de anemia entre as gestações não planejadas foi de 8,3% (n = 14), enquanto nas planejadas foi de 1,9% (n = 3) (p = 0,02). Conclusão: As participantes cujas gestações não são planejadas são multíparas, mais jovens e não brancas, possuem menor renda e escolaridade, maior proporção de não casadas e maior prevalência de anemia gestacional. A intenção da gestação não apresentou influência sobre o concepto ou desfechos puerperais. Para alterar esse perfil, são primordiais aconselhamento reprodutivo individualizado e medidas de saúde pública voltadas a métodos contraceptivos eficazes.(AU)

Objective: To outline the epidemiological profile of unplanned pregnancies in a hospital in the city of Toledo/Paraná, comparing socioeconomic characteristics, use of contraceptive methods, adherence to prenatal care and maternal and fetal outcomes among planned and unplanned pregnancies. Methods: Interviews were conducted with puerperal participants, through the application of a form designed by the authors. A descriptive analysis was done and the data were compared between groups through a bivariate analysis. The significance level was set at 5%. Results: The total number of interviewed participants was 327. The incidence of unplanned pregnancies was 51.6% (n = 169). Of the total, 10.3% (n = 34) were adolescents. Participants with unplanned pregnancies averaged 0.4 more pregnancies (p = 0.004), 68% (n = 98) of this group were non-white (p = 0.009); 60.9% (n = 103) married or in a stable relationship; 17.2% (n = 29) had an income of up to 1 minimum wage (p = 0.007); 50.3% (n = 85) did not use contraceptive methods. The proportion of anemia among unplanned pregnancies was 8.3% (n = 14), while in planned pregnancies, it was 1.9% (n = 3) (p = 0.02). Conclusion: Participants whose unplanned pregnancies occur, are multiparous, younger and non-white, they have lower income and education access, higher proportion of unmarried women and gestational anemia. The intention of the pregnancy does not influence the conceptus or postpartum outcomes. To change this profile, individualized reproductive counseling and public health measures aimed at more effective contraceptive methods are essential.(AU)

Trastornos depresivos en estudiantes de medicina de la Universidad Internacional Tres Fronteras Uninter, Ciudad del Este, Paraguay (2016) / Depressive disorders in students of medicine of the Universidad International Tres Fronteras Uninter, Ciudad del Este, Paraguay (2016)

Introducción: la depresión constituye un trastorno mental frecuente, que se caracteriza por la presencia de tristeza, pérdida de interés o placer, sentimientos de culpa o falta de autoestima, trastornos del sueño o del apetito, sensación de cansancio y falta de concentración. Es una de las formas más frecuentes de enfermedad mental, junto con la ansiedad, y para el año 2020 será considerada la primera causa de enfermedad en el mundo desarrollado. Objetivo: describir y evaluar los trastornos depresivos en estudiantes de Medicina en la Universidad Internacional Tres Fronteras UNINTER de Ciudad del Este, Paraguay durante el año 2016. Materiales y Métodos: trabajo descriptivo, transversal y prospectivo realizado en los estudiantes de Medicina. El instrumento fue el Inventario de Depresión de Beck (Beck Depression Inventory-BDI), mundialmente utilizado para diagnosticar depresión. Contiene 21 preguntas con 4 respuestas posibles, las cuales son puntuadas. Una puntuación persistente de 17 o más puntos indica que el encuestado puede necesitar alguna ayuda profesional. Participaron 206 estudiantes, 63 %(129) mujeres y 37% (77) hombres. El 63% (130) de los estudiantes viven en Brasil y el 51% viven con algún familiar. Resultado: la prevalencia de la depresión, en cualquiera de sus estadios, fue del 13% (27). El 69% (142) presentaron altibajos considerados normales, y un 2% presentaron depresión considerada como moderada y extrema. Al relacionar con el sexo, las mujeres presentaron alteraciones del estado de ánimo o algún nivel de depresión intermitente, moderada o grave en un 40% en tanto que los hombres presentaron un 15% para los mismos estadios. El mayor porcentaje de estudiantes con algún síntoma de depresión se dio en el primer año de estudios con 35% (46 alumnos). Conclusión: en esta población de alumnos demuestran una prevalencia preocupante de trastornos de ánimo, ansiedad y depresión. La alta prevalencia fue observada en el 1º y5º curso de la carrera.

Introduction: depression is a frequent mental disorder, characterized by the presence of sadness, loss of interest or pleasure, feelings of guilt or lack of self-esteem, sleep or appetite disorders, feeling tired and lack of concentration. It is one of the most frequent forms of mental illness, along with anxiety, and by the year 2020 it will be considered the first cause of illness in the developed world. Objective: to describe and evaluate depressive disorders in medical students at the International University Three Borders UNINTER of Ciudad del Este, Paraguay during 2016. Materials and Methods: descriptive, transversal and prospective work carried out in medical students. The instrument was the Beck Depression Inventory (Beck Depression Inventory -BDI), used worldwide to diagnose depression. It contains 21 questions with 4 possible answers, which are punctuated. A persistent score of 17 or more points indicates that the respondent may need some professional help. 206 students participated, 63% (129) women and 37% (77) men. 63% (130) of the students live in Brazil and 51% live with a relative. Result: the prevalence of depression, in any of its stages, was 13% (27). 69% (142) presented highs and lows considered normal, and 2% presented depression considered moderate and extreme. When related to sex, women presented alterations in mood or some level of intermittent depression, moderate or severe in 40% while men presented 15% for the same stages. The highest percentage of students with any symptoms of depression occurred in the first year of studies with 35% (46 students). Conclusion: in this population of students demonstrate a worrying prevalence of mood disorders, anxiety and depression. The high prevalence was observed in the 1st and 5th year of the race.