Influence of Diabetes complications and limitations on health-related quality of life: a study in a southeastern Brazilian city.

PURPOSE: The aim of this study was to measure how diabetes, its complications, and limitations are associated to the domains of health-related quality of life (HRQoL). METHODS: A population-based cross-sectional study was conducted with 2178 individuals from the 2014/2015 City of Campinas Health Survey. The SF-36 was used to measure HRQoL. Mean scores were calculated. Crude and adjusted beta coefficients were estimated using multiple linear regression. RESULTS: Diabetes was associated with a significant reduction in the scores of five SF-36 domains. However, no significant reduction of scores was found among diabetics without complications and with no reports of limitations. The reduction in HRQoL was more accentuated with the increase in the number of complications. Three domains were affected in diabetics with one complication and all were affected in those with two or more complications, especially the role physical, role emotional, and physical functioning. Five domains were affected among diabetics who reported some degree of limitation and all were affected in those who reported high degree of limitation. Patients who reported limitation even in the absence of complications had reductions of the scores especially in the role emotional and social functioning. CONCLUSIONS: The results reveal that the association between diabetes and HRQoL only prevail in the occurrence of complications and limitations imposed by the disease, indicating the necessity to avoid or delay the emergence of chronic complications with adequate control methods and paying attention to the perception of limitation reported by the patient.

Napping, functional capacity and satisfaction with life in older adults: A population-based study.

AIM AND OBJECTIVE: To analyse the association between napping, functional capacity and satisfaction with life in older adult residing in the community. METHOD: A cross-sectional population-based study using data from a health survey conducted in a city of the state of São Paulo. Information on sociodemographic and clinical variables was collected through a questionnaire, as well as the occurrence or not of napping and satisfaction with life. Functional capacity was assessed using the Katz Index and Lawton-Brody Scale. Statistical analysis was performed using the Rao-Scott chi-square test and a hierarchical analysis using stepwise backward multiple Poisson regression. p-Values <0.05 were considered significant. In this paper, we adhere to STrengthening the Reporting of OBservational studies in Epidemiology guidelines. RESULTS: There was predominance of the 60-69 years age group (51.3%) and of females (60.8%). The majority of the older adults (57.5%), of both sexes, reported napping. A higher prevalence of napping was found in the older subjects, the male sex, the subjects without children, those with health problems and those that were partially dependent in instrumental activities of daily living. CONCLUSIONS: The study showed that naps are prevalent in older adults. The need to identify the issues that permeate napping is emphasised, in order to promote health in individuals of this age group, before classifying the practice as beneficial or harmful. RELEVANCE TO CLINICAL PRACTICE: It is essential that health professionals, in their practices, consider the complaints and reports of naps in the elderly, in an attempt to detect and reduce possible consequences in activities of daily living.

Factors associated with the fragmentation and stability of the rest-activity rhythm in adults and older adults.

This cross-sectional study aimed to identify factors related to the fragmentation and stability of the rest-activity rhythm (RAR) in adults and older adults. It is part of a larger research project investigating aspects concerning sleep duration, quality, and disorders in a representative subsample of the population. Sociodemographic data, lifestyle, health habits and subjective sleep variables were obtained; RAR records were collected by means of actigraphy and analyzed using non-parametric variables (IS, IV, M10, L5, RA, sL5, and sM10). Study participants were 313 individuals with complete actigraphy records. There was a prevalence of older adults (50.2%) and females (51.1%). Females, individuals with 4-8 y of education, and those who used alcohol abusively exhibited lower RAR fragmentation. Higher fragmentation was observed in individuals who napped and those reporting poor sleep quality. Greater rhythm stability was evident in females, older adults, those with 4-8 y of education, and those who had a partner. Smokers demonstrated lower RAR stability. These findings may contribute valuable insights for decision-making aimed at preventing and treating issues related to fragmentation and instability of the rhythm and its possible consequences to health.

Religious affiliation and psychiatric morbidity in Brazil: higher rates among evangelicals and spiritists.

AIMS: To verify the association between the prevalence of mental symptoms and excessive alcohol intake with religious affiliation, church attendance and personal religiosity. METHODS: A household survey of 515 adults randomly sampled included the WHO SUPRE-MISS questionnaire, SRQ-20 and AUDIT. Weighted prevalences were estimated and logistic analyses were performed. RESULTS: Minor psychiatric morbidity was greater among Spiritists and Protestants/ Evangelicals than in Catholics and in the ;no-religion' group. The latter had a greater frequency of abusive alcohol drinking pattern and Protestants/Evangelicals showed lower drinking patterns. CONCLUSIONS: Although belonging to Protestant/Evangelical churches in Brazil may inhibit alcohol involvement it seems to be associated to a higher frequency of depressive symptoms. Processes of seeking relief in new religious affiliations among sub-groups with previous minor psychiatric symptoms may probably occur in the Brazilian society.

Fatal motorcycle crashes: a serious public health problem in Brazil.

INTRODUCTION: The numbers of two-wheel vehicles are growing across the world. In comparison to other vehicles, motorcycles are cheaper and thus represent a significant part of the automobile market. Both the mobility and speed are attractive factors to those who want to use them for work or leisure. Crashes involving motorcyclists have become an important issue, especially fatal ones. Specific severe injuries are responsible for the deaths. Defining them is necessary in order to offer better prevention and a more suitable medical approach. METHODS: All fatal motorcycle crashes between January 2001 and December 2009 in Campinas, Brazil, were analyzed in this study. Official data have been collected from police incident reports, hospitals' registers and autopsies. Both incidents and casualties were analyzed according to relevant variables. The Injury Severity Score (ISS) was calculated, describing the most potentially fatal injuries. RESULTS: There were 479 deaths; 90.8% were male; the mean age was 27.8 (range 0-73); 86.4% were conductors of the vehicles; blood alcohol was positive in 42.3%; 49.7% died at a hospital; 32.6% died at the scene; 26.1% of the accidents occurred at night, 69.1% were urban and 30.9% occurred on highways. The main causes of injury were collisions (63%) and falls (14%). The mean ISS was 38.5 (range 9-75). With regard to injuries, head trauma (67%) and thoracic trauma (40%) were the most common, followed by abdominal trauma (35%). Traumatic brain injury (67%) and hypovolemic shock (38%) were the most frequent causes of death. CONCLUSIONS: Alcohol was a significant factor in relation to the accidents. Head trauma was the most frequent and severe injury. Half of the victims died before receiving adequate medical attention, suggesting that prevention programs and laws should be implemented and applied in order to save future lives.