Objectives: The primary aim of the CHANGE survey is to determine the current state of gender equity within rheumatology, and secondarily, to review the physician perspective on bullying, harassment and equipoise of opportunities within rheumatology. Methods: The CHANGE e-survey is a cross-sectional self-reported questionnaire adapted from EULAR's gender equity in academic rheumatology task force. The survey was launched in January 2023; it is available in six languages and distributed widely via rheumatology organizations and social media. Eligible participants include rheumatologist physicians and rheumatology health-care professionals. Survey responses will undergo descriptive analysis and inter-group comparison aiming to explore gender-based discrimination using logistic regression, with subgroup analyses for country/continent variations. Conclusion: This e-survey represents a comprehensive global initiative led by an international consortium, aimed at exploring and investigating the gender-related disparities and obstacles encountered by rheumatologists and rheumatology health-care professionals across diverse communities and health-care environments. By pursuing this initiative, we aim to take the broader rheumatology community a step closer to understanding the underlying origins of inequities and their determinants. Such insights are pivotal in identifying viable interventions and strategies to foster gender equity within the field. Ultimately, our collective objective is to ensure equitable access to opportunities for every individual, irrespective of gender, thereby promoting inclusivity and fairness across the entire spectrum of professional practice and career development.
Cigarette filters were utilized as carbon source for the production of solid carbon acid catalysts. In this study, the process of carbonization and simultaneous sulfonation via hydrothermal treatment was employed. The catalysts were prepared by mixing cigarette filters and sulfuric acid at temperatures of 100, 150, and 190 °C for durations ranging from 2 to 8 h. It was observed that the highest conversion of oleic acid occurred when the catalyst was synthesized at 190 °C for 4 h. The optimized conditions for the esterification reaction using this catalyst included an oleic acid to methanol molar ratio of 1:12, a catalyst loading of 5 wt%, and a temperature of 100 °C for 1 h. Additionally, the catalyst was successfully reused four times without significantly impacting the reaction yield. These findings highlight a promising approach for the utilization of waste materials, with immediate implications for waste management practices and positive environmental impacts.
Biofuels , Oleic Acid , Esterification , Temperature , Catalysis , Carbon
The increase in burning, deforestation, and the exorbitant use of fossil fuels have contributed to the increase in carbon dioxide emissions; this gas is responsible for the intensification of the greenhouse effect and radical climate changes. In this way, it becomes necessary to find alternatives to reduce its emission. Porous carbon materials synthesized from lignocellulosic waste can be employed in technologies for capture and utilization of CO2 due to the advantages such as selectivity, low-cost synthesis, high surface area and pore volume, and thermal and chemical stability. Considering the availability of Brazil nut biomass residues in the Amazon region, this article proposes to synthesize activated carbon from the lignocellulosic residue using physical and chemical activation methods for CO2 capture. The analysis of N2 adsorption-desorption isotherms proves the predominance of a microporous structure when using the two synthesis methods described here. In physical activation, the surface area was 912 m2/g, while, in chemical activation, it was 1421 to 2730 m2/g. The sample treated via the chemical method (BS6-K1) showed better performance in CO2 adsorption, with adsorption results of 3.8 and 6 mmol/g of CO2 at 25 â and 0 °C, respectively, at 101 kPa. CO2 adsorption capacity is due to the high volume of ultramicropores. It is believed that the microporous carbon material synthesized from Brazil nut residues is an alternative precursor for carbon materials used as CO2 capture.
Bertholletia , Carbon Dioxide , Carbon Dioxide/chemistry , Adsorption , Porosity , Charcoal
Objetivo: Analisar a téchne aristotélicae sua implicação para o cuidado de enfermagem. Metodologia: Texto reflexivo regido pela questão: como a filosofia aristotélica pode implicar o cuidado de enfermagem? Para resposta estabelecem-se os principais elementos que fundam a filosofia de Aristóteles no livro II da Física e na obra Metafísica; e as noções que essa filosofia projeta sobre a ciência e a arte da enfermagem. Resultados: A arte da profissão se manifesta na prática assistencial, na pesquisa e no ensino pelo cuidado de enfermagem. Conclusão: O cuidado de enfermagem é conjugação entre o saber-pensar, saber-fazer e o saber-conviver expresso na téchne da profissão; engloba habilidades manuais, capacidade de inovação, agir humano perante o paciente, organização, gerenciamento de pessoas e unidades; ele medeia o encontro científico e dialógico, marcado pelo senso estético, com o paciente. No sistema aristotélico, epistéme, práxis e a poiésis estão em relação indissolúvel.
Objective: To analyze the Aristotelian techne and its implications for the nursing care. Methodology: Reflective text governed by the question: how can Aristotelian philosophy imply nursing care? For this answer, the main elements that found Aristotle's philosophy in book II of Physics and in the work Metaphysics; and the notions that this philosophy projects on the science and art of nursing are stablished. Results: The art of the profession is manifested in care practice, research, and teaching for nursing care. Conclusion: Nursing care is a combination of know-think, know-how, and know-coexist expressed in the techne of the profession; this encompasses manual skills, capacity for innovation, human behavior towards the patient, organization, management of people and units; it mediates the scientific and dialogic encounter, marked by the aesthetic sense, with the patient. In the Aristotelian system, episteme, praxis, and poiesis are in an indissoluble relationship.
Objetivo: Analizar la técnica aristotélica y sus implicaciones en la atención de enfermería. Metodología: Texto reflexivo realizado desde la pregunta: ¿Cómo la filosofía aristotélica puede implicar la atención de enfermería? Para responderla, se establecen los principales elementos que fundamentan la filosofía de Aristóteles en el Libro II de la Física y en la obra Metafísica; y las nociones que esta filosofía proyecta sobre la ciencia y el arte de la enfermería. Resultados: El arte de la profesión se manifiesta en la práctica asistencial, en la investigación y en la enseñanza para la atención de enfermería. Conclusión: La atención de enfermería es una combinación de saber pensar, saber hacer y saber convivir que se expresa en la técnica de la profesión; abarca habilidades manuales, capacidad de innovación, acción humana hacia el paciente, organización, gestión de personas y unidades; y media el encuentro científico y dialógico con el paciente marcado por el sentido estético. En el sistema aristotélico, episteme, praxis y poiesis están en una relación indisoluble.
Humans , Philosophy , Art , Nursing , Knowledge , Nursing Care
Abstract This study evaluated the association between religiosity and binge drinking in early adolescence. A cross-sectional study was conducted with adolescents aged 10-13 from Belo Horizonte, Brazil. Stratified random sampling was performed considering the administrative district and school year. Adolescents filled an AUDIT-C form, containing questions about religiosity and binge drinking by parents and their best friends. Adolescents' caregivers answered a form regarding socioeconomic issues. Descriptive analysis, univariate, and multivariate logistic regression were performed. A total of 650 adolescents participated in the study. The frequency of binge drinking was 13.7%. In the adjusted model, religiosity was not associated with binge drinking. The covariates associated were the age of 12-13 years (OR: 1.94; CI95%: 1.06-3.56; p=0.030), maternal binge drinking (OR: 3.12; CI95%: 1.76-5.52; p<0.001) best friend binge drinking (OR: 6.01; CI95%: 3.40-10.62; p<0.001) and nonnuclear family (OR: 1.80; CI95%: 1.01-3.23; p=0.045). The findings revealed that, for binge drinking, the main factors that influenced this decision were the best friend and maternal binge drinking and family structure, although the adolescents claimed to be religious.
Resumo O objetivo do estudo foi avaliar a associação entre religiosidade e binge drinking no início da adolescência. Um estudo transversal realizado com adolescentes de 10 a 13 anos de Belo Horizonte, Brasil. Foi realizada uma amostragem aleatória estratificada considerando distrito administrativo e ano escolar. Os adolescentes preencheram um formulário com o AUDIT C, perguntas sobre religiosidade e perguntas sobre binge drinking pelos pais e melhor amigo. Um formulário sobre questões socioeconômicas foi respondido pelos responsáveis. Foi realizada análise descritiva, regressão logística univariada e multivariada. Participaram do estudo 650 adolescentes. A frequência de binge drinking foi de 13,7%. No modelo ajustado, a religiosidade não esteve associada ao binge drinking. As covariáveis associadas foram idade de 12-13 anos (OR: 1,94 IC95%: 1,06-3,56; p=0,030), binge drinking pela mãe (OR: 3,12; IC95%: 1,76-5,52; p<0,001) binge drinking pelo melhor amigo (OR: 6,01; IC95%: 3,40-10,62; p<0,001) e família não nuclear (OR: 1,80; IC95%: 1,01-3,23; p=0,045). Os achados revelaram que apesar dos adolescentes afirmarem serem religiosos, para o binge drinking, os principais fatores que influenciaram essa decisão foi o binge drinking pelo melhor amigo, mãe e família não nuclear.
This study evaluated the association between religiosity and binge drinking in early adolescence. A cross-sectional study was conducted with adolescents aged 10-13 from Belo Horizonte, Brazil. Stratified random sampling was performed considering the administrative district and school year. Adolescents filled an AUDIT-C form, containing questions about religiosity and binge drinking by parents and their best friends. Adolescents' caregivers answered a form regarding socioeconomic issues. Descriptive analysis, univariate, and multivariate logistic regression were performed. A total of 650 adolescents participated in the study. The frequency of binge drinking was 13.7%. In the adjusted model, religiosity was not associated with binge drinking. The covariates associated were the age of 12-13 years (OR: 1.94; CI95%: 1.06-3.56; p=0.030), maternal binge drinking (OR: 3.12; CI95%: 1.76-5.52; p<0.001) best friend binge drinking (OR: 6.01; CI95%: 3.40-10.62; p<0.001) and nonnuclear family (OR: 1.80; CI95%: 1.01-3.23; p=0.045). The findings revealed that, for binge drinking, the main factors that influenced this decision were the best friend and maternal binge drinking and family structure, although the adolescents claimed to be religious.
Binge Drinking , Adolescent , Alcohol Drinking/epidemiology , Binge Drinking/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Humans , Socioeconomic Factors
BACKGROUND: Children and adolescents with vision impairment (VI) may be at increased risk of oral health issues, such as periodontal inflammation, poor oral hygiene, dental caries, and dental trauma, but this is inconclusive in the literature. AIM: To systematically review the literature to determine the main oral health issues of children and adolescents with VI compared to those without VI. DESIGN: Electronic and manual searches were performed to identify observational studies involving children and adolescents with and without VI, to determine and compare their oral health issues. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tool. Studies that had homogeneity of methods were incorporated into meta-analyses. RESULTS: Fifteen cross-sectional studies were included. Overall, most studies presented methodological flaws and high risk of bias. The meta-analysis showed that children and adolescents with VI were 3.86 times as likely to exhibit dental trauma (OR = 3.86, 95% CI = 2.63-5.68, I2 = 0%) and had higher/poorer values for plaque (MD = 0.80, 95% CI = 0.58-1.02, I2 = 96%), gingivitis (MD = 0.69, 95% CI = 0.02-1.37, I2 = 100%), calculus (MD = 0.04, 95% CI = 0.03-0.06, I2 = 0%), and oral hygiene indices (MD = 0.71, 95% CI = 0.24-1.18, I2 = 97%), as well as DMFS (MD = 0.90, 95% CI = 0.68-1.13, I2 = 26%). CONCLUSION: Across a wide array of assessments, children and adolescents with vision impairment had worse oral health outcomes than those without VI.
Dental Caries , Dental Plaque , Gingivitis , Adolescent , Child , Cross-Sectional Studies , Humans , Oral Health
The aim of this study was to understand drug solubilization as a function of age and identify drugs at risk of altered drug solubility in newborns and young infants in comparison to adults. Multivariate statistical analysis was used to understand drug solubilization as a function of drug's physicochemical properties and the composition of gastrointestinal fluids. The solubility of seven poorly soluble compounds was assessed in adult and age-specific fasted and fed state biorelevant media. Partial least squares regression (PLS-R) was used to assess the influence of (i) drug physicochemical properties and (ii) age-related changes in simulated GI fluids, as well as (iii) their interactions, on the pediatrics-to-adult solubility ratio (Sp/Sa (%)). For five out of seven of the compounds investigated, Sp/Sa (%) values fell outside of the 80-125% limits in at least one of the pediatric media. Lipophilicity was responsible for driving drug solubility differences between adults and children in all the biorelevant media investigated, while drug ionization was most relevant in the fed gastric media, and the fasted/fed intestinal media. The concentration of bile salts and lecithin in the fasted and fed intestinal media was critical in influencing drug solubility, while food composition (i.e., cow's milk formula vs. soy formula) was a critical parameter in the fed gastric state. Changes in GI fluid composition between younger pediatric patients and adults can significantly alter drug luminal solubility. The use of pediatric biorelevant media can be helpful to identify the risk of altered drug solubilization in younger patients during drug development.
This study aimed to explore the potential of biopharmaceutics in vitro tools to predict drug product performance in the pediatric population. Biorelevant dissolution set-ups were used to predict how age and medicine administration practices affect the in vitro dissolution of oral formulations of a poorly water-soluble compound, montelukast. Biorelevant age-appropriate dissolution studies of Singulair® (granules and chewable tablets) were conducted with the µDISS profiler™, USP 4 apparatus, USP 2 apparatus, and mini-paddle apparatus. Biorelevant simulating fluids representative of adult and pediatric conditions were used in the dissolution studies. The biorelevant dissolution conditions were appropriately selected (i.e. volumes, transit times, etc.) to mimic the gastrointestinal conditions of each of the subpopulations tested. Partial least squares regression (PLS-R) was performed to understand the impact of in vitro variables on the dissolution of montelukast. Montelukast dissolution was significantly affected by the in vitro hydrodynamics used to perform the dissolution tests (µDISS profiler™: positive effect); choice of simulation of gastric (negative effect) and/or intestinal conditions (positive effect) of the gastrointestinal tract; and simulation of prandial state (fasted state: negative effect, fed state: positive effect). Age-related biorelevant dissolution of Singulair® granules predicted the in vivo effect of the co-administration of the formulation with applesauce and formula in infants. This study demonstrates that age-appropriate biorelevant dissolution testing can be a valuable tool for the assessment of drug performance in the pediatric population.
Acetates/administration & dosage , Anti-Asthmatic Agents/administration & dosage , Chemistry, Pharmaceutical/methods , Cyclopropanes/administration & dosage , Quinolines/administration & dosage , Sulfides/administration & dosage , Acetates/chemistry , Administration, Oral , Adult , Age Factors , Anti-Asthmatic Agents/chemistry , Biopharmaceutics , Child , Cyclopropanes/chemistry , Drug Liberation , Food-Drug Interactions , Humans , Hydrodynamics , Infant , Least-Squares Analysis , Pediatrics , Quinolines/chemistry , Solubility , Sulfides/chemistry
This study aimed to build a physiologically based pharmacokinetic (PBPK) model coupled with age-appropriate in vitro dissolution data to describe drug performance in adults and pediatric patients. Montelukast sodium was chosen as a model drug. Two case studies were investigated: case study 1 focused on the description of formulation performance from adults to children; case study 2 focused on the description of the impact of medicine co-administration with vehicles on drug exposure in infants. The PBPK model for adults and pediatric patients was developed in Simcyp® v18.2 informed by age-appropriate in vitro dissolution results obtained in a previous study. Oral administration of montelukast was simulated with the ADAM™ model. For case study 1, the developed PBPK model accurately described montelukast exposure in adults and children populations after the administration of montelukast chewable tablets. Two-stage dissolution testing in simulated fasted gastric to intestinal conditions resulted in the best description of in vivo drug performance in adults and children. For case study 2, a good description of in vivo drug performance in infants after medicine co-administration with vehicles was achieved by incorporating in vitro drug dissolution (under simulated fasted gastric to fed intestinal conditions) into a fed state PBPK model with consideration of the in vivo dosing conditions (mixing of formulation with applesauce or formula). The case studies presented demonstrate how a PBPK absorption modelling strategy can facilitate the description of drug performance in the pediatric population to support decision-making and biopharmaceutics understanding during pediatric drug development.
Acetates/administration & dosage , Chemistry, Pharmaceutical/methods , Cyclopropanes/administration & dosage , Drug Development/methods , Models, Biological , Quinolines/administration & dosage , Sulfides/administration & dosage , Acetates/chemistry , Administration, Oral , Adolescent , Adult , Age Factors , Anti-Asthmatic Agents/administration & dosage , Anti-Asthmatic Agents/chemistry , Biopharmaceutics , Child , Child, Preschool , Computer Simulation , Cyclopropanes/chemistry , Drug Liberation , Female , Humans , Infant , Male , Pediatrics , Quinolines/chemistry , Solubility , Sulfides/chemistry , Young Adult
Several single nucleotide polymorphisms (SNPs) could indirectly, as well directly, influence metabolic parameters related to health effects in response to selenium (Se) supplementation. This study aimed to investigate whether the selenoprotein SNPs were associated with the response of Se status biomarkers to the Brazil nut consumption in patients using statins and if the variation in Se homoeostasis could affect antioxidant protection, lipid profile, muscle homoeostasis and selenoproteins mRNA. The study was performed in the Ribeirão Preto Medical School University Hospital. Thirty-two patients using statins received one unit of Brazil nut daily for 3 months. Body composition, blood Se concentrations, erythrocyte glutathione peroxidase (GPX) activity, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triacylglycerol (TAG), creatine kinase (CK) activity and gene expression of GPX1 and selenoprotein P (SELENOP) were evaluated before and after Brazil nut consumption. The volunteers were genotyped for SNP in GPX1 (rs1050450) and SELENOP (rs3877899 and rs7579). SNPs in selenoproteins were not associated with plasma and erythrocyte Se, but SNPs in SELENOP influenced the response of erythrocyte GPX activity and CK activity, TAG and LDL after Brazil nut consumption. Also, Brazil nut consumption increased GPX1 mRNA expression only in subjects with rs1050450 CC genotype. SELENOP mRNA expression was significantly lower in subjects with rs7579 GG genotype before and after the intervention. Thus, SNP in SELENOP could be associated with interindividual differences in Se homeostasis after Brazil nut consumption, emphasising the involvement of genetic variability in response to Se consumption towards health maintenance and disease prevention.
Bertholletia , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Selenium , Antioxidants , Biomarkers , Glutathione Peroxidase/metabolism , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , RNA, Messenger/genetics , Selenoprotein P/genetics , Selenoproteins/genetics , Triglycerides
OBJECTIVES: To evaluate the incidence of COVID-19 and its main outcomes in rheumatic disease (RD) patients on hydroxychloroquine (HCQ) compared to household cohabitants (HC). METHODS: This is a 24-week nationwide prospective multi-centre cohort with a control group without RD and not using HCQ. All participants were monitored through scheduled phone interviews performed by health professionals. Details regarding COVID-19 symptoms, and epidemiological, clinical, and demographic data were recorded on a specific web-based platform. COVID-19 was defined according to the Brazilian Ministry of Health criteria and classified as mild, moderate or severe. RESULTS: A total of 9,585 participants, 5,164 (53.9%) RD patients on HCQ and 4,421 (46.1%) HC were enrolled from March 29th, 2020 to September 30th, 2020, according to the eligibility criteria. COVID-19 confirmed cases were higher in RD patients than in cohabitants [728 (14.1%) vs. 427 (9.7%), p<0.001] in a 24-week follow-up. However, there was no significant difference regarding outcomes related to moderate/ severe COVID-19 (7.1% and 7.3%, respectively, p=0.896). After multiple adjustments, risk factors associated with hospitalisation were age over 65 (HR=4.5; 95%CI 1.35-15.04, p=0.014) and cardiopathy (HR=2.57; 95%CI 1.12-5.91, p=0.026). The final survival analysis demonstrated the probability of dying in 180 days after a COVID-19 diagnosis was significantly higher in patients over 65 years (HR=20.8; 95%CI 4.5-96.1) and with 2 or more comorbidities (HR=10.8; 95%CI 1.1-107.9 and HR=24.8; 95%CI 2.5-249.3, p=0.006, respectively). CONCLUSIONS: Although RD patients have had a higher COVID-19 incidence than individuals from the same epidemiological background, the COVID-19 severity was related to traditional risk factors, particularly multiple comorbidities and age, and not to underlying RD and HCQ.
COVID-19 Drug Treatment , COVID-19 , Rheumatic Diseases , COVID-19/epidemiology , COVID-19 Testing , Humans , Hydroxychloroquine/adverse effects , Incidence , Prospective Studies , Rheumatic Diseases/diagnosis , Rheumatic Diseases/drug therapy , Rheumatic Diseases/epidemiology , Risk Factors , SARS-CoV-2 , Treatment Outcome
RESUMO Objetivo: to analyze the social support network, the activities performed, and the factors associated with the presence of negative feelings of aged individuals who live alone during social distancing due to COVID-19. Método: a cross-sectional study conducted with 119 aged individuals who live alone in the Macro-region of Triângulo Sul, Minas Gerais, Brazil. The data were collected at the homes and with instruments validated in the country. Descriptive and multiple binary regression analyses were performed (p<0.05). Resultados: 97.5% had a social support network for health needs and for maintaining social distancing (79.8%). The activity most frequently performed was household chores (77.3%). The presence of negative feelings was associated with the female gender (p<0.001) and with fewer activities (p=0.012). Conclusão: the data contribute to the development of health actions, revealing situations in the daily life of aged individuals that are exacerbated during the COVID-19 pandemic, as well as aspects related to the negative feelings experienced by aged individuals who live alone.
ABSTRACT Objective: to identify the sociodemographic profile of interpersonal violence associated with alcohol consumption in São Paulo-SP, Brazil. Method: a cross-sectional study carried out through notifications of suspected or confirmed cases of interpersonal violence from the Notifiable Diseases Information System submitted between 2016 and 2019. Collection took place between March and June 2020. Chi-square or Fisher's exact tests were performed in the statistical analysis. Results: 27,775 notifications were obtained, whose prevalent profile was female victims (60.6%), aged between 20 and 34 years old (41.4%), brown- or black-skinned (51%), and with complete high school (18.8%). Physical violence was more frequent (81.9%), perpetrated by an intimate partner (20.3%), motivated by sexism (9.9%) and generational conflict (11.2%). In sexual violence, rape prevailed with 69.4% and there was a low supply of emergency contraception methods (14.7%). Conclusion: the study contributes to reflections and subsidies in the planning of public policies to control the problem.
RESUMEN Objetivo: analizar la red de apoyo social, las actividades realizadas y los factores asociados a la presencia de sentimientos negativos de ancianos que viven solos durante el distanciamiento social debido al COVID-19. Método: estudio transversal realizado con 119 ancianos que viven solos en la Macro-región de Triângulo Sul, Minas Gerais, Brasil. Los datos se recolectaron en los domicilios y con instrumentos validados en el país. Se realizaron análisis descriptivos y de regresión binaria múltiple (p<0,05). Resultados: El 97,5% contaba con una red de apoyo social para necesidades de salud y para mantener el distanciamiento social (79.8%). La actividad más frecuente fue la de tareas domésticas (77,3%). La presencia de sentimientos negativos se asoció al sexo femenino (p<0,001) y a una menor cantidad de actividades realizadas (p=0,012). Conclusión: los datos contribuyen en la elaboración de acciones de salud, evidenciando situaciones en la vida diaria de los ancianos que se vieron agravadas durante la pandemia de COVID-19, como ser los aspectos relacionados a los sentimientos negativos experimentados por los ancianos que viven solos.
O objetivo desse estudo foi avaliar a prevalência do consumo de bebidas alcoólicas em binge na adolescência precoce e sua associação com o consumo de bebidas alcoólicas misturadas com bebidas energéticas, religiosidade e o capital social. Trata- se de um estudo transversal realizado com adolescentes de 10 a 13 anos de idade matriculados em escolas públicas de Belo Horizonte, Brasil. A amostragem foi do tipo aleatória estratificada proporcional por distrito administrativo e por ano letivo. Para selecionar os alunos, foi feito o sorteio das escolas por regional e todos os alunos elegíveis foram convidados a participar. Um total de 650 adolescentes participou do estudo. Os adolescentes preencheram o Teste de Identificação de Transtornos por Uso de Álcool (AUDIT-C), perguntas sobre consumo de bebidas alcoólicas misturadas com bebidas energéticas, consumo de álcool em binge pelos pais e melhor amigo, perguntas sobre a religiosidade e o questionário capital social para adolescentes (QCS-AE). Um formulário referente às questões socioeconômicas foi respondido pelos pais. Foi realizada análise descritiva, regressão logística univariada e múltipla (p <0,05). Os resultados foram apresentados na forma de três artigos. O primeiro artigo abordou a associação entre consumo de bebidas alcoólicas misturadas com bebidas energéticas e o binge drinking, o segundo artigo, a associação entre a religiosidade e o binge drinking e o terceiro artigo a associação entre capital social e binge drinking. A prevalência do binge drinking foi de 13,7%. No modelo ajustado, o consumo de bebidas alcoólicas misturadas com bebidas energéticas (OR: 6,13; IC 95%: 3,81- 11,83; p< 0,001), binge drinking pela mãe (OR: 2,88; IC 95%: 1,59-5,24; p< 0,001), binge drinking pelo melhor amigo (OR: 4,28; IC 95%: 2,35-7,79; p< 0,001) e família não nuclear (OR: 1,89; IC 95%: 1,03- 3,48; p= 0,039) estiveram associadas ao desfecho. A religiosidade não esteve associada ao binge drinking. As covariáveis associadas foram à idade de 12-13 anos (OR: 1,94; IC 95%: 1,06-3,56; p= 0,030), binge drinking pela mãe (OR: 3,07; IC 95%: 1,73-5,46; p < 0,001); binge drinking pelo melhor amigo (OR: 6,01; IC 95%: 3,40-10,62; p< 0,001) e família não nuclear (OR: 1,80; IC 95%: 1,01-3,23; p= 0,045). A alta coesão social na escola (OR: 0,41; IC 95%: 0.20-0.0,83; p=0,024), a alta rede de amigos (OR:1,02; IC 95%: 0.20-0,83; p= 0.013); binge drinking pelo melhor amigo (OR: 6,21; IC 95%: 3,43-11,23; p<0,001); binge drinking pela mãe (OR: 3.26; IC: 1,80-5,89; p<0,001) e a menor escolaridade materna (OR: 2,69; IC 95%: 1,52-4,76; p=0,001) estiveram associadas ao desfecho. Concluiu-se que o consumo de bebidas alcoólicas misturadas com bebidas energéticas, a idade de 12-13 anos, o consumo em binge pela mãe e melhor amigo, a menor escolaridade materna, família não nuclear e a alta rede de amigos foram fatores associados ao binge drinking. A alta coesão na escola foi um possível fator de proteção e a religiosidade não esteve associada ao binge drinking na adolescência precoce.
The aim of this study was to assess the prevalence of binge drinking in early adolescence and its association with the consumption of alcohol mixed with energy drinks, religiosity and social capital. This is a cross-sectional study carried out with adolescents aged 10 to 13 years old enrolled in public schools in Belo Horizonte, Brazil. The random stratified sampling was performed, proportionally by administrative district and by school year. To select students, schools were randomly selected by region and all eligible students were invited to participate. A total of 650 adolescents participated in the study. Adolescents completed the Alcohol Use Disorders Identification Test (AUDIT-C), questions about drinking alcohol mixed with energy drinks, binge drinking by parents and best friend, questions about religiosity, and the social capital questionnaire for adolescents (QSC- AE). A form regarding socioeconomic issues was answered by the parents. Descriptive analysis, univariate and multiple logistic regression (p <0.05) were performed. The results were presented in the form of three articles. The first article addressed the association between the consumption of alcoholic beverages mixed with energy drinks and binge drinking, the second article the association between religiosity and binge drinking and the third article the association between social capital and binge drinking. The prevalence of binge drinking was 13.7%. In the adjusted model, consumption of alcohol mixed with energy drinks (OR: 6.13; 95% CI: 3.81-11.83; p< 0.001), binge drinking by the mother (OR: 2.88; CI 95 %: 1.59-5.24; p< 0.001), binge drinking by the best friend (OR: 4.28; 95% CI: 2.35-7.79; p< 0.001) and non-nuclear family (OR: 1.89; 95% CI: 1.03-3.48; p= 0.039) were associated with the outcome. Religiosity was not associated with binge drinking. The associated covariates were age 12-13 years (OR: 1.94; 95% CI: 1.06-3.56; p= 0.030), binge drinking by the mother (OR: 3.07; 95% CI: 1.73-5.46; p < 0.001); binge drinking by best friend (OR: 6.01; 95% CI: 3.40-10.62; p< 0.001) and non-nuclear family (OR: 1.80; 95% CI: 1.01-3.23 ; p=0.045). High social cohesion at school (OR: 0.41; 95% CI: 0.20-0.0.83; p=0.024), high network of friends (OR: 1.02; 95% CI: 0.20-0.83; p=0.013); binge drinking by best friend (OR: 6.21; 95% CI: 3.43-11.23; p<0.001); binge drinking by the mother (OR: 3.26; 95% CI: 1.80-5.89; p<0.001) and lower maternal education (OR: 2.69; 95% CI: 1.52-4.76; p=0.001 ) were associated with the outcome. It was concluded that the consumption of alcohol mixed with energy drinks, the age of 12-13 years, binge drinking by the mother and best friend, lower maternal education, non-nuclear family and high network of friends were factors associated with binge drinking. High school cohesion was a possible protective factor and religiosity was not associated with binge drinking in early adolescence.
Religion , Adolescent , Energy Drinks , Binge Drinking , Social Capital
The aim of the present study was to investigate the prevalence of oral health-related shame and the associated factors among 8-to-10-year-old Brazilian schoolchildren. A cross-sectional study was conducted with 388 children randomly selected from public and private schools of Diamantina, southeastern Brazil. In order to identify the feeling of shame, self-reports were collected through a single question, "In the last month, did you feel ashamed because of your teeth or mouth? Two calibrated examiners performed the clinical examination for dental caries (DMFT/dmft index), traumatic dental injuries (O' Brien), and malocclusion (Dental Aesthetic Index). Sociodemographic indicators were obtained through a questionnaire answered by the children's caregivers. Descriptive analysis, chi-square test, and hierarchical Poisson regression models were performed (95%CI; p < 0.05). The prevalence of shame was 38.1% (n = 148). The adjusted regression analysis demonstrated a significant association between shame and untreated dental caries (PR: 1.34; 95%CI: 1.04-1.74; p = 0.02), age of 10 years (PR: 1.36; 95%CI: 1.05-1.76; p = 0.01), and with parents with less than eight years of schooling (PR: 1.30; 95%CI: 1.00-1.68; p = 0.04). Older children with untreated dental caries and whose parents had lower education level presented a higher prevalence of oral health-related shame.
Dental Caries , Oral Health , Adolescent , Brazil/epidemiology , Child , Cross-Sectional Studies , DMF Index , Dental Caries/epidemiology , Humans , Prevalence , Quality of Life , Shame , Surveys and Questionnaires
The present study aimed to evaluate the frequency of immediate care seeking after traumatic dental injury (TDI) in primary dentition and its association with the children's characteristics, socioeconomic status, and TDI characteristics. This was a cross-sectional study with dental records of children aged 9 months to 6 years who attended a reference center in TDI in primary dentition between 2007 and 2018. Immediate care seeking after TDI, child's characteristics, sociodemographic conditions and TDI characteristics were collected. Descriptive statistics and Poisson regression analysis with robust variance were performed (p < 0.05; 95%CI). Among the 493 dental records, 61.1% (n = 301) were of males and 50.5% (n = 249) were from children aged 2 years or less. More than one third of the sample (36.9%; n = 182) sought immediate care after TDI. Among the types of TDI, the prevalence of soft tissue injuries was 59.0% (n = 291), while 51.7% (n = 255) were hard tissue injuries and 54.0% (n = 266) were supporting tissue injuries. Immediate care seeking after TDI was higher in children who needed suture (PR: 1.39; 95%CI: 1.01-1.92. p = 0.039), had luxation (lateral, intrusion, or extrusion) (PR: 2.36; 95%CI: 1.36-4.08. p = 0.002) or avulsion (PR: 2.18; 95%CI: 1.28-3.70. p = 0.004). The need for suture, luxation (lateral, intrusion and extrusion), and avulsion were determinant factors for the immediate care seeking after TDI, regardless of the child's characteristics and socioeconomic status.
Tooth Injuries , Brazil/epidemiology , Child , Cross-Sectional Studies , Humans , Male , Patient Acceptance of Health Care , Prevalence , Tooth Injuries/epidemiology , Tooth Injuries/therapy , Tooth, Deciduous
PURPOSE: To understand drug solubilization as a function of age and identify drugs at risk of altered drug solubility in pediatric patients. To assess the discrimination ability of the Abraham solvation parameters and age-related changes in simulated media composition to predict in vitro drug solubility differences between pediatric and adult gastrointestinal conditions by multivariate data analysis. METHODS: Differences between drug solubility in pediatric and adult biorelevant media were expressed as a % pediatric-to-adult ratio [Sp/Sa (%)]. Solubility ratios of fourteen poorly water-soluble drugs (2 amphoteric; 4 weak acids; 4 weak bases; 4 neutral compounds) were used in the analysis. Partial Least Squares Regression was based on Abraham solvation parameters and age-related changes in simulated gastrointestinal fluids, as well as their interactions, to predict the pediatric-to-adult solubility ratio. RESULTS: The use of Abraham solvation parameters was useful as a theory-informed set of molecular predictors of drug solubility changes between pediatric and adult simulated gastrointestinal fluids. Our findings suggest that the molecular solvation environment in the fasted gastric state was similar in the pediatric age-groups studied, which led to fewer differences in the pediatric-to-adult solubility ratio. In the intestinal fasted and fed state, there was a high relative contribution of the physiologically relevant surfactants to the alteration of drug solubility in the pediatric simulated conditions compared to the adult ones, which confirms the importance of an age-appropriate composition in biorelevant media. CONCLUSION: Statistical models based on Abraham solvation parameters were applied mostly to better understand drug solubility differences in adult and pediatric biorelevant media.
Body Fluids/metabolism , Gastrointestinal Absorption/physiology , Administration, Oral , Adult , Age Factors , Body Fluids/chemistry , Child , Gastric Mucosa/metabolism , Humans , Hydrogen-Ion Concentration , Hydrophobic and Hydrophilic Interactions , Intestinal Mucosa/metabolism , Solubility
BACKGROUND: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. METHODS: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. RESULTS: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren's syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). CONCLUSION: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).
Antirheumatic Agents/therapeutic use , COVID-19/prevention & control , Rheumatic Diseases/drug therapy , Adult , Aged , Aged, 80 and over , Arthritis, Rheumatoid/drug therapy , Brazil/epidemiology , COVID-19/epidemiology , Chi-Square Distribution , Cohort Studies , Cross-Sectional Studies , Family Health/statistics & numerical data , Female , Humans , Hydroxychloroquine/therapeutic use , Logistic Models , Male , Middle Aged , Scleroderma, Systemic/drug therapy , Sjogren's Syndrome/drug therapy , Statistics, Nonparametric , Young Adult
