Prevalence of low back pain in young Brazilians and associated factors: Sex, physical activity, sedentary behavior, sleep and body mass index.

BACKGROUND: Low back pain (LBP) has become increasingly common, but the prevalence of this complaint and associated factors in young people remains controversial. OBJECTIVE: This study aimed to identify the prevalence of LBP and to explore the existence of associated factors (sex, physical activity, sedentary lifestyle, sleep, body mass index and waist circumference). METHODS: This study considered all complaints of the lumbar region (acute or chronic) as LBP, which can irradiate to the backside and legs, lasting a minimum of 24 hours. Youngsters aged 15 to 18 years from a school in the south of Brazil were evaluated. Descriptive statistics was used, in particular Chi-square, Mann-Whitney U tests and binary logistic regression. A significance level of p< 0.05 was adopted. RESULTS: A total of 330 youngsters answered a questionnaire and had their anthropometric measurements measured (response rate 84%). The prevalence of LBP in the present was 30%, quarterly 63% and throughout life 77%. There was a significant association between LBP and sex: girls have an increased risk of LBP in the last three-month period (PR = 1.3, 95% CI 1.06-1.56) and throughout life (PR = 1.2, 95% CI 1.04-1.43). The practice of physical activities was also associated with LBP, but as a protection factor in the present and in the last three-month period (PR = 0.7, 95% CI 0.47-0.90). Physical education at school has demonstrated a protective factor regarding LBP throughout life (PR = 0.9, 95% CI 0.77-0.97). Most of the students did not comply with recommendations related to sleep and time spent doing activities in front of a screen, and no association of these factors with LBP was detected. This exposure (physical activity, sleep time, sedentarism) did not present significant association with LBP when adjusted by the confusion factors (sex, age, BMI). CONCLUSIONS: Youngsters reported a high prevalence of LBP. Girls were at greater risk of LBP than boys. It is recommended that prevention strategies focus on the practices of physical activities and scholar physical education. No association of LBP with sedentary lifestyle (TV and computer use time, sleep time), anthropometric measures and sleeping duration was observed.

Violência estrutural e adoecer no Haiti: reflexões sobre uma experiência / Structural violence and illness in Haiti: reflections on an experience

Resumo Falar sobre saúde e principalmente da busca pela cura das doenças em sociedades globais empobrecidas e desassistidas traz à tona amplas e conflitivas reflexões. O Haiti é o país mais pobre das Américas e um dos mais pobres do mundo. A extrema vulnerabilidade a que a população está exposta é facilmente percebida por meio da análise do processo saúde/enfermidade/atenção, uma vez que esse é um dos domínios em que se acentuam as vivências de sofrimento, a percepção da inequidade e as intervenções ineficazes, que se pode observar em cada relato de experiência a violência estrutural como um legado histórico. Perpetuada ainda hoje por forças sociais e políticas globais, a violência estrutural pode ser pensada como fator associado ao risco de adoecer e a viabilidade (ou não) da cura ou do controle das doenças. A partir de um relato particular, discute-se com base nessa teoria o processo de adoecimento e o percurso feito até a resolução do padecimento, considerando a realidade da saúde pública do país.

Abstract Talking about health and especially the search for curing diseases in impoverished and unempowered global societies brings out broad and conflicting reflections. Haiti is the poorest country in the Americas and one of the poorest in the world. The extreme vulnerability to which the population is exposed is easily perceived by analyzing its health/disease/attention process, as this is one of the areas where experiencing suffering, the perception of inequity and ineffective interventions are notorious, depicting structural violence as a historical legacy in each case report. Structural violence is perpetuated today by global social and political forces and can be thought of as a factor associated with the risk of illness and the viability of healing or disease control. A private report was used to discuss the process of falling ill based on this theory and the path taken until the resolution of the disease, considering the public health reality of the country.

Pesquisadores brasileiros na pós-graduação de Antropologia Médica na Espanha: relato de experiência / Investigadores brasileños en el post-grado de antropología médica en España: relato de experiencia / Brazilian researchers in Medical Anthropology Postgraduate Studies in Spain: Experience Report

O objetivo do manuscrito foi relatar e discutir a experiência de pesquisadores brasileiros, do campo da saúde, em um programa da área da antropologia. Trata-se de relato de experiência elaborado na perspectiva de se reconhecerem e discutirem, de maneira crítica, as experiências dos pesquisadores no campo antropológico da educação continuada e permanente, tendo como cenário o doutorado em Antropologia e Comunicação da Universitat Rovira i Virgil em Tarragona, Espanha. O relato da imersão dos pesquisadores nos estudos sobre antropologia médica e saúde global revelou a ampliação de horizontes sobre a compreensão do processo de saúde-enfermidade-atenção, possibilitando a análise do fenômeno sob outra perspectiva, onde os valores da sociedade e da cultura estão fortemente presentes.

El objetivo del manuscrito fue relatar y discutir la experiencia de investigadores brasileños, del campo de la salud, en un programa del área de la antropología. Se trata de un relato de experiencia elaborado desde la perspectiva de reconocer y discutir, de manera crítica, las experiencias de los investigadores en el campo antropológico de la educación continuada y permanente, teniendo como escenario el doctorado en Antropología y comunicación de la Universitat Rovira i Virgil en Tarragona, España. El relato de la inmersión de los investigadores en los estudios sobre antropología médica y salud global reveló la ampliación de horizontes sobre la comprensión del proceso de salud-enfermedad-atención, posibilitando el análisis del fenómeno bajo otra perspectiva, en donde los valores de la sociedad y de la cultura están fuertemente presentes.

The purpose of this manuscript was to report and discuss the experience of Brazilian health researchers, going through a program in the area of anthropology. This experience report aims to acknowledge and critical discuss the experiences of the researchers in the anthropology field of continued and permanent education, in the background of the PhD course in Anthropology and Communication of the Universitat Rovira i Virgili in Tarragona, Spain. The immersion studies on medical anthropology and global health done by the researchers widened their understanding of the health-disease-care process, enabling the analysis of the phenomenon from another perspective, where the society and cultural values are strongly present.

Body surface posture evaluation: construction, validation and protocol of the SPGAP system (Posture evaluation rotating platform system).

BACKGROUND: Several posture evaluation devices have been used to detect deviations of the vertebral column. However it has been observed that the instruments present measurement errors related to the equipment, environment or measurement protocol. This study aimed to build, validate, analyze the reliability and describe a measurement protocol for the use of the Posture Evaluation Rotating Platform System (SPGAP, Brazilian abbreviation). METHODS: The posture evaluation system comprises a Posture Evaluation Rotating Platform, video camera, calibration support and measurement software. Two pilot studies were carried out with 102 elderly individuals (average age 69 years old, SD = ±7.3) to establish a protocol for SPGAP, controlling the measurement errors related to the environment, equipment and the person under evaluation. Content validation was completed with input from judges with expertise in posture measurement. The variation coefficient method was used to validate the measurement by the instrument of an object with known dimensions. Finally, reliability was established using repeated measurements of the known object. RESULTS: Expert content judges gave the system excellent ratings for content validity (mean 9.4 out of 10; SD 1.13). The measurement of an object with known dimensions indicated excellent validity (all measurement errors <1 %) and test-retest reliability. A total of 26 images were needed to stabilize the system. Participants in the pilot studies indicated that they felt comfortable throughout the assessment. The use of only one image can offer measurements that underestimate or overestimate the reality. To verify the images of objects with known dimensions the values for the width and height were, respectively, CV 0.88 (width) and 2.33 (height), SD 0.22 (width) and 0.35 (height), minimum and maximum values 24.83-25.2 (width) and 14.56 - 15.75 (height). In the analysis of different images (similar) of an individual, greater discrepancies were observed in the values found. The cervical index, for example, presented minimum and maximum values of 15.38 and 37.5, a coefficient of variation of 0.29 and a standard deviation of 6.78. CONCLUSIONS: The SPGAP was shown to be a valid and reliable instrument for the quantitative analysis of body posture with applicability and clinical use, since it managed to reduce several measurement errors, amongst which parallax distortion.

Aquisição e refinamento do sentar independente: um estudo transversal / Acquisition and refinement of independent sitting: a cross-sectional study

O desenvolvimento motor normal de uma criança é dependente da maturação do sistema nervoso central, sofrendo influências da genética e do meio em que a criança vive. Observa-se, no entanto, que o desenvolvimento motor apresenta uma ordem seqüencial semelhante em todas as crianças, relacionada com o aprimoramento do controle motor. O objetivo deste estudo foi verificar as habilidades e padrões motores utilizados por crianças neurologicamente normais para atingir a posição sentada. A amostra foi composta por 81 crianças, entre 06 e 12 meses de idade cronológica, de creches públicas e privadas de cidades do Vale do Itajaí-SC. A avaliação foi feita através de três observações consecutivas da forma como a criança atingia o sentar independente a partir da posição supina, voluntariamente ou respondendo a estímulos dados pelo pesquisador. Os dados coletados foram analisados quantitativamente e qualitativamente através do método de análise de distribuição de freqüência em tabelas cruzadas. Os principais achados deste estudo foram que a aquisição da posição sentada inicia-se aos sete meses e requer a passagem pela posição prona com o uso do apoio de cotovelos no solo, evoluindo para o uso de quatro apoios, posição mais adotada nos diversos estratos. A passagem direta da posição supina para a posição sentada requer maior equilíbrio entre a musculatura flexora e extensora eé um marco na evolução desta atividade motora, sendo observada neste estudo em crianças acima de dez meses. Observou-se também uma tendência de comportamento motor nas passagens em cada estrato etário, além de diferenças em crianças da mesma idade, relacionadas, provavelmente, à genética e ao meio.

The normal motor development of a child is dependent on the maturation of the central nervous system, and is influenced by genetics and the environment in which the child lives. It is observed, however, that motor development follows a similar sequence in all children, in relation to the development of motor control. The aim of this study was to determine the motor skills and patterns used by healthy children to reach sitting position. The sample consisted of 81 children aged 6 to 12 months who attended public and private nurseries in the Vale do Itajaí region - Santa Catarina. The evaluation was carried out through three consecutive observations of the way in which the child reached sitting position from supine, either voluntarily or in response to researcher stimuli. The data collected were analyzed both quantitatively and qualitatively through the method of frequency distribution in cross tabs. The major findings of this study were that mastery of sitting position begins at around seven months and requires passing through prone position, supported by the elbows on the ground, progressing to a crawling position, which is the most often adopted position in the various age strata. Direct progression from supine to sitting position requires greater balance between flexor and extensor muscles and represents a milestone in the development of this motor activity, being observed in children above ten months in this study. A trend in motor behavior in the progress of each age strata was also observed, as well as differences among children of the same age probably due to genetics and to the environment.