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The aim of the present study was to describe the use of tapering, carbohydrate (CHO) supercompensation, and supplementation strategies self-reported by athletes in the Olympic triathlon category. A total of 72 triathletes (61 males and 11 females) answered an online questionnaire about their training and performance, supercompensation strategies, carbohydrate supplementation, and use of supplements and other ergogenic substances. The information was summarized and subjected to descriptive analysis. Shapiro-Wilk test was applied to check data normality. The t-test was used to investigate differences in the analyzed variables between sexes. Almost all triathletes reported to have performed tapering (93.05%) and approximately half of them adopted a CHO supercompensation strategy (48.61%); updated CHO supercompensation was the most used strategy (27.77%). Most participants (86.11%) used CHO supplementation during competitions, but in amounts below the 60 g/h recommended for most athletes (96.77%). Thus, since few triathletes performed supercompensation, in addition to the insufficient amount of supplemented carbohydrate taken by them, it could be concluded that triathletes were not sufficiently aware of nutritional recommendations or did not adopt them.

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Interoception is a complex, multidimensional construct that refers to the nervous system's processing of internal bodily signals. Currently, there are no comprehensive measurement tools available to capture the full complexity of interoception. The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), is a widely accepted and utilized interoceptive questionnaire that measures the multiple dimensions of conscious interoception through self-report. The aim of this study was to demonstrate the validity of a new Spanish translation of the MAIA-2 in Peruvian adults and to examine the dimensionality of the MAIA-2. A total of 414 Peruvian participants residing in Lima (Peru) were included; 85% were young adults between 18 and 27 years. The fit of the structural equation model (SEM) was assessed using confirmatory factor analysis (CFA). The dimensionality of the MAIA-2 was assessed using bootstrap exploratory bootstrap graph analysis (bootEGA). The results of the CFA suggest an oblique model (8 factors, 34 items) with modifications (items 11, 12, and 15 deleted). The bootEGA analyses indicate that a five-dimensional model is more parsimonious. These findings suggest that the MAIA-2 may have fewer dimensions than the original eight-dimensional theoretical model. The Peruvian Spanish version of the MAIA-2 proves to be a valid and reliable tool for assessing interoception in Peruvian adults, though slight variations in the dimensional structure were observed compared to the original model. This provides a solid basis for future research and clinical applications in Spanish-speaking contexts.

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BACKGROUND: Women were more prone to consuming alcohol as a coping mechanism for COVID-19 pandemic stressors than men. Worldwide evidence shows increased consumption during the social restriction phases, adversely impacting women's health. The study aimed to describe women's alcohol use throughout the restriction phases of the COVID-19 pandemic in São Paulo, Brazil. METHOD: A cross-sectional self-report survey was conducted by telephone with women who sought primary health care services. The sample comprised 3252 women, and 1308 (40%) reported consuming alcohol. The independent variable was the timing of the COVID-19 pandemic's restriction phases. The AUDIT-C was used as a measurement instrument. The covariates included sociodemographic factors, lifestyle characteristics, and outcomes related to COVID-19 infection. Univariate and bivariate models were used for analysis. A negative binomial distribution with zero inflation was used for the AUDIT-C score as the outcome variable in the entire sample. FINDINGS: Women's alcohol consumption during the COVID-19 restriction phase was compatible with moderate-risk use 3.5 (SD = 2.9). Binge drinking was observed in 41.8% of the participants. Alcohol consumption was 28.9% higher in the transition phase of social restriction than in the restriction and flexibilization phases. Hospitalization for COVID-19 and losing a loved one due to COVID-19 were associated with alcohol consumption. CONCLUSIONS: Women presented a moderate-risk pattern of alcohol use. This consumption was higher during the restriction phase of the pandemic in South America's largest city. Therefore, this study provides critical reflections on women's patterns of alcohol consumption. It reveals this population's social and clinical vulnerability, which might be considered in future health policies and programs.

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BACKGROUND: The popularization of mobile health (mHealth) apps for public health or medical care purposes has transformed human life substantially, improving lifestyle behaviors and chronic condition management. The objective of this study is to evaluate the effect of gamification features in a mHealth app that includes the most common categories of behavior change techniques for the self-report of lifestyle data. The data reported by the user can be manual (i.e., diet, activity, and weight) and automatic (Fitbit wearable devices). As a secondary objective, this work aims to explore the differences in the adherence when considering a longer study duration and make a comparative analysis of the gamification effect. METHODS: In this study, the effectiveness of various behavior change techniques strategies is evaluated through the analysis of two user groups. With a first group of users, we perform a comparative analysis in terms of adherence and system usability scale of two versions of the app, both including the most common categories of behavior change techniques but the second version having added gamification features. Then, with a second group of participants and the best mHealth app version, a longer study is carried out and user adherence, the system usability scale and user feedback are analyzed. RESULTS: In the first stage study, results have shown that the app version with gamification features has achieved a higher adherence, as the percentage of days active was higher for most of the users and the system usability scale score is 80.67, which is categorized as rank A. The app also exceeded the expectations of the users by about 70% for the app version with gamification functionalities. In the second stage of the study, an adherence of 76.25% is reported after 8 weeks and 58% at the end of the pilot for the mHealth app. Similarly, for the wearable device, an adherence of 74.32% is achieved after 8 weeks and 81.08% is obtained at the end of the pilot. We hypothesize that these specific wearable devices have contributed to a decreased system usability scale score, reaching 62.89 which is ranked as C. CONCLUSION: This study evidences the effectiveness of the gamification category of behavior change techniques in increasing the overall user adherence, expectations, and perceived usability. In addition, the results provide quantitative results on the effect of the most common categories of behavior change techniques for the self-report of lifestyle data. Therefore, a higher duration in the study has shown several limitations when capturing lifestyle data, especially when including wearable devices such as Fitbit.

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INTRODUCTION: Humanized care is the first aspect to consider to satisfy the surgical patient who will be or has undergone a surgical intervention. OBJETIVE: Determine the relationship that exists between perceived satisfaction and humanized nursing care in surgical patients in a public hospital in Peru. METHOD: Descriptive, observational, correlational study, with a quantitative approach, with probabilistic sampling of 241 surgical patients. A validated questionnaire adapted to our reality was used, reporting a Cronbach Alpha coefficient of 0.890 (satisfaction) and 0.904 (humanized nursing care), presenting 36 multiple choice questions. RESULTS: The age group of 18-29 years predominated in 26.6% (n = 64), with the average age X = 42.6 years with a DS of 14.47, female sex with 55.2% (n = 133), single marital status 48.5% (n = 117) and secondary education level was 60.2% (n = 145). The majority of patients were satisfied with the care received, reporting 84.6% (n = 204), also found in the dimensions: Humane 81.8% (n = 197), timely 78.8% (n = 190) and safe 80.1% (n = 193). The perceived humanized nursing care was good 81.3% (n = 196), it was also evident in the dimensions: Phenomenological 78.4% (n = 189), interaction 75.9% (n = 183), scientific 61, 8% (n = 149) and human needs (82.2%) (n = 198). CONCLUSIONS: A moderate correlation was found between the variables, behaving in a moderately positive manner, that is, the higher the level of satisfaction, the higher the level of humanized nursing care in the surgical patient, and vice versa.

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BACKGROUND: The association between physical fitness and autistic traits in adolescents remains under explored, especially in adolescents. Understanding this relationship can provide strategies to improve the quality of life of these people. OBJECTIVE: To identify the association between cluster characteristics derived from levels of self-perceived physical fitness and the occurrences of individual levels of autistic traits in Brazilian adolescents. METHOD: This descriptive study employed an analytical, quantitative approach involving 515 adolescents aged 11 to 18 (245 boys and 270 girls). Autistic traits were assessed using the Autism Quotient (AQ50), while physical fitness was measured with the Self-Reported Physical Fitness Questionnaire (QAPA). Cluster analysis using descriptive statistics with bootstrapping and generalized estimating equations was performed. RESULTS: Boys reported higher physical fitness levels than girls, with significant differences in General Power Strength (QAPA 4) and Physical Fitness in Sports (QAPA 7). Girls scored slightly higher on social skills. AQ50 scores indicated that girls had higher aggregated difficulties in imagination, attention, communication, and social skills compared to boys. Higher self-perceived physical fitness was associated with lower levels of autistic traits in both genders. Girls with higher QAPA scores showed significant decreases in autistic traits related to social skills and overall AQ50 scores. Boys with higher physical fitness demonstrated reduced autistic traits in the domains of imagination and communication. Age-adjusted analyses confirmed these findings. CONCLUSION: There is a significant association between self-perceived physical fitness and autistic traits in adolescents. Higher physical fitness levels are linked to fewer autistic traits, highlighting the importance of promoting physical fitness to mitigate challenges associated with autistic traits and improve adolescents' well-being.

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AIM: To determine the prevalence of keratoconus and its associated risk factors within the adult population of Trinidad and Tobago. METHOD: A population-based cross-sectional study was conducted among adults in Trinidad and Tobago, utilizing the Keratoconus Risk Assessment Questionnaire (KRIS) for data collection. Data were exported to the Statistical Package for Social Sciences (SPSS) version 27 for analysis. Descriptive statistics were employed to summarize the variables, while logistic regression was used to identify associated risk factors, with a significance level set at p < 0.05. RESULTS: A total of 413 participants were included in the study, yielding a response rate of 97.4% (413/424). The prevalence of keratoconus (KC) was 1.5% (95% CI: 0.33 - 2.67%). The condition was more prevalent among females (98.5%), individuals aged 19-30 years (66.7%), and participants of mixed race (50%). Allergic or atopic diseases were identified as the most common established risk factor for KC, affecting 50.1% of all participants. Among those diagnosed with KC, eye rubbing emerged as the most common established risk factor. Family history of KC (95% CI: 1.841-48.352, p < 0.007) and the use of rigid contact lenses (95% CI: 8.696-286.051, p < 0.001) were statistically significant predictors of KC. Specifically, participants with a family history of KC were 49.8 times more likely to develop the condition (OR = 49.875), while those using rigid contact lenses were 9.4 times more likely (OR = 9.436). CONCLUSION: The prevalence of KC in Trinidad and Tobago was found to be significant. Among the identified risk factors, atopy was the most common. Additionally, a positive family history and the use of rigid contact lenses were significant predictors of KC. Early screening for keratoconus in this country is strongly recommended to facilitate prompt detection and appropriate management of the condition.

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INTRODUCTION: Severe acute respiratory syndrome coronavirus infection is responsible for multisystemic disease and has high transmissibility. It culminated in a pandemic, challenging scientific knowledge and care capacity. Neurological symptoms are highly prevalent, and cases of encephalitis have been described, in both peri- and postinfectious periods. However, pathogenesis and prognosis are unclear. Thus, we aim to describe the clinical findings in cases of encephalitis in patients infected with severe acute respiratory syndrome coronavirus, together with a 1-year follow-up of self-perception of recovery and remaining neuropsychiatric symptoms. METHODS: This is a retrospective observational study in which patients with cerebrospinal fluid collection and a recent diagnosis of severe acute respiratory syndrome coronavirus infection were screened for encephalitis through analysis of medical records. We describe their clinical and paraclinical findings using descriptive statistics, together with their long-term outcome, through a self-assessment questionnaire. RESULTS: Among the 135 patients screened, 11 patients were included. Most of them were admitted for neurological symptoms (73%), and in 63% of cases, those symptoms occurred within the first 7 days of systemic symptoms. Most patients had minor pulmonary involvement assessed on chest computed tomography. On cerebrospinal fluid analysis, the most relevant finding was hyperproteinorrachia. Three patients (27%) had positive changes on magnetic resonance studies. In the outcome analysis, most patients (77%) reported gait difficulties and 66% reported memory and concentration problems. CONCLUSION: Encephalitis associated with severe acute respiratory syndrome coronavirus 2 infection is rare but responsible for chronic sequelae in cognitive and motor aspects. The pathophysiology seems to be associated with both the immune-mediated and inflammatory processes, and the low frequency of paraclinical findings demands a high clinical suspicion.

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Brazilians are a rapidly growing immigrant population in the United States (U.S.), yet little is known about their mental health and access to mental healthcare. Our goal was to access associations between the pursuit of- and access to-mental healthcare with mental health status and socio-demographic characteristics among Brazilian immigrant women. We conducted an online survey of Brazilian women aged 18 or older who reported being born in Brazil and currently residing in the U.S. We recruited respondents via Brazilian cultural media, community organizations serving Brazilian immigrants, and social media. We assessed respondents' perceived access to mental healthcare, self-reported mental health (CES-D-10), and socio-demographic characteristics and conducted multivariable logistic regression. Our analysis included 351 participants. Half (52%) had CES-D-10 scores indicating high levels of depressive symptomatology. A third (33%) reported seeking care for their mental health in the past 12 months, 87% of whom reported obtaining care. Results of multivariable logistic regression determined that respondents who sought mental healthcare were more likely to have higher CES-D-10 scores (OR = 1.09, 95% CI 1.03-1.15), very low incomes (<$10,000 per year; OR = 0.34, 95% CI 0.12-0.96), and were marginally more likely to have a primary care provider (OR = 2.11, 95% CI 1.00, 4.46). We found that despite a high level of depressive symptomology, only one-third reported accessing care. While difficulty accessing care for mental issues is a widespread issue, our findings suggest that efforts are needed to ameliorate mental health issues for Brazilian women to reduce systemic, interpersonal, and individual barriers to seeking care among the 13% who sought healthcare but were unable to receive it.

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BACKGROUND: Consistent monitoring of PrEP adherence with accurate measurement tools at point-of-care could greatly contribute to reaching adolescents with poor adherence. We aimed to assess the performance of indirect adherence measures to oral PrEP among adolescent men who have sex with men (AMSM) and adolescent transgender women (ATGW). METHODS: PrEP15-19 is a prospective, multicenter, PrEP demonstration cohort study that includes AMSM and ATGW aged 15-19 in three Brazilian cities. A diagnostic accuracy study was conducted using tenofovir-diphosphate (TFV-DP) concentrations in dried blood spots as the reference standard, along with three index tests: medication possession ratio (MPR), pill count, and self-report. We calculated the area under the curve (AUC) for protective TFV-DP levels (≥800 fmol/punch) and sensitivity (SE) and specificity (SP) for established cutoff points. RESULTS: We included 302 samples from 188 participants. Most of participants were AMSM (78.7%), aged 18-19 years (80.3%), and non-whites (72.9%). The AUC was 0.59 for MPR, 0.69 for pill count, and 0.75 for self-report. When combining MPR and self-report, the AUC increased to 0.77. Sensitivity was high for the cutoff points identified by the Youden index, 80% for MPR, 92% for self-report, and 97% for pill count. However, specificities were low 40%, 46%, and 38%, respectively. CONCLUSIONS: Indirect measures were able to discriminate adolescents with good adherence. However, their performance in identifying those with low adherence might be limited, suggesting that it is necessary to initiate adherence interventions when there is no evidence of perfect adherence. Combining measures can provide wider information on adherence.

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OBJECTIVE: To explore the associations and gender differences between health anxiety, eHealth literacy and self-reported health in Chinese university students. METHODS: 1,205 university students aged 18-22 years were voluntarily recruited to respond to an online self-report questionnaire. RESULTS: The severity level of health anxiety among university students was ranked as lifestyle anxiety, psychological anxiety, appearance anxiety, physical anxiety. There were significant gender differences in appearance anxiety, and yet no in eHealth literacy of university students. eHealth literacy was positively associated with self-reported health; health anxiety was negatively associated with self-reported health. Female's eHealth literacy, lifestyle, psychological and physical anxiety, and male's eHealth literacy, appearance anxiety significantly impacted on their self-reported health. CONCLUSION: The lower eHealth literacy or the more health anxiety, the worse their self-reported health. The findings underscored the importance for university students to improve eHealth literacy and reduce health anxiety. Appropriate interventions with gender differences were urgently needed.

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OBJECTIVE: The objective of this study was to determine the prevalence of self-reported myopia in Trinidad and Tobago. MATERIALS AND METHODS: This study was a cross-sectional design, and data were collected using a validated structured questionnaire from January to April 2024. Systematic random sampling was used to select participants aged 15 and above to participate. Descriptive statistics were used to summarise the variables and the Chi-square test was used to assess for associations (P < 0.05). RESULTS: A total of 350 participated in the study giving a response rate of 91.15%. Majority of the participants were female (n = 197, 56.3%), mixed race (n = 126, 36%), resided in urban areas (n = 172, 49.4%) and aged 18-35 years (n = 168, 48.3%). The prevalence of myopia was 40.9% and the prevalence was significantly associated with age group, ethnicity, level of education and religion (P < 0.05). Myopia was associated with family history, lifestyle, use of spectacles, daily use of computers, near work, outdoor activities, sleeping and having a father or mother with myopia (All P < 0.05). In addition, ocular diseases such as cataracts and glaucoma were among the most frequent reported conditions. CONCLUSION: The myopia prevalence observed in our study validates age-related trends, offers estimates across diverse age groups, and reveals a significant association between myopia rates and family history, with a self-reported myopia rate higher than clinical testing surveys but in line with global prevalence reports.

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OBJECTIVE: To estimate prevalence and analyze factors associated with body image dissatisfaction among Brazilian adolescent school students. METHODS: Cross-sectional study with data from the 2019 National School Health Survey (PeNSE). Prevalence of self-reported body image dissatisfaction and respective 95% confidence intervals (95%CI) and its association with individual characteristics were estimated via odds ratios (OR) and 95% CI using logistic regression. RESULTS: Of the 159,245 students, 30.2% (95%CI 29.2;31.1) reported body image dissatisfaction, which was associated with all factors analyzed. Likelihood of dissatisfaction was greater among females (OR = 3.86; 95%CI 3.45;4.32), having internet at home (OR = 8.68; 95%CI 6.83;11.03), thinking that no one cares about them (OR = 3.02; 95%CI 2.60;3.50), that life is not worth it (OR = 3.27; 95%CI 2.88;3.72) and feeling irritated (OR = 2.87; 95%CI 2.53;3.26). CONCLUSION: Body image dissatisfaction is associated with various factors and requires an intersectoral approach. MAIN RESULTS: Prevalence of body image dissatisfaction was 30.2%. The greatest likelihood of dissatisfaction was more related to being female, having internet at home, frequently feeling that no one cares about them, that life is not worth it, and feeling irritated. IMPLICATIONS FOR SERVICES: We suggest that projects be carried out in schools encouraging physical activity, less screen time and good eating habits, in addition to providing psychological support to students, in order to guide care for their mental health. PERSPECTIVES: Projects are needed to encourage and instruct good physical and psychological health practices at school, involving the entire school community, training of education professionals and encouragement of adolescent mental health self-care.

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OBJECTIVE: To assess the previous history of syphilis in transgender women and travestis (TWTs) and identify factors associated with treatment incompleteness. METHODS: : This was a multicenter cross-sectional study conducted between 2019 and 2021, with participants recruited through respondent-driven sampling, in five Brazilian capitals. Dependent variable: "reported syphilis treatment in the last year", "no/incomplete" or "complete". A multivariate-logistic model was used to identify factors associated with completeness. RESULTS: : Of the 1,317 participants, 16.0% reported previous history of syphilis. Of these, 68.9% were Black, 54.6% earned up to 1 minimum wage and 61.1% completed the treatment. Treatment completion was lower in São Paulo (42.7%) and among those who experienced verbal abuse (53.6%; ORa 0.46; 95%CI 0.25;0.85). CONCLUSION: In this sample, both the prevalence of self-reported syphilis and the proportion of participants who reported not having started/completed treatment were high. It is essential to identify the barriers faced by TWTs that hinder healthcare access, and identify their needs in order to ensure adequate diagnosis and treatment. MAIN RESULTS: Of the 16% of participants who reported a previous diagnosis of syphilis, only one-third completed the treatment. Residents of São Paulo were less likely to complete it compared to those from other cities, and those who had experienced verbal abuse. IMPLICATIONS FOR SERVICES: There is a need for healthcare professionals to receive training focused on specific needs of TWTs , including respect for their social names, extended opening hours, point-of-care strategy and alternatives for the administration of intramuscular benzathine penicillin injections. PERSPECTIVES: It is crucial to develop new, more effective therapeutic methods for syphilis treatment and deepen research on the impacts of discrimination and stigma on transgender women and travestis' access to healthcare, especially diagnosis and treatment of sexually transmitted infections.

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To describe patterns of self-rated health (SRH) trajectories and investigate their association with sociodemographic, occupational, and health factors.The sample consisted of 7,738 active public servants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), evaluated from 2008 to 2020. The patterns of SRH trajectories were obtained by eleven time points, using the latent class growth curve. A multinomial logistic model was used to test associations between the exposures and patterns of trajectories of SRH.Three patterns of trajectories of SRH were identified: i- good, ii- moderate, and iii- poor (29%, 61%, and 10% of the participants, respectively). Adjusted results showed that women, mixed-race, frequent work to family or family to work conflict were associated with a greater chance of poor pattern of trajectory of SRH, compared to good pattern. Besides, high school, low income, passive work, high strain, low social support, lack of time selfcare and leisure, overweight, obesity, unhealthy lifestyle, and the presence of comorbidities were associated with a greater chance of moderate and poor pattern of trajectory of SRH, when compared with a good pattern.Adverse socioeconomic and occupational conditions, as well as unhealthy lifestyle and comorbidities were associated with worse SRH patterns of trajectories.

Descrever padrões de trajetórias de autoavaliação de saúde (AAS) e investigar sua associação com fatores sociodemográficos, ocupacionais e de saúde.Amostra composta por 7.738 servidores públicos ativos do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) avaliados entre 2008 e 2020. Utilizando-se a curva de crescimento de classe latente, foram definidos os padrões de trajetórias da AAS, obtidos em 11 pontos no tempo. Modelos logísticos multinomiais foram testados para analisar associações entre as exposições e os padrões de trajetórias de AAS.Três padrões de trajetórias de AAS emergiram: i- boa, ii- regular e iii-ruim (29%, 61% e 10% dos participantes, respectivamente). Após ajustes, tiveram maiores chances de serem classificados com padrões de trajetória de AAS ruim, comparado à boa, o sexo feminino, a raça/ cor autorreferida parda, referir frequente conflito do trabalho para a família ou da família para o trabalho. Além disso, os fatores associados a maiores chances de apresentar padrão de trajetória de AAS ruim ou regular, comparados à boa, foram escolaridade até o ensino médio, menor renda, trabalho passivo, alto desgaste no trabalho, baixo apoio social, ocupação manual, percepção de escassez de tempo para o autocuidado e lazer, ter sobrepeso ou obesidade, um estilo de vida não saudável e comorbidades.Condições socioeconômicas e ocupacionais adversas, estilo de vida não saudável e comorbidades foram associadas ao pior padrão de trajetórias de AAS.

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BACKGROUND: Stroke remains a public health problem, reported as the third cause of disability. Among survivors, the ability to perform usual daily activities may be reduced, requiring rehabilitation. OBJECTIVE: To investigate the prevalence of self-reported stroke, the accessibility of healthcare, and the degree and percentage of patients with limitations in usual activities who are unassisted by physiotherapeutic treatment in different regions of the country. METHODS: This cross-sectional study was conducted using data from the 2019 National Health Survey. Participants aged 15 years or older from all five geographic regions of Brazil who reported a diagnosis of stroke were included. The data were analyzed using sample weighting and expressed as estimates along with a 95% confidence interval (CI). RESULTS: The national prevalence of self-reported stroke in Brazil was 1.9% (95%CI 1.7-2.0), equivalent to 1,975 individuals with diagnosis. Of these, 50.2% reported limitations in their daily activities, and more than half (54.6%) had regular follow-ups with healthcare professionals. However, only 24.6% reported having access to rehabilitation, while 73.4% of individuals with activity limitations received no physiotherapeutic treatment. CONCLUSION: The prevalence of' self-reported stroke in the Brazilian population was 1.9%, with more than half experiencing limitations in their activities. While more than half of the stroke patients underwent follow-ups from a health professional, only » of them reported having access to rehabilitation. Government interventions are necessary to ensure effective access to healthcare, including rehabilitation for the Brazilian population.

ANTECEDENTES: O acidente vascular cerebral (AVC) continua sendo um problema de saúde pública, relatado como a terceira causa de incapacidade. Entre os sobreviventes, a capacidade de realizar atividades diárias habituais pode ser reduzida, demandando reabilitação. OBJETIVO: Investigar a prevalência de AVC autorreferido, a acessibilidade aos cuidados de saúde, assim como o grau e porcentagem de pacientes com limitações nas atividades habituais que não são assistidos por tratamento fisioterapêutico em diferentes regiões do país. MéTODOS: Estudo transversal realizado com dados da Pesquisa Nacional de Saúde de 2019. Foram incluídos participantes com 15 anos ou mais de todas as cinco regiões geográficas do Brasil. Os dados foram analisados por meio de ponderação amostral e expressos como estimativas com intervalo de confiança (IC) de 95%. RESULTADOS: A prevalência nacional de AVC autorreferido no Brasil foi de 1,9% (IC95% 1,7­2,0), equivalente a 1.975 indivíduos com diagnóstico. Destes, 50,2% relataram limitações em atividades diárias e mais da metade (54,6%) faziam acompanhamento regular com profissionais de saúde. Contudo, apenas 24,6% relataram acesso à reabilitação, enquanto 73,4% dos indivíduos com limitação de atividades não receberam tratamento fisioterapêutico. CONCLUSãO: A prevalência de AVC autorreferido no Brasil foi de 1,9%, com mais da metade apresentando limitações em atividades. Embora mais de metade dos pacientes recebessem acompanhamento de um profissional de saúde, apenas » deles relataram ter acesso à reabilitação. Intervenções governamentais são necessárias para garantir o acesso efetivo à saúde, incluindo a reabilitação, para a população brasileira.

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BACKGROUND: Spinal muscular atrophy linked to chromosome 5q (SMA-5q) is a neurodegenerative disorder caused by mutations in the SMN1 gene. OBJECTIVE: To describe the key demographic, clinical and genetic characteristics, as well as natural history data of patients with SMA-5q. METHODS: Up to January 2022, 706 patients with confirmed genetic diagnosis of SMA-5q, or their parents, completed a self-reported questionnaire on natural history, genetic characteristics, drug treatments, and multidisciplinary care. RESULTS: Most patients had type 1 SMA-5q (42%); with 33% having type 2, and 23% type 3. There were 667 patients (94.4%) with a homozygous SMN1-exon 7 deletion. Of the total, 131 (18.6%) patients had a previous family history of the disease, and the familial recurrence rate was higher in type 3 (25.6%). Type 1 patients had a mean age of 3 months at the onset of symptoms and a delay of more than 3 months until genetic diagnosis. The median survival of patients with type 1 without invasive ventilation was 27 months. Before 2018, the median age of use of invasive ventilation was 16 months and, after, most patients (71%) were not submitted to invasive ventilation. About 50% of patients with type 3 lost their walking ability by 37 years of age. Further, 384 (54.4%) patients had access to disease-modifying therapy, and 62.3% of type 1 patients were in treatment, compared with only 47.2% of type 2 and 31.9% of type 3 patients. CONCLUSION: There is still a substantial diagnostic delay, especially in those patients with types 2 and 3 SMA-5q. However, the present study demonstrated prolonged survival, especially in type 1 patients.

ANTECEDENTES: A atrofia muscular espinhal ligada ao cromossomo 5q (AME-5q) é uma doença neurodegenerativa causada por mutações no gene SMN1. OBJETIVO: Descrever as principais características demográficas, clínicas e genéticas, assim como dados de história natural de pacientes com AME-5q no nosso meio. MéTODOS: Até janeiro de 2022, 706 pacientes com diagnóstico genético confirmado de AME-5q, ou seus pais, preencheram questionário sobre dados de história natural, características genéticas, tratamento medicamentoso e cuidados multidisciplinares. RESULTADOS: A maioria dos pacientes tinha AME-5q tipo 1 (42%); 33% tinham tipo 2 e 23% tipo 3. Deleção homozigótica no SMN1 foi notada em 667 pacientes (94,4%). Do total, 131 (18,6%) pacientes tinham história familiar prévia, e a taxa de recorrência familiar foi maior no tipo 3 (25,6%). Os pacientes com tipo 1 tinham idade média de 3 meses no início dos sintomas e atraso de mais de 3 meses até o diagnóstico genético. A sobrevida mediana de pacientes com tipo 1 sem ventilação invasiva foi de 27 meses. Antes de 2018, a idade mediana de uso de ventilação invasiva era de 16 meses e, após, a maioria dos pacientes (71%) não foi submetida a ventilação invasiva. Cerca de 50% dos pacientes com tipo 3 perderam a marcha em média aos 37 anos de idade. Além disso, 384 (54,4%) pacientes tiveram acesso a alguma terapia modificadora da doença; 62,3% dos pacientes tipo 1 estavam sendo tratados, comparados a 47.2% do tipo 2 e 31.9% do tipo 3. CONCLUSãO: Ainda existe um atraso substancial para o diagnóstico, especialmente nos pacientes com AME-5q tipos 2 e 3. Contudo, o presente estudo demonstrou sobrevida prolongada em pacientes tipo 1.

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OBJECTIVE: The objective of this study was to compare drink driving and related road safety issues in 2 urban areas of 6 countries and develop an equation for estimating the rate of crash underreporting to the police in urban areas of countries that lack this information. METHODS: This study is a secondary analysis of 1 to 2 waves of surveys in pairs of matched medium-sized cities in Belgium, Brazil, China, Mexico, South Africa, and Ohio, United States; the surveys supported evaluation of local alcohol harm reduction efforts. Data were from 2017 to 2019 except 2023 for Mexico. Mailed surveys in Ohio and household interviews elsewhere of quota samples matched to census data yielded 23,240 completed interviews. Relevant questions covered drinking, driving under the influence of alcohol (DUI), DUI enforcement, and, except in South Africa, road crashes. GLM regression provided an equation for estimating police reporting rates of urban injury and no-injury crashes from a country's purchasing-power parity-adjusted gross domestic product (GDP) per capita. RESULTS: The percentage of drivers driving unlicensed was 30% in Mexico and South Africa, 15% in Brazil, 8% in China, and <1% elsewhere. Among adults who both drove and drank, self-reported urban DUI rates ranged from 12% in China to 53% in South Africa, with 4 countries between 18% and 26%. Among those reporting DUI, the percentage stopped by police for doing so was 14% in Belgium, 15% in Brazil, 25% in China, 31% in Mexico, 45% in South Africa, and only 3% in Ohio. The surveys yielded data on 380 urban crashes. Past-year crash involvement was 2% to 3% in Belgium and China and 5% to 6% elsewhere. The 10% injury rate in Ohio crashes was significantly below the 24% to 35% rates elsewhere. Injury crashes were almost universally reported except in Brazil (60% reported). Only 49% to 56% of non-injury crashes were reported, except in Ohio (73%). Perceived alcohol-involved crash rates of 18% to 19% in Belgium and Ohio were significantly lower than the 32% reported in Brazil, 41% in China, and 57% in Mexico. In the regression, GDP per capita and injury involvement were positively associated with police crash reporting. CONCLUSIONS: Our equation more closely approximates urban police crash reporting rates than prior studies that assumed that they matched U.S. data. DUI enforcement is weak/ineffective in urban Ohio. With suggested adjustments, our survey questions should be usable in other international road safety and DUI studies.

RESUMEN

BACKGROUND: The prevalence of HIV in Panama is estimated to be 1.0%; only 71% of individuals on antiretroviral treatment (ART) were virally suppressed in 2022. This study aimed to describe the prevalence of suboptimal adherence (≥1 missed doses in previous four weeks) and limited retention in HIV care (≥1 missed HIV care appointments in previous 12 months) among adults (aged ≥18 years) who attended the most populous urban ART Clinic in Panama City. METHODS: In this cross-sectional study, participants completed a self-administered questionnaire. Univariable and bivariable analyses were used to describe the prevalence of suboptimal adherence and limited retention in HIV care. Multivariable logistic regression identified factors associated with suboptimal adherence at p<0.05. RESULTS: We included 375 participants (209 identified as men, 158 as women, 8 another gender). Of those who responded, 37.3% (n = 125/335) reported suboptimal adherence: 28.6% (n = 53/185) of men, 49.0% (n = 71/145) women, 20.0% (n = 1/5) another gender; p<0.01; 18.6% (n = 69/371) reported limited retention in care:13.6% (n = 28/206) men, 24.2% (n = 38/157) women, 37.5% (n = 3/8) another gender, p = 0.01. In multivariable analyses, suboptimal adherence was associated with gender (49.0%women vs. 28.6% men, AOR = 1.86, 95%CI:0.97-3.57), depressive symptoms:46.2% severe symptoms vs. 28.1% minimal-mild, AOR = 2.19,95%CI:0.96-5.04), and lifetime intimate partner emotional violence (IPV) 48.2% vs.no emotional IPV 32.2%, OR = 1.96,95%CI:1.15-2.90, and lifetime physical IPV 46.9% vs.no physical IPV 32.6%, OR = 1.82, 95%CI:1.15-2.90. In unadjusted analyses, limited retention in care was associated with gender (24.2%women vs.13.6% men OR = 2.03, 95%CI:1.18-3.49), difficulty paying rent/mortgage/utilities (22.6% vs.14.9% no difficulty paying, OR = 1.67,95%CI = 0.98-2.83); no variables were associated in the multivariable model. CONCLUSIONS: This study found high prevalence of suboptimal ART adherence and limited retention in care, especially among women; these factors were associated with severe depressive symptoms, as well as lifetime emotional and physical IPV. These results show the need for integrated mental health and IPV intervention for all individuals, including focused support for women.

RESUMEN

Foodborne diseases are a global burden. Actions to fight this group of diseases are necessary, especially for the younger demographic, which consists of consumers, food handlers, and the future workforce of the food chain. To this end, outlining the food safety profile of the target audience is imperative. Thus, this study aimed to understand and evaluate the risk perception, knowledge, and food safety self-reported practices of individuals between 5th and 9th grades (10 to 14 years old, considering the normal teaching flow) of public schools in the Federal District - Brazil. Instruments by Batista et al. (2023) and Brazil (2013) were used to achieve the objectives. The study included 1,420 students aged 9 to 17 (women = 50.6 %; n = 719) with a mean age of 11.9 years (±1.7) enrolled in 25 schools. It was observed that a more significant proportion of students attributed very low and low risk of Foodborne Diseases to the foods produced and served in School Food Services. The presence of optimistic bias, low perception of lethality, average knowledge, risky practices, and the gap between unsafe food knowledge and safe food handling/consumption practices were also identified. Correlations were identified between social vulnerability and risk perception (positive) and self-reported practices (negative). The results show the urgency of considering these individuals to ensure food safety, considering their vulnerability, reality, and the tools at their disposal.