Poor Sleep Quality and Daytime Sleepiness in Health Professionals: Prevalence and Associated Factors.

This study aimed to examine the prevalence rates of poor quality sleep and daytime sleepiness in health professionals and their association with socioeconomic, lifestyle, and anthropometric factors and psychosocial work conditions. This cross-sectional study was performed with health professionals from various public and private hospitals in Rio Verde, Goiás, Brazil. Daytime sleepiness and sleep quality were assessed using the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index, respectively. The variables were analyzed using multiple hierarchical Poisson regression in the statistical package Stata version 13.0. A total of 244 health professionals participated in this study (women, 78.28%). The rates of abnormal daytime sleepiness and poor sleep quality were 50.41% (n = 123) and 55.74% (n = 136), respectively. Reduced physical activity was associated with poor sleep quality (prevalence ratio (PR) = 1.32; 95% confidence interval (CI) 1.02-1.70, p = 0.035). Age between 20 and 29 years (PR = 2.59; 95% CI 1.37-4.91, p = 0.021) and 30 and 49 years (PR = 2.09; 95% CI 1.12-3.91, p = 0.021), as well as excessive alcohol consumption (PR = 1.29; 95% CI 1.01-1.66, p = 0.048), were risk factors for daytime sleepiness. Conversely, adequate bodyweight (PR = 0.52; 95% CI 0.33-0.82, p = 0.005) was considered a protective factor. The present findings suggest high rates of abnormal daytime sleepiness and poor sleep quality among healthcare professionals. We emphasize the importance of physical activity, adequate weight, and healthy habits for better quality sleep and reduced daytime sleepiness.

Brain Maturation, Cognition and Voice Pattern in a Gender Dysphoria Case under Pubertal Suppression.

Introduction: Gender dysphoria (GD) (DMS-5) is a condition marked by increasing psychological suffering that accompanies the incongruence between one's experienced or expressed gender and one's assigned gender. Manifestation of GD can be seen early on during childhood and adolescence. During this period, the development of undesirable sexual characteristics marks an acute suffering of being opposite to the sex of birth. Pubertal suppression with gonadotropin releasing hormone analogs (GnRHa) has been proposed for these individuals as a reversible treatment for postponing the pubertal development and attenuating psychological suffering. Recently, increased interest has been observed on the impact of this treatment on brain maturation, cognition and psychological performance. Objectives: The aim of this clinical report is to review the effects of puberty suppression on the brain white matter (WM) during adolescence. WM Fractional anisotropy, voice and cognitive functions were assessed before and during the treatment. MRI scans were acquired before, and after 22 and 28 months of hormonal suppression. Methods: We performed a longitudinal evaluation of a pubertal transgender girl undergoing hormonal treatment with GnRH analog. Three longitudinal magnetic resonance imaging (MRI) scans were performed for diffusion tensor imaging (DTI), regarding Fractional Anisotropy (FA) for regions of interest analysis. In parallel, voice samples for acoustic analysis as well as executive functioning with the Wechsler Intelligence Scale (WISC-IV) were performed. Results: During the follow-up, white matter fractional anisotropy did not increase, compared to normal male puberty effects on the brain. After 22 months of pubertal suppression, operational memory dropped 9 points and remained stable after 28 months of follow-up. The fundamental frequency of voice varied during the first year; however, it remained in the female range. Conclusion: Brain white matter fractional anisotropy remained unchanged in the GD girl during pubertal suppression with GnRHa for 28 months, which may be related to the reduced serum testosterone levels and/or to the patient's baseline low average cognitive performance.Global performance on the Weschler scale was slightly lower during pubertal suppression compared to baseline, predominantly due to a reduction in operational memory. Either a baseline of low average cognition or the hormonal status could play a role in cognitive performance during pubertal suppression. The voice pattern during the follow-up seemed to reflect testosterone levels under suppression by GnRHa treatment.

Nascer e garantir-se no Reino de Deus; Curitiba, séculos XVIII e XIX / Nacer e inscribirse en el Reino de Dios; Curitiba, siglos XVIII y XIX / Born and guaranteed in the Kingdom of God; Curitiba, 18th and 19th centuries

A historiografia tem indicado a ausência de informações, nos registros paroquiais arrolados na América portuguesa, a respeito da idade em que as crianças eram batizadas. Trata-se de evidência documental característica até, pelo menos, as primeiras décadas dos oitocentos, o que tem compelido os especialistas brasileiros em Demografia Histórica a considerarem a data do batismo como equivalente à do nascimento. Alguns vigários que exerceram seu ministério na Paróquia de Nossa Senhora da Luz dos Pinhais de Curitiba, inusitadamente, anotaram esses dados nas atas concernentes aos anos de 1729 a 1763, calando-se novamente até 1836. Acompanhando uma tendência que parece ter se generalizado nas paróquias brasileiras no século XIX, a partir do ano seguinte (1837) a informação tornou-se corriqueira nas atas de catolicidade. Isso permitiu construir uma base de dados comparativa e realizar análises críticas a respeito do intervalo entre o nascimento e a data do batismo, tendo como fundo as disposições da Igreja (Constituições do Arcebispado da Bahia, 1707). Da mesma forma, é possível realizar algumas inferências relacionadas à importância assumida pelo Sacramento no imaginário da sociedade colonial.

La historiografía ha indicado la ausencia de información, en los registros parroquiales presentes en la América portuguesa, en lo que se refiere a la edad en la que los niños eran bautizados. Se trata de una evidencia documental característica, hasta por lo menos las primeras décadas del siglo XIX, la que ha forzado a los especialistas brasileños en Demografía Histórica a considerar la fecha del Bautismo como equivalente a la del nacimiento. Algunos vicarios que ejercieron su ministerio en la Parroquia de Nuestra Señora de la Luz dos Pinhais de Curitiba, inusitadamente, anotaron esos datos en las actas referentes al periodo de 1729 a 1763, desapareciendo nuevamente hasta 1836. Siguiendo una tendencia que parece haberse generalizado en las parroquias brasileñas en el siglo XIX, a partir del año siguiente (1837) la información se convirtió en algo rutinario en las actas de catolicidad. Eso permitió construir una base de datos comparativa y realizar los análisis críticos respecto al intervalo entre el nacimiento y la fecha del Bautismo, teniendo como fondo las disposiciones de la Iglesia (Normas fundamentales del Arzobispado de Bahía, 1707). De la misma forma, es posible realizar algunas inferencias relacionadas a la importancia asumida por el Sacramento en el imaginario de la sociedad colonial.

Historiographers have noted the absence, in parish ledgers in Portuguese America, of the age of children at their time of baptism. This absence was characteristic at least until the early decades of the 19th century, a fact that has led Brazilian researchers in historical demography to consider the date of baptism as equivalent to that of birth. However, some of the pastors at the Parish of Nossa Senhora da Luz de Pinhais de Curitiba did register age at baptism in the parish logs from 1729 to 1763, and after 1836. The inclusion of this information seems to have been general practice in Catholic parishes during the 19th century, at least as of about 1837. A comparative database could thus be set up and critical analyses could be carried out regarding the period between birth and baptism, based on procedures provided in the Constitutions of the Bishopric of Bahia, of 1707. Inferences can also be made on the basis of the importance given to the sacrament of baptism in colonial thinking and practice in general.