Work-related musculoskeletal disorders in vulnerable populations: what are the most common body parts affected?

BACKGROUND: Studies investigating vulnerable populations have shown that work-related musculoskeletal disorders have a negative impact on quality of life. However, no study has examined the body regions commonly affected by work-related musculoskeletal disorders in vulnerable populations. OBJECTIVE: To describe the body regions commonly affected by work-related musculoskeletal disorders in vulnerable populations. METHODS: Cross-sectional study. We used the ABEP questionnaire, the World Health Organization Quality of Life, the Nordic Musculoskeletal Disorders Questionnaire, the Perceived Stress Scale, and a self-report questionnaire to determine morning-evening in human circadian rhythms (chronotype assessment). To reduce the possibility of information bias, we provided prior training in the use of the instruments and created an electronic database that was filled out in duplicate (in cases of disagreement, a third researcher was consulted). We tested the normality of the data using the Shapiro-Wilk test. RESULTS: The sample consisted of 132 participants, but there was a sample loss of 41.6% (final sample n = 77). We observed the predominance of those who worked from 6 to 8 h/day, rest of 1 h during the working day, from 1 to 10 years of service and only 1 employment relationship. Regarding the quality of life, we observed a worse result in the domain related to the environment, as well as a stress level of 15.43 (± 7.52) with a maximum of 30. Finally, we observed the presence of pain self-reported by the artisanal fishermen in several regions of the body, lumbar being the most mentioned. CONCLUSION: The neck, shoulders, arms, elbows, forearms, wrists, back, lumbar spine, and lower limbs are the most common parts of the body affected by work-related musculoskeletal disorders in artisanal fishermen.

Physical inactivity level and lipid profile in traditional communities in the Legal Amazon: a cross-sectional study : Physical inactivity level in the Legal Amazon.

BACKGROUND: The practice of regular physical activity can alter the lipid profile in populations according to diverse demographic characteristics. OBJECTIVE: To evaluate the association of physical inactivity with the lipid profile among vulnerable populations. METHODS: A cross-sectional study was conducted among 349 vulnerable individuals from Tocantins state, northern Brazil. The International Physical Activity Questionnaire 7 Day short form was used to measure self-reported physical activity levels. Venous blood samples were drawn to evaluate lipid profile. Logistic regression adjusted by the socioeconomic variables was used to analyse the effects of physical inactivity on the lipidic profile. The level of significance was 5% and Stata® (StataCorp, LC) version 11 was used. RESULTS: We observe an inverse relationship between physical inactivity and HDL-C-that is, those who were sedentary or below the WHO Recommendations for physical activity were at 2.6 greater odds (IC95% 1.21, 5.67; p = 0.015) of having a lower HDL compared with those meeting or exceeding WHO physical activity recommendations. CONCLUSION: On the vulnerable populations studied, the insufficiently active or sedentary individuals (called the physical inactivity individuals) have more risk of the altered HDL-C.

Factors associated with blood pressure disorders in Afro-descendant children and adolescents.

BACKGROUND: Hypertension (AH) is an emerging disease that has rapidly increased in the last decades throughout the world. The increase in blood pressure (BP) is observed with growth and development and, although the manifestation of the disease is rare in childhood and adolescence, its occurrence is increasing and the causes are likely to be from different combinations of factors. Afrodescendants have been consistently observed in many populations, including Brazil, which has the largest population of Afrodescendants outside Africa; nevertheless, data is scarce on the disease in children and adolescents. In this study, we investigated BP disorders in children and adolescents of "Quilombola" populations of the state of Tocantins, northern Brazil, and determined the disease occurrence with some factors, namely food consumption, body composition, anthropometric measures, and biochemical data. METHODS: We carried out a cross-sectional study with 67 children aged 10-17 years, comparing the variables studied between the normotensive and non-normotensive groups, using the Chi-square test for qualitative variables and the appropriate tests, according to data adherence to the Gaussian distribution for the quantitative variables. High blood pressure was defined as mean systolic or diastolic blood pressure ≥ 90 percentile for age, height, gender. RESULTS: The rate of adolescents with BP disorders was 19.4% (prehypertension 14.9% and hypertension 4.5%). There were no significant differences between the sexes for high blood pressure. In the Poisson regression analysis, the high fat percentage was associated with elevated blood pressure (p = 0.021) for adolescents. Similar associations were observed for non-HDL-c (p < 0.001) and low calcium intake (p = 0.015). CONCLUSION: Most children and adolescents in "Quilombola" communities had normal blood pressure. However, higher levels of dyslipidemia and low calcium intake are factors associated with prehypertension in the population studied with high BP.

Human metabolism and body composition: prospects for novel studies.

CONTEXT: Most articles on gut microbiota argue the importance of body composition assessment in patients; however, body composition assessments are fragile (ie, with methodological limitations) in the most recent studies. OBJECTIVE: To present two suggestions for further research using the human body composition assessment. METHODS: The methods used in this study are based on a Pinto et al article published in Nutrition Reviews. DATA EXTRACTION: On the basis of data.obtained from the PubMed, SCOPUS, LILACS, and Web of Science databases, Pinto et al provided a current survey of intermittent fasting protocols and an understanding of the outcomes to date in terms of the profile of the intestinal microbiota in obese organisms. DATA ANALYSIS: Of the 82 original articles identified from the databases, 35 were eliminated because of duplication and 32 were excluded for not meeting the inclusion criteria. Two additional articles found in a new search were added, yielding a total of 17 studies to be included in this review. Among the protocols, alternate-day fasting and time-restricted feeding were the most common, and they were shown to have different mechanisms of metabolic signaling. Time-restricted feeding influences body mass control and biochemical parameters by regulating the circadian system and improving satiety control systems by acting on leptin secretion. In contrast, alternate-day fasting leads to a reduction of ±75% of all energy consumption regardless of dietary composition, in addition to promoting hormonal adjustments that promote body mass control. Furthermore, both protocols could remodel the intestinal microbiota by changing the Firmicutes to Bacteroidetes ratio and increasing the abundance of strains such as Lactobacillus spp. and Akkermansia that have a protective effect on metabolism against the effects of body mass gain. CONCLUSION: Changes in adipose tissue (eg, body mass loss, control, gain) should be interpreted via the sum of skinfolds in absolute values, waist perimeter, and patients' body proportionality, because fat is just a fraction of the adipocyte (lipid).

Profile of oropharyngeal dysphagia patients in a teaching hospital in Northern Brazil: a descriptive cross-sectional study.

OBJECTIVE: The aim of this study was to describe the profile of patients with oropharyngeal dysphagia in a teaching hospital in the public health system in northern Brazil. METHODS: This is a descriptive cross-sectional study. All procedures of this study were approved by the ethics committee. A convenience sample composed of participants aged >18 years, of both sexes, with any underlying pathology admitted to the medical clinic on exclusive oral feeding, alternatively enteral or gastric tube feeding (Gastrostomy), or associated by both routes, whose swallowing assessment was performed by a Speech-Language Pathologist. Data from the database/medical records were investigated from March 2020 to September 2021. RESULTS: The sample consisted of 44 patients diagnosed with oropharyngeal dysphagia, with a higher frequency of males (63.64%) aged over 60 years (70.45%). Almost half of the evaluated patients were diagnosed with neurological disorders (47.73%) and had dysphagia associated with other underlying diseases (31.82%). Excluding patients with neurological disorders, trauma/polytrauma, and respiratory disorders from the last group, some patients (11.36%) had two concomitant underlying diseases. CONCLUSION: According to the sample of this study, the profile of oropharyngeal dysphagia patients includes pneumonia, respiratory failure, bronchoaspiration, and the consequent need for ventilatory support.

Psychometric properties of the online Satisfaction with Life Scale in university students from a low-income region.

PURPOSE: To test the feasibility, reliability, and validity of the Satisfaction with Life Scale (SWLS) in an online format in university students from a low-income region. METHODS: This was a psychometric study, involving a study of reliability (n = 117) and validity (n = 195) in university students from a region with a Gini index of 0.56. The scale was applied at two time points with an interval of 2 weeks. This scale measures satisfaction with life based on five statements and responses ranging from 1 to 7 (strongly disagree to strongly agree). We conducted the reliability assessment using temporal stability and internal consistency and construct validity assessment by internal structure solution. RESULTS: All SWLS items showed acceptable (rho > 0.30) and significant (p < 0.05) temporal stability and acceptable internal consistency (alpha > 0.70). In construct validity (internal structure), we identified a factor with an explained variance of 59.0% in the exploratory factor analysis. Additionally, in the confirmatory factor analysis, we identified a one-factor structure solution for SWLS with an acceptable model fitting (chi-square/degrees of freedom [X2/df] = 6.53; Tucker-Lewis Index [TLI] = 0.991; Comparative Fit Index [CFI] = 0.996; root mean square error of approximation [RMSEA] = 0.040; standardized root mean-squared residual [SRMR] = 0.026). CONCLUSION: The Satisfaction with Life Scale, in the online format, is a reliable and valid tool for university students in a low-income context.

Quality of primary health care for quilombolas' Afro-descendant in Brazil: A cross-sectional study.

OBJECTIVE: The aim of this study was to assess the quality of primary health care services through self-reports by caregivers of children and adolescents living in quilombola communities in Brazil. METHODS: This is a cross-sectional study in accordance with the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology). Exposure variables included sociodemographic characteristics; and outcome variable was the quality of primary health care offered to quilombola children and adolescents. RESULTS: A total of 68 individuals participated in the survey. Quilombolas have a low income, a lower level of education, do not work, and receive government benefits. Our results showed that the quality of primary health care, measured by the experience of caregivers of quilombola children and adolescents, generally presents satisfactory values. CONCLUSION: The quality of primary health care has generally satisfactory values. However, as these results differ from most studies, more research should be conducted.

Epidemiological study on the lip and oral cavity cancer in Brazil: connecting science and clinical applicability.

OBJECTIVE: The aim of this study was to describe and discuss the epidemiological indicators of lip and oral cavity cancer in Brazil, in 2017, according to data from the Global Burden of Disease data. METHODS: This is a descriptive study reported according to STROBE guidelines. We identified epidemiological indicators using the Global Burden of Disease results tool. Mortality/incidence rates were described per 100,000 population. Global Burden of Disease 2017 reviews were completed using Python version 2.7, Stata version 13.1, and R version 3.3. RESULTS: In 2017, there were 5,237 deaths from the lip or oral cavity cancer in Brazil, most of them were males aged between 50 and 69 years (2,730 cases, which was equivalent to 52% of the universe of deaths resulting from this cause). Regarding the burden of lip and oral cavity cancer, per 100,000 Brazilians, we observed an incidence of 3.99, prevalence of 15.46, and mortality of 2.29 (with higher indicators in the South and Southeast regions of the country). CONCLUSIONS: Epidemiological indicators of lip and oral cavity cancer were higher in men, with higher mortality indicators in individuals aged 50-69 years, and higher rates (incidence, prevalence, and mortality) in the South and Southeast regions of Brazil. From 2002-2015, there was a reduction in mortality; however, in the period from 2015-2017, there was a resumption in the growth of this indicator.

Protocol of care for foreign-body ingestion in children: a qualitative study.

OBJECTIVE: This study aimed to suggest a care protocol for foreign-body ingestion, address the clinical aspects, and identify the ingested object, severity, and professional conduct. METHODS: This is a qualitative study. We used books and original articles published in national and international journals (BIREME, SCIELO, LILACS, and MEDLINE/PubMed) in Portuguese, Spanish, and English. RESULTS: The ingestion of a radiolucent object should be evaluated radiographically and with endoscopy for cases with symptoms of impaction and radiolucent objects. Coins are the most commonly involved foreign bodies. In asymptomatic patients, it often requires only a conservative form of management. Ingestion of batteries, magnets, and sharp objects carries a high risk of serious clinical complications and should have an endoscopic or surgical approach. In view of this, each pediatric emergency service, based on these recommendations, has the possibility to develop an individual protocol to identify and remove the ingested foreign body. CONCLUSIONS: Protocol of care for foreign-body ingestion in children depends on the object ingested, time of ingestion, symptoms, and local epidemiological context. This study provides some suggestions for decision-making in the conduct of health professionals.

Perceived stress in workers of Emergency Care Units in Palmas, Tocantins.

BACKGROUND: Emergency Care Units are environments susceptible to occupational stress that can lead its staff members to illness. OBJECTIVE: The objective of this study was to identify the levels of perceived stress in professionals who work in Emergency Care Units in the municipality of Palmas, state of Tocantins. METHODS: This was a cross-sectional study conducted with 165 health care professionals working in Emergency Care Units. A structured questionnaire containing sociodemographic and economic aspects and the Perceived Stress Scale (EPS-10) were used. RESULTS: The levels of perceived stress were identified in the 3 groups evaluated, and were more frequent among professionals with higher education, with an average of 17.8. There was a predominance of women (64.9%), 84.2% of the participants were public servants, 52.7% worked for longer than 12 hours, and 59.3% had an average income between R$ 790,00 and R$ 5.000,00. CONCLUSION: Professionals who work in the Emergency Care Units are under stress conditions. Health preventive and promotion measures should be developed and promoted to minimize this reality.

Factors associated with perceived quality of life in artisanal fishermen: a cross-sectional study.

OBJECTIVE: To analyze a combination of socioeconomic and demographic characteristics, chronotype, stress perception and level of physical activity with the perception of quality of life in artisanal fishermen. RESULTS: Several variables were associated with lower scores of quality of life domains: workload (P = 0.047), age (P = 0.01), economic class D-E (P = 0.04) and perceived stress scores (P = 0.01) for scores physical domain; workload (P = 0.03) and perceived stress (P < 0.001) for scores psychological domain; Perceived stress (P < 0.001) and age (P = 0.01) for social domain scores; economic class D-E (P = 0.03) and perceived stress (P = 0.01) for environment domain scores; perceived stress (P = 0.01) and age (P = 0.01) for general quality of life scores and; female sex (P = 0.04) and age (P = 0.02) for the score of satisfaction with quality of life.

The sensitivity, specificity, and agreement of a point of care method: an assessment of the diagnostic accuracy.

The use of new technologies can improve screening in communities with difficult access to health. This article aims to evaluate the sensitivity, specificity, and agreement of a point of care test in comparison to laboratory methods for the determination of glucose (GLI), triglyceride (TG), and total cholesterol (TC) concentrations. This prospective study used data from the remaining adult population of quilombolas in Brazil. Laboratory tests using conventional methods for the analysis of venipuncture samples were used as a standard method to measure the concentrations of GLI (mg/dL), TG (mg/dL), and TC (mg/dL) and compared to the metered dose from the collection of fingertip capillary blood (point of care). Contingency tables (2x2) were used to estimate the sensitivity and specificity of the methods. Lin and Bland & Altman coefficients were used to statistically assess agreement, the level of significance was 5%. There was substantial agreement between the methods for measuring TG and poor agreement for of TC and GLI. Analysis of the Bland & Altman coefficients revealed that the fingertip method did not produce good measures. The point of care method did not offer a good ability to measure compared to that of the reference laboratory method.

Prevalence of and Factors Associated with Metabolic Syndrome in Afro-Descendant Communities in a Situation of Vulnerability in Northern Brazil: A Cross-Sectional Study.

Background: Quilombos are Brazilian communities developed by survivor groups following fight against slavery. They are found in the whole of the Brazilian territory, far from urban centers, living in vulnerable and poor socioeconomic situations and continuously suffering from influence of occidentalization. Based on the hypothesis that the way Quilombolas live may be associated with metabolic syndrome (MS), the objective of this study was to estimate the prevalence of MS and to analyze the associated factors in adult residents of Quilombola communities in the northern region of Brazil. Methods: A cross-sectional study was conducted according to the guidelines of the STROBE Statement in five communities of Tocantins. Results: The study investigated 193 individuals who lived for at least 1 year in the communities. The prevalence of MS in this population was 32.12%. There was a higher prevalence of MS or metabolic disorders in women, as well as metabolic profiles related to low high-density lipoprotein and obesity among participants with MS. Conclusion: The prevalence of MS is higher compared with other Quilombola and African communities, indicating an opportunity to improve or develop new programs to reduce MS and metabolic disorders, by making changes in some habits, such as physical activities, because there were differences in metabolic disorders related to the presence of MS.

Profile of oropharyngeal dysphagia patients in a teaching hospital in Northern Brazil: a descriptive cross-sectional study

SUMMARY OBJECTIVE: The aim of this study was to describe the profile of patients with oropharyngeal dysphagia in a teaching hospital in the public health system in northern Brazil. METHODS: This is a descriptive cross-sectional study. All procedures of this study were approved by the ethics committee. A convenience sample composed of participants aged >18 years, of both sexes, with any underlying pathology admitted to the medical clinic on exclusive oral feeding, alternatively enteral or gastric tube feeding (Gastrostomy), or associated by both routes, whose swallowing assessment was performed by a Speech-Language Pathologist. Data from the database/medical records were investigated from March 2020 to September 2021. RESULTS: The sample consisted of 44 patients diagnosed with oropharyngeal dysphagia, with a higher frequency of males (63.64%) aged over 60 years (70.45%). Almost half of the evaluated patients were diagnosed with neurological disorders (47.73%) and had dysphagia associated with other underlying diseases (31.82%). Excluding patients with neurological disorders, trauma/polytrauma, and respiratory disorders from the last group, some patients (11.36%) had two concomitant underlying diseases. CONCLUSION: According to the sample of this study, the profile of oropharyngeal dysphagia patients includes pneumonia, respiratory failure, bronchoaspiration, and the consequent need for ventilatory support.

Psychometric properties of the online Satisfaction with Life Scale in university students from a low-income region

Purpose: To test the feasibility, reliability, and validity of the Satisfaction with Life Scale (SWLS) in an online format in university students from a low-income region. Methods: This was a psychometric study, involving a study of reliability (n = 117) and validity (n = 195) in university students from a region with a Gini index of 0.56. The scale was applied at two time points with an interval of 2 weeks. This scale measures satisfaction with life based on five statements and responses ranging from 1 to 7 (strongly disagree to strongly agree). We conducted the reliability assessment using temporal stability and internal consistency and construct validity assessment by internal structure solution. Results: All SWLS items showed acceptable (rho > 0.30) and significant (p < 0.05) temporal stability and acceptable internal consistency (alpha > 0.70). In construct validity (internal structure), we identified a factor with an explained variance of 59.0% in the exploratory factor analysis. Additionally, in the confirmatory factor analysis, we identified a one-factor structure solution for SWLS with an acceptable model fitting (chi-square/degrees of freedom [X2/df] = 6.53; Tucker-Lewis Index [TLI] = 0.991; Comparative Fit Index [CFI] = 0.996; root mean square error of approximation [RMSEA] = 0.040; standardized root mean-squared residual [SRMR] = 0.026). Conclusion: The Satisfaction with Life Scale, in the online format, is a reliable and valid tool for university students in a low-income context.