RESUMO
O objetivo do presente estudo foi avaliar em tomografias computadorizadas as dimensões dos tecidos periodontais supracrestais (TPSC). Cem pacientes, 600 dentes anteriores da maxila (200 incisivos centrais, 200 incisivos laterais e 200 caninos), foram avaliados. A distância média da margem gengival até a crista óssea alveolar (COA) foi de 3.25mm (95% IC: 3.20-3.30), enquanto que da junção cemento-esmalte até a COA foi de 1.77mm (95% IC: 1.72-182mm). As medidas foram significativamente diferentes entre os grupos de dentes (ANOVA, p < 0.001). A tomografia, pode representar uma importante ferramenta para a avaliação das dimensões dos TPSC.
The aim of this study was to evaluate the dimensions of the supracrestal periodontal tissues (SPT) on tomographic scans. One hundred patients, 600 maxillary anterior teeth (200 central incisors, 200 lateral incisors and 200 canines), were evaluated. The average distance from the gingival margin to the alveolar bone crest (ABC) was 3.25mm (95% CI: 3.20-3.30), while the distance from the cemento-enamel junction to ABC was 1.77mm (95% CI: 1.72-182mm). The measurements were significantly different between the tooth groups (ANOVA, p < 0.001). When properly indicated, tomography can be an important tool for assessing the dimensions of TPSCs on a case-by-case basis.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Tecidos , Periodonto , Tomografia Computadorizada de Feixe Cônico , MaxilaRESUMO
Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
Purpose: To quantify outer retina structural changes and define novel biomarkers of inherited retinal degeneration associated with biallelic mutations in RPE65 (RPE65-IRD) in patients before and after subretinal gene augmentation therapy with voretigene neparvovec (Luxturna). Methods: Application of advanced deep learning for automated retinal layer segmentation, specifically tailored for RPE65-IRD. Quantification of five novel biomarkers for the ellipsoid zone (EZ): thickness, granularity, reflectivity, and intensity. Estimation of theâ EZarea in single and volume scans was performed with optimized segmentation boundaries. The control group was age similar and without significant refractive error. Spherical equivalent refraction and ocular length were evaluated in all patients. Results: We observed significant differences in the structural analysis of EZ biomarkers in 22 patients with RPE65-IRD compared with 94 healthy controls. Relative EZ intensities were already reduced in pediatric eyes. Reductions of EZ local granularity and EZ thickness were only significant in adult eyes. Distances of the outer plexiform layer, external limiting membrane, and Bruch's membrane to EZ were reduced at all ages. EZ diameter and area were better preserved in pediatric eyes undergoing therapy with voretigene neparvovec and in patients with a milder phenotype. Conclusions: Automated quantitative analysis of biomarkers within EZ visualizes distinct structural differences in the outer retina of patients including treatment-related effects. The automated approach using deep learning strategies allows big data analysis for distinct forms of inherited retinal degeneration. Limitations include a small dataset and potential effects on OCT scans from myopia at least -5 diopters, the latter considered nonsignificant for outer retinal layers.
Assuntos
Aprendizado Profundo , Terapia Genética , Mutação , Tomografia de Coerência Óptica , cis-trans-Isomerases , Humanos , cis-trans-Isomerases/genética , Tomografia de Coerência Óptica/métodos , Masculino , Feminino , Terapia Genética/métodos , Adulto , Criança , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Degeneração Retiniana/genética , Degeneração Retiniana/terapia , Pré-Escolar , Acuidade Visual/fisiologia , Retina/diagnóstico por imagem , Retina/patologiaRESUMO
Polymorphisms in the MBL2 gene exon 1 can decrease serum levels of mannose-binding lectin (MBL), increasing the risk of infection in immunocompromised individuals. This study evaluated the association between the polymorphism in exon 1 of the MBL2 gene, genotypes, serum MBL levels, and infection in 122 patients with acute lymphoid leukemia (ALL). The MBL*A allele exhibited the highest frequency (0.37) within the study population. The MBL*D (0.32) was the predominant variant. The combined frequency of O polymorphic alleles (either B or D) was 0.63. The frequencies of the A/A, A/O and O/O genotypes were 0.13, 0.49 and 0.38, respectively. All patients exhibited consistently low levels of serum MBL, irrespective of their exon 1 genotype. Parasitic infections (n = 103), bacterial (n = 69) and viral (n = 48). A/O genotype (0.49) had higher infection rates, A/A (0.13) had lower rates, and O/O showed increased viral susceptibility (OR: 0.37; 95% CI 0.13-1.06; p = 0.05). Our findings demonstrated that the study population were MBL-deficient, regardless of their MLB2 genotype. Individuals with the A/O genotype had more infections, while those with the O/O genotype appeared more susceptible to viral infections. These findings highlight the impact of MBL levels and genetic variants on infection susceptibility in ALL patients.
Assuntos
Éxons , Predisposição Genética para Doença , Lectina de Ligação a Manose , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Lectina de Ligação a Manose/genética , Lectina de Ligação a Manose/sangue , Masculino , Feminino , Éxons/genética , Adulto , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Pessoa de Meia-Idade , Adolescente , Genótipo , Adulto Jovem , Idoso , Alelos , Polimorfismo de Nucleotídeo Único , Criança , Frequência do Gene , Polimorfismo GenéticoRESUMO
This study compared the degree of secondary hyperalgesia and somatosensory threshold changes induced by topical capsaicin between spinal and trigeminal innervation. This crossover clinical trial included 40 healthy individuals in which 0.25 g of 1% capsaicin cream was randomly applied for 45 minutes to a circular area of 2 cm2 to the skin covering the masseter muscle and forearm in 2 different sessions, separated by at least 24 hours and no more than 72 hours (washout period). The main outcome variables were the area of allodynia and pinprick hyperalgesia, as well as electrical and mechanical pain thresholds within the area of pinprick hyperalgesia. Mixed ANOVA models and McNemar tests were applied to the data (p = 0.050). The occurrence of allodynia and pinprick hyperalgesia was higher in the forearm than in the masseter (p < 0.050). Additionally, the areas of pinprick hyperalgesia and allodynia were larger in the forearm compared to the masseter (p < 0.050). The electrical and mechanical pain thresholds demonstrated a loss of somatosensory function following capsaicin application to the masseter (p < 0.050). However, no significant somatosensory threshold changes were observed at the forearm after capsaicin (p > 0.050). In conclusion, these findings indicate potential differences compatible with central sensitization related to secondary hyperalgesia between trigeminal and spinal innervation.
Assuntos
Capsaicina , Hiperalgesia , Limiar da Dor , Humanos , Capsaicina/efeitos adversos , Capsaicina/farmacologia , Hiperalgesia/induzido quimicamente , Hiperalgesia/fisiopatologia , Masculino , Feminino , Adulto , Limiar da Dor/efeitos dos fármacos , Nervo Trigêmeo/efeitos dos fármacos , Nervo Trigêmeo/fisiopatologia , Músculo Masseter/inervação , Músculo Masseter/efeitos dos fármacos , Músculo Masseter/fisiopatologia , Adulto Jovem , Estudos Cross-Over , Antebraço/inervação , Nervos Espinhais/efeitos dos fármacos , Nervos Espinhais/fisiopatologiaRESUMO
INTRODUCTION: Tackling the inertia of growing threat of antimicrobial resistance (AMR) requires changes in how antibiotics are prescribed and utilized. The monitoring of antimicrobial prescribing in hospitals is a critical component in optimizing antibiotic use. Point prevalence surveys (PPSs) enable the surveillance of antibiotic prescribing at the patient level in small hospitals that lack the resources to establish antimicrobial stewardship programs (ASP). In this study, we analyzed antibiotic use at two public secondary care hospitals in Mexico using PPSs. METHODS: Following WHO methodology, we conducted four cross-sectional PPSs on antibiotic use in two public secondary care facilities in Mexico: two surveys in a women's specialty hospital (H1) and two in a general referral hospital (H2). We collected data from clinical records of all patients with active antibiotic prescriptions (APs) across the medical, surgical, and mixed (MIX) wards, and intensive care units (ICUs). Descriptive statistics were computed to analyze the PPSs data using Stata. RESULTS: The PPSs collected data on 127 patients, and 283 active APs. The prevalence of antibiotic use was 60.4% (H1, n = 29/48) and 70.5% (H2, n = 98/139). Antibiotics were more frequently used among patients in the MIX wards (H1: 87.5%, n = 14/16) and ICUs (H2: 90%, n = 9/10). The most frequent patient indications for antibiotic use were medical prophylaxis (H1: 51.7%, n = 15/29), community-acquired infections (H2: 42.9%, n = 42/98), and preoperative prophylaxis (H1: 27.6%, n = 8/29; H2: 23.5%, n = 23/98). The APs were mostly empirical (H1: 97%, n = 64/66; H2: 98.2%, n = 213/217), and parenterally administered (H1: 90.9%, n = 60/66; H2: 96.8%, n = 210/217). Most clinical records lacked documented post-prescription reviews (H1: 82.8%, n = 24/29; H2: 98%, n = 96/98). Preoperative prophylaxis was predominantly administered as multiple doses for more than one day. Penicillins with extended-spectrum (24.2%, n = 16/66), aminoglycosides (22.7%, n = 15/66), and first-generation cephalosporins (16.7%, n = 11/66) were the most prescribed antibiotic classes in H1, while third-generation cephalosporins (35%, n = 76/217), fluoroquinolones (14.3%, n = 31/217), and carbapenems (13.4%, n = 29/217) were the most prescribed in H2. No hospital had formally established ASP. CONCLUSIONS: This study shows high prevalence rates of antibiotic use and variations in commonly prescribed antibiotic classes in public Mexican secondary care hospitals, along with shared practices in broad-spectrum antibiotic prescription. PPS-based surveillance enables the identification of specific targets to optimize antibiotic use according to the healthcare needs of patients in each hospital and facilitates comparative evaluations across hospitals.
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Antibacterianos , Gestão de Antimicrobianos , Humanos , México/epidemiologia , Antibacterianos/uso terapêutico , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Masculino , Prevalência , Idoso , Centros de Cuidados de Saúde Secundários/estatística & dados numéricos , Atenção Secundária à Saúde/estatística & dados numéricos , Adulto Jovem , Inquéritos e Questionários , Adolescente , Prescrições de Medicamentos/estatística & dados numéricosRESUMO
BACKGROUND: Graduate students face higher depression rates worldwide, which were further exacerbated during the COVID-19 pandemic. This study employed a machine learning approach to predict depressive symptoms using academic-related stressors. METHODS: We surveyed students across four graduate programs at a Federal University in Brazil between October 15, 2021, and March 26, 2022, when most activities were restricted to taking place online due to the pandemic. Through an online self-reported screening, participants rated ten academic stressors and completed the Patient Health Questionnaire (PHQ-9). Machine learning analysis tested whether the stressors would predict depressive symptoms. Gender, age, and race and ethnicity were used as covariates in the predictive model. RESULTS: Participants (n=172), 67.4â¯% women, mean age: 28.0 (SD: 4.53) fully completed the online questionnaires. The machine learning approach, employing an epsilon-insensitive support vector regression (Æ-SVR) with a k-fold (k=5) cross-validation strategy, effectively predicted depressive symptoms (r=0.51; R2=0.26; NMSE=0.79; all p=0.001). Among the academic stressors, those that made the greatest contribution to the predictive model were "fear and worry about academic performance", "financial difficulties", "fear and worry about academic progress and plans", and "fear and worry about academic deadlines". CONCLUSIONS: This study highlights the vulnerability of graduate students to depressive symptoms caused by academic-related stressors during the COVID-19 pandemic through an artificial intelligence methodology. These findings have the potential to guide policy development to create intervention programs and public health initiatives targeted towards graduate students.
Assuntos
COVID-19 , Depressão , Aprendizado de Máquina , Estresse Psicológico , Estudantes , Humanos , Feminino , Masculino , Depressão/diagnóstico , Adulto , Estudantes/psicologia , Universidades , Adulto Jovem , Brasil , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Depression is the leading cause of mental health-related illnesses and disabilities. Physical activity (PA) has been included as part of therapeutic approaches for patients with depression. This study aimed to investigate the associations between depressive symptoms and PA levels in a large representative cohort of Brazilian adults and older individuals. METHODS: Data from 58,445 Brazilian adults (68.6 % males and 31.4 % females) aged 18 years or older (42.2 ± 10 years) who participated in health screening initiatives between 2008 and 2022 at the Center for Preventive Medicine at a quaternary hospital in Sao Paulo, Brazil were analyzed. Standardized health data (anthropometric, laboratory, clinical, and behavioral) were collected. A hierarchical regression model was used to examine the associations based on the presence and absence of depressive symptoms. RESULTS: In the final model, age, gender (female), body mass index (BMI) (each kg/m2), presence of hypertension, presence of diabetes mellitus, risk of alcohol consumption, smoking status, and perceived stress were associated with higher odds of depressive symptoms. However, PA levels were associated with lower odds of depressive symptoms. CONCLUSION: The findings revealed that any level of PA was independently and significantly associated reduced risk of depressive symptoms.
Assuntos
Índice de Massa Corporal , Depressão , Exercício Físico , Humanos , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Depressão/epidemiologia , Depressão/psicologia , Brasil/epidemiologia , Adulto Jovem , Fatores Sexuais , Idoso , Adolescente , Fatores de RiscoRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: The Asháninka people are the largest Peruvian Amazonian group, yet the knowledge of their medicinal plants is scarce. This study on Asháninka herbal medicine offers an insight into the Asháninka aetiological system, resting within the wider ontological framework of animism, and cultural expressions of the biomedical understanding of illnesses. AIM OF THE STUDY: To document wild-grown (non-cultivated) plant species in current use by the Asháninka people and look closer at their herbal practices during the Covid-19 pandemic. The study examines whether the knowledge and use of medicinal plants is gendered in this society. It also compares the findings with available literature concerning the Arawakan groups from Peruvian Amazonia. MATERIAL AND METHODS: The fieldwork was conducted in 13 native communities of the Asháninka people along the Tambo River (Selva Central), Peru, between 2016 and 2018 and in 2022. The main field technique were guided walks in the forest with 27 female and 28 male participants, during which voucher specimens were collected and relevant information was recorded. Semi-structured interviews were performed with specialists in Asháninka traditional medicine and with lay Asháninka people to better understand Asháninka illness aetiologies. The analysis of medicinal plants included medicinal categories and uses, modes of preparations, the frequency of use and the knowledge about the plants between the genders. It also presents and discusses detailed testimonies of herbal remedies during the Covid-19 pandemic. The list of recorded plants was compared with ethnobotanical studies of other Arawakan groups from Peruvian Amazonia. RESULTS: Altogether, 169 wild-grown medicinal plant species were documented. Our findings highlight the importance of the Piperaceae and Acanthaceae botanical families in the Asháninka pharmacopoeia. The plants were used for 23 medicinal categories, of which dermatological disorders, digestive problems and venomous bites were the most prevalent. Over 70% of recorded plants were commonly and moderately known by the study participants. More exclusive species were found among the men than women; however, 64 % of all recorded plants were known to both genders. Sixty-one percent of recorded plants were not mentioned by any other study of medicinal plants among other Arawakan groups in Peruvian Amazonia. During the Covid-19 pandemic, nobody in the native communities at the Tambo River died directly due to the virus, which was attributed, amongst others, to effective and culturally-appropriate prophylaxis and treatments with medicinal plants. CONCLUSION: To this day, the Asháninka people at the Tambo River conserve the knowledge and practices related to medicinal plants which meet the daily needs of dwelling in subtropical forest; these are deeply rooted in animistic ontology, with the emphasis on spirit predation and retaliation. And yet, numerous applications of plants are compatible with the biomedical notion of illness and symptoms. Plant knowledge is shared between the genders, although specific plants exist for men and women, which are related to their gendered social and family roles. Some overlap and consensus exists with other studies regarding medicinal uses, which reflects the rich and diverse knowledge of medicinal plants among the Arawakan groups in Peruvian Amazonia, and this deserves further study.
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COVID-19 , Conhecimentos, Atitudes e Prática em Saúde , Medicina Tradicional , Fitoterapia , Plantas Medicinais , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , COVID-19/epidemiologia , Etnobotânica , Etnofarmacologia , Indígenas Sul-Americanos , Medicina Tradicional/métodos , Peru , Preparações de Plantas/uso terapêutico , RiosRESUMO
This study assessed the diagnostic potential of nonpolar lipid extracts in enzyme-linked immunosorbent assays (ELISAs) for tuberculosis (TB) serodiagnosis. Nonpolar lipid extracts were harvested from Mycobacterium tuberculosis (Mtb) knockout in mce1 operon (∆mce1) and its parental wild type (WT) strains. IgM and IgG anti-nonpolar lipid serum levels were measured in TB patients (n=45), healthy individuals with positive (n=22) and negative (n=44) interferon-gamma release assay (IGRA) results, and symptomatic respiratory (SR) patients with negative TB tests (n=9). IgG anti-WT lipid distinguished TB patients from IGRA-positive individuals with 60% sensitivity and 77.3% specificity. Conversely, IgG anti-∆mce lipid levels didn't vary significantly across groups. Interestingly, most SR patients exhibited significantly higher IgM and IgG anti-WT lipid titers than the IGRA-positive and -nega groups. While the overall diagnostic potential of Mtb nonpolar lipids was limited, the impaired immunogenecity of Δmce1 lipid extract suggests that some missing lipid classes in this extract can potentially induce antibody production in TB patients.
Assuntos
Anticorpos Antibacterianos , Antígenos de Bactérias , Ensaio de Imunoadsorção Enzimática , Imunoglobulina G , Imunoglobulina M , Lipídeos , Mycobacterium tuberculosis , Sensibilidade e Especificidade , Testes Sorológicos , Tuberculose , Humanos , Ensaio de Imunoadsorção Enzimática/métodos , Imunoglobulina M/sangue , Mycobacterium tuberculosis/imunologia , Mycobacterium tuberculosis/genética , Tuberculose/diagnóstico , Antígenos de Bactérias/imunologia , Antígenos de Bactérias/genética , Testes Sorológicos/métodos , Imunoglobulina G/sangue , Anticorpos Antibacterianos/sangue , Masculino , Adulto , Feminino , Lipídeos/sangue , Pessoa de Meia-Idade , Adulto Jovem , Testes de Liberação de Interferon-gama/métodos , Idoso , Proteínas de Bactérias/imunologia , Proteínas de Bactérias/genéticaRESUMO
The study of firearm violence in Mexico has primarily focused on homicides and trafficking. Less attention has been given to understanding how firearms affect other crimes and facilitate criminal activity beyond drug markets. By analyzing two questions, this study explores the role of firearms in extortions perpetrated in Mexico from 2012 to 2021. Questions are: What is the likelihood of reporting extortions to the police if offenders exhibited firearms? What is the likelihood of compliance with demands when offenders are armed with firearms? We obtained data from Mexico's National Crime Victimization Surveys and analyzed 2,619 extortions reported from 2012 to 2021. To explore our research questions, we ran two binary logistic regressions. Our dependent variables were dichotomous (reported to police = 1, complied with demands = 1). The independent variables were weapon types (extortions involving firearms as the reference group). We controlled for victim demographics as well as crime characteristics. Our results indicate that 40% of these extortions (n = 1,058) were perpetrated with a firearm. Fifty-two percent of extortions were perpetrated by unarmed offenders (n = 1,348) and 8% (n = 213) were perpetrated with other weapons (no firearms). Models suggest that, when compared to extortions perpetrated by unarmed offenders or those exhibiting other weapons (no firearms), victims of extortions involving firearms are less likely to report these crimes to police, mainly because of fear of reprisal. Similarly, victims are more likely to comply with demands if offenders exhibit firearms. Findings highlight the role of firearms in criminal enterprises and support the need for a comprehensive policy agenda to address firearm violence in Mexico.
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Vítimas de Crime , Armas de Fogo , Humanos , Armas de Fogo/estatística & dados numéricos , Armas de Fogo/legislação & jurisprudência , Masculino , Feminino , México , Adulto , Vítimas de Crime/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Criminosos/estatística & dados numéricos , Violência/estatística & dados numéricos , Violência com Arma de Fogo/estatística & dados numéricos , Crime/estatística & dados numéricosRESUMO
Though the Explicit Discrimination Scale (EDS) has been subjected to extensive psychometric evaluation in Brazil, the instrument has yet to be comprehensively assessed among working-age adult respondents in the country. This study aimed to fill this knowledge gap. Data from around 1200 diverse members of a cohort investigation were used to examine: (1) the positioning of respondents along the continuum of the EDS latent trait; (2) how well the corresponding items represent the EDS construct map; and (3) the extent to which the EDS items follow their expected levels of intensity. We assessed these properties with Loevinger's H, Guttman errors, and Item Response Theory parameters. Findings suggest that two abridged versions of the instrument-but especially the eight-item EDS-may adequately arrange respondents along the latent trait continuum. Analyses also revealed that scale items are reasonably spread over the construct map, with some discrepancy between the expected levels of intensity and their empirical positioning in the corresponding plot. The shortened versions of EDS have good psychometric properties among Brazilian working-age adult respondents. In addition to examining the invariance of the EDS across multiple groups, future psychometric evaluations should assess the external validity of the scale.
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Psicometria , Humanos , Brasil , Adulto , Masculino , Psicometria/instrumentação , Feminino , Pessoa de Meia-Idade , Inquéritos e Questionários/normas , Adulto Jovem , Reprodutibilidade dos Testes , Estudos de Coortes , Preconceito/psicologiaRESUMO
The study aimed to provide validity evidence and reliability of the Scale of Myths of Romantic Love (SMRL) in Peru among young and adult individuals. Focusing on how romantic love myths affect relationship satisfaction and their ties to interpersonal violence, sexism, and gender inequality, the methodology involved 308 participants, mainly females (75%), using the SMRL and Relationship Assessment Scale. Bayesian Confirmatory Factor Analysis (BCFA) assessed the scale's structure and reliability, complemented by descriptive statistics and correlation analyses to examine the myths' impact on intimate relationships. Results showed the SMRL's two-dimensional structure, confirming its robust psychometric properties and satisfactory internal consistency. Descriptive findings revealed a skeptical view of traditional romantic myths among participants, indicating the scale's good reliability and successful adaptation to the Peruvian context. This validation highlights how debunking romantic love myths can improve relationship dynamics and satisfaction and addresses their wider societal effects.
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Relações Interpessoais , Amor , Psicometria , Humanos , Feminino , Peru , Masculino , Adulto , Psicometria/normas , Psicometria/instrumentação , Reprodutibilidade dos Testes , Adulto Jovem , Adolescente , Satisfação Pessoal , Inquéritos e Questionários/normas , Parceiros Sexuais/psicologia , Pessoa de Meia-IdadeRESUMO
Despite earlier research demonstrating the immunomodulatory effects of acute and chronic exercise in many medical illnesses, there is a lack of literature evaluating the acute and chronic effects of exercise on the cytokine levels in individuals with bipolar disorder (BD) or schizophrenia (SCH). This study aims to examine the acute effects of resistance exercise on cytokines and the chronic effects of resistance exercise by 10 weeks on cytokine levels, symptoms of disease, and muscular strength in individuals with BD and SCH. The included individuals (N=10) performed a single session of band-elastic resistance exercises (six exercises, 3 sets of 12-15 repetitions, 60â¯seconds of interval between sets). A sub-sample (N=6) of individuals performed a supervised band-elastic resistance exercise program (2 times a week, for 10 weeks, 6 exercises, 3 sets of 12-15 repetitions, 60â¯seconds of interval). We verified for acute effects: IL-2 (P=0.0085) and IL-4 (P=0.0253) levels increased, while IL-6 decreased (P=0.0435), and for chronic effects: increased IL-2 and IL-4 levels (significant effect size - Pre vs Post), a decrease in disease symptoms, and an increase in muscular strength. This study adds to what is already known about how resistance exercises affect people with BD and SCH in both short-term (systemic cytokines levels) and long-term (symptoms of disease, muscular strength, and systemic cytokines levels).
Assuntos
Transtorno Bipolar , Citocinas , Força Muscular , Treinamento Resistido , Esquizofrenia , Humanos , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/sangue , Treinamento Resistido/métodos , Projetos Piloto , Esquizofrenia/fisiopatologia , Esquizofrenia/sangue , Masculino , Adulto , Feminino , Citocinas/sangue , Força Muscular/fisiologia , Pessoa de Meia-Idade , Interleucina-6/sangue , Interleucina-4/sangue , Interleucina-2/sangue , Adulto JovemRESUMO
OBJECTIVE: To explore financial toxicity (FT) experienced by the parents of children with cancer at end-of-life (EOL), including exploring differences by race and ethnicity. STUDY DESIGN: We performed secondary analysis of semistructured interviews of bereaved parents' perspectives on quality EOL care. Fifty-five interviews were conducted in California and Alabama representing 48 children (0-21 years at time of death) who died of cancer ≥6 months prior. Quotes related to FT were identified and iteratively grouped into themes without an a priori framework. RESULTS: Most participants were non-Hispanic White (30; 55%), and the most common diagnoses were noncentral nervous system solid tumors (16; 33%) and central nervous system tumors (16; 33%). Children died at a mean age of 11 and a median of 4 years prior to the interview. Almost all parents (52; 95%) discussed FT, including all Black and Hispanic parents. Parents identified transportation, housing, other basic needs, funeral costs, and medical costs as well as work disruptions as contributors to FT at EOL. Barriers to financial wellness included navigating insurance, insufficient financial support from the hospital, and long-term FT from treatment. Many parents discussed how the hospital and community served as facilitators of financial wellness. In some cases, finances prevented families from accessing nursing services and mental health support and affected EOL decisions. CONCLUSIONS: As FT affected almost all families' EOL experience, pediatric oncology programs should routinely screen for FT at EOL and ensure they have the resources to respond.
Assuntos
Luto , Neoplasias , Pais , Pesquisa Qualitativa , Assistência Terminal , Humanos , Criança , Masculino , Feminino , Pré-Escolar , Pais/psicologia , Adolescente , Lactente , Assistência Terminal/economia , Assistência Terminal/psicologia , Adulto Jovem , Adulto , Recém-Nascido , Alabama , CaliforniaRESUMO
This survey evaluated the Brazilian population's physical exercise habits and compared them with those from two decades ago. In this cross-sectional study, 432 people with epilepsy (PWE) assessed the questionnaire. Of these, 387 (age: 33 ± 10.58, 81.4 % women) completed the questionnaire. Among them, 60.5 % were involved in regular physical activities. Among those who exercise regularly, the majority (96.5 %) exercised between 2 and 5 times weekly and had been physically active for at least two years. Only 23.3 % were prohibited by their doctors from participating in physical activities. Only 10 % reported that seizures occur during exercise, and about half of them (55.8 %) believed that exercise improves or has no effect on seizure frequency. Most (79.06 %) did not or rarely believe exercise can trigger seizures. More than half (57.3 %) were not afraid to have seizures during exercise or were not afraid of injury during exercise due to a seizure (69 %). Most believed exercise improves cognition (80.9 %), depression, and anxiety (93.8 %). We visited this scenario two decades early. In our previous study, only 15 % exercised regularly, while in this survey, 58.4 % routinely exercised. Our findings also align with our initial survey, indicating a low seizure frequency during regular exercise, a belief that physical activity reduces seizure frequency, and a reduction in the fear that exercise might trigger seizures. In conclusion, our results show that after two decades, there have been several improvements in physical and sports activity participation among PWE. Implementing strategies to reduce barriers to exercise for PWE and educating them on the benefits of physical activity can help improve this scenario.
Assuntos
Epilepsia , Exercício Físico , Humanos , Brasil/epidemiologia , Epilepsia/psicologia , Epilepsia/epidemiologia , Feminino , Masculino , Adulto , Exercício Físico/fisiologia , Exercício Físico/psicologia , Estudos Transversais , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem , Adolescente , HábitosRESUMO
BACKGROUND: Arterial trauma of the axillary subclavian segment carries considerable morbidity and mortality risks. Surgical approaches are challenging given the hidden trajectory of these vessels, which has made the endovascular approach a valid and potentially better alternative for managing these injuries. We describe the incidence of relevant outcomes for patients with traumatic axillary and/or subclavian artery injury who underwent endovascular therapy at a tertiary care university hospital over a 15-year period in Cali, Colombia. METHODS: We conducted an incidence study based on clinical records that included patients aged 15 years or older with traumatic axillary subclavian arterial injury treated with endovascular therapy between 2008 and 2022. Vascular injuries caused by intra-arterial dialysis catheter insertion (iatrogenic) were excluded. We described clinical and imaging characteristics upon admission, perioperative findings, and the incidence of complications and in-hospital mortality, with accompanying 95% confidence intervals (CIs). RESULTS: We included 32 patients, 93.8% of whom were male, with a median (interquartile range) age of 30 (21-42) years. The type of trauma was penetrating in 75% of patients (62.5% corresponding to gunshot wounds) and blunt in 25%. Upon admission, 12 patients (37.5%) exhibited hard signs of vascular injury, and 20 patients (62.5%) exhibited soft signs. Fourteen patients (47%) had an Injury Severity Score greater than 15, and 12 (37.5%) had hemodynamic instability. All but 3 patients (90.6%) suffered subclavian artery injury (right 48.3%, left 51.7%), while 12.9% had axillary artery injury (one patient with both vessels affected). Intraoperative complications happened in one patient (3.1%, 95% CI: 0.2-18%). Pseudoaneurysms were identified in 11 patients (34.4%), thrombosis in 6 (18.8%), and dissection in 6 (18.8%). Three (9.4%) patients required hybrid management (endovascular therapy following conventional surgery). No cases of ischemia or amputation occurred. The length of hospital stay was 6 (3, 11.5) days. No cases of in-hospital mortality were reported (0%, 95% CI: 0.0-13.4%). CONCLUSIONS: Endovascular treatment in trauma is a minimally invasive technique with favorable clinical outcomes in patients with arterial trauma in the axillary-subclavian segment. This should be a viable therapeutic option for selected cases.
Assuntos
Artéria Axilar , Procedimentos Endovasculares , Mortalidade Hospitalar , Artéria Subclávia , Lesões do Sistema Vascular , Humanos , Masculino , Artéria Axilar/cirurgia , Artéria Axilar/lesões , Artéria Axilar/diagnóstico por imagem , Artéria Subclávia/cirurgia , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/lesões , Feminino , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/cirurgia , Lesões do Sistema Vascular/mortalidade , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/mortalidade , Adulto , Resultado do Tratamento , Adulto Jovem , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Colômbia , Ferimentos não Penetrantes/cirurgia , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/mortalidade , Incidência , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/terapia , Pessoa de Meia-Idade , Ferimentos Penetrantes/cirurgia , Ferimentos Penetrantes/mortalidade , Ferimentos Penetrantes/diagnóstico por imagemRESUMO
PURPOSE: The aim of this study is to investigate the effectiveness of geriatric dentistry courses as a combating strategy against ageism among dental students. METHODS: A pre-post prospective study was conducted in three different dental schools located in the State of Sao Paulo, Brazil, that offered geriatric dentistry courses in their curricula. A questionnaire specifically developed for this research and the "Ageism Scale for Dental Students" (ASDS) were applied before and after geriatric dentistry courses in all three dental schools. RESULTS: Among 184 dental students, 51.6% (n = 95) improved their ageism scores. Dental students who improved ASDS scores were more likely to be from a public dental school (56 .7% vs. 40.4%; p = .040), in their 8th and 10th semesters (56 .7% vs. 40.4%; p = .040), and females (55 .6% vs. 36.8%; p = .040). Other factors such as age, ethnicity, history of living with older adults, history of taking care of older adults, and knowledge of ageism were not significantly associated with ageism score improvement. Only institutional affiliation and age remained significant predictors in the final model. CONCLUSION: In this study, the main variables correlated with reducing ageism among dental students were institutional affiliation and age.
Assuntos
Etarismo , Educação em Odontologia , Odontologia Geriátrica , Estudantes de Odontologia , Humanos , Feminino , Masculino , Estudantes de Odontologia/psicologia , Brasil , Estudos Prospectivos , Odontologia Geriátrica/educação , Currículo , Inquéritos e Questionários , Adulto , Estudos de Coortes , Adulto JovemRESUMO
BACKGROUND: The COVID-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to the COVID-19 pandemic period among cisgender men who have sex with men (MSM) and transgender women (TGW). SETTING: HIV and sexually transmitted infection testing, prevention, and treatment referral service in Rio de Janeiro, Brazil. METHODS: We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of a recent infection testing algorithm to identify recent HIV infection cases and estimate annualized HIV incidences in the pre- (March 2018-February 2020) and post-COVID-19 pandemic onset period (March 2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection. RESULTS: Among 3814 MSM and 776 TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between the COVID-19 periods. Overall annualized HIV incidence rates were 6.0% (95% confidence interval [CI]: 4.2 to 7.7) and 6.6% (95% CI: 4.3 to 9.0) in the pre- and post-COVID-19 periods, respectively. During the post-COVID-19 period, higher incidence rates were observed among TGW (8.4% [95% CI: 2.9 to 13.9]), those aged 18-24 years (7.8% [95% CI: 4.0 to 11.7]), of Black race (7.9% [95% CI: 3.8 to 12.0]), and those with <12 years of schooling (7.8% [95% CI: 4.8 to 10.8]). Compared to the pre-COVID-19 period, incidence rates were significantly higher in the post-COVID-19 period for those aged >30 years and TGW, while being lower for those with more years of schooling. CONCLUSION: HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the COVID-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.
Assuntos
COVID-19 , Infecções por HIV , Homossexualidade Masculina , Pessoas Transgênero , Humanos , COVID-19/epidemiologia , Brasil/epidemiologia , Masculino , Infecções por HIV/epidemiologia , Infecções por HIV/diagnóstico , Pessoas Transgênero/estatística & dados numéricos , Incidência , Adulto , Feminino , Homossexualidade Masculina/estatística & dados numéricos , Adulto Jovem , Adolescente , SARS-CoV-2/imunologia , Teste de HIV , Pessoa de Meia-IdadeRESUMO
The COVID-19 pandemic had a profound impact on various aspects of life. This study aims to investigate whether the COVID-19 pandemic changed food preferences, focusing on cost perceptions, environmental factors, and health attributes. We conducted a panel study with self-administered online surveys among undergraduate students in Chile, both before and during the first wave of the pandemic. Each survey included a discrete choice experiment (DCE) to elicit food preferences. Using mixed logit models, our analysis shows that during the COVID-19 pandemic, sensitivity to cost, preference for foods with low environmental impact, and preference for vitamin-rich foods increased. These changes in preferences can be attributed to individuals' perceived health risks. These findings suggest that the pandemic increased awareness of sustainable and healthy food choices, with important implications for promoting these choices during global crises.