Test-retest, inter- and intra-rater reliability of the flexicurve for evaluation of the spine in children

Introduction: The early evaluation of the spine in children is desirable because it is at this stage of development that the greatest changes in the body structures occur. Objective: To determine the test-retest, intra- and inter-rater reliability of the Flexicurve instrument for the evaluation of spinal curvatures in children. Method: Forty children ranging from 5 to 15 years of age were evaluated by two independent evaluators using the Flexicurve to model the spine. The agreement was evaluated using Intraclass Correlation Coefficients (ICC), Standard Error of the Measurement (SEM), and Minimal Detectable Change (MDC). Results: In relation to thoracic kyphosis, the Flexicurve was shown to have excellent correlation in terms of test-retest reliability (ICC2,2=0.87) and moderate correlation in terms of intra-(ICC2,2=0.68) and inter-rater reliability (ICC2,2=0.72). In relation to lumbar lordosis, it was shown to have moderate correlation in terms of test-retest reliability (ICC2,2=0.66) and intra- (ICC2,2=0.50) and inter-rater reliability (ICC=0.56). Conclusion: This evaluation of the reliability of the Flexicurve allows its use in school screening. However, to monitor spinal curvatures in the sagittal plane in children, complementary clinical measures are necessary. Further studies are required to investigate the concurrent validity of the instrument in order to identify its diagnostic capacity.

Can the adapted arcometer be used to assess the vertebral column in children?

BACKGROUND: The adapted arcometer has been validated for use in adults. However, its suitability for use in children can be questioned given the structural differences present in these populations. OBJECTIVE: To verify the concurrent validity, repeatability, and intra- and inter-reproducibility of the adapted arcometer for the measurement of the angles of thoracic kyphosis and lumbar lordosis in children. METHOD: Forty children were evaluated using both sagittal radiography of the spine and the adapted arcometer. The evaluations using the arcometer were carried out by two trained evaluators on two different days. In the statistical treatment, the intraclass correlation coefficient (ICC), Pearson's product moment correlation, Spearman's rho, the paired t test, and Wilcoxon's test were used (α=.05). RESULTS: A moderate and significant correlation was found between the x-ray and the adapted arcometer regarding thoracic kyphosis, but no correlation was found regarding lumbar lordosis. Repeatability and intra-evaluator reproducibility of the thoracic kyphosis and lumbar lordosis were confirmed, which was not the case of inter-evaluator reproducibility. CONCLUSION: The adapted arcometer can be used to accompany postural alterations in children made by the same evaluator, while its use for diagnostic purposes and continued evaluation by different evaluators cannot be recommended. Further studies with the aim of adapting this instrument for use in children are recommended. .

Epidemiological profile of suicide in the Santa Catarina Coal Mining Region from 1980 to 2007 / Perfil epidemiológico do suicídio na Região Carbonífera Catarinense de 1980 a 2007

BACKGROUND: Suicide is a public health problem worldwide. Estimates have indicated that over 1 million people commit suicide every year all over the world. Brazil has a moderate suicide death rate (4.1 per 100,000 inhabitants), but the fact that it is a large country leads to the coexistence of diverse characteristics and levels of development across the different Brazilian regions. In this sense, the South region has been shown to present suicide rates above the national average. OBJECTIVE: To estimate the profile of suicide in municipalities comprising the Santa Catarina Coal Mining Region from 1980 to 2007. METHODS: This ecological, time-series, descriptive study sought to characterize epidemiological aspects related to suicide method, marital status, sex, age, and occupation in the municipalities of the region in the years 1980 to 2007. RESULTS: A total of 474 suicides occurred in the period, yielding a mean death rate of 10.83 per 100,000 inhabitants. There was a predominance of males, at a 5:1 ratio, and a peak rate in the 55-64-year age group (11.31 per 100,000 inhabitants). The suicide method most commonly used was hanging (72%) and the most frequent occupation was hard labor work (11.60%); in relation to marital status, married subjects (48%) were the ones with the highest rates of suicide. CONCLUSIONS: The Santa Catarina Coal Mining Region has suicide mortality rates above the national average. This study highlights specific characteristics of suicide in the region and may contribute to the development of preventive measures

INTRODUÇÃO: O suicídio é um problema mundial de saúde pública. Estimativas apontam que, anualmente, mais de 1 milhão de pessoas cometem suicídio em todo o mundo. O Brasil possui um coeficiente mediano de suicídio (4,1 por 100 mil habitantes), porém o fato de ser um país de grandes dimensões faz com que características e níveis de desenvolvimento variem grandemente em diferentes regiões. Nesse aspecto, o sul do país se destaca por possuir índices acima da média nacional. OBJETIVOS: Estimar o perfil do suicídio nos municípios da Região Carbonífera Catarinense no período de 1980 a 2007. METODOLOGIA: Estudo ecológico, temporal, descritivo, que buscou caracterizar os aspectos epidemiológicos em relação aos meios empregados para cometer suicídio, estado civil, gênero, faixa etária e ocupação nos municípios da região nos anos de 1980 a 2007. RESULTADOS: Ocorreram 474 suicídios no período, o que gerou um coeficiente médio de 10,83 por 100.000 habitantes. Houve predomínio masculino, na proporção de 5:1, e pico na faixa etária entre 55 e 64 anos (11,31 por 100.000 habitantes). O meio mais utilizado foi o enforcamento (72%), e a ocupação mais frequente foi a dos trabalhadores braçais (11,60%); em relação ao estado civil, os casados foram os que mais cometeram suicídio (48%). CONCLUSÃO: A Região Carbonífera Catarinense apresenta coeficientes de mortalidade por suicídio acima da média nacional. O presente estudo destaca características próprias do suicídio na região, podendo contribuir para o desenvolvimento de ações preventivas

Transtornos psiquiátricos e fatores de risco em uma população carcerária / Psychiatric disorders and risk factors in a prison population

Existem taxas elevadas de transtornos psiquiátricos nas prisões, e não está claro se a doença mental é um fator de risco para o encarceramento. Objetivo: este estudo pretende abordar a prevalência de comportamento violento, e sua associação com as categorias individuais de transtorno mental. Métodos: Estudo transversal de 557 prisioneiros consecutivos, durante um período de onze meses. Os sujeitos foram inquiridos uma série de perguntas a respeito dos eventos chaves da vida e submetidos ao MINI-Plus. Resultados: A prevalência de transtornos psiquiátricos foi elevada entre os presos. As mulheres tiveram uma prevalência mais elevada na maioria dos transtornos. Já os homens tiveram uma maior prevalência de transtorno do pânico e maior risco de suicídio do que as mulheres. Conclusões: É fundamental que a sociedade e o governo trabalhem lado a lado a fim de reduzir barreira ao tratamento psiquiátrico e permitir acompanhamento psicossocial e da adesão ao tratamento em pessoas com transtornos mentais em prisões.

There are elevated rates of psychiatric disorders among prison inmates, and it is unclear whether mental illness is a risk factor for incarceration. Objective: this study aims to approach the prevalence of self-reported violent behavior, and its association with individual categories of mental disorder. Methods: This is a cross-sectional study of 557 consecutive prisoners, over an eleven month period. The subjects were inquired a series of questions regarding key life events and submitted to the MINI-Plus. Results: The prevalence of psychiatric disorders is high among prisoners. Women have an overall higher prevalence in most disorders. Men have a higher prevalence of panic disorder and are at higher risk of suicide than women. Conclusions: It is essential that both society and government work side-by-side in order to reduce barriers and allow psychiatric treatment and follow-up of psychosocial treatment adherence in people with mental disorders in prisons.

Violência intrafamiliar contra idosos: perfil do indiciado e agredido

Introdução: A violência contra os idosos acontecena maioria das vezes no âmbito familiar podendo estarrelacionado a problemas de depressão, demência, históriade álcool, drogas, problemas de saúde mental, históriaanterior de violência e problemas cognitivos.Objetivo: identificar a freqüência de depressão maiore de dependência ao álcool entre os indiciados suspeitosde violência intrafamiliar contra os idosos, verificando operfil da vítima, relação do indiciado com a vítima, motivose tipos de violência.Métodos: Foi realizado um estudo transversal com24 indiciados suspeitos de violência intrafamiliar atravésda Delegacia do idoso do Município de Criciúma e com26 idosos vítimas de violência. Foram aplicados doisinstrumentos de avaliação: Cage e Scid.Resultados: Observou-se que a média de idade dasvítimas de violência intrafamiliar foi de 72,1 anos, 53,8%do sexo feminino, 46,2% com estado civil estável, 100%aposentados/pensionistas e 84,6% com escolaridade atéo ensino fundamental. Nos indiciados a idade média foide 39,75 anos, 62.5% do sexo masculino, 48.5% nãotinham profissão definida, 66,7% estudaram até o ensinofundamental, 75% são filhos, e os tipos de violência maispraticados são: ameaça, abuso psicológico e abandono,45,8% ingerem álcool com freqüência e 62,5%apresentam episódios de depressão.Conclusão: constatou-se que os indiciados são emprimeiro lugar os filhos que apresentam depressão eingerem bebida alcoólica com freqüência, os motivosestão relacionados com vários fatores como dependênciafinanceira e emocional e os tipos de violência maisfreqüentes são a ameaça, abuso psicológico e oabandono.

Introduction: The violence against the elderly occursmost often in the family may be related to problems ofdepression, dementia, a history of alcohol, drugs, mentalhealth problems, previous history of violence and cognitiveproblems.Objective: To identify the frequency of majordepression and alcohol dependence among the indictedsuspects of family violence against the elderly, evaluatingthe profile of the victim, indicted in connection with thevictim, reasons and types of violence.Methods: This was a cross-sectional study with 24indicted suspects of family violence through the Officeof Aging and the city of Invercargill with 26 elderlyvictims of violence. Two instruments were used forevaluation: Cage and Scid.Results: We found that the average age of the victimsof family violence was 72.1 years, 53.8% female, 46.2%with stable marital status, 100% retirees/pensioners and84.6% with schooling to primary school. Indicted in theaverage age was 39.75 years, 62.5% male, 48.5% hadno defined profession, 66.7% studied up to primaryschool, 75% are children, and the types of violence moreeffective: threat, psychological abuse and neglect, alcoholintake 45.8% and 62.5% often have episodes ofdepression.Conclusion: it was found that those indicted areprimarily the children that presented depression and arealcoholic, the reasons are related to several factors suchas financial and emotional dependence and types ofviolence are the most frequent threats, psychologicalabuse and abandonment.