Percepção do peso corporal e dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos / Perception of body weight and difficulties encounteredby people with visual impairment in acquiring, preparing and consuming food

Objetivo: investigar a percepção do peso corporal e as dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos. Metodologia: estudo observacional transversal, com adultos e idosos com deficiência visual em Pelotas/RS, realizado no período de abril a maio de 2023. Foi utilizado um questionário composto de 42 itens. Os dados coletados foram analisados por análise descritiva e analítica, e apresentados como média ± desvio padrão ou percentual. Resultados: a amostra contou com 20 pessoas, predominantemente do sexo feminino e idosas. Em relação ao consumo alimentar, 50% dos participantes consomem feijão, 75% frutas e hortaliças, 50% bebidas adoçadas, biscoitos recheados e doces. Referente à percepção do peso corporal, percebeu-se que a maior parte do grupo sente que está acima do peso adequado e se sentem "insatisfeitos(as)". Sobre as dificuldades encontradas, 85% dos participantes relataram dificuldade extrema para identificar a validade dos alimentos, 70% para comprar alimentos frescos e perecíveis e 40% para usar a faca para cortar e descascar os alimentos. Conclusão: verificou-se que a maior parte do grupo sente que está acima do peso adequado e estão "insatisfeitos(as)" em relação ao peso corporal. Além disso, dependem de outra pessoa para escolher os alimentos a serem comprados, saber o prazo de validade, preparar alimentos que precisam ser porcionados, servir refeições no prato, cortar carnes, descascar vegetais e frutas, utilizar faca, entre outros. Esta dependência pode influenciar diretamente no seu consumo alimentar quando essas pessoas se encontram sozinhas, optando por consumir alimentos industrializados de fácil preparo ou prontos.

Objective: to investigate the perception of body weight and the difficulties encountered by people with visual impairments in acquiring, preparing and consuming food. Methodology: cross-sectional observational study, with adults and elderly people with visual impairment in Pelotas/RS, carried out from April to May 2023. A questionnaire composed of 42 items was used. The collected data were analyzed using descriptive and analytical analysis, and presented as mean ± standard deviation or percentage. Results: the sample included 20 people, predominantly female and elderly. Regarding food consumption, 50% of participants consume beans, 75% fruits and vegetables, 50% sweetened drinks, stuffed cookies and sweets. Regarding the perception of body weight, it was noticed that the majority of the group feels that they are overweight and feel "dissatisfied". Regarding the difficulties encountered, 85% of participants reported extreme difficulty in identifying the expiration date of food, 70% in purchasing fresh and perishable foods and 40% in using a knife to cut and peel food. Conclusion: it was found that the majority of the group feels that they are overweight and are "dissatisfied" with their body weight. Furthermore, they depend on someone else to choose the food to be purchased, know the expiration date, prepare food that needs to be portioned, serve meals on the plate, cut meat, peel vegetables and fruits, use a knife, among others. This dependence can directly influence their food consumption when these people are alone, choosing to consume easily prepared or ready-made processed foods.

Prevenção, detecção e assistência à deficiência em serviços de atenção primária à saúde do Estado de São Paulo, Brasil / Disability prevention, detection and assistance in primary health care services in the state of São Paulo, Brazil

Resumo O objetivo do trabalho consiste em avaliar o desempenho de serviços de atenção primária à saúde (APS) do estado de São Paulo para prevenção, detecção e assistência à deficiência. Realizou-se uma pesquisa avaliativa em 2.739 serviços de saúde em 514 municípios com 128 indicadores da qualidade organizacional do instrumento QualiAB referentes à dimensão avaliativa "Atenção à deficiência em serviços de atenção primária à saúde". Foram utilizadas medidas de desempenho e associações entre os escores de cada domínio e variáveis independentes sobre planejamento, avaliação em saúde e rede de apoio, por meio de regressão linear múltipla. O percentual de desempenho para a dimensão foi de 61,6%, para o domínio estrutura (insumos e recursos humanos), 73,6%, para qualificação da atenção ao pré-natal, 68,7%, qualificação da atenção à saúde da criança, 56,1%, prevenção de incapacidades relacionadas a condições crônicas, 55,8%, e atenção à pessoa com deficiência e ao cuidador, 53,9%. Houve associação significativa com variáveis relacionadas ao tipo de serviço e de participação em avaliações de serviços. Os serviços de APS ainda realizam ações incipientes para prevenção, vigilância e diagnóstico das deficiências, assim como para a atenção integral a pessoas com deficiência.

Abstract The objective of this study was to assess the performance of primary health care (PHC) services for disability prevention, detection and assistance in the state of São Paulo. The study included 2739 health services, from 514 municipalities. 128 organizational quality indicators of the QualiAB instrument referring to the evaluative dimension "Attention to disability in primary health care services". The association of health care performance score of each domain with independent variables, health assessment, and support network were tested using of multiple linear regression. The performance percentage was 61.6% for all domains, 73.6% for structure (inputs and human resources), 68.7% for qualification of prenatal care, 56.1% for qualification of child health care, 55.8% for prevention of disabilities related to chronic conditions, and 53.9% for attention to people with disabilities and caregivers. There was a significant association with variables related to the type of service and participation in service evaluations. PHC services still perform incipient actions for the prevention, surveillance and diagnosis of disabilities as well as for comprehensive care for people with disabilities.

Eficacia de un programa de salud bucal para cuidadores de personas con discapacidad / Effectiveness of an oral health program for caregivers of people with disabilities

Objetivo. Evaluar la eficacia del programa de salud bucal para los cuidadores de las personas con discapacidad. Métodos: Estudio cuasi experimental de intervención directa, longitudinal, con control antes y después, con un muestreo no probabilístico. Se diseñó, aplicó y evaluó un programa educativo de salud bucal a los cuidadores de personas con discapacidad, mediante una encuesta diseñada al efecto, antes y después de su implementación, en 111 cuidadores, así como la evaluación del Índice de Higiene Bucal de sus familiares con discapacidad, en el periodo de octubre a diciembre de 2020. La información fue procesada utilizando las herramientas de Excel y el programa SPSS versión 25. Los datos numéricos fueron resumidos en tablas descriptivas y los datos categóricos en tablas de frecuencia. Resultados: Antes de la intervención 9,9 % de las personas con discapacidad asistían cada seis meses al dentista, lo cual se incrementó a 76,5 %. Antes del programa 102 personas solo usaban cepillos y pasta dentales para la limpieza bucal, después 109 continuaron usando los mismos productos, sin embargo, se incrementó en un 6 % el uso del hilo dental. El Índice de Higiene bucal se mantuvo como regular, aunque disminuyó de 2.30 a 1.68. Conclusiones: La aplicación del programa cambió positivamente la situación de la salud bucal de los discapacitados ya que los cuidadores demostraron la adquisición de los nuevos conocimientos para una adecuada higiene de la cavidad bucal, la constancia en la aplicación del proceso y la necesidad de asistir a la atención odontológica por hábito y no por necesidad puntual.

Objective: Determine the level of knowledge of caregivers of people with disabilities about oral health before and after applying a program of educational workshops on the subject. Methods: It was a quasi-experimental study of direct intervention, longitudinal, with control before and after, with non-probabilistic sampling. An educational oral health program for caregivers of people with disabilities was developed, applied, and evaluated through a survey before and after its implementation, in 111 caregivers, as well as the evaluation of the Oral Hygiene Index of their relatives with disabilities, in the period from October to December 2020. Results: Before the intervention, 9.9% of people with disabilities attended the dentist every six months, which increased to 76.5%. Before the program, 102 people only used toothbrushes and toothpaste for oral cleaning, after 109 continued using the same products, however, the use of dental floss increased by 7 people. The Oral Hygiene Index remained regular, although it decreased from 2.30 to 1.68. Conclusion: The application of the oral health program had a favorable impact on caregivers, improving the knowledge regarding oral hygiene of their relatives with disabilities, improving the Oral Hygiene Index.

Vocal Approach to Transgender Individuals: The Journey Taken in Chile and Argentina

In recent years, there have been international references to the vocal approach for the specific group of transgender individuals, although the Latin American literature is still very timid on this matter. The purpose of this article is to identify the current norms, statistics, and vocal approach towards transgender individuals in Chile and Argentina, considering the experience of two speech and language pathologists with more than twenty years of experience on voice therapy. Reflections were made on the transgender reality in these countries, the limitations in the implementation of the depathologization of the transgender group were outlined, some current and unreliable statistics were presented, some innovative actions in the public system were highlighted, and the lack of knowledge about the benefits of vocal work for transgender men and women was discussed. The identified aspects could benefit from multicenter research that strengthens speech therapy actions with this group, contributing to depathologization and positive approach.

Desde los últimos años es posible encontrar referencias internacionales sobre el abordaje vocal al grupo específico de las personas transgénero, aunque la literatura latinoamericana sigue muy tímida en este asunto. La propuesta de este artículo es identificar las normas vigentes, estadísticas y abordaje vocal hacia las personas transgénero en Chile y Argentina, considerando la experiencia de dos fonoaudiólogas con más de veinte años de experiencia en terapia vocal. Se hicieron reflexiones sobre la realidad transgénero en los países citados, se delinearon las limitaciones en la puesta en práctica de la despatologización del grupo transgénero, se expusieron algunas estadísticas -vigentes y poco confiables-, se plasmaron algunas acciones novedosas en el sistema público y el desconocimiento sobre los beneficios del trabajo vocal en hombres y mujeres transgénero. Los aspectos detectados podrían beneficiarse de investigaciones multicéntricas que fortalezcan acciones fonoaudiológicas con este grupo, contribuyendo a la despatologización y el abordaje positivo.

Injusticias epistémicas normalizadas y restricción de la agencia de las personas con discapacidad

Las injusticias epistémicas son aquellas formas de trato injusto que se relacionan con la producción, trasmisión o utilización del conocimiento por parte de los sujetos. El encuadre ético-epistémico y socio-epistémico proporcionado por estas injusticias se vincula con temas que atraviesan las principales tradiciones filosóficas como el pragmatismo, la fenomenología y la teoría crítica. Estas injusticias se interrelacionan, además, con movimientos sociales e intelectuales como el feminismo, la teoría crítica de la raza, los estudios críticos de la discapacidad y las epistemologías decolonizadoras. Sin embargo, existe un cuestionamiento a que las personas con discapacidad no han sido suficientemente abordadas. El presente artículo se posiciona en los debates actuales sobre las injusticias epistémicas y la discapacidad, y tiene como propósito aportar el concepto de "injusticias epistémicas normalizadas". Partiendo de la constatación de las formas en que se reconocen opresivamente los sujetos con discapacidad, como alejados de la "norma", establece que existen injusticias epistémicas asociadas con esta identificación. Propone que las injusticias epistémicas normalizadas ocurren en la intersección de dos ámbitos: un sistema hermenéutico capacitista y una agencia epistémica restringida en la que se producen al menos tres tipos de configuraciones: no agencia, agencias epistémicas disminuidas y agencias epistémicas en resistencia. Pensar las injusticias epistémicas considerando el peso de la "normalidad" en la constitución como sujetos de las personas con discapacidad permite reconocer una situación crítica de exclusión epistémica para algunas personas, mientras que otras resisten y luchan por ser comprendidas en los recursos hermenéuticos colectivos.

Epistemic injustices refer to those forms of unfair treatment that are related to the production, transmission, or use of knowledge by the subjects. The ethical-epistemic and socio-epistemic framework provided by these injustices is linked to themes that cross the main philosophical traditions such as pragmatism, phenomenology, and critical theory. These injustices are further intertwined with social and intellectual movements such as feminism, critical race theory, critical disability studies, and decolonizing epistemologies. However, there is a question that people with disabilities have not been sufficiently addressed. This article is positioned in the current debates on epistemic injustices and disability, and its purpose is to contribute the concept of "normalized epistemic injustices". Starting from the verification of the ways in which subjects with disabilities are oppressively recognized, as far from the "norm", it establishes that there are epistemic injustices associated with this identification. It proposes that normalized epistemic injustices occur at the intersection of two realms: a capacitist hermeneutic system and a constrained epistemic agency where at least three types of configurations are produced: non-agency; diminished epistemic agencies and epistemic agencies in resistance. Thinking about epistemic injustices considering the weight of "normality" in the constitution as subjects of people with disabilities allows us to recognize a critical situation of epistemic exclusion for some people, while others resist and fight to be understood in collective hermeneutical resources.

As injustiças epistêmicas referem-se àquelas formas de tratamento injusto que estão relacionadas à produção, transmissão ou uso do conhecimento pelos sujeitos. O enquadramento ético-epistêmico e socioepistêmico proporcionado por essas injustiças está vinculado a temas que atravessam as principais tradições filosóficas como o pragmatismo, a fenomenologia e a teoria crítica. Essas injustiças estão ainda mais entrelaçadas com movimentos sociais e intelectuais como o feminismo, a teoria crítica da raça, os estudos críticos da deficiência e as epistemologias descolonizadoras. No entanto, há uma questão de que as pessoas com deficiência não foram suficientemente abordadas. Este artigo se posiciona nos debates atuais sobre injustiças epistêmicas e deficiência, e seu objetivo é contribuir com o conceito de "injustiças epistêmicas normalizadas". A partir da verificação das formas como os sujeitos com deficiência são opressivamente reconhecidos, como distantes da "norma", constata-se que existem injustiças epistêmicas associadas a essa identificação. Propõe que injustiças epistêmicas normalizadas ocorrem na interseção de dois domínios: um sistema hermenêutico capacitista e uma agência epistêmica restrita onde pelo menos três tipos de configurações são produzidas: não-agência; agências epistêmicas diminuídas e agências epistêmicas em resistência. Pensar as injustiças epistêmicas considerando o peso da "normalidade" na constituição como sujeitos das pessoas com deficiência permite reconhecer uma situação crítica de exclusão epistêmica para algumas pessoas, enquanto outras resistem e lutam para serem compreendidas em recursos hermenêuticos coletivos.

Effects of endurance training combined with blood flow restriction on functionality in older adults: a systematic review / Efeitos do treinamento de resistência combinado com restrição de fluxo sanguíneo na funcionalidade de idosos: uma revisão sistemática

The aim of this review was to verify the effects of aerobic exercise combined with blood flow restriction on older adult functionality. Systematic searches were performed in PubMed, Web of Science, and Embase between July and December 2023. Randomized studies with participants aged ≥ 60 years who were evaluated before and after the experimental protocols were included. We registered this systematic review at the International Prospective Register (PROSPERO CRD42022347205). The search strategy identified 2698 studies, four of which were included in the review, with 80 participants. The results suggested that aerobic exercise combined with blood flow restriction increased performance on specific functional tests. However, these results should be interpreted with caution due to the low-to-moderate study quality, as well as the low number of participants and studies. In conclusion, aerobic exercise and blood flow restriction may increase functional capacity in older adults. Further studies are needed to confirm such findings. (AU)

À luz da constituição e produção do racismo: a psicologia hospitalar tem cor? / In the light of the constitution and production of racism: does hospital psychology have color? / A la luz de la constitución y la producción de racismo: ¿la psicología hospitalaria tiene color?

OBJETIVO: Este trabalho apresenta aspectos de uma observação participante em um Hospital Universitário do nível terciário da rede SUS localizado em Vitória, capital da região sudeste do Brasil, durante o primeiro semestre de 2023. Logo, o relato a seguir pretende provocar e incitar a discussão sobre os desafios enfrentados pela psicologia em contexto hospitalar, dentre eles o racismo estrutural impregnado nos corpos e nos gestos que se atualizam naquele estabelecimento. MÉTODO: Trata-se de um relato de experiência, de caráter qualitativo, vivido através do acompanhamento da dinâmica hospitalar da clínica cirúrgica e da clínica médica do referido Hospital. O percurso metodológico foi realizado por meio da análise institucional de linhagem francesa, calcada em discussões de orientações do estágio, onde os diários de campo, observações e participações no campo eram semanalmente discutidas. RESULTADOS: Destaca a produção e reafirmação do racismo estrutural no país, que se expressa tanto no trato com pacientes quanto com funcionários e estudantes. A escuta da equipe profissional do hospital é marcada, muitas vezes, por práticas assistencialistas e por processos de exclusão preconceituosos, fazendo-nos indagar: "A psicologia hospitalar tem cor?" CONCLUSÃO: O objetivo da pesquisa foi cumprido e, além disso, relatar essa experiência suscitou ao campo diversas questões como: de que forma colocar em funcionamento uma gestão hospitalar que propicie uma política de compartilhamento de atenção ao paciente entre os equipamentos da atenção?

OBJECTIVE: This work presents aspects of participant observation in a University Hospital at the tertiary level of the SUS network located in Vitória, capital of the southeast region of Brazil, during the first half of 2023. Therefore, the following report intends to provoke and incite discussion about the challenges faced by psychology in a hospital context, among them the structural racism permeated in the bodies and gestures that are updated in that establishment. METHOD: This is an experience report, of a qualitative nature, experienced through monitoring the hospital dynamics of the surgical clinic and the medical clinic of the aforementioned Hospital. The methodological path was carried out through institutional data analysis, based on discussions of internship guidelines, where field diaries, observations and participation in the internship were discussed weekly. RESULTS: Highlights the production and reaffirmation of structural racism in the country, which is expressed both in dealings with patients, employees and students. Listening to the hospital's professional team is often marked by welfare practices and prejudiced exclusion processes, making us ask: "Does hospital psychology have color?" CONCLUSION: The objective of the research was fulfilled and, in addition, reporting this experience raised several questions in the field, such as: how to put into operation hospital management that provides a policy of sharing patients between care equipment?

OBJETIVO: Este trabajo presenta aspectos de la observación participante en un Hospital Universitario del nivel terciario de la red SUS ubicado en Vitória, capital de la región sureste de Brasil durante el primer semestre de 2023. Por lo tanto, el siguiente informe pretende provocar e incitar a la discusión sobre los desafíos que enfrenta la psicología en el contexto hospitalario, entre ellos el racismo estructural permeado en los cuerpos y gestos que se actualizan en ese establecimiento. MÉTODO: Se trata de un relato de experiencia, de carácter cualitativo, vivida a través del seguimiento de la dinámica hospitalaria de la clínica quirúrgica y de la clínica médica del mencionado Hospital. El recorrido metodológico se realizó a través del análisis de datos institucionales, a partir de discusiones sobre lineamientos de pasantía, donde semanalmente se discutieron diarios de campo, observaciones y participación en la pasantía. RESULTADOS: Destaca la producción y reafirmación del racismo estructural en el país, que se expresa tanto en el trato con pacientes, empleados y estudiantes. La escucha del equipo profesional del hospital muchas veces está marcada por prácticas asistencialistas y procesos de exclusión prejuiciosos, lo que nos lleva a preguntarnos: "¿Tiene color la psicología hospitalaria?". CONCLUSIÓN: El objetivo de la investigación fue cumplido y, además, relatar esta experiencia generó varias preguntas en el campo, tales como: ¿cómo poner en funcionamiento una gestión hospitalaria que prevea una política de reparto de pacientes entre equipos de atención?

Incidence of Muscular Strength, Anthropometry, and Asymmetry in the General Index of Autonomy in Older Chilean Women / Incidencia de la Fuerza Muscular, Antropometría y Asimetría en el Índice General de Autonomía en Mujeres Mayores Chilenas

SUMMARY: Frailty affects the functional autonomy (FA) of older adults and could manifest itself in muscle imbalances in the limbs, resulting in a disparity in size and strength between them. In Chile, information on the relationship between muscle strength (MS) levels and FA asymmetries in older women is limited. This study related the levels of MS, anthropometric parameters, and asymmetries of the lower and upper limbs, with the FA of a group of older Chilean women. The study included 39 women who participated, and their FA was evaluated using the GDLAM index (IG). Based on the score obtained in the IG, they were classified by percentiles as Group 1 with favorable FA (P ≤ 50) and Group 2 with low FA (P > 50). Anthropometric parameters were BMI, fat percentage, bone mass, circumferences (arm, thigh, calf), diameters (humerus, femur) and upper/lower limb strength was evaluated to determine asymmetries. The differences between the covariates of both groups were evaluated using the student's t test and the Mann-Whitney test for independent samples. G1 presented less asymmetry (p > 0.05) in the lower limbs and greater calf circumference than G2 (p < 0.05). G1 presented greater bilateral strength (dominant and non-dominant limb) compared to G2 (p < 0.05). The covariates of age, anthropometry, MS, and lower/upper limb asymmetries influence FA in older women.

La fragilidad afecta la autonomía funcional (AF) de las personas mayores y podría manifestarse en desequilibrios musculares en los miembros, dando lugar a una disparidad de tamaño y fuerza entre ellos. En Chile, la información que relaciona los niveles de fuerza muscular (FM) y las asimetrías con la AF en mujeres mayores es limitada. Este estudio relacionó los niveles de FM, parámetros antropométricos y asimetrías de los miembros inferiores y superiores, con la AF de un grupo de mujeres mayores chilenas. Participaron 39 mujeres, cuya AF se evaluó mediante el índice GDLAM (IG). En función de la puntuación obtenida en el IG, se clasificaron por percentiles en Grupo 1 con AF favorable (P ≤ 50) y Grupo 2 con AF baja (P > 50). Los parámetros antropométricos fueron IMC, porcentaje de grasa, masa ósea, circunferencias (brazo, muslo, pantorrilla), diámetros (húmero, fémur) y se evaluó la fuerza de los miembros superiores/ inferiores para determinar asimetrías. Las diferencias entre las covariables de ambos grupos se evaluaron mediante la prueba t de student y la prueba de Mann-Whitney para muestras independientes. G1 presentó menor asimetría (p > 0,05) en los miembros inferiores y mayor perímetro de pantorrilla que G2 (p < 0,05). G1 presentó mayor fuerza bilateral (miembro dominante y no dominante) en comparación con G2 (p < 0,05). Las covariables de antropometría, FM y asimetrías de extremidades inferiores/superiores influyen en la AF en mujeres mayores.

Study of the clinical profile of older patients with bipolar disorder in a tertiary care center in the Midwest of Brazil / Estudo do perfil clínico de pacientes idosos com transtorno bipolar em um centro terciário do Centro-Oeste do Brasil

Objective: This study aimed to describe the clinical and psychiatric characteristics of older outpatients with bipolar disorder (BD), including psychiatric history (age of onset of symptoms, length of time with the illness, and number of psychiatric hospitalizations), mood state, and cognitive function. Methods: This was a cross-sectional study where clinical and demographic data were obtained by a psychiatric interview with each patient and family members as well as by a review of medical records. The sample consisted of 20 individuals aged 60 years or older with a diagnosis of BD type I according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Descriptive data analysis was performed, with categorical variables expressed as absolute and relative frequencies. Results: No patient had manic or depressive symptoms at the time of the evaluation; 15 (75.0%) had an early onset while 5 (25.0%) had a late onset of the disease. Nine patients (45.0%) showed no cognitive decline whereas 11 (55.0%) showed mild cognitive impairment. Conclusions: This study presents an understudied group of patients with BD. Considering the personal impact and burden on the health system related to this psychiatric condition, it is recommended that further studies be conducted in this area to better evaluate this growing population. (AU)

Diagnóstico del estado nutricional, dislipidemia y factores de riesgo asociados en escolares indígenas yaquis / Diagnosis of nutritional status, dyslipidemia and associated risk factors in indigenous Yaqui schoolchildren

Resumen Antecedentes: La malnutrición es un problema mundial que afecta a niños escolares, capaz de incrementar el riesgo de enfermedades en la edad adulta. Adultos yaquis han presentado graves problemas de salud, por lo que los escolares podrían encontrarse en una situación similar. Objetivo: Evaluar el estado nutricional, el perfil lipídico y los factores asociados en una muestra de escolares yaquis. Material y métodos: Se estudiaron 109 escolares habitantes de los pueblos originarios, en quienes se realizaron mediciones antropométricas, se extrajo una muestra de sangre venosa en condición de ayuno y se aplicaron cuestionarios. Resultados: La prevalencia de sobrepeso/obesidad fue de 38.5 %, sin que se registraran casos de desnutrición crónica; 38.6 % de los escolares presentó dislipidemia. El consumo de fibra resultó ser un factor protector contra sobrepeso/obesidad y el consumo de grasa constituyó un factor de riesgo. La puntuación de actividad física resultó ser un factor protector contra dislipidemia y los factores de riesgo fueron puntuaciones Z del índice de masa corporal/edad, circunferencia de cintura, historia familiar de dislipidemias, nivel educativo y empleo permanente. Conclusiones: Los escolares yaquis padecen por igual alta proporción de sobrepeso/obesidad y dislipidemia. Los factores asociados pueden resultar útiles para el diseño de intervenciones contextualizadas para esta población.

Abstract Background: Malnutrition is a global problem that affects schoolchildren and can increase the risk of diseases in adulthood. Adult members of the Yaqui Indigenous group have been shown to have serious health problems, and Yaqui schoolchildren could therefore find themselves in a similar situation. Objective: To evaluate the nutritional status, lipid profile and associated factors in a sample of Yaqui schoolchildren. Material and methods: A total of 109 Yaqui schoolchildren who lived in their localities of origin were recruited. Anthropometric measurements were carried out, a venous blood sample was extracted in fasting conditions, and several questionnaires were applied. Results: The prevalence of overweight/obesity was 38.5%, with no cases of chronic malnutrition being recorded; 38.6% of the children had dyslipidemia. Fiber consumption was a protective factor against overweight/obesity, while fat intake was a risk factor. The physical activity score was found to be a protective factor against dyslipidemia, and the risk factors were BMI-for-age Z-scores, waist circumference, family history of dyslipidemia, educational level, and permanent employment. Conclusions: Yaqui schoolchildren equally suffer from a high proportion of overweight/obesity and dyslipidemia. The associated factors may be useful for the design of contextualized interventions for this population.

Analysis on the origins of the red doctor's spirit and the great founding spirit of the Party / 中国医学伦理学

The great founding spirit of the Party is not only the source of the spirit of the Communist Party of China,but also the origin of the red doctor's spirit.As the enrichment and development of the great founding spirit of the Party,the red doctor's spirit in medical and health work embodies the unique advantages and distinctive characteristics of adhering to the truth and ideals,fully demonstrating the value position and goal of practicing the original intention and undertaking the mission,specifically demonstrating the heroic nature and strong will of fearless sacrifice and brave struggle,and clearly outlining the political character and public servant feelings of being loyal to the Party and not betraying the people.In the new era,to promote the great founding spirit of the Party in medical and health work,medical colleges,public hospitals,and medical staff should shoulder the heavy responsibility of inheritance,adhere to putting people's health at the center,and jointly promote the leapfrog development of medical and health services.

Design and implementation of establishing morality and cultivating people in classroom teaching in medical colleges and universities / 中国医学伦理学

Practicing the great educational ideology of establishing morality and cultivating people in classroom teaching is a strategic measure for medical colleges and universities to improve the quality of ideological and political education and personnel training.At the juncture of its transition from the exploration stage to the normalization stage,it is necessary to understand the current situation,summarize the experience,as well as discover and solve the problems faced by sustainable development through investigation and research.The empirical research mainly focuses on two related aspects.Firstly,for the stage of lesson preparation,examining and studying the design description of teaching and educating people in randomly selected teaching plans to understand the current situation of teachers'learning and understanding of the concept of establishing morality and cultivating people.Secondly,for the implementation of classroom teaching,utilizing the opportunity of peer listening and supervising class evaluation to conduct on-site inspections and record relevant data,so as to further understand the teacher's concept of establishing morality and cultivating people and their current situation of integrating into classroom.Data statistical analysis and on-site investigation indicated that the exploration of practicing the concept of establishing morality and cultivating people in classroom teaching was generally successful,but there were also some shortcomings.To turn to the normalization stage,it is urgent to solve three major problems,namely,the need to deeply learn and understand the ideology of establishing morality and cultivating people,the need to carefully design teaching ideas of establishing morality and cultivating people in teaching plans,and the need to careful optimization of implementing measures for establishing morality and cultivating people in classroom teaching.

Chinese characteristics and realization paths of bioethical principles / 中国医学伦理学

In the process of localization in China,western bioethical principles face theoretical dilemmas such as the westernization of discourse expression,inconsistency of paradigm standards,and unclear logical order,as well as practical dilemmas such as technology supremacy and capitalization of medical services.Therefore,it is necessary to construct a Chinese characteristic bioethical principle of"life first"based on China's national conditions,highlighting the connotation and life purpose of"life survival,health,dignity,and order",as well as the value characteristics of collectivism,clarifying that western bioethical principles can provide a methodological reference for Chinese characteristic bioethical principles,and forming a theoretical consensus.To promote the realization of Chinese characteristic bioethical principles,it is necessary to interpret them through Chinese discourse,strengthen their publicity and education,improve their theory system,and form a consensus on them.

Influencing Factors of Three-Dimensional Amide Proton Transfer Weighted Imaging on Right Kidney in Normal Chinese / 中国医学影像学杂志

Purpose The study aims to investigate the effects of various ages,genders and body mass index(BMI)on amide proton transfer weighted(APTw)in the right kidney of normal Chinese.Materials and Methods A total of 182 healthy volunteers enrolled from September 2021 to February 2022 at Xi'an GaoXin Hospital were prospectively performed.There were 7 groups(11-80 years)according to age per 10 years;2 groups according to gender,male and female;4 groups according to BMI,slim group,normal group,overweight group and obese group.3D-APTw imaging of the right kidney was performed via intermittent breath-holding.The correlation between APT values and age and BMI was analyzed,and the differences in APT values between age groups,different BMI groups and gender were analyzed,respectively.Results A total of 131 cases were finally included.There was a weak positive correlation between APT and age(r=0.325,P<0.001).There were statistical difference in APT values among different age groups(F=3.566,P=0.003),the post-hoc analysis showed that the APT values of 11-20 years[(1.853±0.357)%]old group was significantly lower than those of 41-50 years[(2.387±0.432)%]old group and 51-60 years[(2.336±0.451)%]old group(P<0.05);the APT value of male[1.980(2.320,1.820)%]was significantly lower than that of female[2.284(2.586,1.825)%;Z=2.301,P=0.021].There was a very weak positive correlation between APT and BMI(r=0.181,P=0.039),with statistically different APT values among BMI groups(F=3.265,P=0.024).The results of intra-group analysis showed that APT values in emaciation group were significantly lower than those in normal group,overweight group and obesity group,respectively(all P<0.05).Conclusion The APT value of the right kidney may be correlated with age and BMI,with males lower than females.The effect of age,gender and BMI on APT on the clinical application of 3D-APTw may be considered.

Optimization of oral fat tolerance test / 中华内分泌代谢杂志

Objective:To compare the effects of different test meals on postprandial triglycerides and to optimize the standard meal composition and the blood sampling protocol for the oral fat tolerance test.Methods:This study is a prospective, open-label, randomized, cross-over trial. In March 2023, 36 volunteers were recruited in Hebei General Hospital. They underwent a health examination and oral glucose tolerance test. Twenty-six healthy volunteers(11 males and 15 females) were included in this study, with an average age of(39.08±4.56) years. Each volunteer received 75 g protein meal, 75 g fat meal, 700 kcal fixed-calorie high-fat mixed meal, and a high-fat mixed meal with energy adjusted based on 10 kcal/kg body weight. A one-week washout period of regular diet was applied before each trial. Blood was collected at fasting status and 1, 2, 3, 4, 5, and 6 hours after a meal to detect serum triglycerides, total cholesterol, low density lipoprotein-cholesterol(LDL-C), high density lipoprotein-cholesterol(HDL-C), glucose, and insulin. The variations of postprandial metabolic indicators over time following the consumption of different test meals were analyzed. The disparities in postprandial metabolic responses between the two types of mixed meals were compared.Results:The protein meal, fat meal, fixed-calorie high-fat mixed meal, and adjusted-calorie high-fat mixed meal resulted in postprandial triglyceride increases of 22.45%, 115.40%, 77.14%, and 63.63%, and insulin increase of 560.43%, 85.69%, 554.18%, and 598.97%, respectively, and with reductions in total cholesterol, LDL-C, and HDL-C ranging from 5.64%-21.81%, respectively. The blood glucose changed slightly. Changes in metabolic indicators mainly occured within 4 hours. The comparison of the characteristics of postprandial triglycerides between the two high-fat mixed meals showed no statistically significant differences( P>0.05). Conclusion:A standardize protocol with a 700 kcal fixed-calorie high-fat mixed meal as test meal, and blood lipid levels measured at fasting and at 1, 2, 3, and 4 hours after consumption, can serve as an optimized approach for oral fat tolerance test.

Status quo and challenges of continuing medical education for general practitioners in China: suggestions based on the concept of people centered and integrated health care / 中华全科医师杂志

Continuing medical education for general practitioners is an important measure to upgrade the quality of primary health care services in China, which is still facing various challenges and need to be further developed and improved. This article analyzes the status quo and existing problems of continuing medical education for general practitioners in China, and proposes suggestions based on the concept of people centered and integrated health care (PCIC), including faculty development, training contents, assessment methods, and experience learning, to provide references for the improvement of continuing medical education for general practitioners.

Discussion on the Theoretical System of Inspection Model Based on Twenty-five Kinds of Yin-Yang People / 浙江中医药大学学报

[Objective]To construct the inspection model to provide reference for clinical inspection and other related diagnosis and treatment,based on Lingshu·Twenty-Five People of Yin and Yang.[Methods]This paper examined the model and fundamental theory of the Twenty-five Kinds of Yin-Yang People,as well as"five upper"main components of their color,physique,spirit,physiological constitution and pathological constitution characteristics,etc.,and analyzed the subtypes of the ritual,physique,color,and Qi and blood characteristics.[Results]It is thought that the philosophy is founded on Twenty-five People of Yin and Yang theory,which may judge the five elements of the human body and define the traits of the five elements,and this kind of classification method is a deep concern for the complexity of the human physiological and pathological physique,thus building a thorough and complete physiological and pathological physique identification standard system.Moreover,it has all the elements corresponding to the requirements of holistic diagnosis,such as appearance,color,physique and posture,which can be systematically recognized and applied as the theoretical precursor of clinical diagnosis.[Conclusion]If the method of looking at the body is connected to this strict structure system,the clinical looking at the body can be carried out more systematically and accurately,and even the whole clinical diagnosis and treatment activities,which is of great significance to further improve and develop the clinical diagnosis and treatment system of traditional Chinese medicine.

Effect of mindfulness-based therapy on postoperative cognitive function and sleep quality in elderly patients after surgery under local anesthesia / 四川精神卫生

BackgroundPostoperative cognitive dysfunction （POCD） is a common complication in elderly patients after surgery， and has a great impact on postoperative rehabilitation of patients. ObjectiveTo explore the effect of mindfulness-based therapy on cognitive function and sleep quality in elderly patients after surgery under local anesthesia， so as to provide references for reducing their incidence risk of POCD and improving sleep quality. MethodsThe simple random sampling method was utilized to select 78 elderly patients who underwent surgery under local anesthesia in The Third Hospital of Mianyang from March 2022 to March 2023. Participants were assigned into study group and control group， each with 39 cases. All patients were subjected to conventional treatment and nursing interventions， and study group added mindfulness-based therapy on this basis. Mini-Mental State Examination （MMSE） was administered to patients on 1 day before surgery， and on the 1st， 3rd and 5th day after surgery. Pittsburgh Sleep Quality Index （PSQI） was employed on 1 day before surgery and on the 3rd day after surgery. ResultsMMSE scores revealed a significant time effect， group effect and time×group interaction effect （F=78.251， 197.071， 371.915， P<0.05）. Analysis of simple effect denoted that study group scored higher on MMSE on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （t=-3.579， -1.764， -0.253， P<0.05）. Study group reported lower incidence rates of POCD on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （χ2=2.631， 3.471， 5.135， P<0.05）. On the 3rd day after surgery，study group scored lower on PSQI than control group（P<0.05）， and PSQI total score， sleep latency， subjective sleep quality， daytime dysfunction and hypnotic drug use factor scores of study group were lower than baseline， with statistical significance（F=43.175， 12.594， 11.092， 4.579， 3.514， P<0.01）. ConclusionMindfulness-based therapy may have certain value in reducing incidence of POCD and improving sleep quality in elderly patients who underwent surgery under local anesthesia.

Prognostic Model of Traditional Chinese and Western Medicine in Middle-aged and Elderly Patients with Type 2 Diabetes Mellitus Complicated with Stable Angina Pectoris / 中国实验方剂学杂志

ObjectiveThis study aims to explore risk factors for the development of major adverse cardiovascular and cerebrovascular events （MACCEs） in middle-aged and elderly patients with type 2 diabetes mellitus complicated with stable angina pectoris （T2DM-SAP） based on real-world clinical data in traditional Chinese medicine （TCM）， so as to develop a COX proportional risk prediction model and visualize the predicted results using a nomogram. MethodBased on the clinical scientific research information sharing system， the medical records of 586 T2DM-SAP patients （45-94 years old） were collected from January 2012 to December 2019， including age， gender， course of disease， major medical history， laboratory examination， tongue image， pulse image， TCM syndrome， and major treatment drugs. MACCE outcome indicators of patients were obtained by telephone follow-up and re-hospitalization records. The data was divided into a training set and a validation set according to 7∶3. In the training set， COX univariate analysis was used to determine the risk factors for MACCE in T2DM-SAP patients， and then variables were screened by forward-backward stepwise regression method， so as to establish a MACCE risk prediction model and construct a nomogram. The predictive efficacy of the model was reflected by the C-index， receiver operating characteristic （ROC） curve， calibration map， and clinical decision curve. ResultThe history of cerebrovascular disease ［Hazard ratio （HR）=1.983， 95% confidence interval （CI，1.314-2.993）］， low-density lipoprotein （LDL-C/mmol·L-1）≥4.1［HR=2.683， 95%CI（1.461-4.925）］， dull red tongue ［HR=1.955， 95%CI（1.273-3.002）］， dull purple tongue ［HR=4.214， 95%CI（2.017-8.803）］， white thick coating ［HR=3.030， 95%CI（1.634-9.293）］， thin and weak pulse ［HR=2.233， 95%CI（1.283-3.888）］， and syndrome of wind-phlegm blocking collaterals ［HR=2.007， 95%CI（1.179-3.418）］ were found to be risk factors in middle-aged and elderly T2DM-SAP patients. Insulin ［HR=0.604， 95%CI（0.399-0.914）］， glycosidase inhibitor ［HR=0.627， 95%CI（0.409-0.962）］， and TCM treatment ［HR=0.328， 95%CI（0.214-0.503）］ were protective factors in middle-aged and elderly T2DM-SAP patients. The prediction model was constructed based on the above risk factors. The C-index of the model was 0.818 （95% CI 0.777 -0.859） in the training set and 0.814 （95% CI 0.773-0.855） in the validation set， and the change of C-index over time was plotted. The AUC of patients for 5， 10， 15 years in the training set was 0.71， 0.67， and 0.61. The AUC of patients for 5， 10， and 15 years in the validation set was 0.60， 0.68， and 0.63， respectively. The calibration map and clinical decision curves of 5， 10， 15 years were drawn in the training set and the validation set， respectively. The model was well calibrated and clinically effective. ConclusionThe history of cerebrovascular disease， LDL， dull red tongue， dull purple tongue， white thick coating， thin and weak pulse， and syndrome of wind-phlegm blocking collaterals are risk factors for MACCE in middle-aged and elderly T2DM-SAP patients， and insulin， glycosidase inhibitors， TCM treatment are protective factors for MACCE in middle-aged and elderly T2DM-SAP patients. A clinical prediction model is established accordingly. This model has good discrimination， calibration degree， and clinical effectiveness and provides a scientific basis for the prevention and treatment of MACCE in middle-aged and elderly T2DM-SAP patients.

Prevalence of central obesity among the elderly with different body mass indexes in Xuhui District， Shanghai / 上海预防医学

ObjectiveTo investigate the prevalence and influencing factors of overweight， obesity and central obesity among elderly residents in Xuhui District， and to analyze the epidemiological status of central obesity in elderly people with different body mass indexes. MethodsThe third round of health status and health service utilization monitoring data in Xuhui District was used. The information collected from questionnaire survey and physical examination were analyzed. SPSS 20.0 software was used for χ2 test， trend χ2 test and multinominal logistic regression analysis. Results5 096 survey subjects were included. The prevalence of overweight， general obesity， and central obesity in the residents aged 60 and above in Xuhui District were 34.3%， 6.5%， and 29.2%， respectively. There was gender difference in the rates of overweight， obesity， and central obesity among the residents. The overweight and central obesity rates in males were higher than those in females， while the obesity rate was lower than that in females （P<0.05）. Multinominal logistic regression analysis showed that in comparison with the normal weight non-central obesity group drinking only at party （OR=1.729， 95%CI： 1.184‒2.525）， and hypertension （OR=1.637， 95%CI： 1.305‒2.053）， were highly associated with normal weight with central obesity. Aged 60‒ years （OR=1.589， 95%CI： 1.190‒2.120）， aged 70‒ years （OR=1.763， 95%CI： 1.327‒2.342）， male （OR=1.379， 95%CI： 1.134‒1.676）， hypertension （OR=2.231， 95%CI： 1.878‒2.649）， former smokers （OR=1.437， 95%CI： 1.027‒2.011）， drinking at party only （OR=1.491， 95%CI： 1.107‒2.006）， and drinking ≥3 times per week （OR=1.611， 95%CI： 1.116‒2.325）， were highly associated with overweight combined with central obesity. Aged 60‒ years （OR=3.817， 95%CI： 2.251‒6.474）， aged 70‒ years （OR=3.084， 95%CI： 1.838‒5.175）， hypertension （OR=3.683， 95%CI： 2.753‒4.929）， diabetes （OR=2.085， 95%CI： 1.511‒2.878）， former smokers （OR=1.835， 95%CI： 1.043‒3.226）， were highly associated with compound obesity. Central obesity was found in the elderly residents with different BMI categories， and the rate of central obesity increased with the increase of BMI grade. ConclusionThe prevalence of overweight， obesity and central obesity among the elderly aged 60 years and above in Xuhui District is not optimistic. Attention should be paid to the elderly under 80 years old who are with hypertension and/or diabetes， alcohol consumption， low educational level and not doing physical exercise. Especially for the central obesity population with normal BMI， measures should be taken to prevent and intervene the occurrence of obesity and related diseases.