Aplicaciones de un instrumento para evaluar factores de riesgo comportamentales asociados a enfermedades no transmisibles en población trabajadora

Introducción: La Organización Mundial de la Salud diseñó un instrumento para la vigilancia de los factores de riesgo asociados con las enfermedades crónicas, este abarca tres pasos que incluyen los datos personales y comportamentales, antropométricos y bioquímicos. Objetivo: Describir las aplicaciones del Instrumento STEPS (paso 1) para la identificación de factores de riesgo comportamentales asociados a enfermedades no transmisibles en adultos trabajadores, según país y año de publicación. Metodología: Revisión narrativa de estudios originales que utilizaron el STEPS, publicados entre 2015 y 2019 en español, inglés y portugués en las bases de datos PubMed, SciELO y el motor de búsqueda Google Scholar. Resultados: Se revisaron 20 documentos de los cuales 6 fueron de Asia y África, y el año de mayor publicación fue 2017. El consumo nocivo del alcohol, tabaquismo, inactividad física y alimentación no saludable son los riesgos más estudiados. Conclusiones: La utilización del instrumento STEPS en publicaciones es más frecuente en países de África y Asia. Se requiere que su implementación sea sistemática y difundida en otros países, con la finalidad de diseñar e implementar estrategias de salud pública para la prevención, mitigación y tratamiento oportuno de las enfermedades no transmisibles.

Introduction: The World Health Organization designed an instrument for the surveillance of risk factors associated with chronic diseases, it has three steps that include personal and behavioral, anthropometric, and biochemical data. Objective: To describe the applications of the STEPS Instrument (step 1) to identify behavioral risk factors associated with noncommunicable diseases in working adults, according to country and year of publication. Methodology: Narrative review of original studies that used STEPS, published between 2015 and 2019 in Spanish, English and Portuguese in the databases PubMed, SciELO, and the search engine Google Scholar. Results: A total of 20 studies were reviewed, of which 6 were from Asia and Africa, and the year of most significant publication was 2017. The most studied risks are harmful alcohol consumption, smoking, physical inactivity, and unhealthy eating. Conclusions: the use of the STEPS instrument in publications is more frequent in countries of Africa and Asia. Its implementation must be systematic and disseminated in other countries to design and implement public health strategies for the prevention, mitigation, and timely treatment of noncommunicable diseases.

Guía metodológica para la enseñanza de los pasos y carreras en gimnasia rítmica. Multimedia / Guia metodológico para o ensino de passos e corridas em ginástica rítmica. Multimídia / Methodological guide for the teaching of steps and runs in rhythmic gymnastics. Multimedia

RESUMEN Introducción: El trabajo de investigación que se muestra en este artículo, ofrece una respuesta a la carencia de documentos orientadores para el direccionamiento del proceso de enseñanza aprendizaje de los pasos y carreras como elementos técnicos de enlace en los ejercicios competitivos de gimnasia rítmica; lo que a su vez, constituye un apoyo a la aplicación del Programa Integral de Preparación del Deportista (PIPD 2017-2020) y de soporte de capacitación a las entrenadoras encargadas de la preparación de las gimnastas. Objetivo: Ello encaminó el objetivo de la investigación a la elaboración de una guía metodológica en formato multimedia que sirva a las entrenadoras en el proceso de enseñanza de estos elementos contenidos en el PIPD. Materiales y métodos: Los métodos de investigación de nivel teórico utilizados (análisis y síntesis, enfoque de sistema) y los de nivel empírico (la encuesta, la entrevista y el criterio de especialista, el análisis de documentos y la observación de videos). Resultados: Se demuestra la afectación agravada de la enseñanza por los diversos modelos técnicos metodológicos actuantes. Conclusiones: Se concluye planteando que una guía metodológica debe contener la descripción técnica y su metodología de enseñanza, los errores más comunes, elementos de preparación especial para la consecución y las recomendaciones.

RESUMO Introdução: O trabalho de pesquisa mostrado neste artigo, oferece uma resposta à falta de documentos orientadores para a direção do processo de ensino-aprendizagem das etapas e corridas como elementos técnicos de ligação nos exercícios competitivos da ginástica rítmica; o que, por sua vez, constitui um apoio para a aplicação do Programa Integral de Preparação do Atleta (PIPD 2017-2020) e de apoio ao treinamento dos treinadores encarregados da preparação dos ginastas. Objetivo: Isto levou o objetivo da pesquisa à elaboração de um guia metodológico em formato multimídia que serve aos treinadores no processo de ensino destes elementos contidos no PIPD. Materiais e métodos: Os métodos de pesquisa utilizados foram teóricos (análise e síntese, abordagem de sistema) e empíricos (pesquisa, entrevista e critérios especializados, análise de documentos e observação de vídeo). Resultados: A afetação agravada do ensino pelos vários modelos metodológicos de atuação técnica é demonstrada. Conclusões: Conclui-se propondo que um guia metodológico deve conter a descrição técnica e sua metodologia de ensino, os erros mais comuns, elementos de preparação especial para a realização e recomendações.

ABSTRACT Introduction: The research work shown in this article offers a response to the lack of guiding documents for the direction of the teaching-learning process of the steps and runs as technical elements of connection in the competitive exercises of rhythmic gymnastics; which, in turn, constitutes support for the application of the Comprehensive Program for the Preparation of the Athlete (PIPD 2017-2020) and training support for the coaches in charge of preparing the gymnasts. Objective: This directed the objective of the research to the elaboration of a methodological guide in multimedia format that serves the trainers in the process of teaching these elements contained in the PIPD. Materials and methods: The theoretical level research methods used (analysis and synthesis, system approach) and the empirical level (survey, interview and specialist criteria, document analysis and video observation). Results: The aggravated affectation of teaching by the various acting methodological technical models is demonstrated. Conclusions: It is concluded by stating that a methodological guide must contain the technical description and its teaching methodology, the most common errors, elements of special preparation for achievement and recommendations.

La preparación metodológica del profesor universitario de Educación Física a través del tratamiento de temas medioambientales

La formación de la cultura ambiental en el profesor de Educación Física resulta ser un factor de importancia en la preparación integral de este profesional. El objetivo de este estudio se centra en: proponer un sistema de talleres metodológicos orientados a la apropiación de la cultura ambiental del profesor de la disciplina Educación Física en la Universidad de Oriente de Santiago de Cuba. La investigación posee un enfoque mixto de tipo explicativa. Se aplicaron métodos teóricos y empíricos, técnicas e instrumentos que permitieron acopiar la información necesaria para el estudio. Se efectuó un diagnóstico a 15 profesores de la disciplina Educación Física en la Universidad de Oriente. Sus resultados expresaron las insuficiencias en la cultura ambiental del profesor de la disciplina Educación Física. En el procesamiento de los datos, se utilizó la estadística de contraste: prueba W de Kendall y prueba de T-Student, con un nivel de significación establecido en 0.05. La concordancia de los criterios emitidos por los especialistas consultados y la diferencia de los resultados entre el pretest y postest y con el grupo control, ambos con una significación de 0.00, permitió valorar de factible y funcional la propuesta.

A conformação da cultura ambiental no professor de Educação Física é um importante fator para a preparação integral deste profissional. O objetivo deste estudo é: propor um sistema de oficinas metodológicas orientadas para a apropriação da cultura ambiental do professor de Educação Física na Universidade de Oriente, em Santiago de Cuba. A pesquisa tem uma abordagem explicativa mista. Métodos, técnicas e instrumentos teóricos e empíricos foram utilizados para coletar as informações necessárias para o estudo. Foi realizado uma diagnose em 15 professores de educação física na Universidade de Oriente. Os resultados revelaram as deficiências na cultura ambiental dos professores de Educação Física. No processamento dos dados, foram usadas estatísticas de contraste: teste W de Kendall e teste T de Student, com um nível de significância fixado em 0,05. A coincidência dos critérios formulados pelos especialistas consultados e a diferença de desempenho entre o pré-teste e o pós-teste e com o grupo de controle, ambos com um significado de 0,00, nos permitiu avaliar a proposta como viável e funcional.

The formation of environmental culture in the Physical Education teacher turns out to be an important factor in the comprehensive preparation of this professional. The objective of this study is focused on: proposing a system of methodological workshops aimed at the appropriation of the environmental culture of the professor of the Physical Education discipline at the Universidad de Oriente de Santiago de Cuba. The research has a mixed explanatory approach. Theoretical and empirical methods, techniques and instruments were applied that made it possible to collect the necessary information for the study. A diagnosis was made to 15 professors of the Physical Education discipline at the Universidad de Oriente. Their results expressed the insufficiencies in the environmental culture of the professor of the Physical Education discipline. In data processing, the contrast statistic was used: Kendall's W test and Student's T test, with a level of significance set at 0.05. The concordance of the criteria issued by the specialists consulted and the difference in the results between the pre-test and post-test and with the control group, both with a significance of 0.00, allowed the proposal to be assessed as feasible and functional.

Warming acupuncture combined with "three steps and seven methods" of tuina for chronic nonspecific low back pain of yang deficiency and cold-dampness blockage: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy and possible mechanism of warming acupuncture combined with "three steps and seven methods" of tuina and simple "three steps and seven methods" of tuina in treatment of chronic nonspecific low back pain (NLBP) of yang deficiency and cold-dampness blockage.@*METHODS@#A total of 138 patients were randomized into an observation group (69 cases, 5 cases dropped off) and a control group (69 cases, 7 cases dropped off). In the control group, "three steps and seven methods" of tuina was applied. On the basis of the treatment in the control group, warming acupuncture was applied at Shenshu (BL 23), Yaoyangguan (GV 3), Mingmen (GV 4), Weizhong (BL 40) and ashi points. The treatment was given once a day, 6 times a week for 3 weeks in both groups. Before and after treatment, the short form of McGill pain questionnaire (SF-MPQ) score, Oswestry disability index (ODI) score, finger-to-floor distance (FFD), Schober test distance, fear-avoidance beliefs questionnaire (FABQ) score and yang deficiency and cold-dampness blockage score were observed, the serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and thromboxane B2 (TXB2) were detected in both groups. The recurrence rate was evaluated in follow-up of 6 months after treatment.@*RESULTS@#After treatment, the scores of PRI, PPI, VAS, ODI, FABQ and FFD, yang deficiency and cold-dampness blockage scores were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01); the Schober test distances were increased compared before treatment in both groups (P<0.01), and that in the observation group was larger than the control group (P<0.01). After treatment, the serum levels of TNF-α, IL-1β, IL-6 and TXB2 were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01). In follow-up, the recurrence rate was 12.8% (6/47) in the observation group, which was lower than 34.3% (12/35) in the control group (P<0.05).@*CONCLUSION@#Warming acupuncture combined with "three steps and seven methods" of tuina can effectively alleviate pain in patients with chronic NLBP of yang deficiency and cold-dampness blockage, improve activity and dysfunction of waist, the clinical efficacy is superior to simple "three steps and seven methods" of tuina, its mechanism may be relate to the inhibition of inflammatory reaction.

Follow-up to the baby friendly hospital initiative in two hospitals of the Mexican Social Security Institute / Seguimiento de la iniciativa hospital amigo del niño y la niña en dos hospitales del Instituto Mexicano del Seguro Social

Abstract Background: The Baby Friendly Hospital Initiative has proven to be effective to increase exclusive and prolonged breastfeeding. Material and methods: Longitudinal study, in two hospitals of second level, in the period from 2015 to 2018. A percentage above 85% in each step was considered acceptable. The statistical analysis was descriptive using student's t test to compare the mean between the two hospitals and ANOVA to compare the mean throughout time in SPSS v.25. Results: Steps 1 and 7 were different between the hospitals with p = 0.010 and p = 0.023, respectively. In the follow-up, General Zone Hospital No. 5 kept steps 1, 2, 3, 7, 8, and 9 above 85%, while those who did not were steps 4, 5, 6, and 10, p = 0.37. Steps of General Hospital No. 15 that remained over 85% were 1, 3, 7, and 9; those that oscillated over time with a <85% rating were steps 2, 4, 5, 6, 8, and 10, p = 0.003. Conclusion: Monitoring child-friendly hospitals allow us to observe areas of opportunity to strengthen training for both clinical and non-clinical staff, pregnant women, the general population, and to improve exclusive and prolonged breastfeeding.

Resumen Introducción: La Iniciativa Hospital Amigo del Niño y la Niña ha probado ser efectiva para mejorar la lactancia materna exclusiva y prolongada. Material y métodos: Estudio longitudinal, en dos hospitales de segundo nivel, en el periodo de 2015 a 2018. Un porcentaje superior al 85% en cada paso se consideró aceptable. El análisis estadístico fue descriptivo, utilizando la prueba t de Student para comparar las medias entre los dos hospitales y el análisis de la varianza para compararlas a lo largo del tiempo empleando el programa SPSS v.25. Resultados: Los pasos 1 y 7 variaron entre los hospitales (con p = 0.010 y p = 0.023, respectivamente). En el seguimiento, el Hospital General de Zona (HGZ) 5 mantuvo los pasos 1, 2, 3, 7, 8 y 9 por encima del 85%, y < 85% los pasos 4, 5, 6 y 10 (p = 0.37). Las medidas del HGZ 15 que se mantuvieron > 85% fueron 1, 3, 7 y 9; aquellos que oscilaron a lo largo del tiempo con una calificación < 85% fueron los pasos 2, 4, 5, 6, 8 y 10 (p = 0.003). Conclusión: Estos seguimientos permiten observar áreas de oportunidad para reforzar la capacitación al personal clínico y no clínico como a las mujeres embarazadas, a la población en general y para mejorar la lactancia materna exclusiva y prolongada.

Decreasing for walking steps with collegiate students during COVID-19 pandemic in Japan –A survey based on smartphone application– / 体力科学

Novel coronavirus disease (COVID-19) spread worldwide. In Japan, From April 16 to May 25, 2020, a state of emergency was declared and people were “strongly requested to refrain from going out unnecessarily and thoroughly reduce contact with others.” As a result, the number of steps of all generations was expected to be lower than usual due to the novel coronavirus disease pandemic. This study investigated the weather walking steps decrease in the collegiate student due to COVID-19. A total of 221 collegiate students used their smartphones to enter the average number of steps taken every month from January to May. The number of steps taken by all students was 4,988±2,345 steps in January, 5182±2,516 steps in February, 5,118±2,291 steps in March, 3,281±1,689 steps in April, and 2,834±1,676 steps in May. A comparison between sex groups showed that the number of steps in April and May was significantly different (p<0.05), which means that the steps of women group was lower than that of men. These results suggest that the number of steps taken by students decreased with the outbreak of the novel coronavirus disease.

Patients with asthma have reduced functional capacity and sedentary behavior / Pacientes com asma apresentam redução da capacidade funcional e comportamento sedentário

Abstract Objective The modified shuttle test is a field test that avoids the ceiling effect, and there are no reports of a multidimensional assessment concerning physical activity in asthmatic patients. Thus, the aim was to evaluate functional capacity by MST, additionally to perform a multidimensional assessment as physical activity in daily life, muscle strength, and cytokine levels in children and adolescents with asthma, and to correlate these variables. Method This cross-sectional study included volunteers aged between 6 and 18 years who were divided into two groups: asthma group (n = 43) that received regular treatment and control group (n = 24). Functional capacity was evaluated by distance walked during the MST; physical activity in daily life was evaluated using an accelerometer by the number of steps. Quadriceps femoris strength was evaluated by load cell. Results Distance walked was lower for the asthma group (790 m [222 m]) when compared with the control group (950 m [240 m]; p = 0.007); however, the number of steps was similar between the two groups (asthma group: 7743 [3075]; control group: 7181 [3040]; p = 0.41), and both groups were classified as sedentary behavior. There was no difference in muscle strength. Tumor necrosis factor-α differed, but interleukin levels were similar between groups. Quadriceps strength was correlated to distance walked (r = 0.62; p < 0.001) and tumor necrosis factor-α to the number of steps taken (r = −0.54, p = 0.005). Conclusion Children and adolescents undergoing regular asthma treatment showed reduced functional capacity and sedentary behavior. The lower the quadriceps strength, the shorter the distance walked; the higher the tumor necrosis factor-α levels, the lower their daily physical activity levels.

Resumo Objetivo O Teste Shuttle Modificado é um teste clínico de campo que evita o efeito-teto e não existem relatos de avaliação multidimensional com relação à atividade física em pacientes com asma. Assim, o objetivo era avaliar a capacidade funcional, a atividade física na vida cotidiana, a força muscular e os níveis de citocina em crianças e adolescentes com asma, a fim de correlacionar essas variáveis. Método Este estudo transversal incluiu voluntários entre seis e 18 anos, os quais foram divididos em dois grupos: o grupo com asma (n = 43), que recebeu tratamento regular, e o grupo de controle (n = 24). A capacidade funcional foi avaliada pela distância percorrida durante o Teste Shuttle Modificado, ao passo que a atividade física na vida cotidiana foi avaliada utilizando um acelerômetro pelo número de passos. A força muscular do quadríceps femoral foi avaliada por uma célula de carga. Resultados A distância percorrida foi menor no grupo com asma (790 m [222 m]) em comparação com o grupo de controle (950 m [240 m]; p = 0,007), contudo o número de passos foi semelhante nos dois grupos (grupo com asma: 7.743 [3.075]; grupo de controle: 7.181 [3.040]; p = 0,41) e ambos os grupos foram classificados como sedentários. Não houve diferença na avaliação da força muscular. O fator de necrose tumoral-α apresentou divergências, porém os níveis de interleucina foram semelhantes entre os grupos. A força muscular do quadríceps foi correlacionada com a distância percorrida (r: 0,62; p < 0,001) e o fator de necrose tumoral-α, ao número de passos dados (r = −0,54, p = 0,005). Conclusão Crianças e adolescentes que recebem tratamento regular de asma apresentaram redução da capacidade funcional e comportamento sedentário. Quanto menor a força muscular do quadríceps, menor a distância percorrida; quanto maiores os níveis de fator de necrose tumoral-α, menores seus níveis diários de atividade física.

Prevalence of Risk Factors of Noncommunicable Diseases in 12 Barangays of the AMIGA Municipalities of Cavite

Objective@#This study aims to determine the prevalence of risk factors of non-communicable diseases (NCDs) in 16 barangays of the AMIGA municipalities of Cavite. @*Methods@#The research is a cross-sectional study. Randomly chosen participants were interviewed using a translated version of the WHO Steps questionnaire. Interviewees were then invited to participate in another session where their anthropometric measurements were taken and their fasting blood sugar and cholesterol levels were determined.@*Results@#The research was done in 12 out of the 16 targeted barangays. A total of 1,527 participants were interviewed and 1,123 of them completed the study. The most significant findings in all 12 barangays were a very high rate of passive smoking (range of 60-80%); a relatively high proportion of respondents with obesity by all 3 parameters (BMI 29-52%; waist circumference 42-78%; and waist-to-hip ratio 41-78%) despite sufficient intake of fruits and vegetables and more than adequate physical activity; and a high proportion of participants with hypertension (more than 30% in 8 out of 12 barangays) and diabetes mellitus (more than 8% in 7 out of 12 barangays). @* Conclusion@#A high prevalence of risk factors of NCDs, particularly obesity, hypertension, and diabetes was found in the 12 barangays of AMIGA that participated in the study. Results of this study should provide the baseline data against which the success of an ongoing program in the area can be measured.

Clustering of cardiovascular disease risk factors – Syndemic approach: Is sit a time to shift toward integrated noncommunicable disease clinic?

Background: The concurrent occurrence of many noncommunicable disease (NCD) risk factors is common, and it can play a synergistic role in occurrence of NCDs. Objectives: This study aimed to identify the magnitude of clustering of NCD risk factors, patterns of risk factors emerged in clustering, and variations in clustering of risk factors based on socioeconomic factors. Methods: A cross-sectional survey was undertaken in an urban area of Puducherry among 2399 adults during 2014–2015. Sociodemographic and behavioral risk factors were assessed through a validated STEPS survey tool. Individuals with three or more risk factors were classified to have clustering of NCD risk factors. Socioeconomic positions in relation to clustering were identified through Chi-square analysis followed by multiple logistic regression where clustering at family and area was adjusted through multilevel modeling techniques. Results: Of the 2399 adults, 1741 (73%) had clustering of NCD risk factors. Inadequate consumption of fruits and vegetables, high salt intake, and high waist circumference are the three predominant risk factors across all subgroups. Adults belonging to Christian religion (adjusted odds ratio [adjOR]: 2.8, 95% confidence interval [CI]: 1.5–5.2), aged 35 years and over (adjOR: 2.0, 95% CI: 1.4–6.0), and illiterates (adjOR: 1.8, 95% CI: 1.1–5.5) are more likely to have clustered NCD risk factors compared to others. Conclusions: Clustering of NCD risk factors is highly prevalent in this region and mainly driven by dietary practices and obesity measures. There is an urgent need to reorient the health system toward integrated approach with mandated inclusion of nutritionist in NCD health service delivery.

Prevalence of risk factors for coronary artery disease among adults in a rural area of Tamil Nadu

Background: Lifestyle changes have increased the epidemic of obesity, diabetes, hypertension (HTN), dyslipidemia, and cardiovascular diseases in the 20th century. In India, the estimated adult prevalence of coronary artery disease (CAD) is increasing which leads to a huge economic loss. Objectives: The objective of the study is to measure the prevalence of risk factors for CAD among population aged 30 years and above in a rural area of Tamil Nadu. Materials and Methods: A community-based cross-sectional study was done in 16 villages under the field practice area of the Department of Community Medicine, Pondicherry Institute of Medical Sciences. 631 participants were selected by multistaged random sampling and interviewed using modified WHO-STEPS questionnaire. The variables studied were age, sex, socioeconomic status, smoking, alcohol, diet, physical activity, obesity, diabetes, and HTN. Data analysis was done using SPSS version 20. Results: Out of 631 participants interviewed in this study, the prevalence of smoking was 13.8%. 29.6% respondents had consumed alcohol once in their lifetime. Almost all the respondents (99.5%) did not consume fruits and vegetables adequately. Majority of the participants consumed salt dense foods and used unsaturated oil for cooking. Only 17.8% were sedentary workers. 32.5% were pre-hypertensives and 25.8% were hypertensives. 28.2% were overweight and 6.6% were obese. Conclusion: The prevalence of various risk factors for CAD such as unhealthy diet, obesity, alcohol consumption, and comorbidities was found to be high among our study population. Hence, concerted efforts should be taken by various stakeholders to reduce the risk of developing CAD.

Behavioral and biological risk factors of noncommunicable diseases among tribal adults of rural siliguri in Darjeeling District, West Bengal: A cross-sectional study

Background: The increasing burden of noncommunicable diseases (NCDs) urges continuous survey of risk factors in different population groups. Objectives: The study was conducted to assess the prevalence and determinants of behavioral and biological risk factors of NCDs, in rural tribal population. Methods: A community-based cross-sectional study was conducted from June 2014 to May 2015, in rural Siliguri, among 172 tribal people aged 25–64 years selected by multistage cluster random sampling using WHO-STEPS instrument. Study participants were interviewed for sociodemographic and behavioral risk factors, and biological measurements were taken. Descriptive and logistic regression analyses were performed to explore the determinants of risk factors. Results: Among the study participants, the prevalence of current tobacco use and alcohol use were 69.8% and 40.7%, respectively; 96.5% consumed unhealthy diet and 2.9% were physically inactive. The prevalence of abdominal obesity and overweight were 26.2% and 12.2%, respectively. Odds of tobacco use were significantly raised among men (adjusted odds ratio [AOR]: 47.7 [95% confidence interval (CI) 11.1, 203.9]) and increased age of the participants. Men showed higher odds of alcohol consumption (AOR: 13.4 [95% CI 4.6, 38.9]). Odds of abdominal obesity were higher among older participants, whereas lower odds were found among men (AOR: 95% CI 0.11 [0.0, 0.5]) compared to women. Conclusions: Most of the behavioral and biological risk factors of NCDs were quite high among tribal population of rural Siliguri except physical inactivity. Increasing awareness about NCDs through locally accepted and culturally appropriate strategies need to be implemented in the study area.

Isolated diastolic hypertension and its risk factors in semi-rural population of South India

Background Isolated diastolic hypertension (IDH) has been actively discussed for the last two decades because of its prevalence in a younger population and its association with cardiovascular disease. Furthermore, the association of IDH is significant in South Asian Countries such as India because relatively younger populations are known to have a higher risk of cardiovascular events. Objective The objective of this study is to find prevalence of IDH and its risk correlates in a semiurban population of South Indian state of Andhra Pradesh. Methods Data were collected using the modified World Health Organization - STEPwise approach to Surveillance (WHO STEPS) questionnaire for 16,636 individuals from a group of villages under Thavanampalle Mandal. Collated data were analyzed for prevalence and risk factors of IDH. Results Prevalence of IDH was found to be 4.0% with mean age of 46.0 (±SD 13.6) years and a relatively higher prevalence in men (5.3%) as compared with women (3.2%). The prevalence of IDH peaked in the fifth decade of life (40–49 years of age) and declined thereafter. Among various risk factors that were analyzed for their association with IDH, only age, body weight, and body mass index retained their significance in multivariate binary logistic regression analysis. Conclusion There is a significant prevalence of IDH below 50 years of age in the semiurban population of South India. As IDH in young and middle age is known to be associated with increased risk of cardiovascular events and end organ involvement, it highlights need for study and development of effective IDH management strategies to reduce associated morbidity and mortality.

Asociación entre actividad física y riesgo cardiovascular en conductores de transporte público de cochabamba, 2018 / Association between physical activity and cardiovascular risk in car drivers of the public transport from cochabamba, 2018

Introducción: La inactividad física, es uno de los factores de riesgo comportamentales más importantes para el desarrollo de las enfermedades cardiovasculares, considerada la primera causa de mortalidad prematura en edad laboral a nivel mundial. Objetivo: Analizar la relación entre actividad física y riesgo cardiovascular en conductores de transporte público de la ciudad de Cochabamba. Métodos: Se realizó un estudio observacional, analítico, de corte transversal; participaron 66 conductores de transporte público de ambos sexos, mayores de 18 años. Se recogió la información a partir del cuestionario STEP de la OMS, recolectándose información sobre el perfil sociodemográfico, comportamientos de riesgo y parámetros clínico-laboratorial. Para el análisis estadístico se utilizó Chi Cuadrado (x2), T de student, y Curva Característica Operativa del Receptor-COR. Resultados: El 56,1 % presentaron un nivel bajo de actividad física; un 4,5% con riesgo cardiovascular moderado. Los conductores con riesgo cardiovascular moderado presentaron una menor actividad física (media: 480 ± 831 MET [Equivalente Metabólico]) que aquellos con riesgo bajo (855 ± 1172 MET), siendo esta diferencia estadísticamente significativa (p=0,035); siendo más preponderante en aquellos con mayor edad, baja escolaridad y entre 10 a 20 años de antigüedad en el servicio de transporte. Conclusión: Se evidencia asociación estadísticamente significativa entre la baja actividad física y el incremento riesgo cardiovascular en conductores de transporte público de la ciudad de Cochabamba.

Introduction: Physical inactivity is one of the most important behavioral risk factors for the development of cardiovascular diseases, that its considered the first cause of premature mortality in working-age worldwide. Objective: To analyze the relationship between physical activity and cardiovascular risk in drivers of public transport from Cochabamba city. Methods: An observational, analytical, cross-sectional study was conducted; 66 drivers of both sexes, of the public transport system, over 18 years participated. The information was collected using the WHO STEP questionnaire, about the sociodemographic profile, risk behaviors, clinical and laboratory parameters. For the statistical analysis Chi-square (x2), t-test, and ROC curve were used. Results: 56,1% had a low level of physical activity; 4,5% with moderate cardiovascular risk. The drivers with moderate cardiovascular risk presented a lower physical activity (average: 480 ± 831 MET [Metabolic Equivalent]) than those with low cardiovascular risk (855 ± 1172 MET), this difference being statistically significant (p=0,035); being more low in elderly drivers, those low schooling and between 10 to 20 years of active work in the transport service. Conclusion: There is a statistically significant association between low physical activity and increased cardiovascular risk in public transport drivers in the city of Cochabamba.

Caracterización del perfil epidemiológico del síndrome metabólico y factores de riesgo asociados. Cochabamba, Bolivia / Characterization of the epidemiological profile of the metabolic syndrome and associated risk factors. Cochabamba, Bolivia

La evaluación del perfil epidemiológico del Síndrome Metabólico en población general usando la metodología WHO-STEPS de la Organización Mundial de la Salud es incipiente o nula en muchos países Latino Americanos. OBJETIVO: caracterizar el perfil epidemiológico del Síndrome Metabólico y sus factores de riesgo asociados en población general mayor de 18 años en la ciudad de Cochabamba, Bolivia, durante la gestión II-2016. MÉTODOS: se realizó un estudio observacional, analítico de corte transversal, en población general de 18 o más años, con una muestra de n=186 sujetos ajustados por grupo etario y sexo en base a la pirámide poblacional de Cochabamba-Bolivia. Se aplicó la metodología STEPS (pasos) de la OPS/OMS para la recolección de la información centrada en datos sociodemográficos, hábitos de vida, evaluación física y laboratorial. Se calcularon proporciones e intervalos de confianza al 95% conforme lo establecido en el manual de implementación de la metodología STEP; y regresión logística multivariada para la obtención del OR ajustado para el nivel de riesgo asociados al Síndrome Metabólico. RESULTADOS: la prevalencia global de Síndrome metabólico fue de 44,1%; la prevalencia de sus factores de riesgo asociados fue: STEP-1, Tabaquismo 11,29%; consumo actual de alcohol 63,44%; bajo consumo de frutas y vegetales 76,88%; sedentarismo o bajo nivel de actividad física 75,81%. STEP-2: sobrepeso 44,62%; obesidad 24,73%; obesidad abdominal 38,7% y presión arterial elevada en 35,14%. STEP3: Glicemia alterada en ayunas 36,02%; Insulina basal alterada 36,56%; colesterol total elevado 36,02%; Triglicéridos elevados 46,77% y HDL-colesterol reducido en el 66,67%. Los niveles de OR ajustado fueron >1 y estadísticamente significativas para las medidas físicas y laboratoriales. CONCLUSIÓN: el síndrome metabólico en altamente prevalente en la población general de la ciudad de Cochabamba y se asocia a niveles elevados de IMC, presión arterial elevada y perfil laboratorial alterado.

The epidemiological profile evaluation of Metabolic Syndrome in the general population using the WHO-STEPS approach of the World Health Organization is incipient or null in many Latin American countries. OBJECTIVE: to characterize the epidemiological profile of Metabolic Syndrome and risk factors associated in the general population over 18 years of age in Cercado-Cochabamba city, from Bolivia, during the second semester of 2016. METHODS: an observational, analytical, cross-sectional study was conducted in the general population of 18 years of age or older, with a sample of n = 186 subjects adjusted by age group and sex based on the population pyramid of Cochabamba-Bolivia. WHO-STEPS approach was applied for the collection of information focused on sociodemographic data, life habits, physical and laboratory evaluation. Proportions and 95% confidence intervals were calculated as established in the STEP ́ implementation manual, and multivariate logistic regression was calculated to obtain adjusted OR for the level of risk associated with Metabolic Syndrome. RESULTS: the overall prevalence of metabolic syndrome was 44.1%; the prevalence of risk factors associated were: STEP-1, Smoking 11.29%; current alcohol consumption 63.44%; low consumption of fruits and vegetables 76.88%; sedentary lifestyle or low level of physical activity 75.81%. STEP-2: overweight 44.62%; obesity 24.73%; abdominal obesity 38.7% and high blood pressure 35.14%. STEP3: Hyperglycemia in 36.02%; basal insulin elevated 36.56%; total cholesterol 36.02%; Triglycerides elevated 46.77% and HDL-cholesterol reduced in 66.67%. CONCLUSION: metabolic syndrome is highly prevalent in the general population in Cochabamba City and is associated with high levels of BMI, high blood pressure high values of the laboratorial profile.

Critical vitrification steps towards survival of Garcinia hombroniana (Clusiaceae) shoot tips after cryopreservation / Etapas críticas de vitrificación para la supervivencia de ápices caulinares de Garcinia hombroniana (Clusiaceae) después de crioconservación

Abstract A cryopreservation protocol was developed for in vitro shoot tips of Garcinia hombroniana using the vitrification technique. Four critical steps in the technique were investigated, namely preculture, loading, dehydration with Plant Vitrification Solution 2 (PVS2), and unloading. Shoot tips precultured for 48 h gave significantly higher survival (75 %) compared to 24 h preculture (50 %) after cryopreservation. Treatment with 1 M glycerol plus 0.4 M sucrose as a loading solution gave higher survival (45.83 %) compared to the other treatments (0.4 M sucrose + 2 M glycerol; 0.4 M sucrose). Shoot tips dehydrated with PVS2 for 25 min gave the highest survival after immersion in liquid nitrogen. Stepwise PVS2 treatment for 15 min with 50 % PVS2 followed by 10 min with 100 % PVS2 solution improved survival of the shoot tips after cryopreservation (41.67 %). Murashige and Skoog medium with 0.4 M sucrose gave significantly higher survival (66.67 %) than MS with 1.2 M sucrose (25 %) as an unloading solution. Water content was shown to decrease throughout the whole vitrification steps from 6.83 ± 1.66 g g-1 dw for fresh shoot tips down to 2.93 ± 0.28 g g-1 dw after PVS2 treatment. Further study on each step including recovery medium is required to improve the survival. Nevertheless, the present study showed the potential of using the vitrification technique for cryopreservation of G. hombroniana. Rev. Biol. Trop. 66(3): 1314-1323. Epub 2018 September 01.

Resumen Se desarrolló un protocolo de crioconservación in vitro para ápices caulinares de Garcinia hombroniana mediante la técnica de vitrificación, con cuatro etapas críticas: precultivo, carga de crioprotector, deshidratación con solución de vitrificación vegetal 2 (PVS2), y descarga. Ápices precultivados por 48 h sobrevivieron más (75 %) que los de 24 h (50 %) después de la crioconservación. El tratamiento con glicerol 1 M más sacarosa 0.4 M como solución de carga permitió mayor sobrevivencia (45.83 %) que los otros tratamientos (sacarosa 0.4 M + glicerol 2 M; sacarosa 0.4 M). Los ápices deshidratados con PVS2 por 25 min registraron la mayor sobrevivencia tras inmersión en nitrógeno líquido. El tratamiento gradual por 15 min con solución de PVS2 al 50 %, seguido por 10 min al 100 %, mejoró la sobrevivencia de ápices tras la crioconservación (41.67 %). El medio Murashige-Skoog (MS) con sacarosa 0.4 M produjo una sobrevivencia significativamente mayor (66.67 %) que MS con sacarosa 1.2 M (25 %) como solución de descarga. El contenido de agua disminuyó a lo largo del proceso de vitrificación desde 6.83 ± 1.66 g g-1 peso seco, en ápices frescos, hasta 2.93 ± 0.28 g g-1 peso seco después del tratamiento con PVS2. Se requiere de más investigación sobre cada etapa, incluyendo el medio de recuperación, para mejorar la tasa de sobrevivencia. Sin embargo, este estudio muestra el potencial de la vitrificación para la crioconservación de G. hombroniana.

Effects of different steps of brisk walking on the fitness of middle-aged and old men / 中国应用生理学杂志

OBJECTIVES@#To analyze the effect of walking pace on the fitness of middle-aged and elderly people in order to provide more theoretical data for the development of entensive mass fitness based on the means of sports physiological and biochemical techniques.@*METHODS@#The selected 80 middle-aged and elderly subjects were divided into three groups:brisk walking group A (=30, 56.26 ±3.68 years), brisk walking group B (=30, 57.65 ±4.78 years), and control group C (=20, 55. 73 ±4. 18 years). Exercise group A:10 000~12 000 steps/day, a total of 16 weeks; walking group B:10 000~12 000 steps/day in the first 10 weeks, 14 000~15 000 steps/day in the last 6 weeks. Control group C:keeping the normal living conditions. The indicators were tested before the experiment and after the tenth week and the sixteenth week of the experiment. Test indicators included systolic blood pressure, diastolic blood pressure, heart rate, vital capacity, timed vital capacity, total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol.@*RESULTS@#The levels of systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride were decreased significantly (<0.05, <0.01), while the vital capacity and high density lipoprotein cholesterol were increased significantly in both exercise groups afler 10 and 16 weeks compared with those in the same group betor test(<0. 05, <0. 01). The levels of diastolic blood pressure, timed vital capacity, serum triglyceride and high density lipoprotein cholesterol in exercise group B after 16 weeks were significantly higher than those of exercise group A (<0.05).@*CONCLUSIONS@#Ten thousand steps away every day can effectively improve the indexes of blood pressure, vital capacity, serum triglyceride, total cholesterol and high density lipoprotein cholesterol of middle-aged and elderly men and it can further improve the indicator above by increasing the number of steps after 10 weeks.

Application of three-step teaching in the antidiastole of vertigo in the standardized training of general practitioners / 中华医学教育探索杂志

Vertigo is one of the most common symptoms in general practice. During the standardized training in theory and practice of vertigo diagnosis and treatment, researchers from group of vertigo subspe-cialty of department of neurology analyzed the epidemiological characteristics of vertigo disease and the present teaching situation of theory and practice teaching. They put forward and adopted the "Three Steps"(laying firm foundation, consolidating and strengthening, and improving skills) which is based on multidis-cipline and conforming to trainees' understanding of the disease. It helped general practitioners tofamiliarize themselves with the etiology, diagnosis, and treatment of vertigo, to perfect their multidisciplinary knowl-edge structure, to establish scientific clinical thinking, and to improve their levels of the diagnosis and treatment of diseases relating to vertigo, which has produced good effects and has been playing an important role in improving the prognosis for vertigo patients.

"Point-line-surface" three steps method of straight light beam green laser vaporesection of the prostate for treatment of benign prostatic hyperplasia / 新乡医学院学报

Objeodve To discuss the safety and efficacy of " point-line-surface" three step method of straight light beam green laser photoselective vaporesection of the prostate(PVRP) for the treatment of benign prostatic hyperplasia(BPH).Methods The data of one hundred and twenty-six BPH patients who were treated with surgery in the First Affiliated Hospital of Xinxiang Medical University from May 2016 to August 2017 was analyzed retrospective.In all of the patients,69 cases were given "point-line-surface" three step method of straight light beam green laser PVRP(PVRP group),57 cases were given photoselective vaporization of the prostate (PVP group).Operation time,blood loss,postoperative washing time,indwelling catheter time,international prostate symptom score (IPSS),quality of life score (QOL),maximum urinary flow rate (Qmax) and postvoid residual urine (PVR) were compared between the two groups.Results The operation time in the PVRP group was shorter than that in the PVP group(P ＜ 0.05).There was no significant difference in the blood loss,postoperative washing time and indwelling catheter time between the PVRP group and PVP group(P ＜ 0.05).There was no significant difference in the IPSS,QOL,Qmax and PVR between the PVRP group and PVP group before operation (P ＜ 0.05).In the two groups,the IPSS,QOL and PVR were lower after operation than that before operation (P ＜ 0.05),while Qmax was higher after operation than that before operation(P ＜ 0.05).There was no significant difference in the IPSS,QOL,Qmax and PVR between the PVRP group and PVP group after operation(P ＜ 0.05).The rate of postoperative complications in the PVRP group and PVP group was 1.4％(1/69) and 1.8％ (1/57),respectively;there was no significant difference in the rate of postoperative complications between the PVRP group and PVP group (x2 =11.968,P ＜ 0.05).Conclusion " Point-line-surface" three steps of straight light of PVRP for treating BPH have simple steps and short operation time.It is a safe and ideal surgical method for BPH.

Lesiones cervicales no cariosas / Non-carious cervical lesions

El objetivo de este trabajo consiste en describir las distintas lesiones cervicales no cariosas, la abrasión, la erosión y la abfracción. Se desarrollarán en detalle su etiología, localización y características clínicas. Se mencionarán los diferentes procedimientos a realizar para su prevención y los materiales a utilizar para su restauración.

This article describes the different types of non-cariouscervical lesions, for example abrasion, erosionand abfraction. We will discuss their etiology, location and clinical features in detail. We will describe the procedures to prevent them, aswell as the materials used for their restoration.

Padrões de deslocamento de bezerras de corte recebendo suplemento em pastagem de azevém / Displacement patterns of beef heifers receiving supplement in Italian ryegrass pasture

O objetivo deste trabalho foi avaliar o tempo de permanência, o número de bocados nas estações e o deslocamento entre estações alimentares por bezerras de corte em pastagem de azevém (Lolium multiflorum Lam.) e recebendo farelo de arroz integral como suplemento em três níveis (0,0; 0,5 e 1,0% PC). O método de pastejo foi rotacionado, com número variável de animais. O período de descanso foi estabelecido pela soma térmica (ST) de 187,5ºC, equivalente à ST necessária para a emissão de 1,5 folhas de azevém. O delineamento experimental foi inteiramente ao acaso, com medidas repetidas no tempo, três níveis de suplemento e seis ciclos de pastejo. O tempo de permanência em cada estação alimentar (9,4s) foi semelhante para bezerras exclusivamente a pasto e as que receberam 1,0% PC de suplemento. As bezerras que receberam 0,5% PC de suplemento permanecem 1,1s a mais na estação alimentar quando comparadas com as bezerras nos demais níveis. O deslocamento entre estações alimentares (1,7 passos) e o número de bocados em cada estação alimentar (sete bocados) foram semelhantes independentemente do nível de farelo de arroz fornecido. As bezerras, ao receberem 0,5% PC de farelo de arroz, são mais dependentes da presença de lâminas foliares no estrato pastejável do dossel.(AU)

The aim of this study was to evaluate the length of stay and number of bites in the feeding stations and displacement between feeding stations for beef heifers on ryegrass pasture (Lolium multiflorum Lam.) and receiving rice bran as a supplement in three levels (0.0; 0.5 and 1.0% BW). The grazing method was rotational with variable number of animals. The interval between grazing was set by the thermal sum (TS) of 187.5ºC equivalent to TS necessary for externalization of 1.5 leaf lamina of ryegrass. The experimental design was completely randomized with repeated measures on time, three levels of supplement and six grazing periods. The stay time at each feeding station (9.4 sec.) was similar for heifers exclusively on pasture and receiving 1.0% supplement BW. Heifers that received 0.5% supplement BW remained 1.1 sec. longer at the feeding station than heifers on other supplement levels. Displacement between feeding stations (1.7 steps) and the number of bites in each feeding station (7 bites) were similar regardless of the supplied rice bran level. Heifers receiving 0.5% rice bran BW are more dependent on the presence of leaf blades in grazeable stratum of canopy.(AU)