Adolescencia y bienestar digital: herramientas para los profesionales de la salud / Adolescence and Digital Well-being: Tools for Healthcare Professionals

La adolescencia constituye una etapa atravesada por cambios físicos, emocionales y sociales significativos, que incluyen la adquisición de múltiples habilidades. Aumentan los riesgos de sufrir alteraciones mentales, consumo de sustancias, embarazo no deseado, trastornos alimentarios, y se evidencian los efectos negativos del uso inapropiado de las redes sociales. El bienestar digital implica el uso saludable de la tecnología, la protección de la privacidad y la seguridad en línea. Los adolescentes utilizan las redes con la finalidad de identificarse, relacionarse, entretenerse y buscar información. La exposición no regulada conlleva riesgos: acceso a contenido inapropiado, ciberacoso, consumo problemático y fraudes. Desde el ámbito pediátrico, se debe acompañar a los adolescentes para que optimicen el uso de la tecnología y, para ello, es fundamental implementar estrategias multisectoriales para minimizar los riesgos y promover el bienestar de los adolescentes en línea, así como garantizar la alfabetización digital y el acceso equitativo a recursos tecnológicos de calidad y telesalud.

Adolescence is a period characterized by significant physical, emotional, and social changes, including the acquisition of multiple skills. It is also a time when the risks of mental disorders, substance use, unwanted pregnancy, eating disorders, and negative effects of inappropriate social media use manifest greatly. Digital well-being implies the healthy use of technology, the protection of privacy and security online. Adolescents use social media to identify themselves, interact with others, entertain themselves, and seek information. However, risks are present, including access to inappropriate content, cyberbullying, problematic consumption, and fraud. The pediatric field must support adolescents in optimizing their online use. Implementing multisectoral strategies can minimize risks, promote digital literacy, and ensure equitable access to quality technological resources and telehealth, thereby promoting adolescent online well-being.

Salud y discapacidad en niñas y niños argentinos con cardiopatías congénitas complejas operadas. Resultados a los dos años de vida / Health and disability in Argentine children with complex congenital heart disease undergoing surgery. Outcomes at 2 years of life

Introducción. Las cardiopatías congénitas complejas son las malformaciones más frecuentes con una importante carga de morbimortalidad. Se busca conocer el estado de salud y discapacidad de niños operados en un hospital de tercer nivel. Población y métodos. Fueron evaluados en las áreas de crecimiento, neurodesarrollo y discapacidad 84 pacientes entre 21 y 39 meses de edad operados con circulación extracorpórea durante el primer año de vida. Resultados. La mayoría de los niños crece por debajo del percentil 50 en los tres parámetros, con mayor compromiso en aquellos con síndrome genético asociado. La frecuencia de discapacidad fue del 55 %. En el grupo con CC aislada, la gravedad de la cardiopatía y el examen neurológico patológico al alta se asociaron con discapacidad (p = 0,047 y p = 0,03). Contar solo con cobertura de salud pública se asocia a un menor acceso a intervenciones oportunas (p = 0,02). Conclusiones. Cerca de la mitad de los pacientes evoluciona con discapacidad moderada-grave. Es competencia del equipo de salud conocer las morbilidades más allá del aspecto cardiovascular y los factores de riesgo. Las barreras en el acceso a las intervenciones adecuadas advierten a los profesionales sobre la relevancia de buscar estrategias para vencerlas y lograr el máximo potencial de desarrollo de los pacientes.

Introduction. Complex congenital heart defects are the most frequent malformations and entail a significant burden of disease. The objective of this study was to determine the health status and disability of children who underwent surgery at a tertiary care hospital. Population and methods. A total of 84 patients aged 21 to 39 months who had a surgery with extracorporeal circulation during their first year of life were assessed in terms of growth, neurodevelopment, and disability. Results. In most children, growth was below the 50th percentile in all 3 parameters, and greater involvement was observed in those with an associated genetic disorder. The frequency of disability was 55%. In the group with isolated congenital heart disease, the severity of disease and a pathological neurological examination at discharge were associated with disability (p = 0.047 and p = 0.03). Having only public health coverage was associated with less access to timely interventions (p = 0.02). Conclusions. Nearly half of the patients develop moderate-severe disability. Being aware of morbidities beyond the cardiovascular aspect and risk factors is part of the health care team's scope. Barriers in access to appropriate interventions caution health care providers of the relevance of seeking strategies to overcome them and achieve the maximum development potential of patients.

Calidad de vida relacionada con la salud en niños y niñas con síndrome de Down / Health-related quality of life in children with Down syndrome

Introducción. Los pacientes con síndrome de Down (SD) presentan características que pueden afectar su calidad de vida. El objetivo de este trabajo fue evaluar la calidad de vida relacionada con la salud (CVRS) en pacientes con síndrome de Down. Población y métodos. Se realizó un estudio de corte transversal para evaluar CVRS con el cuestionario PedsQL 4.0 a pacientes de 2 a 4 años con síndrome de Down y a pacientes sanos en 2020-2021 en un hospital universitario. Resultados. Se incluyeron 51 pacientes en cada grupo. El puntaje de CVRS en infantes con SD fue 82,1 vs. 88 (p = 0,003) comparado con población sin SD. La salud psicosocial fue la más afectada (p = 0,007), especialmente, en el funcionamiento social y el escolar (p = 0,0001). Conclusión. Se observó que los niños y niñas con SD de 2 a 4 años tuvieron menor CVRS. La escala de la salud psicosocial fue más afectada, especialmente, el funcionamiento social y el escolar.

Introduction. The characteristics of patients with Down syndrome (DS) may affect their quality of life. The objective of this study was to assess the health-related quality of life (HRQoL) in patients with DS. Population and methods. This was a cross-sectional study to assess the HRQoL with the PedsQL 4.0 questionnaire administered to patients with DS and healthy patients aged 2 to 4 years in 2020­2021 at a teaching hospital. Results. Each study group included 51 patients. The HRQoL score in children with DS was 82.1 compared to 88 (p = 0.003) in the population without DS. Psychosocial health was impacted the most (p = 0.007), especially in terms of social and school functioning (p = 0.0001). Conclusion. Children with DS aged 2 to 4 years were observed to have a lower HRQoL. The psychosocial health scale was affected the most, especially in terms of social and school functioning.

Lineamientos técnicos para la actuación del Comité técnico evaluador de casos de asistencia en salud de embarazadas, niñas, niños y adolescentes en situación de peligro inminente de la vida o condiciones graves de salud / Technical guidelines for the action of the Technical Committee for the Evaluation of Health Care Cases of Pregnant Women, Children and Adolescents in Situation of Imminent Danger of Life or Serious Health Conditions

El presente documento es una herramienta por la cual se busca regular el funcionamiento interno del Comité técnico evaluador de casos de asistencia en salud de embarazadas, niñas, niños y adolescentes en situación de peligro inminente de la vida o condiciones graves de salud, en adelante el Comité técnico, designado para conocer de aquellos casos en los que habiendo ingresado la mujer embarazada, la niña, el niño o adolescente en el Sistema Nacional Integrado de Salud, en adelante SNIS, y el caso es de tal gravedad, que se debe ponderar la procedencia de atención en salud más allá de las capacidades institucionales y definir así el plan de atención pertinente, sustentado en evidencia científica, así como las condiciones de viabilidad relacionadas. De igual forma, busca definir la idoneidad de la propuesta médica para tales casos extremos, ya sean estos hospitalarios, de estudios de gabinete y laboratorio, evaluaciones médicas, intervenciones o procedimientos, entre otros

This document is a tool for regulating the internal functioning of the Technical Committee for the Evaluation of Health Care Cases of Pregnant Women, Children and Adolescents in Situations of Imminent Danger of Life or Serious Health Conditions, hereinafter referred to as the Technical Committee, which is designated to deal with cases in which a pregnant woman, child or adolescent, has entered the National Integrated Health System, hereinafter referred to as SNIS, and the case is of such gravity, that the provenance of health care should be weighed beyond institutional capacities and thus define the relevant care plan, supported by scientific evidence, as well as related viability conditions. Similarly, it seeks to define suitability

Accidente laboral y estresores de la organización del trabajo en el personal de salud: una mirada desde la seguridad y la salud en el trabajo: revisión narrativa / Workplace accident and work organization stressors in health personnel: a narrative review from safety and health at work / Acidentes de trabalho e estressores da organização do trabalho em profissionais de saúde: uma perspectiva de segurança e saúde no trabalho: revisão narrativa

Los accidentes laborales en el personal de salud se presentan como consecuencia de los estresores de la organización del trabajo. Estos estresores afectan la satisfacción laboral y la productividad. El objetivo de la presente revisión es reportar la evidencia científica sobre la relación entre el accidente laboral y los estresores de la organización del trabajo en el personal de salud, desde la perspectiva de la seguridad y salud en el trabajo. En la recolección de información se identificaron inicialmente 190 artículos, de los cuales se excluyeron siete por duplicación; se revisaron 183 títulos y resúmenes, descartando 139 de ellos. Luego, se revisaron 44 estudios completos, descartando 17. Por último, fueron incluidos en la revisión 27 estudios que cumplieron con los criterios de elegibilidad. En el sector salud los accidentes laborales se encuentran ligados a factores como la sobre­carga, largas jornadas de trabajo y el turno nocturno, que afectan de forma negativa la salud y el bienestar de los trabajadores. Los estresores de la organización del trabajo, específicamente la sobrecarga laboral, la falta o insuficiencia de recursos humanos y las jornadas extendidas de trabajo, son la principal causa de accidentes de origen laboral en el personal de salud, por ello, es necesario implementar estrategias de prevención y control tendientes al mejoramiento de las condiciones de salud y bienestar de los trabajadores.

Workplace accidents in health personnel occur as a consequence of work organization stressors. These stressors affect job satisfaction and productivity. The objective of this review is to report the scientific evidence on the relationship between workplace accidents and work organization stressors in health personnel, from the perspective of safety and health at work. In the collection of information, 190 articles were initially identified, of which seven were excluded due to duplication; 183 titles and abstracts were reviewed, discarding 139 of them. Then, 44 complete studies were reviewed, discarding 17. Finally, 27 studies that met the eligibility criteria were included in the review. In the health sector, workplace accidents are linked to factors such as overload, long work hours and night shifts, which negatively affect the health and well-being of health workers. The stressors of work organization, specifically work overload, the lack or insufficiency of human resources and extended working hours, are the main cause of work-related accidents in health personnel. Therefore, it is necessary to implement prevention and control management strategies aimed at improving the health and well-being of health workers.

Os acidentes de trabalho em profissionais de saúde ocorrem como consequência dos estressores da organização do trabalho. Esses estressores afetam a satisfação no trabal-ho e a produtividade. O objetivo desta revisão é relatar as evidências científicas sobre a relação entre acidentes de trabalho e estressores da organização do trabalho em profissionais de saúde, sob a perspectiva da saúde e segurança ocupacional. Na coleta de informações, inicialmente foram identificados 190 artigos, dos quais sete foram excluídos por duplicidade; Foram revisados 183 títulos e resumos, descartando-se 139 deles. Em seguida, 44 estudos completos foram revisados, descartando 17. Finalmente, 27 estudos que atenderam aos critérios de elegibilidade foram incluídos na revisão. No setor saúde, os acidentes de trabalho estão ligados a fatores como sobrecarga, longas jornadas de trabalho e plantões noturnos, que afetam negativamente a saúde e o bem-estar dos trabalhadores. Os estressores da organização do trabalho, especificamente a sobrecarga de trabalho, a falta ou insuficiência de recursos humanos e as jornadas de trabalho extensas, são a principal causa de acidentes de trabalho em profissionais de saúde, portanto, é necessário implementar estratégias de prevenção e controle que visem melhorar a saúde e o bem-estar dos trabalhadores.

Estigma de cortesia e condições de saúde: revisão sistemática de literatura / Estigma de cortesía y condiciones de salud: revisión sistemática de la literatura / Courtesy stigma and health conditions: systematic literature review

RESUMO A literatura científica aponta consistentemente que grupos historicamente alvos de estigma social experimentam efeitos deletérios, em diversas esferas da vida. A despeito da sua gravidade e pervasividade, ainda existem lacunas na investigação do tema, tais como aquela voltada para o Estigma de Cortesia, que é vivenciado por pessoas que possuem vínculos afetivos ou profissionais com o indivíduo estigmatizado. O presente artigo teve como objetivo apresentar o estado da arte sobre estigma de cortesia, por meio de uma revisão sistemática de estudos empíricos originais publicados em periódicos revisados por pares e indexados nas principais bases relacionadas ao campo de investigação (PsycNET (APA), Pubmed, Bvs Brasil, Periódicos CAPES, SciELO e Pepsic). Como palavras-chave, para a busca dos resumos, utilizou-se: estigma de cortesia, estigma de afiliação e estigma de associação. Ao todo, 94 textos completos atenderam aos critérios de inclusão e exclusão. Os estudos apontaram que o estigma de cortesia tem sido investigado predominantemente entre familiares de pessoas que possuem algum tipo de problema relacionado com sua saúde mental, além de pais de crianças com algum tipo de deficiência.

RESUMEN La literatura científica señala constantemente que los grupos históricamente afectados por el estigma social experimentan efectos nocivos en diferentes ámbitos de la vida. A pesar de su gravedad y omnipresencia, todavía hay vacíos en la investigación del tema, como el centrado en el estigma de cortesía, que experimentan las personas que tienen vínculos afectivos o profesionales con el individuo estigmatizado. Este artículo tuvo como objetivo presentar el estado del arte sobre el estigma de cortesía a través de una revisión sistemática de estudios empíricos originales publicados en revistas revisadas por pares e indexados en las principales bases de datos relacionadas con el campo de investigación (PsycNET (APA), Pubmed, Bvs Brasil, CAPES, SciELO y revistas Pepsic). Como palabras clave para la búsqueda de resúmenes, utilizamos: estigma de cortesía, estigma de afiliación y estigma de asociación. En total, 94 textos completos cumplieron con los criterios de inclusión y exclusión. Los estudios han demostrado que el estigma de cortesía se ha investigado principalmente entre miembros de la familia de personas que tienen algún tipo de problema relacionado con su salud mental, además de los padres de niños con algún tipo de discapacidad.

ABSTRACT The scientific literature consistently points out that groups historically targeted by social stigma experience deleterious effects in different spheres of life. Despite its gravity and pervasiveness, there are still gaps in the investigation of the topic, such as that focused on the Courtesy Stigma, which is experienced by people who have affective or professional ties with the stigmatized individual. This article aimed to present the state of the art on Courtesy Stigma through a systematic review of original empirical studies published in peer-reviewed journals and indexed in the main databases related to the research field (PsycNET (APA), Pubmed, Bvs Brasil, CAPES, SciELO, and Pepsic journals). As keywords for the search for abstracts, we used: courtesy stigma, affiliate stigma and associative stigma. Altogether, 94 complete texts met the inclusion and exclusion criteria. Studies have shown that the Courtesy Stigma has been investigated predominantly among family members of people who have some type of problem related to their mental health, in addition to parents of children with some type of disability.

Relationship between anticholinergic load and self-perceived health in a population aged 44 years or older / Relação entre carga anticolinérgica e autopercepção de saúde em população com mais de 44 anos

OBJECTIVE: To investigate the relationship between anticholinergic load (ACL) and self-perceived general health in adults in a medium-sized municipality in southern Brazil. METHODS: This cross-sectional study was based on 2015 data from a medium-sized municipality in southern Brazil. All respondents aged 44 years or older who reported using drugs in the 2 weeks before the interview were included (n = 662). The Anticholinergic Drug Scale was used to measure the ACL. Self-perceived health was categorized as positive self-perception (PSP) or negative self-perception (NSP). Crude and adjusted Poisson regression analyses were conducted to investigate the association between ACL and self-perceived health. RESULTS: NSP was found in 50.91% of 662 respondents. Significant ACL, older age, lower economic status, lower education, polypharmacy, and depression correlated with a higher frequency of NSP. Individuals with significant ACL had a prevalence of NSP of 1.27 (95% confidence interval: 1.02 ­ 1.58), and each additional ACL level represented a 6.10% higher chance of worse self-perceived health, regardless of confounding factors. CONCLUSIONS: An association was found between significant ACL and NSP, with an effect dependent on ACL level

OBJETIVO: Investigar a relação entre carga anticolinérgica (CAC) e autopercepção de saúde em adultos de um município de médio porte do sul do Brasil. METODOLOGIA: Trata-se de um estudo transversal com dados de 2015, realizado em um município de médio porte do sul do Brasil. Todos os entrevistados com 44 anos ou mais que relataram uso de drogas nas duas semanas anteriores à entrevista foram incluídos (n = 662). A Anticholinergic Drug Scale (ADS) foi utilizada para medir a CAC. A autopercepção da saúde foi categorizada em autopercepção positiva (APP) ou autopercepção negativa (APN). Análises de regressão de Poisson bruta e ajustada foram realizadas para investigar a associação entre CAC e autopercepção de saúde. RESULTADOS: Entre os 662 participantes, a CAC foi encontrada em 50,91% dos respondentes. CAC significativa, idade avançada, situação econômica mais baixa, menor escolaridade, polifarmácia e depressão foram correlacionados com maior frequência de APN. Indivíduos com CAC significativo apresentaram prevalência de APN de 1,27 (intervalo de confiança de 95%: 1,02 ­ 1,58), e cada nível adicional de CAC representou uma chance 6,10% maior de pior autopercepção de saúde, independentemente de fatores de confusão. CONCLUSÕES: Encontrou-se associação entre ACL significativo e APN, com efeito dependente do valor do CAC

Depression, health status and life satisfaction in voice hearers / Depressão, estado de saúde e satisfação de vida em ouvidores de vozes

Objective: The objective of this study was to review the occurrence of depressive episodes and their relationship with the health status and life satisfaction in patients who hear voices. Methods: This is a cross-sectional study carried out between February and March 2019. For data collection, a questionnaire was used on socioeconomic and health conditions as well as the Beck's Depression Inventory and Life Satisfaction Scale. The database was elaborated in the Epidata program and the analysis in Stata 11. Results: A total of 112 patients participated in the survey; 82 answered all the questions in Beck's inventory. Patients who reported that they considered their health as very bad or bad and those who had high blood pressure experienced depression. Poor life satisfaction was also associated with the presence of depressive symptoms. Conclusion: It is therefore evident the importance of considering such aspects in the health care of voice-hearers.

Objetivo: O objetivo deste estudo foi analisar a ocorrência de episódios depressivos e sua relação com estado de saúde e satisfação de vida em usuários ouvidores de vozes. Método: Trata-se de um estudo transversal realizado entre fevereiro e março de 2019. Para coleta de dados utilizou-se um questionário com questões socioeconômicas, condições de saúde, Inventário de Depressão de Beck e Escala de Satisfação com a Vida. O banco de dados foi elaborado no programa Epidata e a análise no Stata 11. Resultados: Participaram da pesquisa 112 usuários, sendo que 82 responderam todas as questões do inventário de Beck. Os usuários que referiram considerar sua saúde como péssima/ruim e aqueles que possuíam hipertensão arterial apresentaram depressão. Além disso, a baixa satisfação com a vida também foi associada com a presença de sintomas depressivos. Conclusão: Diante disso, evidencia-se a importância de se considerar esses aspectos no cuidado à saúde de ouvidores de vozes.

Hospitalizations in Brazil according to National Health Survey estimates, 2013 and 2019 / Hospitalizações no Brasil pelas estimativas da Pesquisa Nacional de Saúde, 2013 e 2019

ABSTRACT OBJECTIVE To compare the profile and prevalence of hospitalizations in Brazil based on estimates from the National Health Survey (PNS), 2013 and 2019. METHODS A cross-sectional study that used data from the 2013 PNS and the 2019 PNS. The outcome was having been hospitalized for 24 hours or more in the last 12 months. We calculated the proportion of the population in different categories of age group, presence or absence of chronic diseases, and perception of health status. We estimated the total number of hospitalizations and the proportion corresponding to each category of age group, chronic disease, and perceived health status. We calculated the prevalence of hospitalization according to geographic, socioeconomic, and health conditions. We compared the estimates of two editions of the PNS using Student's t-test for independent samples. We considered significant differences when the p-value was less than 0.01. And finally, we compared hospitalization estimates with administrative data to assess data consistency. RESULTS We observed that the proportion of chronically ill people in the population increased from 15.04% to 31.48%. This group was responsible for 36.76% of the total number of hospitalizations in 2013 and 57.61% in 2019. The prevalence of hospitalizations increased significantly between the two surveys and the increases were higher in the Southeast region and among people who have private health insurance. A discrepancy was found between administrative data and survey estimates. Obstetric hospitalizations and health insurance hospitalizations were underestimated. CONCLUSION There was an increase in overall hospitalization rates in the period between the PNS 2013 and PNS 2019, especially among people with better access to health services. The hospitalization profile also changed—in the 2013 PNS, hospitalizations of people without chronic diseases predominated. This was reversed in PNS 2019.

RESUMO OBJETIVO Comparar o perfil e a prevalência das hospitalizações no Brasil com base nas estimativas da Pesquisa Nacional de Saúde (PNS), 2013 e 2019. MÉTODOS Estudo transversal seriado que utilizou os dados das PNS 2013 e PNS 2019. O desfecho foi ter ficado internado por 24 horas ou mais nos últimos 12 meses. Calculamos a proporção da população nas diversas categorias de faixa etária, de presença ou ausência de doenças crônicas e de percepção do estado de saúde. Estimamos o número total de hospitalizações e a proporção correspondente a cada categoria de faixa etária, de doença crônica e de percepção do estado de saúde. Calculamos a prevalência de internação segundo fatores geográficos, socioeconômicos e condições de saúde. Comparamos as estimativas das duas edições da PNS utilizando o teste t de Student para amostras independentes. Consideramos as diferenças significativas quando o valor de p foi menor que 0,01. E finalmente comparamos as estimativas de hospitalização com os dados administrativos para avaliar a consistência dos dados. RESULTADOS Observamos que a proporção de doentes crônicos na população passou de 15,04% para 31,48%. Este grupo foi responsável por 36,76% do total de internações em 2013 e de 57,61% em 2019. A prevalência de hospitalizações aumentou significativamente entre os dois inquéritos e os incrementos foram maiores na região Sudeste e entre pessoas que possuem plano de saúde privado. Foi encontrada uma discrepância entre os dados administrativos e as estimativas dos inquéritos. As internações obstétricas e as internações por plano de saúde foram subestimadas. CONCLUSÃO Houve um aumento nas taxas globais de hospitalização no período compreendido entre as PNS 2013 e 2019, especialmente entre as pessoas com melhor acesso aos serviços de saúde. O perfil de hospitalização também mudou - na PNS 2013 predominaram internações de pessoas sem doenças crônicas. Isto se inverteu na PNS 2019.

Dificuldades financeiras, aspectos alimentares e de saúde em estudantes universitários, durante a pandemia de Covid-19 / Financial difficulties, dietary and health aspects in university students during the Covid-19 pandemic

Introdução: As dificuldades financeiras advindas da pandemia, em virtude de mudanças econômicas do país, além de refletirem no estado de segurança alimentar e nutricional e no estado de saúde dos indivíduos, acarretaram o aumento da evasão dos cursos superiores. Objetivo: Verificar a associação entre as dificuldades financeiras, durante a pandemia de Covid-19, com os aspectos alimentares e de saúde dos graduandos da Universidade Federal de Juiz de Fora (UFJF). Método: Estudo transversal com graduandos da UFJF. Os dados foram coletados entre setembro de 2020 e março de 2021, através de questionário on-line. Utilizou-se Teste Qui-quadrado (p<0,05) para avaliar os fatores associados às dificuldades financeiras durante a pandemia. Verificou-se a razão de chances (Odds Ratio - OR) das associações encontradas. Resultados: Avaliaram-se 584 graduandos, dentre os quais se constatou que 31,7% passaram por dificuldades financeiras durante a pandemia. Notou-se que a presença de dificuldades financeiras no período pandêmico se associou positivamente à presença de Insegurança Alimentar e Nutricional (INSAN), à autopercepção negativa de saúde, à má qualidade do sono e às alterações de depressão, ansiedade e estresse. Além disso, os indivíduos caracterizados com dificuldades financeiras tinham maiores chances de apresentarem INSAN, percepção negativa de saúde, má qualidade do sono, bem como alterações nos níveis de depressão, ansiedade e estresse, quando comparados à sua contraparte. Conclusão: Conclui-se que as dificuldades financeiras durante o período pandêmico são associadas à presença de INSAN e aspectos de saúde alterados. Assim, ressalta-se a necessidade de criação de estratégias que visem à assistência financeira e psicológica dos graduandos.

Introduction: The financial difficulties caused by the pandemic due to economic changes in the country, in addition to affecting food and nutrition security and the state of health of individuals, resulted in greater evasion from higher education courses. Objective: To check the association between financial difficulties during the COVID-19 pandemic with the dietary and health aspects of undergraduate students from Universidade Federal de Juiz de Fora (Federal University of Juiz de Fora ­ UFJF). Methods: Transversal study with UFJF undergraduate students. The data were collected between September 2020 and March 2021, via an online survey. The chi-square test (p<0.05) was used to evaluate the factors associated with financial difficulties during the pandemic. We also checked the odds ratio (OR) for the associations found. Results: We assessed 584 undergraduate students, 31.7% of which were found to have gone through financial difficulties during the pandemic. We observed that the presence of financial difficulties in that period was positively associated with Food and Nutrition Insecurity (INSAN, Portuguese acronym), negative self-perception of health, bad sleep quality, and changes in depression, anxiety, and stress levels. Moreover, individuals characterized as having financial difficulties had a higher chance of having INSAN, negative perception of health, bad sleep quality, as well as changes in the levels of depression, anxiety, and stress, when compared to their counterparts. Conclusion: We concluded that financial difficulties during the pandemic period are associated with INSAN and affected health aspects. Therefore, we highlight that there is a need for the development of strategies which aim to provide financial and psychological assistance to undergraduate students.

A multi-center analysis of thyroid-stimulating hormone level in apparently healthy elderly population in China / 南方医科大学学报

OBJECTIVE@#To investigate serum thyroid stimulating hormone (TSH) level and its changes with age in apparently healthy Chinese elderly population and analyze the differences between TSH levels detected using Roche and Snibe electrochemiluminescence immunoassay analyzers.@*METHODS@#General clinical data and frozen fasting serum samples were collected from 5451 apparently healthy Chinese elderly individuals (> 60 years) from 10 centers in different geographic regions in China. Thyroid function indexes including TSH level were detected using Roche and Snibe electrochemiluminescence immunoassay analyzer, and the median (2.5% and 97.5% quantiles) TSH level was calculated. The variations of TSH level among the participants with geographic regions, gender, and age (with an interval of 5 years) were analyzed to determine the influence of these factors on TSH level.@*RESULTS@#The reference ranges of serum TSH level established using Roche and Snibe electrochemiluminescence immunoassay analyzers were 0.42-9.47 mU/L and 0.36-7.98 mU/L, respectively, showing significant differences between the two methods (P < 0.001). The TSH levels measured at two centers in Western China were significantly higher than those at the other centers (P < 0.05). In elderly male population, serum TSH level tended to increase with age, which was not observed in elderly female population. At the age of 60-75 years, women generally had higher serum TSH level than men, but this difference was not observed in the population beyond 75 years.@*CONCLUSION@#In elderly population, serum TSH level can vary with geographic region, gender, and age, but there was no need for establishing specific reference ranges for these factors. The differences between different detection methods should be evaluated when interpreting the detection results of TSH level.

The past, present and future of sleep medicine in China / 北京大学学报(医学版)

Sleep is a highly conserved phenomenon in endotherms, and has a universal physiological function across all species. In mammals, sleep can be divided into two stages: rapid eye movement (REM) sleep and non-REM (NREM) sleep, which alternate in a cyclic manner. Humans spend about one-third of their lives asleep. Sufficient sleep is necessary for humans to sustain everyday functioning. Sleep plays an important role in regulating energy metabolism, immune defense, endocrine function, and the consolidation of memory process. With the development of social economy and the change of life style, sleep duration of the residents has gradually decreased and the incidence of sleep disturbances has increased. Sleep disturbances can lead to severe mental disorders, such as depression, anxiety disorders, dementia, and other mental diseases, and may increase the risk of physical diseases, such as chronic inflammation, heart disease, diabetes, hypertension, atherosclerosis and others. Maintaining good sleep is of great significance for developing social productive forces, promoting sustainable development of economic society, and is a necessary condition for carrying out the "Healthy China Strategy". The sleep research in China started in 1950s. After decades of development, researchers have made great progress in the molecular mechanisms of sleep and wakefulness, the pathogenesis of sleep disorders and the development of new therapies. With the advancement of science and technology and the public's attention to sleep, the level of clinical diagnosis and therapy of sleep disorders in China is gradually brought in line with international standards. The publication of diagnosis and treatment guidelines in the field of sleep medicine will promote the standardization of the construction. In the future, it is still necessary to promote the development of sleep medicine in the following aspects: Strengthening the professional training and discipline construction, improving the cooperation of sleep research, promoting the intelligent diagnosis and treatment of sleep disorders, and developing the new intervention strategies. Therefore, this review will comprehensively summarize the origin, current situation, and future expectations of sleep medicine in China, including discipline construction of sleep medicine, the number of sleep project grants, research findings, the status and progress of diagnosis and treatment of sleep disorders, and the development direction of sleep medicine.

Investigation on health status of workers exposed to glyphosate / 中华劳动卫生职业病杂志

Objective: To analyze the concentrations of glyphosate and its metabolites in occupational exposed workers and their possible effects on human health, so as to provide a reference for improving the safe use of glyphosate and toxicity research. Methods: From April to December 2020, 247 workers directly exposed to glyphosate in 5 enterprises were selected as the contact group, and 237 workers who were not exposed to glyphosate and other pesticides in the same enterprise were selected as the control group. Questionnaire survey and occupational health examination were conducted on objects, and the concentrations of glyphosate and its metabolites in the air of workplaces and biological samples were detected. The correlation between the concentrations and the difference of health examination between the two groups were analyzed. Results: The urine glyphosate concentration (0.022-47.668 mg/L), the rate of exceeding the standard (60.32%, 149/247) and the urine aminomethyl phosphonic acid concentration (<0.010-1.624 mg/L) in the contact group were higher than those in the control group [urine glyphosate concentration (<0.020-4.482 mg/L), the rate of exceeding the standard (2.53%, 6/237) and the urine aminomethyl phosphonic acid concentration (<0.010-0.524 mg/L) ], respectively (P<0.001). The exceeding standard rate of glyphosate concentration in the workplace was 33.67% (33/98). The concentration of glyphosate in the workplace was positively correlated with the concentrations of glyphosate and aminomethylphosphonic acid in urine (r(s)=0.804, 0.238, P<0.001), and the concentration of glyphosate in urine was positively correlated with the concentration of aminomethylphosphonic acid in urine (r(s)=0.549, P<0.001). The alanine aminotransferase (ALT), white cell ratio, creatinine, uric acid, the abnormal rates of ALT and total protein (TP) in the contact group were higher than those in the control group, and TP was lower than that in the control group, the differences were statistically different (P<0.05). The abnormal rates of overall liver function, overall renal function, blood routine test, urine routine test, electrocardiogram, liver B ultrasound and blood lipid in the contact group were significantly higher than those in the control group (P<0.05) . Conclusion: The concentration of glyphosate in the workplace is related to the concentrations of glyphosate and aminomethyl phosphonic acid in the urine of workers, and exposure to glyphosate may have some harmful effects on human health.

Cardiovascular health status of Chinese adults based on "Life's Essential 8" score / 中华流行病学杂志

Objective: To assess the cardiovascular health status of adults in China by using the "Life's Essential 8" score, and provide reference for the development and improvement of cardiovascular disease prevention and control policies and measures. Methods: Chronic Disease and Nutrition Surveillance was conducted in 298 counties/districts in 2015 in 31 provinces (autonomous regions, municipalities) across China, multi-stage stratified cluster random sampling was used to select 45 households in each village or neighborhood, and 20 households were further selected to conduct dietary surveys. In this study, a total of 70 093 adults aged ≥20 years who completed the dietary survey and had complete information were included, their cardiovascular health status were assessed by using the "Life's Essential 8" score, a cardiovascular health scoring standard released by the American Heart Association in 2022. All results were adjusted using complex design-based sampling weights to achieve a better estimate of the population. Results: In 2015, the overall cardiovascular health score of Chinese adults aged ≥20 years was 73.3±12.6, the score was significantly higher in women (77.9±11.6) than in men (68.7±11.8), and higher in urban area (74.5±12.8) than in rural area (71.9±12.2), the differences were significant (P<0.001). It was estimated that about 0.25% (95%CI: 0.16%-0.33%) of adults in China had cardiovascular health score of 100, and 33.0% (95%CI: 31.6%-34.3%), 63.2% (95%CI: 62.1%-64.3%), and 3.9% (95%CI: 3.5%-4.2%) of adults had high, moderate and low cardiovascular health scores, respectively. The proportion of those with high cardiovascular health scores was relatively low in men, those with low education level, those with low income, those living in rural areas, and those living in southwest China (P<0.001). Of the eight factors, diet had the lowest mean score (46.0, 95%CI: 44.7-47.3), followed by blood pressure (59.4, 95%CI: 58.2-60.6) and tobacco exposure (61.4, 95%CI: 60.6-62.2). Conclusions: The cardiovascular health status of two-thirds of adult population in China needs to be improved. Diet, tobacco exposure, and blood pressure are the factors affecting the cardiovascular health of Chinese population, to which close attention needs to be paid, and men, rural residents, and those with lower socioeconomic status are key groups in cardiovascular health promotion.

Application of entropy weight TOPSIS comprehensive method in the evaluation of students' physical health level / 中华预防医学杂志

Objective: To comprehensively evaluate the physical health level of students of different school-age segments in four regions of Anhui province using the entropy weight approximation ideal solution ranking method (TOPSIS), and to provide a scientific method and basis for conducting school health work evaluation. Methods: Using the physical fitness survey data of four regions in Anhui province, the entropy weight method was used to draw the weights of various indicators for different school-age segments of men and women. Then, the TOPSIS method was used to evaluate the school-age segments of men and women in the four regions. Finally, the physical health level of students in four regions was classified according to the results of entropy weight TOPSIS and the rank sum ratio method. Results: A total of 10 127 students were included in this study, with an average age of (11.85±3.82) years, including 5 050 males (49.8%) and 5 072 urban students (50.1%). The results of the entropy weight method showed that the weight of body mass index of boys was similar to that of girls in each school-age segment. According to the TOPSIS and rank sum ratio analysis, the physical health level of students in the four regions of Anhui province was different. The physical health score of Suzhou was 0.617 4 points, which was classified as the best grade. The scores of Hefei and Wuhu were 0.556 3 and 0.411 2, which were classified as middle. Jiju City scored 0.381 9 points, which was classified as poor. Conclusion: TOPSIS combined with rank sum ratio can reflect the level of students' physical health, which can be applied to the evaluation of students' physical health and provide a basis for monitoring students' physical health .

Progress in researches on cardiovascular health behaviors and factors in perinatal women / 中华预防医学杂志

The cardiovascular health index (CVH) is a composite index consisting of 7 CVH metrics (CVHM) to evaluate the cardiovascular health status in the population. CVH has been proven to be closely related to a variety of health outcomes and widely used in the prevention of many diseases and the evaluation of intervention effectiveness. This review summarizes the recent distribution of CVH and CVHM in pregnant women and the relationship between CVH and CVHM with adverse health outcomes, which aims to explore the application of CVH and CVHM in preventing pregnancy-related diseases and improving the long-term health level of perinatal women and their offspring.

Analysis on health status and influencing factors of 1353 mercury workers in Xinjiang / 中华劳动卫生职业病杂志

Objective: To investigate the health status of workers exposed to occupational mercury, and to provide the theoretical basis for formulating reasonable health monitoring and targeted protection measures. Methods: In November 2021, 1353 mercury-exposed workers who underwent occupational health examination in a hospital in Xinjiang Uygur Autonomous Region from 2018 to 2021 were collected as research subjects. By analyzing their blood pressure, electrocardiogram, blood routine, liver function and urine β2-microglobulin and urinary mercury in different gender, age, length of service, industry and enterprise scale, and the health status. And the influencing factors of urinary mercury were evaluated. Results: Among 1353 workers exposed to mercury, there were 1002 males (74.1%), the average age was (37.2±9.8) years old, and the length of service was 3.1 (2.0, 8.0) years. The abnormal rates of physical examination, blood pressure, electrocardiogram, blood routine, liver function, urinary β2-microglobulin and urinary mercury were 73.9% (1000/1353), 12.3% (166/1353), 30.2% (408/1353), 59.9% (810/1353), 32.5% (440/1353), 15.2% (205/1353) and 2.2% (30/1353), respectively. The abnormal rates of blood pressure, blood routine, liver function, urinary β2-microglobulin and urinary mercury in male workers were higher than those in female workers (P<0.05). The abnormal rates of workers' blood pressure and physical examination results increased with the increase of age and length of service, while the abnormal rate of electrocardiogram results were opposite (P<0.05). There were statistically significant differences in the abnormal rates of blood pressure, blood routine, urinary β2-microglobulin and physical examination results among workers of different enterprises and different industries (P<0.05). Multivariate logistic regression analysis showed that the workers with age ≥30 years old, microminiature enterprises, abnormal physical examination results and urinary β2-microglobulin were the susceptible population with abnormal urinary mercury (P<0.05) . Conclusion: The occupational health status of mercury workers in Xinjiang Uygur Autonomous Region is not optimistic, and the health monitoring of microminiature enterprises and older workers should be improved to effectively protect the physical and mental health of workers.

Residents' sense of acquisition and influencing factors in China's Sanitary City Initiative / 中华流行病学杂志

Objective: To analyze the residents' sense of acquisition (recognition, perceptibility and satisfaction) and influencing factors in China's Sanitary City Initiative. Methods: A cross-sectional survey was conducted from December 2020 to February 2021. The data about the residents' sense of acquisition were collected by using questionnaire from 2 465 residents who were aged ≥18 years and had lived in local communities for at least one year in 31, 14 and 16 cities with national sanitary city title in eastern, central and western China the influencing factors of residents' sense of acquisition in China's Sanitary City Initiative were analyzed by using multivariate multilevel model. Results: The total score of residents' sense of acquisition in China's Sanitary City Initiative was 231.15±32.45. After converting the scores according to the 100-score standardized method, the results showed that the recognition score, perception score and the satisfaction score were 85.02, 59.08 and 61.42, respectively. The results of influencing factors analysis showed that education level, gender, marital status, age, prevalence of physical exercise and self-assessment of health status were correlated with the scores of residents' recognition (β:1.24-2.54,all P<0.05); the concentration of inhalable fine particles , the green coverage of built-up area, the level of GDP per capita and the type of residential community, prevalence of physical exercise and self-assessment of health status were correlated with the score of residents' perception (β:1.76-8.86,all P<0.05); the concentration of inhalable fine particles , the green coverage of built-up area, the level of GDP per capita and the type of residential community, education level, prevalence of physical exercise and self-assessment of health status were correlated with the score of residents' satisfaction (β:1.34-6.26,all P<0.05). Conclusions: The total score of residents' sense of acquisition in China's Sanitary City Initiative was relatively high, indicating that the policy has been widely recognized. The detailed management of policy implementation should be strengthened in the future, and more attention needs to be paid to actual needs of the residents to further improve the residents' sense of acquisition in China's Sanitary City Initiative.

Application of emerging technologies for gut microbiome research

Microbiome is associated with a wide range of diseases. The gut microbiome is also a dynamic reflection of health status, which can be modified, thus representing great potential to exploit the mechanisms that influence human physiology. Recent years have seen a dramatic rise in gut microbiome studies, which has been enabled by the rapidly evolving high-throughput sequencing methods (i.e. 16S rRNA sequencing and shotgun sequencing). As the emerging technologies for microbiome research continue to evolve (i.e. metatranscriptomics, metabolomics, culturomics, synthetic biology), microbiome research has moved beyond phylogenetic descriptions and towards mechanistic analyses. In this review, we highlight different approaches to study the microbiome, in particular, the current limitations and future promise of these techniques. This review aims to provide clinicians with a framework for studying the microbiome, as well as to accelerate the adoption of these techniques in clinical practice.