Human social isolation and stress: a systematic review of different contexts and recommendations for future studies

Abstract Objectives The emergence of the coronavirus disease 2019 (COVID-19) pandemic and subsequent lockdowns and social distancing measures adopted worldwide raised questions about the possible health effects of human social isolation. Methods We conducted a systematic review on PubMed, Scopus, and Embase electronic databases using terms related to human social isolation - defined as the isolation of an individual from regular routines and usual social contact - and psychological stress, searching for simulated or naturalistic isolation environments. We present the main results, as well as the validity and limitations of each model. PROSPERO registry number: CRD42021241880. Results Despite the diversity of contexts reviewed, some outcomes almost ubiquitously relate to psychological stress, i.e., longer periods, expectation of a longer period, confinement, lack of social interaction, and support. Based on the results, and considering that most studies were not designed for the purpose of understanding isolation itself, we propose a group of recommendations for future experimental or naturalistic research on the topic. Conclusion Evidence on the impact of different situations in which individuals are subjected to social isolation can assist in development of directed preventive strategies to support people under similar circumstances. Such strategies might increase the general public's compliance with social distancing as a non-pharmacological intervention for emerging infectious diseases.

Relationship between Smoking and Vocal Self-perception of Trans Women

Objective: To verify the relationship between smoking, age, schooling, and the vocal self-perception of trans women. Methods: Cross-sectional observational quantitative study conducted with 24 trans women over 18 years old, living in their affirmed gender for a minimum of 6 months. Data collection involved selected questions from the translated and authorized Portuguese version of the Trans Woman Voice Questionnaire (TWVQ) and information regarding age, education, occupation, and smoking status. All variables were analyzed descriptively, and the association with smoking was assessed using Pearson's Chi-square, Fisher's Exact, Student's T, and Mann-Whitney tests, with a significance level of 5%. Results: The mean age of trans women was 28.2 +/- 6.5 years (range: 21 - 48). Most participants (41.6%) had completed their high school education and pursued diverse careers. Regarding smoking habits, 58.3% of women were either current smokers or had smoked at least 100 cigarettes in their lifetime. A statistically significant association was found between smoking and age (p = 0.001), with smokers having a lower average age (24.9 years) compared to nonsmokers (32.9 years). However, no statistical significance was observed between smoking, education, and self-perception of vocal femininity. Only 9 (37.5%) trans women perceived their voices as feminine, while 17 (70.7%) desired a more feminine-sounding voice. Limitation: The limited sample size in this study may have constrained the ability to detect significant differences between the analyzed groups using statistical tests. Conclusion: The smoking prevalence was notably high among younger trans women. However, there was no statistically significant difference in vocal self-perception between those who smoked and those who did not. The majority of trans women expressed a desire for their voices to sound more feminine, particularly among smokers.

Objetivo: Verificar la relación entre el tabaquismo, edad, escolaridad y la autopercepción vocal de mujeres trans. Métodos: Estudio observacional transversal cuantitativo realizado con 24 mujeres trans mayores de 18 años, que viven en su género afirmado durante 6 meses. Para la recolección de datos se utilizaron preguntas seleccionadas de la versión portuguesa traducida y autorizada del Trans Woman Voice Questionnaire (TWVQ) y datos sobre edad, educación, ocupación y tabaquismo. Todas las variables se analizaron descriptivamente y la asociación con el tabaquismo se realizó mediante las pruebas Chi-cuadrado de Pearson, Exacta de Fisher, T de Student y Mann Whitney, con un nivel de significación del 5%. Resultados: La edad promedio de las mujeres trans fue de 28,2 +/- 6,5 (rango 21 - 48). La mayoría de las participantes (41,6%) había terminado la escuela secundaria con carreras muy diversas. Respecto al tabaquismo, el 58,3% de las mujeres fuman actualmente o han fumado al menos 100 cigarrillos en su vida. Hubo una asociación estadísticamente significativa entre el tabaquismo y la edad (p = 0,001), en la que la edad promedio entre los fumadores (24,9 años) fue menor que la de los no fumadores (32,9 años). No hubo significación estadística entre el tabaquismo, la educación y la autopercepción vocal. Solo 9 (37,5%) mujeres trans actualmente consideran su voz femenina y 17 (70,7%) dijeron que la voz ideal podría sonar más femenina. Limitación: La pequeña casuística puede haber limitado la identificación de diferencias entre los grupos analizados a través de pruebas estadísticas. Conclusión: El tabaquismo fue alto entre las mujeres trans, especialmente las más jóvenes. La autopercepción vocal no fue estadísticamente diferente entre los grupos de fumadores y no fumadores. La mayoría de las mujeres trans dijeron que sus voces podrían sonar más femeninas, especialmente las fumadoras.

Factors related to the readiness of Brazilian chronic pediatric patients to transition to care in adult clinics

Abstract Objective Advances in medicine have increased the life expectancy of pediatric patients with chronic illnesses, and challenges with the guided transition of adolescents and young adults from pediatric clinics to adult clinics have grown. The aim of this study was to better understand readiness and factors related to this transition process in Brazil. Method In this cross-sectional study of 308 patients aged from 16 to 21 years under follow-up in pediatric specialties, the degree of readiness for transition was assessed using the Transition Readiness Assessment Questionnaire (TRAQ) and its domains. Associations with demographic data, clinical data, socio-economic level, medication adherence, family functionality, and parental satisfaction with health care were evaluated. Results The median TRAQ score was 3.7 (3.2 - 4.2). Better readiness was associated with female patients, socio-economic class A-B, current active employment, higher level of education, not failing any school year, attending medical appointments alone, functional family, and a good knowledge of disease and medications. A low correlation was observed between TRAQ and age. TRAQ presented good internal consistency (alpha-Cronbach 0.86). In the multiple linear regression, TRAQ score showed a significant association with female gender, advanced age, socio-economic class A-B, better knowledge of disease and medications, and independence to attend appointments alone. Conclusion TRAQ instrument can guide healthcare professionals to identify specific areas of approach, in order to support adolescents with chronic disease to set goals for their own personal development and improve their readiness to enter into the adult healthcare system. In this study, some factors were related to better TRAQ scores.

Sarcoma de Ewing extraesquelético: relato de um caso raro e exuberante simulando lipoma / Extraskeletal Ewing's sarcoma: report of a rare and exuberant case simulating lipoma

Sarcoma de Ewing extraesquelético (EES) é tumor raro e agressivo, acomete mais homens entre 10-20 anos e representa 25% dos sarcomas de Ewing. Caso relatado pelo diagnóstico prévio de lipoma de crescimento acelerado, destacando a importância do diagnóstico histopatológico. Masculino, 14 anos, apresentando tumoração de 10x10cm no ombro direito há um ano, com ultrassonografia sugestiva de lipoma. Realizada exérese da lesão, sendo confirmado EES pela imuno-histoquímica. O diagnóstico de EES em jovens é desafiador frente a outras tumorações subcutâneas, sendo a histopatologia imprescindível. A rápida progressão do tumor e os elevados índices metastáticos evidenciam a importância da terapêutica precoce.

Extraskeletal Ewing sarcoma (EES) is a rare tumor that affects men between 10-20 years old and represents 25% of Ewing sarcomas. We report a case due to the previous diagnosis of a fast-growing lipoma to highlight the importance of histopathological diagnosis. A 14-year-old boy presented 10x10 cm tumor in the right shoulder for a year with ultrasonography suggesting lipoma. The lesion was excised and EES was confirmed by immunohistochemical analysis. EES diagnosis in young people is challenging compared to subcutaneous tumors, and histopathology is essential. The rapid progression of the tumor and high metastatic rates highlight the significance of early treatment.

Identificação perceptiva do posicionamento da língua na produção de [s] por acadêmicos em Fonoaudiologia / Identificación perceptiva del posicionamiento de la lengua de la producción de [s] por académicos en Fonoaudiología / Perceptual analysis of the tongue position in the production of [s] by SLP students

Introdução: a identificação visual do posicionamento dos articuladores e o resultado auditivo na produção de [s] são necessários para decisões clínicas e monitoramento de tratamento. Para avaliadores não treinados esta tarefa pode ser desafiadora. Objetivo: verificar se avaliadores não treinados são capazes de identificar visualmente posições normal e alterada da língua na produção do [s] e perceber, auditivamente, produções normais e alteradas; bem como buscar quais ajustes da língua são mais difíceis de serem percebidos visualmente e quais resultados auditivos são mais facilmente identificados. Método: dez acadêmicos de Fonoaudiologia analisaram 20 amostras de fala gravadas, 10 com produção normal e 10 alterada do fone [s], sendo as respostas comparadas a uma avaliação padrão-ouro. Na análise foi utilizada a concordância Kappa, o teste Qui-quadrado, o Anova de Medidas repetidas e o teste t Student, com 5% de significância. Resultados: houve associação e concordância com a avaliação padrão-ouro para a posição da língua, com porcentagem média de 40% de respostas corretas para a posição normal, 17,5% quando a língua estava contra os dentes e 10% quando interposta. No resultado auditivo, a maioria dos avaliadores não apresentou associação e concordância com o padrão-ouro, sendo a porcentagem média de 50% de respostas corretas na ausência de distorção e com redução significativa quando presente (18,5%). Conclusão: os acadêmicos tiveram dificuldade na identificação visual da posição da língua, particularmente, quando alterada, bem como na identificação auditiva das produções normal ou alterada, sendo maior quando a distorção estava presente.

Introduction: thevisual identification of articulator positioning and auditory perception in the phoneme [s] are needed for clinical decisions and treatment monitoring. This can be challenging for untrained evaluators. Objective: to verify whether untrained evaluators are able to visually identify typical and atypical tongue positions in the production of phoneme [s] and to auditorily perceive typical and atypical productions; as well as to understand which tongue adjustments are more difficult to be visually perceived and which auditory productions are more easily identified. Methods: ten speech-language pathology students analyzed 20 recorded speech samples, being 10 with typical speech production and 10 atypical speech production regarding the [s] movement, and the answers were compared with a gold-standard evaluation. The Kappa agreement, Chi-squared test, Anova repeated measures and Student ́s t-test were used with 5% of significance. Results: there was an association and agreement with the gold standard evaluation for tongue positioning, with a mean percentage of 40% for correct answers regarding typical position, 17.5% when the tongue was against the teeth and 10% when interposed. In the auditory perception; most evaluators did not show association and agreement with the gold standard evaluation, with an average percentage of 50% for correct answers in the absence of distortion and a significant reduction in the presence (18.5%). Conclusion: the students had difficulty in the visual identification of the tongue positioning for atypical speech productions, as well as in the auditory identification of typical or atypical productions, and the greater difficulty occurred when there was distortion.

Introducción: identificar visualmente el posicionamiento del articulador y el resultado auditivo en la producción del [s] son necesarios para tomar decisiones clínicas y monitorear el tratamiento. Objetivo:verificar si los evaluadores no capacitados pueden identificar visualmente las posiciones normales y alteradas de la lengua en la producción del [s] y percibir auditivamente las producciones normales y alteradas; además buscar qué ajustes de la lengua son más difíciles de percibir visualmente y qué resultados auditivos se identifican más fácilmente. Método: estudiantes de Fonoaudiología analizaron 20 muestras de habla grabadas, 10 con producción normal y 10 con producción del fono [s] alterado. Compararon las respuestas con una evaluación patrón oro. En el análisis utilizaron la concordancia Kappa, la prueba Chi-cuadrado, el Anova de Medidas repetidas y la prueba t de Student, con 5% de significancia. Resultados:hubo asociación y concordancia con la evaluación patrón oro para la posición de la lengua, con media de 40% de respuestas correctas para la posición normal, 17,5% con la lengua contra los dientes y 10% cuando interpuesta. En el resultado auditivo, la mayoría de los evaluadores no presentaron asociación y concordancia con el patrón oro, con media de 50% de aciertos en ausencia de distorsión y con reducción significativa cuando presente (18,5%). Conclusión: los estudiantes tuvieron dificultad en identificar visualmente la posición de la lengua, particularmente cuando alterada, y en la identificación auditiva de producciones normales o alteradas, siendo mayor con la distorsión presente.

Vascular accesses for hemodialysis in Ceará-Brazil / Acessos vasculares para Hemodiálise no Ceará-Brasil

Introduction: the ideal access for hemodialysis is represented by arteriovenous fistulas both as initial access and in use and are determinants of health care parameters for chronic renal patients.Objective: to evaluate vascular access for hemodialysis.Methods: this is a cross-sectional study, with a sample of 2513 individuals on hemodialysis in Ceará. Data were collected on age, sex, time of treatment, underlying disease, initial access and access in use. The data were divided into two groups, the interior of the state and the Metropolitan Region of Fortaleza, in the State of Ceará, and compared using the Student's Test (p<0.05).Results: the most common age group was between 19 and 64 years (73%). Men prevailed in both regions, 713 (63%) in the countryside and 792 (57%) in the metropolitan area. The most common cause of Chronic Kidney Disease was Hypertension 306 (27%), followed by Disease of undetermined cause 295 (26%) in the countryside; in the metropolitan region, Diabetes Mellitus 356 (26%) was the main cause, followed by Hypertension and Disease of undetermined cause, each with 344 (25%), p=0.001. In the countryside, 9% started treatment for fistula while in the metropolitan area 12%, p=0.011. 79% of patients in the countryside used fistulas and 81% in the metropolitan area, p=0.156.Conclusion: arteriovenous fistulas are more frequent as initial accesses in the metropolitan region than in the interior, but there is an equivalence of fistulas in use in both regions. Catheter is the main initial access route. The evaluation of vascular accesses in Ceará showed that hemodialysis services are able to maintain good parameters of care for patients with chronic kidney disease.

Introdução: o acesso ideal para hemodiálise é representado por fístulas arteriovenosas tanto como acesso inicial quanto em uso e são determinantes de parâmetros de atenção à saúde do paciente renal crônico.Objetivo: avaliar os acessos vasculares para hemodiálise.Método: trata-se de estudo transversal, com amostra de 2513 indivíduos em hemodiálise no Ceará. Foram coletados os dados da idade, sexo, tempo de tratamento, doença de base, acesso inicial e acesso em uso. Os dados foram divididos em dois grupos, interior do estado e Região Metropolitana de Fortaleza, no Estado do Ceará e comparados através do Teste de Student (p<0,05). Resultados: a faixa etária mais comum era entre 19 a 64 anos (73%). Os homens prevaleciam nas duas regiões, 713(63%) no interior e 792(57%) na zona metropolitana. A causa mais comum de Doença Renal Crônica era por Hipertensão 306(27%), seguida de Doença de causa indeterminada 295(26%) no interior; já na região metropolitana, Diabetes Melittus 356(26%) era a principal causa, seguida por Hipertensão e Doença de causa indeterminada, cada uma com 344(25%), p=0,001. No interior, 9% iniciaram o tratamento por fístula enquanto na área metropolitana 12%, p=0,011. 79% dos pacientes do interior usavam fístulas e 81% na área metropolitana, p=0,156.Conclusão: as fistulas arteriovenosas são mais frequentes como acessos iniciais na região metropolitana do que no interior mas há uma equivalência de fistulas em uso nas duas regiões. Cateter é a principal via de acesso inicial. A avaliação dos acessos vasculares no Ceará demostrou que os serviços de hemodiálise conseguem manter bons parâmetros de atenção ao portador de doença renal crônica.

Plataforma CLIMSS como herramienta de alfabetización en salud durante la crisis sanitaria de Covid-19 / CLIMSS online platform as a health literacy tool during the health crisis of Covid-19

Resumen: Objetivo: Describir a la plataforma Cursos en Línea Masivos del IMSS (CLIMSS) como herramienta de alfabetización en salud, a través de la evaluación de la eficiencia terminal, la ganancia de competencias y satisfacción de los usuarios de cursos en línea masivos en el tema de Covid-19. Material y métodos: Se analizaron datos de 20 cursos ofertados entre marzo y octubre de 2020. Se evaluaron las calificaciones pre y pos, el número total de registros, el total de cursos terminados y la satisfacción del usuario. Resultados: Se registraron un total de 4.9 millones de usuarios y 10 millones de inscripciones, en todos los estados de la República mexicana, con una eficiencia terminal de 85%, una ganancia de competencias de 30% y una satisfacción de 9.34 (10). Conclusiones: La plataforma CLIMSS ha mostrado ser una herramienta para la alfabetización en salud con un alcance de millones de mexicanos en temas relacionados con la crisis sanitaria Covid-19.

Abstract: Objective: To describe the Massive Online Open Courses (MOOC) or Cursos en Línea Masivos del IMSS (CLIMSS) platform as a health literacy tool by evaluating the terminal efficiency, the competence gains, and the users' satisfaction of the massive online courses offered by the Mexican Institute of Social Security, on Covid- 19. Materials and methods: Data from 20 courses offered between March and October 2020 were analyzed. We evaluated scores from the pre and post-tests, the total number of registries, total courses completed, and users' satisfaction. Results: We registered a total of 4.9 million users and 10 million registrations, in all Mexican states, with a terminal efficiency of 85%, a competence gain of 30%, and a users' satisfaction of 9.34 (10). Conclusions: The CLIMSS platform has proven to be a tool for health literacy reaching millions of Mexicans on Covid-19 related topics.

Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic

Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study - mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.

Associação entre peso ao nascer, idade gestacional e diagnósticos secundários na permanência hospitalar de recém-nascidos prematuros / Asociación entre peso al nacimiento, edad gestacional y diagnóstico secundario en estancia hospitalaria de recién nacido prematuro / Association between birth weight, gestational age and secondary diagnoses in the hospital stay of premature newborns

RESUMO Objetivo: verificar a associação entre peso ao nascer, idade gestacional e diagnósticos médicos secundários no tempo de permanência hospitalar de recém-nascidos prematuros. Métodos: estudo transversal, com 1.329 prontuários de recém-nascidos no período de julho de 2012 a setembro de 2015, em dois hospitais de Belo Horizonte, que utilizam o sistema Diagnosis Related Groups Brasil. Para determinar um ponto de corte para o peso ao nascer e a idade gestacional no nascimento que melhor determinasse o tempo de internação, foi utilizada a curva Receive Operator Characteristic. Posteriormente, utilizou-se o teste de análise de variância e teste de Duncan para a comparação entre a média de tempo de permanência hospitalar. Resultados: a prematuridade sem problemas maiores (DRG 792) foi a categoria mais prevalente (43,12%). O maior tempo médio de internação foi de 34,9 dias, identificado entre os recém-nascidos prematuros ou com síndrome da angústia respiratória (DRG 790). A combinação de menor peso ao nascer e menor IG ao nascimento apresentou o maior risco de permanência hospitalar, aumentada quando comparados aos demais perfis formados para esse DRG. Conclusão: os achados poderão direcionar a assistência em relação à mobilização de recursos físicos, humanos e de bens de consumo, além da análise crítica de condições que influenciam os desfechos clínicos. A possibilidade da otimização do uso desses recursos hospitalares aliada à melhoria da qualidade dos atendimentos e da segurança dos pacientes está associada à minimização do tempo de permanência hospitalar e da carga de morbidade e mortalidade neonatal.

RESUMEN Objetivo: verificar la asociación entre el peso al nacer, la edad gestacional y los diagnósticos médicos secundarios en la duración de la estancia hospitalaria de los recién nacidos prematuros. Métodos: estudio transversal, con 1.329 registros de recién nacidos de julio de 2012 a septiembre de 2015, en dos hospitales de Belo Horizonte, que utilizan el sistema Diagnosis Related Groups Brasil. Para determinar un punto de corte para el peso al nacer y la edad gestacional al nacer que mejor determina la duración de la estadía, se utilizó la curva Receive Operator Characteristic. Posteriormente, se utilizó la prueba de análisis de varianza y la prueba de Duncan para comparar la duración media de la estancia hospitalaria. Resultados: la prematuridad sin mayores problemas (DRG 792) fue la categoría más prevalente (43,12%). La estancia media más larga fue de 34,9 días, identificada entre los recién nacidos prematuros o aquellos con síndrome de dificultad respiratoria (DRG 790). La combinación de menor peso al nacer y menor IG al nacer presentó el mayor riesgo de estancia hospitalaria, que se incrementó en comparación con los otros perfiles formados para este DRG. Conclusión: los hallazgos pueden orientar la atención en relación con la movilización de recursos físicos, humanos y de bienes de consumo, además del análisis crítico de las condiciones que influyen en los resultados clínicos. La posibilidad de optimizar el uso de estos recursos hospitalarios, aliada a mejorar la calidad de la atención y la seguridad del paciente, está asociada a minimizar la duración de la estancia hospitalaria y la carga de morbilidad y mortalidad neonatal.

ABSTRACT Objective: to verify the association between birth weight, gestational age, and secondary medical diagnoses in the length of hospital stay of premature newborns. Methods: cross-sectional study, with 1,329 medical records of newborns from July 2012 to September 2015, in two hospitals in Belo Horizonte, which use the Diagnosis Related Groups Brasil system. To determine a cutoff point for birth weight and gestational age at birth that best determined the length of hospital stay, the Receive Operator Characteristic curve was used. Subsequently, the analysis of variance test and Duncan's test were used to compare the mean length of hospital stay. Results: prematurity without major problems (DRG792) was the most prevalent category (43.12%). The longest mean length of hospital stay was 34.9 days, identified among preterm infants or infants with respiratory distress syndrome (DRG 790). The combination of lower birth weight and lower GA at birth presented the highest risk of hospital stay, increased when compared to the other profiles formed for this DRG. Conclusion: the findings may direct assistance in relation to the mobilization of physical, human and consumer goods resources, in addition to the critical analysis of conditions that influence clinical outcomes. The possibility of optimizing the use of these hospital resources, allied to improving the quality of care and patient safety, is associated with minimizing the length of hospital stay and the burden of neonatal morbidity and mortality.

Evaluation of pulse wave velocity and central systolic blood pressure in children and adolescents with chronic kidney disease

ABSTRACT Objective Investigate pulse wave velocity and central systolic blood pressure among pediatric population with chronic kidney disease. Methods In this cross-sectional study, 57 patients (61.4% male) aged 6.2 to 17.5 years old, 44 with nondialysis chronic kidney disease and 13 on chronic dialysis, were included in the analysis. The pulse wave velocity and the central systolic blood pressure were measured with an oscillometric device with an inbuilt ARC SolverⓇ algorithm and were compared with previously established percentiles. Results The prevalence of elevated pulse wave velocity was 21.1% (95%Cl: 11.4-33.9) and elevated central systolic blood pressure was 28.1% (95%CI: 17.0-41.5). According to the generalized linear model, there was a higher risk of elevated pulse wave velocity in patients undergoing chronic dialysis treatment than nondialysis chronic kidney disease patients (adjPR=4.24, 95%CI: 1.97-9.13, p=<0.001). Hypertensive patients (stage 2) had a higher risk of elevated pulse wave velocity than normotensive ones (adjPR=2.70, 95%CI: 1.05-6.95, p=0.040), as did patients younger than 12 years than the older patients (adjPR=2.95, 95%CI: 1.05-8.40, p=0.041). Hypertensive patients had a higher risk of elevated central systolic blood pressure than normotensives (adjPR=3.29, 95%Cl: 1.36-7.94), as did patients undergoing chronic dialysis treatment when comparing to nondialysis chronic kidney disease patients (adjPR=2.08, 95%Cl: 1.07-4.02). Conclusion Younger age, dialysis, and hypertension in children are independently associated with higher pulse wave velocity. Hypertension and dialysis are independently associated with higher central systolic blood pressure.

The Phubbing Scale (PS-8) in the Portuguese population: psychometric properties

Phubbing is defined as ignoring other individuals by using a mobile phone during a face-to-face conversation. The Phubbing Scale (PS) was developed to assess this practice. In this study, we analyze the psychometric properties of the 8-item version of the PS (PS-8) in the Portuguese population, providing validity evidence based on internal structure and on relationships with other variables, and examining item properties, reliability, and measurement invariance across gender. Participants were 391 Portuguese adults (132 men, 259 women) who completed a battery of questionnaires. Confirmatory factor analysis yielded satisfactory goodness-of-fit indices for the two-factor structure (communication disturbance and phone obsession), which was invariant across gender. Item homogeneity and reliability of factor scores (McDonald's omega) were satisfactory. Validity evidence based on relationships with other variables was provided by positive associations with time spent on the Internet on weekdays and at the weekend, time spent on social networking sites, number of social networks used, Internet addiction, problematic mobile phone use, Facebook intrusion, fear of missing out, and depression. These associations show the addictive component of phubbing and its relationship with mental health. The PS-8 is a short and easy-to-administer scale with adequate psychometric properties for measuring phubbing in the Portuguese population. (AU)

Covid-19 vaccination priorities defined on machine learning

ABSTRACT OBJECTIVE Defining priority vaccination groups is a critical factor to reduce mortality rates. METHODS We sought to identify priority population groups for covid-19 vaccination, based on in-hospital risk of death, by using Extreme Gradient Boosting Machine Learning (ML) algorithm. We performed a retrospective cohort study comprising 49,197 patients (18 years or older), with RT-PCR-confirmed for covid-19, who were hospitalized in any of the 336 Brazilian hospitals considered in this study, from March 19th, 2020, to March 22nd, 2021. Independent variables encompassed age, sex, and chronic health conditions grouped into 179 large categories. Primary outcome was hospital discharge or in-hospital death. Priority population groups for vaccination were formed based on the different levels of in-hospital risk of death due to covid-19, from the ML model developed by taking into consideration the independent variables. All analysis were carried out in Python programming language (version 3.7) and R programming language (version 4.05). RESULTS Patients' mean age was of 60.5 ± 16.8 years (mean ± SD), mean in-hospital mortality rate was 17.9%, and the mean number of comorbidities per patient was 1.97 ± 1.85 (mean ± SD). The predictive model of in-hospital death presented area under the Receiver Operating Characteristic Curve (AUC - ROC) equal to 0.80. The investigated population was grouped into eleven (11) different risk categories, based on the variables chosen by the ML model developed in this study. CONCLUSIONS The use of ML for defining population priorities groups for vaccination, based on risk of in-hospital death, can be easily applied by health system managers

Translation and adaptation of the indoor environmental quality questionnaire to Brazilian portuguese

Introduction: Indoor environmental quality (IEQ) impacts well-being, performance, and mental and physical health. A questionnaire for assessing occupants' perception of IEQ was developed in English. This study aimed to translate this instrument into Brazilian Portuguese and adapt it to the Brazilian population.Methods: The translation and adaptation process consisted of forward translation, reconciliation, back translation, back translation review, harmonization, two cognitive debriefings, and finalization.Results: The final translated version included new questions and changed the scale to a visual-analog format. The clarity assessment showed that, after cognitive debriefings, all questions displayed satisfactory scores, with the majority rated higher than 9 on a 0-10 scale.Conclusions: The Brazilian Portuguese version of the IEQ questionnaire is a simple tool that can be employed in biomedical and building research to investigate the association of perceived IEQ with health-related parameters, as well as in architecture, engineering, and management projects. As a next step, a psychometric validation of the instrument will be performed.

Seroprevalencia de SARS-CoV-2 en adultos y adultos mayores en México y su asociación con enfermedades crónicas. Ensanut 2020 Covid-19 / Seroprevalence of SARS-CoV-2 in adults and older adults in Mexico and its association with chronic diseases. Ensanut 2020 Covid-19

Resumen: Objetivo: Analizar la asociación entre seropositividad a SARS-CoV-2 y enfermedades crónicas en adultos y adultos mayores mexicanos. Material y métodos: Se utilizó la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19 (Ensanut 2020 Covid-19) para evaluar la asociación de seropositividad a SARS-CoV-2 con hipertensión arterial sistémica, diabetes tipo 2, índice de masa corporal, LDL-c elevado, HDL-c bajo, colesterol total elevado e hipertrigliceridemia. Resultados: Se observó una mayor seropositividad en personas con mayor índice de masa corporal. La seroprevalencia fue 25% mayor entre los adultos que presentaban obesidad en comparación con aquellos de peso normal en modelos ajustados (RP: 1.25 IC95%: 1.08,1.46). No se observó asociación entre seropositividad y otras enfermedades crónicas en adultos o adultos mayores. Conclusiones: Las personas con obesidad podrían tener una mayor susceptibilidad a la infección por SARS-CoV-2. Este hallazgo debe ser confirmado con estudios longitudinales. No se encontró evidencia de asociación para otras enfermedades.

Abstract: Objective: To analyze the association between seropositivity to SARS-CoV-2 and chronic diseases in Mexican adults and older adults. Materials and methods: We used the 2020 National Health and Nutrition Survey on Covid-19 to evaluate the association of seropositivity to SARS-CoV-2 with high blood pressure, type 2 diabetes, body mass index, elevated LDL-c, low HDL-c, high total cholesterol, and hypertriglyceridemia. Results: We observed a higher seropositivity at higher body mass index levels. In adjusted models, seroprevalence was 25% higher among adults with obesity compared to those of normal weight (PR: 1.25 95%CI: 1.08,1.46). We did not observe any association between seropositivity and other chronic diseases in adults or older adults. Conclusions: Adults with obesity could be at increased susceptibility of SARS-CoV2 infection. This observation needs to be confirmed through longitudinal studies. We did not find evidence of an association with other chronic diseases.

Prevalence of diabetes and glycemic control in Mexico: national results from 2018 and 2020 / Prevalencia de diabetes y control glucémico en México: resultados nacionales 2018 y 2020

Abstract: Objective: To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors. Materials and methods: We used data from Ensanut 2018 (n=12 648) and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors. Results: The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control. Conclusion: Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.

Resumen: Objetivo: Estimar la prevalencia de diabetes total (diagnosticada y no diagnosticada), control glucémico en México y sus factores asociados. Material y métodos: Se analizó información de la Ensanut 2018 (n=12 648) y 2020 (n=2 309). Se definió diabetes como glucosa en ayunas ≥126 mg/dl o HbA1c≥6.5% o diagnóstico previo; se consideró control glucémico si HbA1c<7%. Usando modelos de regresión de Poisson, se estimaron los factores asociados con diabetes y control glucémico. Resultados: La prevalencia de diabetes fue de 16.8% en 2018 y 15.7% en 2020. En 2018, 38% de los adultos con diabetes desconocían su enfermedad, en 2020 fue 29%. El control glucémico se observó en 42% de los participantes en 2018 y en 39% en 2020. Mayor tiempo de diagnóstico se asoció con descontrol glucémico mientras que mayor edad, seguir una dieta y estar afiliado al IMSS, Pemex/Sedena o privados se asoció con control glucémico. Conclusión: México se encuentra entre los países con mayor prevalencia de diabetes. Una alta proporción de adultos con diabetes no tenía un diagnóstico previo y la proporción con control glucémico es baja. Fortalecer la detección, el diagnóstico oportuno y el control glucémico es clave para el manejo de la diabetes.

Acceptance, refusal, and hesitancy of Covid-19 vaccination in Mexico: Ensanut 2020 Covid-19 / Aceptabilidad, rechazo y duda ante la vacunación contra Covid-19 en México: Ensanut 2020 Covid-19

Abstract: Objective: To estimate the willingness to vaccinate against Covid-19 (acceptance) in the Mexican population and to identify socioeconomic factors associated with vaccine hesitancy and refusal. Materials and methods: We estimated the acceptance, refusal and hesitancy proportions using data from the Covid-19 National Health and Nutrition Survey conducted from August to November 2020. Factors associated with refusal and hesitancy were explored using multinomial logistic regression. Results: Covid-19 vaccination acceptance was 62.3%, refusal 28.2% and hesitancy 9.5%. Refusal and hesitancy were associated with being female, having older age, lower educational level, lower socioeconomic status and working in the informal sector. Conclusion: National campaigns to incentivize vaccine acceptance need to consider specific subgroups were the likelihood of hesitancy and refusal is high. In Mexico, refusal and hesitancy were higher in vulnerable groups, and people at a higher risk of Covid-19 complications and death.

Resumen: Objetivo: Estimar la aceptabilidad de la vacunación contra Covid-19 en la población mexicana e identificar factores socioeconómicos asociados con el rechazo o la duda. Material y métodos: Se estimó la proporción de aceptabilidad, rechazo y duda utilizando los datos de la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19 levantada durante agosto y noviembre de 2020. Se exploraron los factores asociados con rechazo y duda mediante un modelo de regresión multinomial. Resultados: La aceptabilidad de la vacunación contra Covid-19 fue de 62.3%, el rechazo de 28.2% y la duda de 9.5%. El rechazo y la duda se asociaron con ser mujer, tener mayor edad, menor nivel de educación, menor nivel socioeconómico y trabajar en el sector informal. Conclusión: Las campañas para incentivar la aceptabilidad de la vacuna necesitan considerar los subgrupos específicos con una alta proporción de rechazo y duda. En México observamos un mayor rechazo y duda en grupos con mayor riesgo de complicaciones y muerte por Covid-19.

Autopercepção do ponto de constrição da língua nas fricativas alveolares em mulheres jovens com posicionamento de língua normal e alterado / Self-perception of tongue tip constriction in alveolar fricatives produced by young women with and without normal tongue positioning

RESUMO Objetivo Investigar a autopercepção do ponto de constrição da língua na produção de [s] e [z] por jovens monolíngues com posicionamento de língua normal e alterado. Método Três fonoaudiólogas analisaram gravações de fala em vídeo de 49 mulheres, com idades entre 18 e 28 anos (média=20 anos e 7 meses), classificando-as em: Grupo 1, (G1, n=25), com ausência de alterações no posicionamento de língua na produção de [s] e [z] e Grupo 2 (G2, n=24), com alterações no posicionamento de língua nestes fones. A autopercepção do ponto de constrição da língua foi investigada questionando cada jovem sobre o local em que sua ponta da língua encostava (apical, laminal ou "outros ajustes") ao produzir [s] e [z] na leitura de palavras e pseudopalavras. O teste de Friedman, com comparações par a par posteriores, foi utilizado para análise intragrupo. O teste de Mann-Whitney foi utilizado para as comparações entre grupos. Adotou-se nível de significância de 5%. Resultados Em G1 houve relatos de ponto de constrição apical e laminal enquanto em G2 houve estes relatos, e também de outros ajustes de língua. A presença de outros ajustes da língua diferenciou G1 e G2 (p=0,002). Em G1, houve diferença significativa entre [s] e [z], sendo que o ponto laminal ocorreu com mais frequência em [s] do que em [z]. Conclusão Jovens com posicionamento de língua normal e alterado relataram pontos de constrição da língua apical e laminal em fricativas alveolares. Porém, outros ajustes de língua foram percebidos diante de posicionamento de língua alterado.

ABSTRACT Purpose This study investigated the self-perception of 49 women, monolingual speakers of Brazilian Portuguese, about their tongue position for the alveolar articulation of the fricatives [s] and [z]. Methods The video recording of speech samples of these 49 women (ages 18 to 28) were analyzed by three Speech-Language Pathologists. They were classified into two groups: Group 1 (G1, n=25), with no alterations in the tongue position during the production of [s] and [z], and Group 2 (G2, n=24), with alterations in the tongue position during the production of [s] and [z]. The tongue position self-perception experiment required the participants to identify the specific tongue constriction point in the production of [s] and [z] (apical, laminal, or "other") during the reading of 24 words and 24 pseudowords. The Friedman test, with posterior paired comparisons, was used for the intragroup analysis. The Mann-Whitney test was used for intergroup comparisons. The statistical significance adopted was 5% (p<0.05). Results G1 reported apical and laminal tongue constrictions while GE reported these constrictions plus other tongue adjustments. The presence of other tongue adjustments differentiated the groups, G1 and G2 (p=0,002). There were significant differences between [s] and [z] for G1, with the laminal position occurring more often in [s] compared to [z]. Conclusion Women with and without alteration in the tongue position reported apical and laminal constrictions. Howerer, other tongue adjustments were self-perceived in the presence of altered tongue position.