Prevalência de transtornos psiquiátricos de pessoas em situação de rua em um grande centro urbano no Brasil / Prevalence of psychiatric disorders in homeless people in a large urban center in Brazil / Prevalencia de trastornos psiquiátricos en personas sin hogar en un gran centro urbano de Brasil

Introdução: O presente estudo visa descrever as condições de saúde mental mais prevalentes na população de rua em um grande centro urbano brasileiro. Objetivo: Descrever as condições de saúde mental mais prevalentes na população de moradores de rua em um grande centro urbano brasileiro. Métodos: Este é um estudo transversal realizado nas regiões centrais e periferias da cidade de São Paulo (SP), Brasil. Para a descrição dos transtornos psiquiátricos utilizamos o Patient Health Questionnaire-9 (PHQ-9) para sintomas depressivos, item 9 do Inventário de Depressão de Beck para ideação suicida, pergunta autorreferida para uso de álcool e drogas ilícitas e item 3 do PHQ-9 para qualidade do sono. Resultados: A média de idade dos participantes foi de 44,54 (desvio padrão ­ DP=12,63) anos, e a maioria era do sexo masculino (n=342; 75%). Quanto à frequência de transtornos psiquiátricos identificados, 49,6% (n=226) dos participantes apresentaram sintomas depressivos, 29,8% (n=136) exibiram ideação suicida, 55,7% (n=254) informaram uso de álcool semanalmente, 34,2% (n=156) informaram usar drogas ilícitas semanalmente e 62,3% (n=284) tinham problemas com sono. Conclusões: A prevalência de condições que afetam a saúde mental entre os participantes é alta. Estes resultados poderão auxiliar profissionais de saúde na elaboração de estratégias de prevenção e tratamento nessa população, pouco estudada.

Introduction: The present study aims to describe the most prevalent mental health conditions in the homeless population in a large Brazilian urban center. Objective: To describe the most prevalent mental health conditions in the population of homeless people in a large Brazilian urban center. Methods: This is a cross-sectional study carried out in the central and periphery regions of São Paulo, state of São Paulo, Brazil. For the description of psychiatric disorders, the following instruments were used: Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, item 9 of the Beck Depression Inventory for suicidal ideation, the self-reported question for the use of alcohol and illicit drugs, and item 3 of the PHQ-9 for sleep quality. Results: The mean age of participants was 44.54 (Standard Deviation=12.63) years, and most were men (n=342; 75%). Regarding the frequency of the identified psychiatric disorders, 49.6% (n=226) of the participants had depressive symptoms, 29.8% (n=136) had suicidal ideation, 55.7% (n=254) reported weekly alcohol use, 34.2% (n=156) reported using illicit drugs weekly, and 62.3% (n=284) had sleep problems. Conclusions: The prevalence of conditions that affect mental health among participants is high. These results may help health professionals to develop prevention and treatment strategies for this understudied population.

Introducción: El presente estudio tiene como objetivo describir las condiciones de salud mental más prevalentes en la población sin hogar en un gran centro urbano brasileño. Objetivo: Describir las condiciones de salud mental más prevalentes en la población de personas sin hogar en un gran centro urbano brasileño. Métodos: Se trata de un estudio transversal realizado en las regiones central y periférica de São Paulo, SP, Brasil. Para la descripción de los trastornos psiquiátricos se utilizó el Cuestionario de Salud del Paciente - 9 (PHQ-9) para síntomas depresivos, el ítem 9 del Inventario de Depresión de Beck para ideación suicida, la pregunta autorreportada para uso de alcohol y drogas ilícitas y ítem 3 del PHQ-9 para la calidad del sueño. Resultados: La edad media de los participantes fue de 44,54 (DE=12,63) años, y la mayoría eran hombres (n=342; 75%). En cuanto a la frecuencia de los trastornos psiquiátricos identificados, el 49,6% (n=226) de los participantes presentaba síntomas depresivos, el 29,8% (n=136) tenía ideación suicida, el 55,7% (n=254) refería consumo semanal de alcohol, el 34,2% (n=156) refirió consumir drogas ilícitas semanalmente y el 62,3% (n=284) presentaba problemas de sueño. Conclusiones: La prevalencia de condiciones que afectan la salud mental entre los participantes es alta. Estos resultados pueden ayudar a los profesionales de la salud a desarrollar estrategias de prevención y tratamiento para esta población poco estudiada.

Mental health difficulties and related factors in Chinese children and adolescents during the COVID-19 pandemic: a cross-sectional study

Abstract Objective: To examine the mental health status and related factors in children and adolescents, and to assess age groups and sexes differences in factors influencing mental health. Methods: This cross-sectional study was performed on Chinese children aged 6-18 years from November 2021 to January 2022. Mental health difficulties were accessed by the Strengths and Difficulties Questionnaire. Multivariate logistic regression was used to analyze factors associated with mental health status. Multiple linear regression was used to evaluate factors associated with the scores of the Strengths and Difficulties Questionnaire. Results: The prevalence of mental health difficulties was 12.98% (n =1348). Age (OR, 0.909, [95%CI, 0.830-0.996]), sex (OR, 1.424, [95%CI, 1.033-1.963]) and screen time on weekdays ("≥2" h/d vs "< 1" h/d: OR, 2.001, [95%CI, 1.300-3.080]) were related factors for mental health difficulties. For children (year ≤ 12), the strongest related factor for mental health difficulties was screen time on weekdays ("≥ 2" h/d vs "< 1" h/d: OR, 1.821 [95%CI, 1.203-2.755]). The risk of mental health difficulties in females with ≥ 2 h/d screen time on weekends was 3.420 times higher than those with < 1 h/d (OR, 3.420, [95%CI, 1.923-6.081]). Conclusion: The prevalence of mental health difficulties among children and adolescents was relatively high. The lower age, female sex and excessive screen time were associated with a higher risk of mental health difficulties. The factors influencing mental health varied by different age groups and sexes. Thus, specific measures for different age groups and sexes should be adopted to mitigate the impact.

Prevalencia de anomalías dentomaxilares y necesidad de tratamiento de ortodoncia en niñas/os de 6 años en cinco comunas de Chile. Estudio Preliminar

Objetivo: Determinar la prevalencia de las anomalías dentomaxilares (ADM) y necesidad de tratamiento de ortodoncia en escolares de 6 años en cinco comunas en Chile. Material y método: Estudio de corte transversal, observacional y descriptivo. La muestra fue de 1102 escolares. Se realizaron exámenes clínicos aplicando la Guía de Referencia Clínica a Ortodoncia para Servicios Públicos de Salud, para determinar la prevalencia de las ADM y necesidad de tratamiento de ortodoncia. El análisis estadístico utilizó el programa STATA®, considerando estadísticamente significativo p 0.05. Resultados: 1102 escolares de 6 años fueron examinados, 48,8% niñas y 51,2% niños. La prevalencia de niño/as con anomalías dentomaxilares fue 59.1%. Las tres más prevalentes fueron: apiñamiento dentario o rotaciones (21,6%), resalte aumentado (17,6%) y overbite aumentado (15,9%). La necesidad de tratamiento de ortodoncia encontrada fue de 34,7% con evidente necesidad y un 25,3% con leve necesidad. Conclusión: Se evidencia la necesidad de incluir en las políticas públicas de salud oral, estrategias de diagnóstico y tratamiento temprano de ADM por su alta prevalencia.

Objective: To determine the prevalence of dento-maxillary anomalies (DMA) and the orthodontic treatment need in 6-year-old schoolchildren in five areas of Chile. Material and method: Cross-sectional, observational and descriptive study. The sample consisted of 1102 6-year-old schoolchildren. Clinical examinations were carried out applying the Clinical Reference Guide for Orthodontics in Public Health Services, to determine the prevalence of DMA and the need for orthodontic treatment. Statistical analysis used the STATA® program, considering p ≤ 0.05 statistically significant. Results: 1102 6-year-old children were examined, 48.8% were girls and 51.2% boys. The prevalence of children with DMA was 59.1%. The three most prevalent were: dental crowding or rotations (21.6%), increased overjet (17.6%), and increased overbite (15.9%). The orthodontic treatment need was 34.7% of patients with great need and 25.3% with moderate need. Conclusion: The need to include early diagnosis and treatment strategies for DMA in public oral health policies is evident due to its high prevalence.

Prevalence of Musculoskeletal Pain in Amateur Golfers in the State of São Paulo: A Cross-sectional Study / Prevalência de dor musculoesquelética em golfistas amadores do estado de São Paulo: Um estudo transversal

Abstract Objective To verify the prevalence of musculoskeletal pain in amateur golfers in the State of São Paulo, Brazil. Methods The present is a cross-sectional study performed from September 2019 to March 2020 in golf clubs affiliated to Federação Paulista de Golfe (São Paulo Golf Federation). Federation players were evaluated regarding data on golf practice and sport routine by a main investigator, though an assessment form with multiple-choice questions, to determine sample characteristics and recent pain intensity by the Visual Analogue Scale. Results Approximately 359 amateur golfers were analyzed. The prevalence of pain was of 55.15% (95% confidence interval [95%CI]: 50.0% to 60.3%); the average pain intensity according to the VAS was moderate (mean ± standard deviation: 5.21 ± 2.04; odds ration [OR]: 47,98%). The golfer's age range was significantly associated with the presence of pain (p < 0.05). The highest prevalence estimate of pain was of 68.80% in the age group between 30 and 39 years (OR: 7,33; 95%CI: 2,26 to 23,85; p = 0,0009). The segments most affected by pain were the upper limbs (65.66%), followed by the spine (59.09%) and the lower limbs (32.83%). Conclusion There is a high prevalence rate of pain in Brazilian amateur golfers, especially in younger players in the age group between 30 and 39 years.

Resumo Objetivo Verificar a prevalência de dores musculoesqueléticas em golfistas amadores do estado de São Paulo. Métodos Este é um estudo transversal realizado de setembro de 2019 a março de 2020 em clubes de golfe afiliados à Federação Paulista de Golfe. Jogadores federados foram avaliados quanto a dados da prática de golfe e da rotina esportiva por um investigador principal, por meio de um formulário de avaliação com questões de múltipla escolha, para a determinação das características da amostra e da intensidade da dor recente pela Escala Visual Analógica (EVA). Resultados Cerca de 359 golfistas amadores foram analisados. A prevalência de dor foi de 55,15% (intervalo de confiança de 95% [IC95%]: 50,0% a 60,3%); a intensidade média da dor segundo a EVA foi moderada (média ± desvio padrão: 5,21 ± 2,04; razão de probabilidades [odds ratio, OR, em inglês]: 47,98%). A faixa etária dos golfistas esteve significativamente associada à presença de dor (p < 0,05). A maior estimativa de prevalência de dor foi de 68,80% na faixa etária de 30 a 39 anos (OR: 7,33; IC95%: 2,26 a 23,85; p = 0,0009). Os segmentos mais acometidos por dor foram os membros superiores (65,66%), seguidos da coluna (59,09%) e dos membros inferiores (32,83%). Conclusão Há uma alta taxa de prevalência de dor em golfistas amadores brasileiros, especialmente em jogadores mais jovens, na faixa etária de 30 a 39 anos.

Prevalence of self-reported swallowing difficulties and associated factors among older Colombians / Prevalência de dificuldades de deglutição autorreferidas e fatores associados entre idosos colombianos

Objective: We aimed to determine the prevalence of self-reported swallowing difficulty (dysphagia) among older Colombians and to explore the factors associated with this condition. Methods: This study presents a secondary analysis of the SABE-Colombia survey, a crosssectional study of community-dwelling older adults. The dependent variable was self reported swallowing difficulty, assessed through the question: "How often do you have difficulty or discomfort swallowing?" Descriptive and bivariate analyses of the sample were performed, followed by multivariate analysis, adjusting for confounding variables. Results: The final sample included 19 004 older Colombians, whose mean age was 69 years (56% women). The overall prevalence of swallowing difficulty was 12.2%. In the multivariate analysis, significant associations were observed between swallowing difficulty and several factors, including male sex (OR 1.14, 95%CI 1.03 ­ 1.26), age > 80 years (OR 1.26, 95%CI 1.08 ­ 1.47), dependence in activities of daily living (OR 1.62, 95%CI 1.23 ­ 2.13), cognitive impairment (OR 1.49, 95%CI 1.30 ­ 1.70), depressive symptoms (OR 1.38, 95%CI 1.15 ­ 1.65), sarcopenia (OR 1.32, 95%CI 1.02 ­ 1.69), malnutrition (OR 1.35, 95%CI 1.23 ­ 1.49), and osteoarticular disease (OR 1.18, 95%CI 1.07 ­ 1.38). Conclusion: There was a high prevalence of swallowing difficulty among older community-dwelling Colombians. Our results showed a strong correlation between swallowing difficulty and risk factors such as cognitive impairment, depressive symptoms, osteoarticular disease, and dependence in activities of daily living, but not with malnutrition or sarcopenia. (AU)

Associação entre prática de atividade física e aptidão cardiorrespiratória em adolescentes / Association between physical activity practice and physical fitness in school adolescents

O objetivo do estudo foi verificar a associação entre diferentes volumes de atividade física moderada e/ou vigorosa durante o lazer e a aptidão cardiorrespiratória (ACR) adequada em adolescentes de ambos os sexos. A atividade física moderada (AFM), vigorosa (AFV ) ou moderada-vigorosa (AFMV) de lazer foi avaliada por meio de questionário e a ACR foi medida com o teste de vai-e-vem de 20m. Foram utilizados modelos de Regressão Poisson para análises. As AFM, AFV ou AFMV no lazer foram categorizadas de acordo com três limiares de atividade física no lazer (150, 300 e 420 min/sem). Foram consideras para as análises de associação as AFM, AFV e AFMV, de acordo com o compêndio de atividade físicas para adolescentes. A prática de AFMV no lazer por pelo menos 420 min/sem obteve a maior probabilidade de ACR adequada (RP = 2,03; IC95%: 1,18 ­ 3,51). Na mesma direção, a prática de AFV por pelo menos 150 min/sem também foi estatisticamente significativa (RP = 1,72; IC95%: 1,07 ­ 2,80). Os resultados indicaram uma associação positiva entre prática de atividade física no lazer e ACR, independentemente da intensidade e limiar de tempo, enfatizando que a participação em ambas as intensidades de atividade física no lazer estão associadas aos níveis adequados de aptidão cardiorrespiratória.

The aim of this study was to verify the association between different volumes of moderate and/or vigor-ous physical activity during leisure time and adequate cardiorespiratory fitness in adolescents of both sexes. Leisure-time moderate and/or vigorous physical activity (MPA, VPA, and MVPA) was assessed by means of a questionnaire and cardiorespiratory fitness was measured with the 20m back-and-forth test. Poisson regression models were used for analyses where moderate and/or vigorous physical activity in leisure time, it was categorized according to three thresholds of leisure-time physical activity (150, 300 and 420 min/week). The following factors were considered for the association analyses: MPA, VFA, and MVPA, according to the compendium of physical activity for adolescents. Leisure time MVPA for at least 420 min/week had the highest probability of adequate cardiorespiratory fitness (PR = 2.03; 95%CI: 1.18 ­ 3.51). In the same direction, the practice of VFA for at least 150 min/week was also statistically significant (PR = 1.72; 95%CI: 1.07 ­ 2.80). The results indicated a positive association between leisure time physical activity and cardiorespiratory fitness, regardless of intensity and time threshold, emphasizing that participation in both modalities of leisure time physical activity can provide substantial benefits for cardiorespiratory fitness.

Occupational Exposure to Domestic Waste and Oral Mucosal Lesions: a Cross-Sectional Study / Exposição Ocupacional a Resíduos Domésticos e Lesões de Mucosa Oral: Estudo Transversal

This study aimed to evaluate the occurrence of oral mucosal lesions (OML) in domestic waste collectors and their association with occupational exposure to domestic waste. This cross-sectional study included 295 adult men who worked in a waste management company: 129 men were exposed to domestic waste during their labor of waste collection, and 166 were not. The waste collectors used personal protective equipment. The lips, buccal mucosa and sulcus, gum, alveolar ridge, tongue, the floor of the mouth, and soft and hard palate were evaluated. The chi-square or Fisher's exact test assessed the variables associated with OML (P ≤ 0.05). Twenty-five OMLs were observed in 22 volunteers, 8 in the exposed and 17 in the non-exposed group. Actinic cheilitis in the lips and candidiasis were the most common lesions in both groups. OML was not associated with waste exposure (OR= 0.72, 95% CI = 0.29-1.77, P = 0.47). There was no association between domestic waste exposure and actinic cheilitis (OR = 0.70, 95% CI= 0.23-2.15, P = 0.37), candidiasis (OR = 0.42, 95% CI= 0.08-2.12, P = 0.24) or leukoplakia (OR = 0.99, 95% CI= 0.97-1.01, P = 0.32). Actinic cheilitis in the lips and candidiasis were the most common lesions in both exposed and non-exposed groups. Occupational exposure to domestic waste was not related to OML. Proper use of personal protective equipment may have prevented the development of OML in domestic waste collectors. (AU)

Este estudo teve como objetivo avaliar a ocorrência de lesões de mucosa oral (LMO) em coletores de lixo doméstico e sua associação com a exposição ocupacional a resíduos domésticos. Este estudo transversal incluiu 295 homens adultos que trabalhavam numa empresa de gestão de resíduos: 129 homens foram expostos a resíduos domésticos durante o seu trabalho de coleta de resíduos e 166 não. Os coletores de lixo usavam equipamentos de proteção individual. Foram avaliados lábios, mucosa bucal e vesticulo, gengiva, rebordo alveolar, língua, assoalho da boca e palato mole e duro. O teste qui-quadrado ou exato de Fisher avaliou as variáveis associadas à LMO (P ≤ 0,05). Vinte e cinco LMO foram observadas em 22 voluntários, 8 no grupo exposto e 17 no grupo não exposto. Queilite actínica nos lábios e candidíase foram as lesões mais comuns em ambos os grupos. A LMO não foi associada à exposição a resíduos (OR = 0,72, IC 95% = 0,29-1,77, P = 0,47). Não houve associação entre exposição a resíduos domésticos e queilite actínica (OR = 0,70, IC 95% = 0,23-2,15, P = 0,37), candidíase (OR = 0,42, IC 95% = 0,08-2,12, P = 0,24) ou leucoplasia ( OR = 0,99, IC 95% = 0,97-1,01, P = 0,32). A queilite actínica nos lábios e a candidíase foram as lesões mais comuns nos grupos expostos e não expostos. A exposição ocupacional a resíduos domésticos não esteve relacionada com LMO. O uso adequado de equipamentos de proteção individual pode ter evitado o desenvolvimento de LMO em coletores de lixo doméstico. (AU)

Meta-analysis of Distribution Frequency of Traditional Chinese Medicine Syndrome in Primary Osteoporosis / 中国实验方剂学杂志

ObjectiveTo systematically evaluate the distribution of traditional Chinese medicine（TCM） syndromes of primary osteoporosis（POP） in China by using evidence-based medicine methods， and to understand the distribution law of the syndromes. MethodChina National Knowledge Infrastructure（CNKI）， VIP Chinese Science and Technology Journal Database（VIP）， WanFang Data Knowledge Service Platform（WanFang） and China Biology Medicine（CBM） were searched to obtain representative literature， and each database was searched from the 1994 World Health Organization defined diagnostic criteria for osteoporosis until May 1， 2023. Two researchers independently screened literature according to the criteria， extracted data， and cross-checked them. Meta analysis was conducted using R4.1.3， and subgroup analysis was performed. ResultA total of 56 Chinese papers were included， involving 14 415 patients. After standardized classification of syndromes， 11 articles were excluded， and Meta analysis results of the ultimately included 45 Chinese articles showed that the distribution frequencies of liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome in 12 723 patients were 27%［95% confidence interval（CI） 0.24-0.31］， 32%（95% CI 0.29-0.36）， 36%（95% CI 0.30-0.42）. Subgroup analysis showed that there was a statistically significant difference in the distribution of the three TCM syndromes in the north and south（P<0.05）. In addition， the incidence of TCM syndrome fractures in different types of POP was 15%（95% CI 0.09-0.24） for liver-kidney Yin deficiency syndrome， 20%（95% CI 0.12-0.30） for spleen-kidney Yang deficiency syndrome， and 31%（95% CI 0.25-0.39） for kidney deficiency and blood stasis syndrome. ConclusionThe distribution of syndromes in POP patients is mainly kidney deficiency， accompanied by liver and spleen dysfunction. Liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome are all the main syndromes of POP and osteoporotic fractures， and kidney deficiency and blood stasis syndrome is most closely related to the development of osteoporotic fractures. The reference standards for syndrome determination among the included studies are inconsistent， and in the future， it is necessary to focus on their determination standards to obtain consensus research results， at the same time， conduct large-scale syndrome research to obtain representative research results， providing a basis for clinical practice and research.

Research on the status and risk factors of cognitive function among nursing home population in Changning District, Shanghai / 公共卫生与预防医学

Objective To investigate the prevalence and risk factors of cognitive impairment in the nursing home population in Changning District, Shanghai. Methods In this study, random cluster sampling method was used to select 570 elderly people from 5 nursing homes in Changning District. Multivariate logistic regression was used to analyze the risk factors influencing cognitive function. Results The total prevalence of cognitive impairment in Changning nursing home population was 22.5%. The prevalence rates of ≤80 and >80 age groups were 16.8% and 23.9%, respectively, and the prevalence rates of men and women were 19.2% and 23.9%, respectively. Multivariate analysis showed that age ≥ 80 years old (OR=1.839, 95% CI: 1.045~3.235), no habit of reading book or newspaper (OR=2.087, 95%CI: 1.282~3.398), limitation of daily activity ability (OR=1.577, 95% CI: 1.023~2.431), and having depressive symptoms (OR=2.809, 95% CI: 1.840~4.288) were all influencing factors for cognitive impairment. Conclusion More than one fifth of elderly people in nursing homes in Changning District have symptoms of cognitive impairment. It is necessary to carry out routine cognitive assessment and appropriate cognitive intervention for the nursing home population to reduce the health and economic losses caused by cognitive impairment.

Analysis on the status quo and influencing factors of medication belief in patients with myasthenia gravis / 重庆医学

Objective To explore the status quo of medication belief in the patients with myasthenia gravis and analyze their influencing factors,so as to provide reference for health care professionals to develop targeted interventions.Methods A total of 145 patients with myasthenia gravis visiting the First Affiliated Hospital of Guangzhou University of Chinese Medicine from July 2021 to March 2022 were selected.The Be-liefs about Medicines Questionnaire(BMQ)was used to investigate.The multiple linear regression was used to analyze the relevant influencing factors.Results The scores of medication belief,necessity belief and con-cern belief in 145 patients were(4.17±1.23)points,(19.52±3.45)points and(18.29±4.26)points respec-tively.There was statistically significant difference between the scores of necessity belief and concern belief(P＜0.05).The education level,financial burden,duration of illness,length of medication,number of recur-rent hospitalizations,and inappropriate medication-induced exacerbations had influence on the medication be-lief scores of the patients with myasthenia gravis(P＜0.05).The duration of illness,length of medication and number of recurrent hospitalizations had the influence on the medication necessity scores of patients with my-asthenia gravis(P＜0.05).The financial burden had the influence on the medication concerns scores of the patients with myasthenia gravis(P＜0.05).Conclusion The medication belief in the patient swith myasthe-nia gravis is at a low level,and the number of recurrent hospitalizations and financial burden are the independ-ent risk factors affecting the medication belief scores in the patients with myasthenia gravis.The number of recurrent hospitalizations is an independent risk factor for the score of medication necessity dimension.