Factors associated with the health and reproductive autonomy of Quilombola women in Brazil / Factores asociados a la salud y la autonomía reproductiva de las mujeres quilombolas en Brasil / Fatores associados à saúde e autonomia reprodutiva de mulheres quilombolas no Brasil

Objective.To verify the association between reproductive autonomy and sociodemographic, sexual, and reproductive characteristics in Quilombola women (a term indicating the origin of politically organized concentrations of Afro-descendants who emancipated themselves from slavery).Methods. Cross-sectional and analytical study with 160 women from Quilombola communities in the southwest of Bahia, Brazil. Data were collected using the Reproductive Autonomy Scale and the questionnaire from the National Health Survey (adapted).Results. Out of the 160 participating women, 91.9% declared themselves as black, one out of every three were aged ≤ 23 years, 53.8% were married or had a partner, 38.8% had studied for ≤ 4 years, over half (58.1%) were unemployed, only 32.4% had a monthly income > R$ 430 (80 US dollars), 52.5% had their first menstruation at the age of 12, 70.7% had not accessed family planning services in the last 12 months, and over half used some method to avoid pregnancy (59.0%). The women had a high level of reproductive autonomy, especially in the "Decision-making" and "Freedom from coercion" subscales with a score of 2.53 and 3.40, respectively. A significant association (p<0.05) was found between the "Total reproductive autonomy" score and marital status, indicating that single or unpartnered women had higher autonomy compared to married or partnered women. Conclusion.The association of social determinants of health such as marital status, education, and age impacts women's reproductive choices, implying risks for sexual and reproductive health. The intergenerational reproductive autonomy of Quilombola women is associated with sociodemographic and reproductive factors.

Objetivo. Verificar la asociación entre autonomía reproductiva y características sociodemográficas, sexuales y reproductivas en mujeres quilombolas (término que indica procedencia de concentraciones de afrodescendientes políticamente organizadas que se emanciparon de la esclavitud). Métodos. Estudio transversal y analítico con 160 mujeres de comunidades quilombolas del sudoeste de Bahía, Brasil. Los datos fueron recolectados utilizando la Escala de Autonomía Reproductiva y el cuestionario de la Encuesta Nacional de Salud (adaptado). Resultados. De las 160 mujeres participantes 91.9% se declararon negras, una de cada tres tenía edad ≤ 23 años, 53.8% estaban casada o tenían pareja, 38.8% había estudiado por ≤ 4 años, más de la mitad (58.1%) no trabajaba, solo 32.4% tenía renta > R$ 430 mensual (87 $US dólares), el 52.5% tuvo la primera menstruación a los 12 años, 70.7% no había acudido a servicios de planificación familiar en los últimos 12 meses y más de la mitad usaba algún método para evitar embarazo (59%). Las mujeres tuvieron un alto nivel de autonomía reproductiva, especialmente en las subescalas "Toma de decisiones" y "Ausencia de coerción" con una puntuación de 2.53 y 3.40, respectivamente. Se encontró asociación significativa (p<0.05) entre la puntuación de "Autonomía reproductiva total" con el estado civil, indicando el análisis que las mujeres solteras o sin pareja tenían mayor autonomía en comparación con las casadas o con pareja. Conclusión. La asociación de determinantes sociales de la salud como el estado civil, la escolaridad y la edad interfieren en las opciones reproductivas de las mujeres, implicando riesgos para la salud sexual y reproductiva. La autonomía reproductiva intergeneracional de las mujeres quilombolas está asociada a factores sociodemográficos y reproductivos.

Objetivo. Verificar a associação entre a autonomia reprodutiva e características sociodemográficas, sexuais e reprodutivas em mulheres quilombolas (termo que indica a origem de concentrações politicamente organizadas de pessoas de ascendência africana que se emanciparam da escravatura). Métodos. Estudo transversal e analítico com 160 mulheres (80 mães e 80 filhas) de comunidades quilombolas no sudoeste baiano, no Brasil. Os dados foram construídos através da aplicação da Escala de Autonomia Reprodutiva e do questionário da Pesquisa Nacional de Saúde (adaptado). Resultados. das 160 mulheres participantes 91.9% se autodeclararam negra, a maioria com idade ≤ 23 anos (35.6%), 53.8% são casadas ou com companheiro, 38.8% com estudos ≤ 4 anos, mais da metade (58.1%) não trabalham, apenas 32.4% têm renda > R$ 430, a maioria teve a primeira menstruação até os 12 anos de idade (52.5%), não participou de grupo de planejamento familiar nos últimos 12 meses (70.7%), mais da metade utilizava método para evitar a gravidez (59%). Apresentaram elevada autonomia reprodutiva, com destaque para as subescalas "Tomada de decisão" e "Ausência de coerção" medindo 2.53 e 3.40, respectivamente. Encontrou-se associação significativa (p<0.05) entre o escore de "Autonomia reprodutiva total" e estado conjugal, com a análise indicando que mulheres solteiras ou sem companheiro apresentaram maior autonomia, comparadas às mulheres casadas ou com companheiro. Conclusão. A associação dos determinantes sociais de saúde como estado civil, menarca, escolaridade e idade interferem nas escolhas reprodutivas das mulheres, implicando em riscos à saúde sexual e reprodutiva. A autonomia reprodutiva intergeracional das mulheres quilombolas está associada a fatores sociodemográficos e reprodutivos.

Does Transcranial Direct Current Stimulation Combined with Peripheral Electrical Stimulation Have an Additive Effect in the Control of Hip Joint Osteonecrosis Pain Associated with Sickle Cell Disease? A Protocol for a One-Session Double Blind, Block-Randomized Clinical Trial.

Chronic pain in Sickle Cell Disease (SCD) is probably related to maladaptive plasticity of brain areas involved in nociceptive processing. Transcranial Direct Current Stimulation (tDCS) and Peripheral Electrical Stimulation (PES) can modulate cortical excitability and help to control chronic pain. Studies have shown that combined use of tDCS and PES has additive effects. However, to date, no study investigated additive effects of these neuromodulatory techniques on chronic pain in patients with SCD. This protocol describes a study aiming to assess whether combined use of tDCS and PES more effectively alleviate pain in patients with SCD compared to single use of each technique. The study consists of a one-session double blind, block-randomized clinical trial (NCT02813629) in which 128 participants with SCD and femoral osteonecrosis will be enrolled. Stepwise procedures will occur on two independent days. On day 1, participants will be screened for eligibility criteria. On day 2, data collection will occur in four stages: sample characterization, baseline assessment, intervention, and post-intervention assessment. These procedures will last ~5 h. Participants will be divided into two groups according to homozygous for S allele (HbSS) (n = 64) and heterozygous for S and C alleles (HbSC) (n = 64) genotypes. Participants in each group will be randomly assigned, equally, to one of the following interventions: (1) active tDCS + active PES; (2) active tDCS + sham PES; (3) sham tDCS + active PES; and (4) sham tDCS + sham PES. Active tDCS intervention will consist of 20 min 2 mA anodic stimulation over the primary motor cortex contralateral to the most painful hip. Active PES intervention will consist of 30 min sensory electrical stimulation at 100 Hz over the most painful hip. The main study outcome will be pain intensity, measured by a Visual Analogue Scale. In addition, electroencephalographic power density, cortical maps of the gluteus maximus muscle elicited by Transcranial Magnetic Stimulation (TMS), serum levels of Brain-derived Neurotrophic Factor (BDNF), and Tumor Necrosis Factor (TNF) will be assessed as secondary outcomes. Data will be analyzed using ANOVA of repeated measures, controlling for confounding variables.

Screening for Structural Hemoglobin Variants in Bahia, Brazil.

Brazil was the country that received the largest number of Africans during the time of colonization, and Bahia was the Brazilian state that received the largest number of slaves from Africa. The purpose of this study was to evaluate the coverage of the newborn screening program for sickle cell disease in the Recôncavo Baiano region of the state of Bahia, and to show the frequency of the subjects with hemoglobin variants in the 2006-2009 period. Blood samples from neonates in twelve cities in the Recôncavo Baiano region were analyzed by High Performance Liquid Chromatography. A total of 16,402 children were born in this period, 14,773 of which underwent newborn screening. In this period 1416 children were born carrying hemoglobin variants HbS and HbC. Forty-seven patients--20 HbSS genotype and 27 HbSC genotype--were diagnosed in eleven of the twelve cities surveyed. The proportion of children born with sickle cell disease in the Recôncavo Baiano region was 1/314, which was higher than the 1/650 rate for the state of Bahia. The data presented in this study confirm the high frequency of sickle cell disease in Recôncavo Baiano, demonstrating the need to create a referral center for the care of patients with sickle cell diseases in the region.

Biomechanical and organizational risk and prevalence of low back pain in the old adults caregivers of a nursing home in Joao Pessoa/PB.

The objective present study was to investigate the presence of low back pain in caregivers of a nursing home, related with the labored activities executed by these workers. 16 subjects were investigated, 15 female and one male, with 40,8 age average all being caregivers as their profession. It consisted of three phases, where the first concerns the analysis of the collective work, assessed in a perspective of caregivers, Second, a postural assessment to verify the retractions in such workers and the third stage was used Diagram of Corllet to identify the presence of signs and symptoms in caregivers. The study demonstrated that organizational and biomechanical factors are responsible for the high level of physical fatigue and presence of pain in 93,75% of the caregivers in some region of the body. 50% referred pain in the lumbar region. The results of the postural evaluation confirmed that the caregivers had alterations in the postural alignment, presenting retractions of the anterior and posterior chain. The suggestions are to minimize the risk factors of this productive process and the symptoms and signals presented from these workers by adoption ergonomic measures and the realization of a physical program with stretching and muscular strengthening of the muscles of the anterior and posterior body chain based on the method of Reorganization Postural Sensoperceptive.

Evaluation of the exercise intervention with the "Back School" education program in a Brazilian company of cigars: a case study.

The purpose of this study was to assess the benefits of an exercise program associated to the educational phase of the "Back School Program" in the quality of life of workers from a cigar factory. This is a case study conducted over four months with three activities a week, two times a day, with the third day devoted to educational activities, focusing on healthy lifestyle, correct posture, postural orientations, daily living and work activities, work motivation, and other issues.

Comparative analysis of assessment of the craniocervical equilibrium through two methods: cephalometry of Rocabado and cervical range of motion.

UNLABELLED: There are several instruments of evaluation of the craniocervical equilibrium; the most reliable are the radiographies. This study used the cephalometric analysis of Rocabado to measure the sensibility and specificity of the Cervical Range of Motion (CROM), a goniometer designed to assess cervical movements in degrees, and measure the forward head position in centimeters. This instrument frequently used, has been tested as a reliable instrument to evaluate the cervical movements but not the forward head. The sample consisted of 30 volunteers, 18 females, 12 males, mean age of 24.63 years. All participants were evaluated with CROM and radiographies in the resting head position and in erect head position. The values considered by the cephalometry consisted in the angle made between the McGregor plane and the vertical line formed by the base of the odontoid process to its apex; the posterior space between C0-C1 and C1-C2 and the hyoid triangle. RESULTS: 30% of the subjects had forward head posture, according to de cephalometry of Rocabado (decreased space between C0-C1, C1-C2) and 43,3% according to CROM. 16,6% had decreased posterior-inferior angle, and 13% had the hyoid triangle facing up. ROC curve of identifying forward head posture yielded area under the curve of 0,778 (95% confidence interval 0,596-0,960). The sensibility of CROM was: 77%. The specificity 71%. CONCLUSION: This study suggests that CROM has a moderate sensibility and specificity, useful for clinic use, but not for research.

Características da marcha em sujeitos com deficiência visual / Gait characteristics in subjects with visual disability

Introdução: A marcha é um evento bastante estudado, principalmente no que diz respeito às suas caracterísiticas espaço-temporais e angulares, no entanto, em se tratando de populações especiais, a exemplo dos cegos, estas variáveis ainda são pouco conhecidas. Objetivo: Avaliar as características espaço-temporais do andar no plano de portadores de deficiência visual e comparar com sujeitos norma-visuais, sem uso de alta tecnologia. Método: Participaram do estudo 20 sujeitos de ambos os sexos, divididos em dois grupos: portadores de deficiência visual - PDV (idade = 17,8 ± 2,8 anos; massa corporal = 56,6 ± 12,5 kg; estatura = 1,57 ± 0,06 m; IMC = 23,0 ± 0,7 kg/m2; altura da pelve = 87,8 ± 3,8 cm), composto por 10 sujeitos (6 homens e 4 mulheres) e norma-visuais - NV (idade = 22,5 ± 1,6 anos; massa corporal = 59,0 ± 16,7 kg; estatura = 1,63 ± 0,95 m; IMC = 22,2 ± 0,5 kg/m2; altura da pelve = 87,3± 4,1 cm), também composto por 10 sujeitos (3 homens e 7 mulheres). Os sujeitos caminharam sobre uma passarela de 7m e foram registrados os dados de variáveis espaço-temporais dos 5m centrais por meio do método Step Page. Para análise dos dados utilizou-se o SPSS (16.0), comparando-se as médias intra (teste t Student e Wilcoxon) e intergrupos (teste t Student, Mann-Whitney e ICe), adotando-se um nível de significância de 5% em todas as comparações. Resultados: Na comparação intra-grupos, não houve diferença estatística entre os membros para as variáveis de comprimento do passo (CP), comprimento da passada (CPas) e ângulo de rotação do pé (ARP) para ambos os grupos. Porém, na comparação entre os grupos (PDV x NV), houve diferença estatisticamente significante no comprimento do passo direito (CPD; p<0,05); comprimento do passo esquerdo (CPE; p

Introduction: The gait is an event well studied, especially with regard to their spatiotemporal and angular characteristics, however, when it comes to special populations, like the blind, these variables are still poorly known. Objective: The objective was to evaluate spatial and temporal gait characteristics of subjects with visual impairments and to compare them with normal vision subjects, without use of high technology. Method: The study included 20 individuaisof both sexes, divided into two groups: those with visual impairments - VIP (age = 17.8 ± 2.8 years, body weight =56.6 ± 12.5 kg, height = 1.57 ± 0.06 m, BMI = 23.0 ± 0.7 kg/m2; the pelvis = 87.8 ± 3.8 cm), composed of 10 subjects(6 men and 4 women) and normal visual - NV (age = 22.5 ± 1.6 years, body mass = 59.0 ± 16.7 kg, height =1.63 ± 0.95 m, BMI = 22.2 ± 0.5 kg/m2 ; the pelvis = 87.3 ± 4.1 cm), also composed of 10 subjects (3 men and 7 women). The subjects walked on a walkway of 7m and the data of spatiotemporal variables of the central 5m were recorded by the method Step Page. It was used the SPSS software (16.0) for the data analysis, the mean intra (Student t test and Wilcoxon) and between groups (Student t test, Mann-Whitney and ICe) were compared, adopting a significance levei of 5% for ali comparisons. Results: In comparison within groups there was no statistical difference between the members of the variables of step length (StL), stride length (SdL) and rotation angle of the foot (ARP) for both groups. But in the between groups analysis (VIP x NV), there was statistically significant difference for the variables right step length (RStL, p <0.05), left step length (LStL, p <0.01), right stride length (RSdL p <0.01), left stridelength (LSdL, p <0.01) and gait speed (p <0.01). Conclusion: According to the results of this study, we can inferthat the visually impaired patients group (VIP) moves more slowly and with shorter steps than the subjects with normal vision group (NV).