Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil.

OBJECTIVE: To identify the prevalence and factors associated with common mental disorders among farmers living in a medium-sized municipality in Northeastern Brazil between 2019 and 2020. METHODS: Trained interviewers applied the standardized questionnaire in 450 participants. Sociodemographic, health, income and working characteristics were assessed. The screening of common mental disorders was performed using the Self-Reporting Questionaire, with the cutoff point ≥ 7 for women and ≥ 5 for men. Poisson regression with robust estimation was applied to verify the prevalence ratios in the bivariate and multivariate analysis. RESULTS: The prevalence of common mental disorders among farmers was 55.1% (95%CI: 50.4-59.6). The variables that remained significant and associated with common mental disorders were: men (PR = 1.7), > 60 years old (PR = 0.5), poor or very poor self-assessment of health (PR = 1.4), previous mental health treatment (PR = 1.2), alcohol abuse (PR = 1.2) and loss of production (PR = 1.3). CONCLUSION: These results indicate that common mental disorders are associated with individual factors and with the farmers' context of life and work, which shows the importance of social, economic and health services support to this group of workers.

Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil / Fatores associados aos transtornos mentais comuns entre agricultores em um município de médio porte no nordeste do Brasil

ABSTRACT OBJECTIVE To identify the prevalence and factors associated with common mental disorders among farmers living in a medium-sized municipality in Northeastern Brazil between 2019 and 2020. METHODS Trained interviewers applied the standardized questionnaire in 450 participants. Sociodemographic, health, income and working characteristics were assessed. The screening of common mental disorders was performed using the Self-Reporting Questionaire, with the cutoff point ≥ 7 for women and ≥ 5 for men. Poisson regression with robust estimation was applied to verify the prevalence ratios in the bivariate and multivariate analysis. RESULTS The prevalence of common mental disorders among farmers was 55.1% (95%CI: 50.4-59.6). The variables that remained significant and associated with common mental disorders were: men (PR = 1.7), > 60 years old (PR = 0.5), poor or very poor self-assessment of health (PR = 1.4), previous mental health treatment (PR = 1.2), alcohol abuse (PR = 1.2) and loss of production (PR = 1.3). CONCLUSION These results indicate that common mental disorders are associated with individual factors and with the farmers' context of life and work, which shows the importance of social, economic and health services support to this group of workers.

RESUMO OBJETIVO Identificar a prevalência e os fatores associados aos transtornos mentais comuns entre agricultores residentes em um município de médio porte no nordeste do Brasil, entre 2019 e 2020. MÉTODOS Entrevistadoras treinadas aplicaram o questionário padronizado em 450 participantes. Investigou-se características sociodemográficas, de saúde, renda e trabalho. O rastreamento dos transtornos mentais comuns foi realizado mediante a utilização do questionário SRQ-20 ( Self-Reporting Questionaire ), com o ponto de corte ≥ 7 para mulheres e ≥ 5 para homens. Foi aplicada a regressão de Poisson com estimação robusta para verificar as razões de prevalência na análise bivariada e multivariada. RESULTADOS A prevalência dos transtornos mentais comuns entre agricultores foi de 55,1% (IC95% 50,4-59,6). As variáveis que permaneceram significativas e associadas aos transtornos mentais comuns foram: ser do sexo masculino (RP = 1,7), ter mais de 60 anos (RP = 0,5), ter autoavaliação de saúde ruim ou muito ruim (RP = 1,4), ter realizado tratamento anterior para saúde mental (RP = 1,2), fazer uso abusivo do álcool (RP = 1,2) e ter tido perda de produção (RP = 1,3). CONCLUSÃO Esses resultados indicam que os transtornos mentais comuns estão associados a fatores individuais e do contexto de vida e trabalho dos agricultores, o que demonstra a importância do suporte social, econômico e dos serviços de saúde a esse grupo de trabalhadores.

Abuse of alcohol among farmers: Prevalence and associated factors.

We sought to identify the prevalence and factors associated with alcohol abuse among farmers living in a medium-sized municipality in northeastern Brazil during 2019 and 2020. Trained interviewers applied the standardized questionnaire to 450 participants. Sociodemographic, health, income and work characteristics were investigated. The tracking of alcohol misuse was done using the CAGE questionnaire (Cut down, Annoyed by criticism, Guilty and Eye-opener), being the cut-off point ≥ 2. Poisson Regression was applied with robust estimation to verify the reasons of prevalence (RP) in bivariate and multivariate analysis. The prevalence of alcohol abuse among farmers was 32% (95% CI 27.8-36.4). Factors such as being male, having a diagnosis of mental disorder in the family, being a smoker, and using drugs were associated with the higher prevalence of the outcome. Being 60 years old or older was associated with a lower prevalence of alcohol abuse. These results indicate the need for social support to this group of workers in the context of occupational health.

Factors Associated with Suicidal Behavior in Farmers: A Systematic Review.

This review aimed to investigate the factors associated with suicidal behavior in farmers in the scientific literature. Two researchers participated independently in searching databases, specifically PubMed/MEDLINE, LILACS, Web of Science, Scopus, PsycINFO, and SciELO. Only observational studies were included. The quality of the selected studies was assessed with a critical assessment checklist for cross-sectional analytical and case-control studies, prepared by the Joanna Briggs Institute. Data related to the publication were collected (author and year; city/country); methodological design; sample/population (gender; average age), outcome, measuring instrument and factors associated with suicidal behavior. A total of 14 studies were included in the systematic review, and factors associated with farmers' behavior in mental health (depression), seasonal impacts (drought), and work exposures (herbicides and insecticides) were identified. However, heterogeneity was found in terms of the method, measurement of suicidal behavior, and associated factors, which indicates the need for further studies.

Incidence and mortality by larynx cancer in Central and South America.

OBJECTIVE: To describe how the incidence and mortality trends for laryngeal cancer in South and Central American countries. METHODS: Time series study, with incidence data from the International Agency for Research on Cancer, from 1990 to 2012 and mortality data from 17 countries of the World Health Organization, from 1995 to 2013. The trend was analyzed by Joinpoint regression. RESULTS: The highest incidence rate for laryngeal cancer was in Brazil, with 5.9 new cases per 100,000 men, and the highest mortality rate in Uruguay with 4.2 deaths per 100,000 men. The incidence ratio between genders ranged from 4: 1 (Colombia) to 12: 1 (Ecuador). The mortality ratio between the sexes ranged from 4: 1 (Peru) to 14: 1 (Uruguay). CONCLUSION: Most countries had low incidence rates and reduced mortality in Latin America.

Incidence and mortality by larynx cancer in Central and South America / Incidencia y mortalidad por cáncer de laringe en Centro y Sudamérica / Incidência e mortalidade por câncer de laringe na América Central e do Sul

ABSTRACT Objective: To describe how the incidence and mortality trends for laryngeal cancer in South and Central American countries. Methods: Time series study, with incidence data from the International Agency for Research on Cancer, from 1990 to 2012 and mortality data from 17 countries of the World Health Organization, from 1995 to 2013. The trend was analyzed by Joinpoint regression. Results: The highest incidence rate for laryngeal cancer was in Brazil, with 5.9 new cases per 100,000 men, and the highest mortality rate in Uruguay with 4.2 deaths per 100,000 men. The incidence ratio between genders ranged from 4: 1 (Colombia) to 12: 1 (Ecuador). The mortality ratio between the sexes ranged from 4: 1 (Peru) to 14: 1 (Uruguay). Conclusion: Most countries had low incidence rates and reduced mortality in Latin America.

RESUMEN Objetivo: Describir cómo tendencias de incidencia y mortalidad por cáncer de laringe en países de América del Sur y Central. Métodos: Estudio de series temporales, con datos de incidencia de Agencia Internacional de Investigación sobre el Cáncer, de 1990 a 2012 y datos de mortalidad de 17 países de Organización Mundial de Salud, de 1995 a 2013. La tendencia se analizó mediante regresión de Joinpoint. Resultados: La tasa de incidencia más alta para el cáncer de laringe fue en Brasil, con 5.9 casos nuevos por cada 100,000 hombres, y tasa de mortalidad más alta en Uruguay con 4.2 muertes por cada 100,000 hombres. La razón de incidencia entre géneros varió de 4: 1 (Colombia) a 12: 1 (Ecuador). La razón de mortalidad entre los sexos varió de 4: 1 (Perú) a 14: 1 (Uruguay). Conclusión: La mayoría de países tenían tasas de incidencia bajas y mortalidad reducida en América Latina.

RESUMO Objetivo: Descrever as tendências da incidência e mortalidade para o câncer de laringe em países da América do sul e central. Métodos: Estudo de série temporal, com dados de incidência da Agência Internacional para Pesquisa do Câncer, no período de 1990-2012 e dados de mortalidade de 17 países da Organização Mundial da Saúde, no período de 1995-2013. A tendência foi analisada pela regressão Joinpoint. Resultados: A taxa de incidência mais elevada para o câncer de laringe foi no Brasil, com 5,9 casos novos por 100.000 homens, e a taxa de mortalidade mais elevada foi no Uruguai com 4,2 óbitos por 100.000 homens. A razão de incidência entre os sexos variou de 4:1 (Colômbia) até 12:1 (Equador). A razão de mortalidade entre os sexos variou de 4:1 (Peru) a 14:1 (Uruguai). Conclusão: A maioria dos países apresentou baixas taxas de incidência e redução de mortalidade na América Latina.

Fatores associados ao pensamento de morte e comportamento suicida entre agricultores do município de Caicó-RN / Factors associated with thoughts of death and suicidal behavior among farmers in the municipality of Caicó-RN

Introdução: O comportamento suicida é frequentemente precedido por pensamentos de morte e configura-se como uma conduta autodeliberada com o propósito de provocar um dano ou morte, e pode ser compreendido como um interim entre a ideação suicida, tentativas de suicídio e que podem culminar no ato de suicidar. Os agricultores encontram-se em risco de ideação suicida em decorrência da vulnerabilidade e exposição a diferentes fatores associados às condições de vida e ao trabalho no campo. Objetivo: Analisar os fatores associados ao pensamento de morte e comportamento suicida em agricultores. Método: Trata-se de um estudo de diferentes métodos. 1) desenvolveu-se uma revisão sistemática de estudos observacionais sobre os fatores associados ao comportamento suicida em agricultores, com buscas nas bases de dados PubMed, LILACS, Web of Science, Scopus, PsycInfo e CINAHL; 2) estudo transversal, realizado no período de agosto de 2019 a março de 2020, com 450 agricultores de Caicó/Rio Grande do Norte, onde avaliou-se a prevalência de pensamentos de morte e ideação suicida através da The Beck Scale for Suicide Ideation (BSSI), e foram analisadas variáveis sociodemográficas, de saúde, renda, trabalho; 3) estudo caso-controle, a fim de avaliar o pensamentos de morte ou comportamento suicida (PS e CS) em que a amostra correspondeu a quatro controles por caso e, para compensar possíveis perdas, aumentou-se 15%, sendo o tamanho final definido em 62 casos e 288 controles. Resultados: Foram incluídos 14 estudos na revisão sistemática, e identificados fatores associados ao comportamento suicida em agricultores na saúde mental (depressão), impactos sazonais (seca) e exposições no trabalho (herbicidas e inseticidas). Na etapa transversal, a prevalência de pensamentos de morte ou ideação suicida foi de 12,4% (IC95% 9,69-15,84). No modelo multivariado final, as variáveis associadas à maior prevalência de PS/IS foram: sexo feminino (RP=3,28), ter diagnóstico de transtorno mental na família (RP=2,37), presença de transtorno mental comum (RP=2,50), uso abusivo do álcool (RP=2,22) e ser assalariado ou temporário (R=1,91). No estudo caso-controle observou-se associação positiva e significativa entre OS/CS e ter diagnóstico de transtorno mental na família (OR=2,30), ter transtorno mental comum (OR=3,16), ter realizado previamente tratamento para saúde mental (OR=3,08), realizar trabalho assalariado ou temporário (OR=2,69) e ter tido intoxicação por agrotóxicos (OR=3,34). Conclusão: pensamentos de morte e comportamento suicida em agricultores estão associados principalmente a aspectos de saúde, especialmente saúde mental, ao trabalho e ao sexo, e sinaliza para a necessidade do fortalecimento das políticas públicas de prevenção do suicídio com o direcionamento de estratégias efetivas para o trabalhador rural (AU).

Introduction: Suicidal behavior is configured as a self-deliberate conduct with the purpose of causing harm or death, and can be understood as an interim between suicidal ideation, suicide attempts and that may culminate in the act of committing suicide. Farmers are at risk of suicidal ideation due to vulnerability and exposure to different factors associated with living conditions and work in the field. Objective: To analyze factors associated with death thought, ideation and suicide attempts in farmers. Method: This is a study of different methods. 1) a systematic review of observational studies on factors associated with suicidal behavior in farmers was developed, with searches in PubMed, LILACS, Web of Science, Scopus, PsycInfo and CINAHL databases; 2) cross-sectional study, carried out from August 2019 to March 2020, with 450 farmers in Caicó/Rio Grande do Norte, where the prevalence of suicidal ideation was assessed through the The Beck Scale for Suicide Ideation (BSSI), and sociodemographic variables were analyzed, of health, income, work; 3) case-control study, in order to assess suicidal behavior considering suicidal ideation and suicide attempt, in which the sample corresponded to four controls per case and, to compensate for possible losses, 15% was increased, with the final size defined in 62 cases and 288 controls. Results: 14 studies were included in the systematic review, and factors associated with suicidal behavior in farmers were identified in mental health (depression), seasonal impacts (drought) and occupational exposures (herbicides and insecticides). In the cross-sectional stage, the prevalence of suicidal ideation was 12.4% (95%CI 9.69-15.84). In the final multivariate model, the variables associated with the highest prevalence of IS were: female gender (PR=3.28), having a diagnosis of mental disorder in the family (PR=2.37), presence of common mental disorder (PR=2. 50), alcohol abuse (RP=2.22) and being salaried or temporary (R=1.91). In the case-control study, a positive and significant association was observed between suicidal behavior and having a diagnosis of mental disorder in the family (OR=2.30), having a common mental disorder (OR=3.16), having previously undergone health treatment mental (OR=3.08), perform salaried or temporary work (OR=2.69) and have been poisoned by pesticides (OR=3.34). Conclusion: suicidal ideation and suicide attempt in farmers are mainly associated with health aspects, especially mental health, work and the female gender, and signals the need to strengthen public policies for suicide prevention with targeting strategies effective for the rural worker (AU).

[The use of artificial neural networks to classify the social vulnerability of municipalities in Rio Grande do Norte State, Brazil]. / Uso de redes neurais artificiais para classificação de municípios quanto à vulnerabilidade social no Estado do Rio Grande do Norte, Brasil.

The objective was to apply artificial neural networks to classify municipalities (counties) in Rio Grande do Norte State, Brazil, according to their social vulnerability. This was an ecological study using 17 variables that reflected epidemiological, demographic, socioeconomic, and educational indicators for the year 2010. The sources were the Human Development Atlas for Brazil and the Brazilian Institute of Geography and Statistics. For classification of the municipalities, the study applied the artificial neural networks of the PNN and Multilayer feedforward types, resulting in a classification in five categories of vulnerability: very high, high, medium, low, and very low. The networks' training phase used the minimum and maximum values, 25th and 75th percentiles, and medians for the 17 selected variables. The Multilayer feedforward network with six nodes showed the best results. The municipalities from the Metropolitan Area (Natal, Parnamirim) and the eastern and western Seridó micro-regions (Caicó, Currais Novos, São José do Seridó, Jardim do Seridó, Parelhas, Carnaúba dos Dantas) showed the lowest levels of vulnerability. The municipalities with high and very high vulnerability were located in the East of the state, in the micro-regions of the Northeast Coast (João Câmara, Touros, Caiçara do Rio dos Ventos) and Southern Coast (Nísia Floresta, São José do Mipibu, Arês, Canguaretama). The neural network classified the municipalities with high precision, distinguishing those with extreme vulnerability from those with better social indicators.

O cuidado com os pés e a prevenção da úlcera em pacientes diabéticos no Brasil / The care of feet and the prevention of ulcers in diabetic patients in Brazil

Resumo Introdução O Diabetes Mellitus configura-se como um problema de saúde pública em ascensão e, uma vez mal controlado, favorece o desenvolvimento de complicações altamente incapacitantes, como o pé diabético. Objetivo avaliar a prevalência e os fatores associados às ações de prevenção das úlceras dos pés em pacientes diabéticos no Brasil. Método Trata-se de um estudo transversal que utilizou dados da Pesquisa Nacional de Saúde 2013, relativos à proporção de indivíduos com diagnóstico de diabetes em relação às recomendações do cuidado e a prevalência de úlcera nos pés. A PNS sorteou um total de 81.187 domicílios, sendo selecionado um indivíduo por domicílio, sendo entrevistadas 60.202 pessoas. Resultados A realização do exame dos pés em portadores de diabetes por profissionais de saúde foi maior na Região Sudeste e a menor na Região Centro-Oeste. A não realização do exame foi mais prevalente no sexo feminino, em residente em área rural, de cor/raça parda, solteiro, sem instrução ou ensino fundamental incompleto. No Brasil, apenas 58,4% dos pacientes diabéticos que fizeram consulta regular receberam a orientação para examinar os pés; a ocorrência de ferida no pé foi significativamente maior para o sexo masculino; na raça-cor preta/parda; a presença de ferida no pé foi significativamente maior entre os pacientes diabéticos que faziam consulta regularmente. Conclusão Desse modo, no Brasil, a adesão dos profissionais na orientação para prevenção de úlceras diabéticas é considerada precária, com as menores prevalências de realização do cuidado nos grupos mais vulneráveis.

Abstract Background Diabetes mellitus is a public health issue and once corrected, it favors the development of highly disabling complications, such as diabetic foot. Objective This study aims to evaluate the prevalence and factors associated with actions to prevent foot ulcers in diabetic patients in Brazil. Method This is a cross-sectional study using data from the National Health Survey 2013, regarding the diagnosis of diabetes related to the recommendations for care and a prevalence of foot ulcers. Results The examination of patients with diabetes by health professionals was higher in the Southeast and Minor regions of the Central-West Region. Non-predominance of the test was more prevalent among females, in rural, color/race, single, uninstructed or incomplete elementary school subjects. In Brazil, only 58.4% of diabetic patients receiving regular consultation received guidance to examine the feet. The occurrence of sores was important for males; in black people/pardo Brazilians. The presence of foot wound was more significant among diabetic patients who had a regular visit. Conclusion Thus, in Brazil, one of the guidelines for the prevention of diabetic ulcers is precarious, with lower prevalence of care in the most vulnerable groups.

[Space-time analysis of mortality by suicide in the State of Rio Grande do Norte, Brazil, in the period from 2000 to 2015]. / Análise espaço-temporal da mortalidade por suicídio no Rio Grande do Norte, Brasil, no período de 2000 a 2015.

The objective of this study was to analyze the space-time distribution of mortality by suicide in the State of Rio Grande do Norte (RN) between 2000 and 2015. This is a mixed ecological study that evaluated the deaths due to suicide registered in RN. Spatial analysis was performed using crude and standardized rates. Univariate analysis was conducted using the Moran Global and Local Index, and spatial bivariate analysis was assessed using the cross-referencing of sociodemographic variables and mortality rates. By applying Joinpoint Regression, it was possible to verify the suicide mortality trend. There were 2,266 suicide deaths from 2000 to 2015, and spatial analysis showed poor spatial autocorrelation (I <0.3) for the Standardized Mortality Rates for both sexes, with formation of spatial clusters in the Seridó Region. The bivariate analysis showed the formation of clusters in the Seridó Region with HDI and Aging variables. In addition, there was a trend of increased male mortality up to 2003 (APC = 15.3%, CI = 9.2-21.8), followed by a period of stability.

O objetivo deste estudo foi analisar a distribuição espaço-temporal da mortalidade por suicídio no Rio Grande do Norte (RN) no período de 2000 a 2015. Trata-se de um estudo ecológico misto que avaliou os óbitos decorrentes de suicídio registrados no RN. A análise espacial foi realizada utilizando as taxas brutas e padronizadas. A análise univariada foi realizada através do Índice de Moran Global e Local, e a análise bivariada espacial por meio do cruzamento entre as variáveis sociodemográficas e as taxas de mortalidade. Através da Regressão Joinpoint foi possível verificar a tendência de mortalidade por suicídio. Foram registrados 2.266 óbitos por suicídio de 2000 a 2015, e a análise espacial mostrou fraca autocorrelação espacial (I < 0,3) para as Taxas de Mortalidade Padronizadas para ambos os sexos, com formação de aglomerados espaciais na Região do Seridó. A análise bivariada mostrou formação de clusters na Região do Seridó com as variáveis IDH e Envelhecimento. Além disso, foi observada uma tendência de aumento da mortalidade no sexo masculino até o ano de 2003 (APC = 15,3%; IC = 9,2-21,8), seguido de um período de estabilidade.