The experience of children and family in pediatric home hospitalization: A systematic review of qualitative evidence.

OBJECTIVE: To synthesize the experiences of children and parents/caregivers in the process of pediatric home hospitalization (PHH). INTRODUCTION: The practice of home hospitalization (HH), while not a new concept has expanded in recent years. This model of care consists of continuous care at home for children with acute illness or acute chronic disease and presents itself as an alternative to conventional hospitalization (Middel, 2007; Parab et al., 2013). Excellence in pediatric healthcare is fundamental and this review provides a necessary understanding towards the experiences of children and their families in HH. METHODS: Research was carried out in three phases and included both published and grey literature in the CINAHL, MEDLINE, MedicLatina, PubMed, Cochrane Library, Psychology and Behavioral Sciences Collection, and OpenAIRE databases to find relevant articles. Studies published in Portuguese, English, Spanish, and French with no time limit were considered. RESULTS: Findings were aggregated into five categories: communication and care experiences, parental dynamics and role carers, benefits and challenges for parents and children, relationship between parents, children's, and healthcare professionals and enhancing continuity of care and family support. According to ConQual the confidence level of the results was moderate in all articles. CONCLUSIONS: Through PHH, it is possible to avoid the impact of a conventional hospitalization since it promotes family union, increases the affective bond, the feeling of security, comfort, tranquillity, relief, confidence, and autonomy, reducing stressors such as anxiety, fear, nervousness, uncertainty, and fear.

Educational intervention on perceived stress among adults with type 2 diabetes and metabolic syndrome: a non-randomized clinical trial / Intervención educativa sobre el estrés percibido en adultos con diabetes tipo 2 y síndrome metabólico: ensayo clínico no aleatorizado / Intervenção educativa sobre o estresse percebido de adultos com diabetes tipo 2 e síndrome metabólica: ensaio clínico não-randomizado

Objective.To assess the effectiveness of an educational intervention on perceived stress and metabolic syndrome parameters among adults with type 2 diabetes mellitus. Method. Fifty-one adults (aged 48.73±7.84; 86.3% of women) were included in a non-randomized clinical trial performed in a healthcare unit for six months (Brazilian Clinical Trial Registry: RBR-43K52N). All participants were diagnosed with type 2 diabetes mellitus and metabolic syndrome (intervention group, n=26; control group, n=25). The intervention consisted of a nurse-led educational health-promoting program with a multidisciplinary approach organized in seven workshops. The primary outcome was decreased perceived stress, and the secondary outcome was improvement in metabolic syndrome parameters according to perceived stress levels. These outcomes were assessed at two points in time, at the baseline and follow-up. Results. Participation in the intervention program resulted in a significant decrease in perceived stress (p=0.028). The stressed participants in the intervention group experienced a significant decrease in blood glucose levels (p=0.001) and a significant increase in high-density lipoprotein-cholesterol (p=0.003) concentrations after the six-month intervention. Conclusion.The nurse-led educational health-promoting program decreased perceived stress among adults with type 2 diabetes mellitus and metabolic syndrome, improving fasting blood glucose and high-density lipoprotein cholesterol among the stressed participants in the intervention group.

Objetivo. Evaluar la efectividad de una intervención educativa sobre el estrés percibido y los componentes del síndrome metabólico en adultos con diabetes mellitus tipo 2. Métodos. Se incluyeron 51 adultos (48.73±7.84 años; 86.3% mujeres) de un estudio no-ensayo aleatorizado realizado en una unidad de salud durante seis meses, con Registro Brasileño de Ensayos Clínicos: RBR-43K52N, todos los participantes fueron diagnosticados con diabetes mellitus tipo 2 y síndrome metabólico (grupo intervención, n=26; grupo control, n=25). La intervención consistió en un programa educativo de promoción de la salud con enfoque multidisciplinario, liderado por una enfermera, estructurado en siete talleres grupales. El resultado primario fue la reducción del estrés percibido y el secundario, la mejora de los componentes del síndrome metabólico influenciados por el nivel de estrés percibido, evaluado en dos momentos, al inicio y después del seguimiento. Resultados. La participación en el programa de intervención resultó en una reducción significativa del estrés percibido en comparación con el grupo control (p=0.028). Los participantes estresados en el grupo de intervención tuvieron, respectivamente, una disminución y un aumento significativos en las concentraciones séricas de glucosa (p=0.001) y lipoproteínas de alta densidad-colesterol (p=0.003) después de seis meses de intervención. Conclusión. Un programa educativo de promoción de la salud liderado por enfermeras fue eficiente para reducir el estrés percibido entre adultos con diabetes mellitus tipo 2 y síndrome metabólico, además de mejorar la glucemia en ayunas y el colesterol unido a lipoproteínas de alta densidad en los participantes del grupo estresado de intervención.

Objetivo. Avaliar a efetividade de uma intervenção educativa sobre o estresse percebido e os componentes da síndrome metabólica em adultos com diabetes mellitus tipo 2. Métodos. Foram incluídos 51 adultos (48.73±7.84 anos de idade; 86.3% mulheres) em um ensaio clínico não-randomizado realizado em uma unidade de saúde durante seis meses, com Registro de Ensaio Clínico Brasileiro: RBR-43K52N.Todos os participantes apresentavam diagnóstico de diabetes mellitus tipo 2 e síndrome metabólica (grupo intervenção, n=26; grupo controle, n=25). A intervenção consistiu em um programa educativo de promoção da saúde com abordagem multidisciplinar, liderado por enfermeiro, estruturado em sete oficinas em grupo. O desfecho primário foi a redução do estresse percebido, e o secundário, a melhora dos componentes da síndrome metabólica conforme influência do nível de estresse percebido, avaliados em dois momentos, na condição basal e após o acompanhamento. Resultados. A participação no programa de intervenção resultou na redução significativa do estresse percebido em comparação com o grupo controle (p=0.028). Os participantes estressados do grupo intervenção tiveram, respectivamente, diminuição e aumento significativos das concentrações séricas de glicose (p=0.001) e da lipoproteína-colesterol de alta densidade (p=0.003) após seis meses de intervenção. Conclusão. Um programa educativo de promoção da saúde liderado por enfermeiros foi eficiente para reduzir estresse percebido entre adultos com diabetes mellitus tipo 2 e síndrome metabólica, além de causar melhora da glicemia de jejum e e da lipoproteína-colesterol de alta densidade dos participantes estressados do grupo intervenção.

Exploring men's health in medium and high complexity care in Brazil: A deductive thematic analysis of social determinants.

Background: Men's health is influenced by a complex interplay of social, economic, and cultural determinants. Understanding how these aspects affect the health of adult cisgender men in medium and high-complexity healthcare settings is essential for improving healthcare services and promoting better health outcomes. Objective: This study aimed to analyze the health status of adult cisgender men in medium and high-complexity healthcare settings based on social determinants and conditioners. Methods: This study employed a qualitative design involving 45 adult cisgender men receiving care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren and Whitehead's Model of Social Determinants of Health using deductive thematic analysis. Results: Proximal determinants included biological aspects, preventive behaviors, lifestyle/social life, and aging processes. Intermediate factors included work conditions, access/utilization of healthcare services/medications, and psychosocial factors. Macro determinants involved income distribution, power dynamics, resource allocation, health inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and structural elements. Conclusion: The health status of men in medium/high complexity care was profoundly influenced by structural social determinants. These determinants impacted healthcare attention, service organization, cultural influences, the reproduction of hegemonic masculinity patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right to health. Nursing practices should conduct comprehensive assessments that extend beyond physical health indicators.

A qualidade de vida e a relação com a toxicidade financeira no tratamento hemodialítico / Calidad de vida y relación con la toxicidad financiera en el tratamiento en hemodiálisis / Quality of life and the relationship with financial toxicity in hemodialysis treatment

Introdução: Pessoas com doença renal crônica podem ter redução da qualidade de vida associada aos custos do tratamento. Objetivo: Avaliar a qualidade de vida relacionada a saúde e a relação com a toxicidade financeira de pessoas com doença renal crônica em tratamento hemodialítico. Material e Método: Estudo observacional, descritivo e transversal realizado com 214 pessoas, cuja coleta de dados ocorreu de fevereiro a maio de 2022, em quatro clínicas especializadas em diálise na região sul do Brasil. Utilizouse os questionários sociodemográfico e clínico, COmprehesive Score for Financial Toxicity e o Kidney Disease Quality Of Life–Short Form. Os dados das variáveis da caracterização sociodemográfica e clínica, foram analisados descritivamente com frequências absolutas e relativas; para os escores da toxicidade financeira e qualidade de vida relacionada à saúde foi usado a correlação de Pearson. Resultados: Quatro itens do questionário Kidney Disease Quality Of Life – Short Form tiveram média abaixo de 50, sendo consideradas com escore ruim de qualidade de vida, são eles: “Saúde geral” (10,75), “Limitações das funções físicas” (29,93), “Sobrecarga da doença renal” (37,76) e “Situação de trabalho” (39,49), e compostos físico (34,49) e mental (49,19). A relação da toxicidade financeira e a qualidade de vida relacionada à saúde, evidenciou que um pior escore de toxicidade financeira foi associado à maior número de dimensões prejudicadas. Houve correlação significativa entre a toxicidade financeira e a dimensão saúde mental e a efeitos da doença renal. Conclusão: Os participantes tiveram comprometimento da qualidade de vida relacionada à saúde, havendo correlação positiva com a toxicidade financeira. (AU)

Introdución: Las personas con enfermedad renal crónica pueden tener una calidad de vida reducida asociada a los costes del tratamiento. Objetivo: Evaluar la calidad de vida relacionada con la salud y la relación con la toxicidad financiera en personas con enfermedad renal crónica sometidas a tratamiento de hemodiálisis. Material y Método: Estudio observacional, descriptivo y transversal de 214 personas, con datos recogidos entre febrero y mayo de 2022 en cuatro clínicas especializadas en diálisis del sur de Brasil. Fueron utilizados los cuestionarios sociodemográfico y clínico, el COmprehesive Score for Financial Toxicity y el Kidney Disease Quality Of Life - Short Form. Los datos de las variables sociodemográficas y clínicas se analizaron descriptivamente con frecuencias absolutas y relativas; se utilizó la correlación de Pearson para las puntuaciones de toxicidad financiera y calidad de vida relacionada con la salud. Resultados: Cuatro ítems del cuestionario Kidney Disease Quality Of Life - Short Form obtuvieron una puntuación media inferior a 50, y se consideró que tenían una mala calidad de vida, a saber: “Salud general” (10,75), “Limitaciones de las funciones físicas” (29,93), “Carga de la enfermedad renal” (37,76) y “Situación laboral” (39,49), y compuestos: físico (34,49) y mental (49,19). La relación entre la toxicidad financiera y la calidad de vida relacionada con la salud mostró que una peor puntuación de toxicidad financiera se asociaba con un mayor número de dimensiones deterioradas. Existía una correlación significativa entre la toxicidad financiera y la dimensión de salud mental y los efectos de la enfermedad renal. Conclusión: La calidad de vida relacionada con la salud de los participantes se vio comprometida y hubo una correlación positiva con la toxicidad financiera. (AU)

Introduction: Individuals with chronic kidney disease may experience reduced quality of life associated with treatment costs. Objective: To evaluate health-related quality of life and its relationship with financial toxicity in individuals with chronic kidney disease undergoing hemodialysis treatment. Material and Methods: An observational, cross-sectional study involving 214 individuals was carried out, with data collected from February to May 2022 at four specialized dialysis clinics in the southern region of Brazil. Sociodemographic and clinical questionnaires, the Comprehensive Score for Financial Toxicity, and the Kidney Disease Quality of Life - Short Form were utilized. Descriptive analysis with absolute and relative frequencies was conducted for sociodemographic and clinical variables, and Pearson correlation was used for financial toxicity and health-related quality of life scores. Results: Four items of the Kidney Disease Quality of Life-Short Form questionnaire had an average score below 50, indicating poor quality of life: “General health” (10.75), “Limitations in physical functioning” (29.93), “Burden of kidney disease” (37.76), and “Work status” (39.49), with physical (34.49) and mental (49.19) composite scores. The relationship between financial toxicity and health-related quality of life revealed that a worse financial toxicity score was associated with a greater number of impaired dimensions. There was a significant correlation between financial toxicity, the mental health dimension, and the effects of kidney disease. Conclusion: Participants experienced compromised health-related quality of life, with a positive correlation with financial toxicity. (AU)

The spectrum of neurological presentation in individuals affected by TBL1XR1 gene defects.

BACKGROUND: TBL1XR1 encodes a F-box-like/WD40 repeat-containing protein that plays a role in transcription mediated by nuclear receptors and is a known genetic cause of neurodevelopmental disease of childhood (OMIM# 608628). Yet the developmental trajectory and progression of neurologic symptoms over time remains poorly understood. METHODS: We developed and distributed a survey to two closed Facebook groups devoted to families of patients with TBL1XR1-related disorder. The survey consisted of 14 subsections focused upon the developmental trajectories of cognitive, behavioral, motor, and other neurological abnormalities. Data were collected and managed using REDCap electronic data capture tools. RESULTS: Caregivers of 41 patients with a TBL1XR1-related disorder completed the cross-sectional survey. All reported variants affecting a single amino acid, including missense mutations and in-frame deletions, were found in the WD40 repeat regions of Tbl1xr1. These are domains considered important for protein-protein interactions that may plausibly underlie disease pathology. The majority of patients were diagnosed with a neurologic condition before they received their genetic diagnosis. Language appeared most significantly affected with only a minority of the cohort achieving more advanced milestones in this domain. CONCLUSION: TBL1XR1-related disorder encompasses a spectrum of clinical presentations, marked by early developmental delay ranging in severity, with a subset of patients experiencing developmental regression in later childhood.

Clinical and sociodemographic factors associated with time spent sitting in military police.

OBJECTIVE: To verify the association between clinical and sociodemographic factors and time spent sitting in military police. METHOD: This is a cross-sectional study, with 432 military police officers from Eastern Regional Policing Command units of the Military Police of Bahia de Feira de Santana. Data collection took place from August to December 2022 through Google Forms using the International Physical Activity Questionnaire. RESULTS: Men predominated (82.35%), race/color was black (87.04%), the head of the family had completed higher education (47.69%) and police officers with a partner (81.94%). The risk of time spent sitting ≥ 180 minutes per day was lower in males (IRR < 1). Increasing age was associated with a lower risk of time spent sitting ≥ 180 minutes per day (IRR < 1). CONCLUSION: Male police officers with more years of experience were less exposed to sedentary behavior. Specific interventions and health policies aimed at combating sedentary behavior become relevant, aiming to promote health and prevent diseases.

Características sociodemográficas, hábitos de vida y condiciones de salud de las personas privadas de libertad / Características sociodemográficas, hábitos de vida e condições de saúde de pessoas privadas de liberdade / Sociodemographic characteristics, life habits and health conditions of people deprived of liberty

La privación de la libertad, por sus características, impone a las personas hábitos y costumbres diferenciados que pueden influir en su salud. En ese sentido, el propósito de este estudio es describir las características sociodemográficas, hábitos de vida y condiciones de salud de las personas privadas de libertad. Se trata de un estudio transversal y descriptivo, realizado en cuatro centros penitenciarios de una ciudad del sur de Brasil. La recopilación de datos se realizó mediante un instrumento semiestructurado y se utilizó la estadística descriptiva para el análisis. Participaron 326 personas privadas de libertad, 90,8% eran hombres, 53,4% jóvenes, entre 18 y 29 años, 43,3% solteros, 55,8% con menos de nueve años de escolaridad, 61,3% realizaban alguna actividad en la unidad carcelaria, 63,2% eran fumadores o exfumadores, 28,2% ingerían bebidas alcohólicas y 60,4% eran usuarios o exusuarios de drogas ilícitas, 71,2% practicaban actividades físicas, 86,1% evaluaban positivamente su estado de salud y 52,5% reportaban alguna enfermedad crónica. Las enfermedades más frecuentes declaradas en sus relatos fueron las respiratorias, las gastrointestinales, las mentales, las cardiovasculares y las musculoesqueléticas. Las personas privadas de libertad tienen enfermedades crónicas y factores de riesgo prevalentes en la población general. Conocer el perfil epidemiológico de este grupo de población puede contribuir a las acciones de promoción de la salud, prevención y control de los factores de riesgo. (AU)

A privação de liberdade, por suas características, impõe as pessoas hábitos e costumes diferenciados que podem influenciar em sua saúde. Nesse sentido, o objetivo deste é descrever as características sociodemográficas, hábitos de vida e condições de saúde de pessoas privadas de liberdade. Trata-se de um estudo transversal, descritivo, realizado em quatro unidades penais de um município do sul do Brasil. A coleta de dados foi realizada por instrumento semiestruturado e utilizou-se estatística descritiva para análise. Participaram 326 pessoas privadas de liberdade, dessas 90,8% eram do sexo masculino, 53,4% jovens, com idade entre 18 e 29 anos, 43,3% solteiras, 55,8% com escolaridade inferior a nove anos, 61,3% realizavam alguma atividade na unidade penal, 63,2% eram fumantes ou ex-fumantes, 28,2% ingeriam bebida alcoólica e 60,4% usuários ou ex-usuários de drogas ilícitas, 71,2% praticavam atividades físicas, 86,1% avaliaram positivamente o estado de saúde e 52,5% relatou alguma doença crônica. As doenças que prevaleceram nos autorrelatos foram as respiratórias, gastrointestinais, psíquicas, cardiovasculares e osteomusculares. As pessoas privadas de liberdade possuem as doenças crônicas e fatores de risco prevalentes na população em geral. Conhecer o perfil epidemiológico desse grupo populacional pode contribuir com ações promotoras de saúde, prevenção e controle dos fatores de risco. (AU)

The deprivation of liberty, due to its characteristics, imposes on people differentiated habits and customs that can influence their health. In that sense, the objective of this is to verify the prevalence of chronic diseases in the prison population. This is a cross-sectional descriptive study, carried out in four prison unity in a city in southern Brazil. Data collection was performed by a semi-structured instrument and descriptive statistics were used for analysis. Participated 326 people deprived of freedom, 90.8% were male, 53.4% young, aged between 18 and 29 years, 43.3% single, 55.8% with less than nine years of schooling, 61.3% performed some activity in the penal unit, 63.2% were smokers or former smokers, 28.2% drank alcohol and 60.4% used or ex used illicit drugs, 71.2% practiced physical activities, 86.1% positively evaluated their health status and 52.5% reported some chronic disease. The most prevalent self-reported diseases were respiratory, gastrointestinal, mental, cardiovascular, and musculoskeletal. People deprived of freedom have chronic diseases and risk factors prevalent in the general population. Knowing the epidemiological profile of this population group can contribute to health-promoting actions, prevention, and control of risk factors. (AU)

Arrival time at a referral hospital and functional disability of people with stroke: a cohort study.

BACKGROUND: Stroke is a major cause of death and functional disability worldwide. Knowledge of the associated factors is essential for defining education, management, and healthcare strategies. OBJECTIVE: To analyze the association between arrival time at a neurology referral hospital (ATRH) and functional disability in patients with ischemic stroke 90 days after the event. DESIGN AND SETTING: Prospective cohort study conducted at a public institution of higher education in Brazil. METHODS: This study included 241 people aged ≥ 18 years who presented ischemic stroke. The exclusion criteria were death, inability to communicate without companions who could answer the research questions, and > 10 days since ictus. Disability was assessed using the Rankin score (mR). Variables for which associations showed a P value ≤ 0.20 in bivariate analysis were tested as modifiers between ATRH and disability. Significant interaction terms were used for multivariate analysis. Multivariate logistic regression analysis was performed with all variables, arriving at the complete model and adjusted beta measures. The confounding variables were included in the robust logistic regression model, and Akaike's Information Criterion was adopted to choose the final model. The Poisson model assumes a statistical significance of 5% and risk correction. RESULTS: Most participants (56.0%) arrived at the hospital within 4.5 hours of symptom onset, and 51.7% presented with mRs of 3 to 5 after 90 days of ictus. In the multivariate model, ATRH ≥ 4.5 hours and females were associated with more significant disability. CONCLUSIONS: Arrival at the referral hospital 4.5 hours after the onset of symptoms or wake-up stroke was an independent predictor of a high degree of functional disability.

SPTSSA variants alter sphingolipid synthesis and cause a complex hereditary spastic paraplegia.

Sphingolipids are a diverse family of lipids with critical structural and signalling functions in the mammalian nervous system, where they are abundant in myelin membranes. Serine palmitoyltransferase, the enzyme that catalyses the rate-limiting reaction of sphingolipid synthesis, is composed of multiple subunits including an activating subunit, SPTSSA. Sphingolipids are both essential and cytotoxic and their synthesis must therefore be tightly regulated. Key to the homeostatic regulation are the ORMDL proteins that are bound to serine palmitoyltransferase and mediate feedback inhibition of enzymatic activity when sphingolipid levels become excessive. Exome sequencing identified potential disease-causing variants in SPTSSA in three children presenting with a complex form of hereditary spastic paraplegia. The effect of these variants on the catalytic activity and homeostatic regulation of serine palmitoyltransferase was investigated in human embryonic kidney cells, patient fibroblasts and Drosophila. Our results showed that two different pathogenic variants in SPTSSA caused a hereditary spastic paraplegia resulting in progressive motor disturbance with variable sensorineural hearing loss and language/cognitive dysfunction in three individuals. The variants in SPTSSA impaired the negative regulation of serine palmitoyltransferase by ORMDLs leading to excessive sphingolipid synthesis based on biochemical studies and in vivo studies in Drosophila. These findings support the pathogenicity of the SPTSSA variants and point to excessive sphingolipid synthesis due to impaired homeostatic regulation of serine palmitoyltransferase as responsible for defects in early brain development and function.

Clinical and sociodemographic factors associated with time spent sitting in military police / Factores clínicos y sociodemográficos asociados al tiempo de permanencia en la policía militar / Fatores clínicos e sociodemográficos associados ao tempo gasto sentado em policiais militares

ABSTRACT Objective: To verify the association between clinical and sociodemographic factors and time spent sitting in military police. Method: This is a cross-sectional study, with 432 military police officers from Eastern Regional Policing Command units of the Military Police of Bahia de Feira de Santana. Data collection took place from August to December 2022 through Google Forms using the International Physical Activity Questionnaire. Results: Men predominated (82.35%), race/color was black (87.04%), the head of the family had completed higher education (47.69%) and police officers with a partner (81.94%). The risk of time spent sitting ≥ 180 minutes per day was lower in males (IRR < 1). Increasing age was associated with a lower risk of time spent sitting ≥ 180 minutes per day (IRR < 1). Conclusion: Male police officers with more years of experience were less exposed to sedentary behavior. Specific interventions and health policies aimed at combating sedentary behavior become relevant, aiming to promote health and prevent diseases.

RESUMEN Objetivo: Verificar la asociación entre factores clínicos y sociodemográficos y el tiempo de permanencia en la policía militar. Método: Estudio transversal, con 432 policías militares de unidades del Comando de Policía Regional Este de la Policía Militar de Bahía de Feira de Santana. La recolección de datos se realizó de agosto a diciembre de 2022 a través de Google Forms utilizando el Cuestionario Internacional de Actividad Física. Resultados: Predominaron los hombres (82,35%), la raza/color fue negra (87,04%), el jefe de familia tenía estudios superiores (47,69%) y los policías con pareja (81,94%). El riesgo de pasar tiempo sentado ≥ 180 minutos por día fue menor en los hombres (IRR < 1). El aumento de la edad se asoció con un menor riesgo de pasar tiempo sentado ≥ 180 minutos por día (IRR < 1). Conclusión: Los policías varones con más años de experiencia estuvieron menos expuestos al comportamiento sedentario. Cobran relevancia intervenciones y políticas de salud específicas dirigidas a combatir el sedentarismo, con el objetivo de promover la salud y prevenir enfermedades.

RESUMO Objetivo: Verificar a associação entre fatores clínicos e sociodemográficos e o tempo gasto sentado em policiais militares. Método: Estudo transversal, com 432 policiais militares das unidades do Comando de Policiamento Regional Leste da Polícia Militar da Bahia de Feira de Santana. A coleta de dados ocorreu de agosto a dezembro de 2022 através do Google Forms constando o Questionário Internacional de Atividade Física. Resultados: Predominaram homens (82,35%), raça/cor negra (87,04%), nível de escolaridade do chefe da família superior completo (47,69%) e policiais com companheiro(a) (81,94%). O risco do tempo gasto sentado ≥ 180 minutos por dia foi menor no sexo masculino (IRR < 1). O aumento da idade foi associado a menor risco de tempo gasto sentado ≥ 180 minutos por dia (IRR < 1). Conclusão: Policiais do sexo masculino e com mais anos de vida estavam menos expostos ao comportamento sedentário. Intervenções específicas e políticas de saúde voltadas ao combate do comportamento sedentário se tornam relevantes, visando à promoção da saúde e prevenção de agravos.

Arrival time at a referral hospital and functional disability of people with stroke: a cohort study

ABSTRACT BACKGROUND: Stroke is a major cause of death and functional disability worldwide. Knowledge of the associated factors is essential for defining education, management, and healthcare strategies. OBJECTIVE: To analyze the association between arrival time at a neurology referral hospital (ATRH) and functional disability in patients with ischemic stroke 90 days after the event. DESIGN AND SETTING: Prospective cohort study conducted at a public institution of higher education in Brazil. METHODS: This study included 241 people aged ≥ 18 years who presented ischemic stroke. The exclusion criteria were death, inability to communicate without companions who could answer the research questions, and > 10 days since ictus. Disability was assessed using the Rankin score (mR). Variables for which associations showed a P value ≤ 0.20 in bivariate analysis were tested as modifiers between ATRH and disability. Significant interaction terms were used for multivariate analysis. Multivariate logistic regression analysis was performed with all variables, arriving at the complete model and adjusted beta measures. The confounding variables were included in the robust logistic regression model, and Akaike's Information Criterion was adopted to choose the final model. The Poisson model assumes a statistical significance of 5% and risk correction. RESULTS: Most participants (56.0%) arrived at the hospital within 4.5 hours of symptom onset, and 51.7% presented with mRs of 3 to 5 after 90 days of ictus. In the multivariate model, ATRH ≥ 4.5 hours and females were associated with more significant disability. CONCLUSIONS: Arrival at the referral hospital 4.5 hours after the onset of symptoms or wake-up stroke was an independent predictor of a high degree of functional disability.

A Saúde Mental dos enfermeiros dos cuidados de saúde primários versus diferenciados e que prestam cuidados a doentes Covid-19: estudo comparativo / Influencia y origen de la experiencia de escuchar voces / The Mental Health of primary versus differentiated health care nurses and providing care to Covid-19 patients: comparative study

Resumo Contexto: O enfermeiro é um profissional de referência dos indivíduos, famílias e comunidades. Para cuidar dos outros o enfermeiro precisa de cuidar de si, devendo garantir a sua saúde mental. Alterações ao nível da saúde mental podem implicar, de forma negativa, a qualidade dos cuidados. Objetivos: (i) Avaliar o nível de saúde mental dos enfermeiros e a sua relação com as variáveis de caraterização biossocial e profissional; (ii) Analisar se o nível de saúde mental dos enfermeiros difere em função das unidades de prestação de cuidados: cuidados de saúde primários versus diferenciados, bem como da prestação de cuidados a doentes Covid-19. Metodologia: Estudo transversal quantitativo de comparação entre grupos. Aplicou-se um questionário com duas partes, a 1ª caracteriza a amostra através das variáveis biossociais e profissionais; a 2ª integra o "Inventário de Saúde Mental" de Pais Ribeiro (2001). Amostra não probabilística de 81 enfermeiros. Análise descritiva das variáveis de caraterização e inferencial para detetar diferenças estatisticamente significativas entre grupos. Resultados: A amostra é constituída por 81 enfermeiros 84,0% (n=68) são mulheres, 75,3% (n=61) são enfermeiros dos cuidados de saúde diferenciados e 54,3% (n=44) prestaram cuidados a doentes Covid-19. O score total do MHI é significativamente mais baixo em enfermeiros dos cuidados de saúde primários em comparação com os colegas dos cuidados diferenciados (63,5±17,71 versus 72,5±16,15 p=0.027), bem como nos enfermeiros que prestam cuidados a doentes Covid-19 em comparação com os que não prestam esses cuidados (68,6±15,83 versus 75,5±15,71 p<0.001). Conclusão: Apesar de o nível de saúde mental destes enfermeiros ser elevado, os resultados demonstram risco de deterioração da saúde mental nos enfermeiros dos cuidados de saúde primários, bem como nos que prestam cuidados de saúde a doentes Covid-19.

Resumen Contexto: El enfermero es considerado un profesional de referencia para los individuos, las familias y la comunidad, un motivo importante para que se sientan bien consigo mismos para brindar cuidados. La falta de salud mental puede reflejar negativamente la calidad de la atención brindada. Para cuidar de los usuarios, las enfermeras deben saber cuidarse a sí mismas y deben velar por su propia salud mental. Objetivo: (i) Analizar si el nivel de salud mental de los encuestados difiere según las unidades de salud servicios hospitalarios vs servicios comunitários, (ii) Evaluar el nivel de salud mental de los enfermeros y su relación con las características biosociales y profesionales. Metodología: Estudio transversal cuantitativo de comparación de grupos. Se aplicó un cuestionario que consta de dos partes, la primera parte caracteriza la muestra a través de variables biosociales y profesionales, mientras que la segunda parte integra el "Inventario de Salud Mental" de Pais Ribeiro (2001). La estrategia de análisis de datos implicó realizar un análisis descriptivo, así como un análisis inferencial para detectar diferencias estadísticamente significativas entre grupos. Resultados: La muestra está compuesta por 81 enfermeras, el 84,0% (n=68) son mujeres, el 75,3% (n=61) son enfermeras de atención diferenciada en salud y el 54,3% (n=44) brindan atención a pacientes Covid-19. La puntuación total del MHI es significativamente menor en enfermeras de atención primaria en comparación con sus pares en atención diferenciada (63,5±17,71 versus 72,5±16,15 p=0,027), así como en enfermeras que brindan atención a pacientes con Covid-19 en comparación con las que no lo hacen. brindar dicha atención (68,6±15,83 versus 75,5±15,71 p<0,001). Conclusión: Si bien el nivel de salud mental de estas enfermeras es alto, los resultados demuestran un riesgo de deterioro de la salud mental en las enfermeras de atención primaria, así como en aquellas que trabajan com pacientes con Covid-19.

Abstract Context: The nurse is considered a professional reference for individuals, families and the community, an important reason for them to feel good about themselves to provide care. Lack of mental health can negatively reflect the quality of care provided. To take care of users, nurses need to know how to take care of themselves and must ensure their own mental health. Objective: (i) To analyze whether the respondents' mental health level differs between those working in the primary healthcare units and those working in tertiary healthcare , (ii) To assess the nurses' mental health level and its relationship with biosocial and professional characteristics. Methodology: This is a descriptive cross-sectional study for comparison between groups. A questionnaire was applied that includes two parts, the first part characterizes the sample based on biosocial and professional variables, while the second part integrates the "Mental Health Inventory" by Pais Ribeiro (2001). The data analysis strategy included a descriptive analysis, as well as inferential analysis to detect statistically significant differences between groups. Results: The sample consists of 81 nurses, 84.0% (n=68) were women, 75.3% (n=61) were nurses of tertiary healthcare facilities and 54.3% (n=44) provided care to Covid-19 patients. The total MHI score is significantly lower among primary care nurses compared to their colleagues in tertiary healthcare facilities (63.5±17.71 versus 72.5±16.15 p=0.027), as well as in nurses who provided care to Covid-19 patients compared to those who do not provide such care (68.6±15.83 versus 75.5±15.71 p<0.001). Conclusion: Although the level of mental health of these nurses was high, the results demonstrate a risk of deterioration of mental health in nurses in primary healthcare services, as well as in those who provided health care to Covid-19 patients.

Genomic insights into host and parasite interactions during intracellular infection by Toxoplasma gondii.

To gain insights into the molecular interactions of an intracellular pathogen and its host cell, we studied the gene expression and chromatin states of human fibroblasts infected with the Apicomplexan parasite Toxoplasma gondii. We show a striking activation of host cell genes that regulate a number of cellular processes, some of which are protective of the host cell, others likely to be advantageous to the pathogen. The simultaneous capture of host and parasite genomic information allowed us to gain insights into the regulation of the T. gondii genome. We show how chromatin accessibility and transcriptional profiling together permit novel annotation of the parasite's genome, including more accurate mapping of known genes and the identification of new genes and cis-regulatory elements. Motif analysis reveals not only the known T. gondii AP2 transcription factor-binding site but also a previously-undiscovered candidate TATA box-containing motif at one-quarter of promoters. By inferring the transcription factor and upstream cell signaling responses involved in the host cell, we can use genomic information to gain insights into T. gondii's perturbation of host cell physiology. Our resulting model builds on previously-described human host cell signalling responses to T. gondii infection, linked to induction of specific transcription factors, some of which appear to be solely protective of the host cell, others of which appear to be co-opted by the pathogen to enhance its own survival.

Factors related to the pattern of alcohol consumption in rural women / Factores relacionados con el patrón de consumo de alcohol entre las mujeres rurales / Fatores relacionados ao padrão de consumo de bebida alcoólica em mulheres rurais

ABSTRACT Objective: to investigate factors related to the pattern of alcohol consumption in rural women. Method: this is a quantitative study of non-probabilistic convenience sampling carried out with 259 women from a rural community in Bahia in primary health care. A structured form and the Alcohol Use Disorders Identification Test were used. Data were analyzed using descriptive statistics to estimate the independent contribution of each variable to the probability of outcomes related to alcohol consumption. Logistic regression analysis was applied using the R 4.0.2 software for Windows, with variables in decreasing order of statistical significance. Results: the sample was composed of women between 30 and 49 years old, predominantly black, with religion, with a partner, who complete high school, remunerated activity, family income less than one minimum wage, and living in their own or assigned home. Having a religion reduces the chance of consuming alcohol by 0.15%. Living in a house with up to 3 residents, "not being injured because of drinking" and having a religion increase, respectively, by 89.1, 21.7, and 8.43% the chances of staying in the low-risk zone. Not having a religion increases the chances of moderate drinking by 97.4%. Being injured because of drinking increases the chances of making harmful consumption of alcoholic beverages by 98.9%. Not having a religion and being injured because of drinking increases the chances of using alcohol with probable dependence by 99.7%. Conclusion: religion proved to be a protective factor for greater consumption of alcoholic beverages. On the other hand, being injured or hurting someone because of drinking was characterized as a risk factor.

RESUMEN Objetivo: investigar los factores relacionados con el patrón de consumo de alcohol entre las mujeres rurales. Método: estudio cuantitativo de muestreo no probabilístico por conveniencia, con 259 mujeres de una comunidad rural de Bahía, en atención primaria de salud. Se utilizó un for mulario estructurado y el Test de Identif icación de Trastornos por Consumo de Alcohol. Los datos se analizaron mediante estadísticas descriptivas para estimar la contribución independiente de cada variable en la probabilidad de resultados relacionados con el consumo de alcohol. El análisis de regresión logística se aplicó utilizando el programa informático R 4.0.2 para Windows, con las variables en orden descendente de significación estadística. Resultados: muestra compuesta por mujeres de 30 a 49 años, predominantemente negras, religiosas, con pareja, educación secundaria completa, actividad remunerada, ingresos familiares inferiores a un salario mínimo, que viven en casa propia o asignada. Tener una religión disminuye la posibilidad de consumir bebidas alcohólicas en un 0,15%. Tener hasta 03 residentes, "no haber sufrido daños por la bebida" y tener una religión aumentan las posibilidades de permanecer en la zona de bajo riesgo en un 89,1, 21,7 y 8,43 veces. El hecho de no tener una religión aumenta las posibilidades de beber con moderación en un 97,4%. Sufrir un accidente a causa de la bebida aumenta en un 98,9% las probabilidades de que el consumo de alcohol sea perjudicial. No tener religión y ser perjudicado por la bebida aumentó en un 99,7% las posibilidades de consumo de bebidas alcohólicas con probable dependencia. Conclusión: la religión se evidenció como un factor de protección para el aumento del consumo de bebidas alcohólicas, y resultar herido o lesionado por beber se caracterizó como un factor de riesgo.

RESUMO Objetivo: investigar fatores relacionados ao padrão de consumo de bebida alcoólica em mulheres rurais. Método: estudo quantitativo de amostragem não probabilística por conveniência realizado com 259 mulheres de comunidade rural da Bahia na atenção primária à saúde. Utilizouse formulário estruturado e o Alcohol Use Disorders Identification Test. Os dados foram analisados empregando estatísticas descritivas para estimar a contribuição independente de cada variável na probabilidade dos desfechos relacionados ao consumo de bebida alcoólica. Aplicou-se a análise de regressão logística pelo software R 4.0.2 for Windows, com variáveis em ordem decrescente de significância estatística. Resultados: amostra composta por mulheres de 30 a 49 anos, predominantemente pretas, com religião, com companheiro, ensino médio completo, atividade remunerada, renda familiar menor que um salário mínimo, residentes em casa própria ou cedida. Ter religião diminui em 0,15% a chance de consumir bebida alcoólica. Morar em habitação com até 3 residentes, "não ficar ferida porque bebeu" e ter religião aumentam, respectivamente, em 89,1, 21,7 e 8,43% as chances de se manter na zona de baixo risco. Não possuir religião aumenta em 97,4% as chances de beber moderadamente. Ficar ferida porque bebeu aumenta em 98,9% as chances de fazer consumo nocivo de bebida alcoólica. Não ter religião e ficar ferida porque bebeu aumentam em 99,7% as chances de fazer uso de bebida alcoólica com provável dependência. Conclusão: a religião evidenciou-se como fator de proteção para o maior consumo de bebida alcoólica. Por outro lado, ficar ferida ou ferir alguém porque bebeu, se caracterizou como fator de risco.

Associação entre fatores sociodemográficos e consumo de álcool, tabaco e hipnóticos em mulheres rurais / Asociación entre factores sociodemográficos y consumo de alcohol, tabaco e hipnóticos en mujeres rurales / Association between sociodemographic factors and consumption of alcohol, tobacco and hypnotics in rural women

Objetivo: investigar a associação entre fatores sociodemográficos e consumo de álcool, tabaco e hipnóticos em mulheres rurais. Método: estudo transversal realizado com 259 mulheres rurais. Para a coleta dos dados, utilizou-se formulário estruturado e o Alcohol, Smoking and Substance Involvement Screening Test. Para a análise empregou-se o Teste qui-quadrado e/ou Exato de Fisher com intervalo de confiança de 95%. Resultados: observou-se associação entre o uso do tabaco e a cor (p=0,041), a crença religiosa (p=0,001) e benefício governamental (p=0,006). Houve associação entre o consumo de álcool e a crença religiosa (p≤0,001). Quanto a necessidade de intervenção, observou-se associação entre tabaco e cor (p=0,009), renda (p=0,001) e benefício governamental (p=0,006), assim como álcool e idade (p=0,035), crença religiosa (p=0,006) e renda (p=0,002). Conclusão: fatores como religião, cor, renda, idade e benefício governamental estão associados ao uso de álcool e tabaco em mulheres rurais.

Objetivo: investigar la asociación entre factores sociodemográficos y consumo de alcohol, tabaco e hipnótico en mujeres rurales. Método: estudio transversal realizado con 259 mujeres rurales. Para la recolección de datos, se utilizó un formulario estructurado y se utilizó la Prueba de Detección de Alcohol, Smoking and Substance Involvement Screening Test. Para el análisis se utilizó el Chi-Cuadrado y/o la Prueba Exacta de Fisher con un intervalo de confianza del 95%. Resultados: hubo asociación entre el consumo de tabaco y el color (p=0,041), la creencia religiosa (p=0,001) y el beneficio gubernamental (p=0,006). Hubo una asociación entre el consumo de alcohol y las creencias religiosas (p≤0,001). En cuanto a la necesidad de intervención, hubo una asociación entre el tabaco y el color (p=0,009), los ingresos (p=0,001) y el beneficio del gobierno (p=0,006), así como el alcohol y la edad (p=0,035), las creencias religiosas (p=0,006) y los ingresos (p=0,002). Conclusión: factores como la religión, el color, los ingresos, la edad y el beneficio del gobierno están asociados con el consumo de alcohol y tabaco en las mujeres rurales.

Objective: to investigate the association between sociodemographic factors and alcohol, tobacco and hypnotic consumption in rural women. Method: cross-sectional study conducted with 259 rural women. For data collection, a structured form was used and the Alcohol, Smoking and Substance Involvement Screening Test was used. For the analysis, the Chi-Square and/or Fisher's Exact Test with a 95% confidence interval was used. Results: there was an association between tobacco use and color (p=0.041), religious belief (p=0.001) and governmental benefit (p=0.006). There was an association between alcohol consumption and religious belief (p≤0.001). Regarding the need for intervention, there was an association between tobacco and color (p=0.009), income (p=0.001) and government benefit (p=0.006), as well as alcohol and age (p=0.035), religious belief (p=0.006) and income (p=0.002). Conclusion: factors such as religion, color, income, age and government benefit are associated with alcohol and tobacco use in rural women.

Fatores associados ao tempo de chegada precoce em pacientes com acidente vascular cerebral isquémico

Objetivo: Conhecer os fatores associados ao tempo de chegada precoce de pacientes com acidente vascular cerebral isquêmico de um hospital público do Brasil. Material e Método: Estudo transversal com 220 pacientes com acidente vascular cerebral isquêmico que chegaram a unidade de neurologia de um hospital na cidade de Salvador/ Bahia/ Brasil. Os pacientes foram dicotomizados em grupo precoce (tempo desde o início dos sintomas até a chegada ao hospital 4,5 h). Utilizou-se os testes Qui quadrado de Pearson e Exato de Fisher para associação do tempo de chegada hospitalar e os dados sociodemográficos, clínicos e evento neurológico. Resultados: 81 pacientes (36,8%) realizaram a trombólise venosa, apesar de 157 pacientes terem chegado dentro da janela trombolítica. Os fatores associados com a precocidade hospitalar foram: ser residente na cidade de Salvador (p< 0,001), utilização de carro particular/táxi (p= 0,029), reconhecimento dos sintomas como acidente vascular cerebral (p= 0,007), tempo de decisão em até 30 min para procurar por serviço de saúde (p< 0,001), procurar inicialmente o hospital referência em neurologia (p=0,005). Não houve estatística significante para os fatores de atraso hospitalar. Pacientes que chegaram até < 4,5 h, conseguiram realizar a trombólise venosa (p< 0,001). Conclusões: A maioria dos pacientes se apresentou ao hospital referência dentro da janela trombolítica, entretanto, menos da metade da amostra teve acesso à terapêutica. Os resultados podem contribuir no planejamento dos serviços de saúde, bem como para orientações aos pacientes.

Objective: To identify the factors associated with early hospital arrival of patients with ischemic stroke in a public hospital of Brazil. Materials and Methods: Cross-sectional study carried out with 220 patients affected by ischemic stroke, who were admitted to the neurology unit of a hospital in the city of Salvador, Bahia, Brazil. Patients were divided into an early group (time from the symptom onset to hospital admission 4.5 h). Pearson's Chi-square and Fisher's exact tests were used to associate hospital admission time and sociodemographic, clinical and neurological data. Results: 81 patients (36.8%) underwent venous thrombolysis, although 157 patients were admitted within the thrombolytic window. Factors associated with early hospitalization were being a resident in the city of Salvador (p< 0.001), use of private car/taxi (p= 0.029), recognition of stroke symptoms (p= 0.007), decision time within 30 min to seek a health service (p< 0.001), initial search for the neurological referral hospital (p= 0.005). There were no statistically significant factors for hospital delay factors. Patients who reached < 4.5 h were able to undergo venous thrombolysis (p< 0.001). Conclusions: Most patients arrived at the referral hospital within the thrombolytic window; however, less than half of the sample had access to therapy. These results may contribute to health services planning, as well as patient guidance.

Objetivo: Conocer los factores asociados al tiempo de llegada temprana de pacientes con ictus isquémico de un hospital público de Brasil. Material y Método: Estudio transversal con 220 pacientes con ictus isquémico que fueron admitidos en la unidad de neurología de un hospital en la ciudad de Salvador, Bahía, Brasil. Los pacientes se dividieron en un grupo temprano (tiempo desde el inicio de los síntomas hasta la admisión al hospital 4,5 h). Se utilizaron las pruebas Chi cuadrado de Pearson y Exacta de Fisher para asociar la hora de admisión al hospital y los datos sociodemográficos, clínicos y neurológicos del evento. Resultados: 81 pacientes (36,8%) fueron sometidos a trombólisis venosa, aunque 157 fueron admitidos dentro de la ventana trombolítica. Los factores asociados a la precocidad hospitalaria fueron: ser residente en la ciudad de Salvador (p< 0,001), utilizar auto/ taxi particular (p= 0,029), reconocimiento de síntomas de ictus (p= 0,007), tiempo de decisión de hasta 30 min para buscar un servicio de salud (p< 0,001), buscar inicialmente el hospital de referencia en neurología (p= 0,005). No hubo factores estadísticamente significativos para los factores de retraso hospitalario. Los pacientes que alcanzaron < 4,5 h pudieron someterse a trombólisis venosa (p< 0,001). Conclusiones: La mayoría de los pacientes acudieron al hospital de referencia dentro de la ventana trombolítica, sin embargo, menos de la mitad de la muestra tuvo acceso a la terapia. Los resultados pueden contribuir a la planificación de los servicios de salud, así como a la orientación a los pacientes.

Associação de características sociodemográficas com fatores de risco cardiovascular em homens hipertensos / Asociación de características sociodemográficas con factores de riesgo cardiovascular en hombres hipertensos / Association of sociodemographic characteristics with cardiovascular risk factors in hypertensive men

Objetivo: investigar a associação de características sociodemográficas com fatores de risco cardiovascular em homens hipertensos. Método: estudo transversal efetuado com 80 homens entrevistados e avaliados clinicamente. Dados analisados descritivamente e pelos testes Qui-Quadrado de Person ou Exato de Fisher. O nível de significância estatística foi de 5%. Resultados: houve maior prevalência de tabagismo em ?60 anos (p=0,002), nível insuficiente de atividade física em ?60 anos (p=0,017), fumantes passivos em brancos (p=0,026) e sem companheira (p=0,039) e consumo excessivo de álcool no final de semana em brancos (p=0,043) e homens com menor escolaridade (p=0,041). Conclusão: foi observada a associação de características sociodemográficas com elevada prevalência de fatores de risco cardiovascular descontrolados em homens hipertensos.

Objetivo: investigar la asociación de características sociodemográficas con factores de riesgo cardiovascular en hombres hipertensos. Método: estudio transversal realizado con 80 hombres entrevistados y evaluados clínicamente. Datos analizados descriptivamente y por pruebas de Persona de Fisher o Chi-Cuadrado Exacto. El nivel de significación estadística fue del 5%. Resultados: hubo mayor prevalencia de tabaquismo en ?60 años (p=0,002), nivel insuficiente de actividad física en ?60 años (p=0,017), fumadores pasivos en blancos (p=0,026) y sin pareja (p=0,039) y consumo excesivo de alcohol en fin de semana en blancos (p=0,043) y hombres con menor escolaridad (p=0,041). Conclusión: se observó la asociación de características sociodemográficas con una alta prevalencia de factores de riesgo cardiovascular no controlados en hombres hipertensos.

Objective: to investigate the association of sociodemographic characteristics with cardiovascular risk factors in hypertensive men. Method: a cross-sectional study was conducted with 80 men interviewed and clinically evaluated. Data were analyzed descriptively and by Fisher's Exact or Person Chi-Square tests. The level of statistical significance was 5%. Results: there was a higher prevalence of smoking in ?60 years (p=0.002), insufficient level of physical activity in ?60 years (p=0.017), passive smokers in whites (p=0.026) and without a partner (p=0.039), and excessive consumption of alcohol at the weekend in whites (p=0.043) and men with lower schooling (p=0.041). Conclusion: sociodemographic characteristics were associated with a high prevalence of uncontrolled cardiovascular risk factors in hypertensive men.

Qualidade de vida de idosos com insuficiência cardíaca

RESUMO Objetivo: Avaliar a qualidade de vida de idosos com diagnóstico de insuficiência cardíaca acompanhados no ambulatório de um hospital universitário em Salvador, Estado da Bahia, Brasil. Material e Método: Estudo avaliativo, realizado com 68 idosos portadores de insuficiência cardíaca. Os dados foram coletados a partir das escalas WHOQOL-OLD e BREF, e analisados por meio da estatística descritiva. Resultados: Houve equivalência entre os sexos dos participantes, a maioria (64,7%) tinha entre 60 e 69 anos, 86,8% aposentados, 83,8% ensino fundamental, 92,6% renda de 1 a 3 salários mínimos, 82,3% moravam com 1 ou mais pessoas e 72,1% eram provedores exclusivos do lar. Os fatores relacionados aos domínios Físico (83,8%) e Meio Ambiente (86,8%) influenciaram para uma pior qualidade de vida (média 1,96 e 1,76 de 5 respectivamente), e os relacionados ao Funcionamento do Sensório (51,5%) e Morte e Morrer (47,1%) à melhor qualidade de vida (média 2,43 e 2,28 de 5 respectivamente). Conclusão: A qualidade de vida desses idosos está aquém do ideal. A manutenção dos impactos das doenças cardíacas e o incremento no envelhecimento em âmbito global torna essencial o conhecimento proporcionado pelo estudo para desenvolvimento de estratégias de controle da doença, melhoramento da qualidade de vida e redução de gastos com a saúde.

ABSTRACT Objective: To analyze the quality of life of elderly patients diagnosed with heart failure in an outpatient clinic of a university hospital in Salvador, State of Bahia, Brazil. Material and Method: Evaluative study performed with 68 patients with heart failure. Data was collected from WHOQOL-OLD and BREF scales and then analyzed using descriptive statistics. Results: There was similar gender representation. Most of the participants were between 60 to 69 years old (64.7%), retired (86.8%), had attended primary school (83.8%), received 1 to 3 minimum wages (92.6%), lived with 1 or more people (82.3%) and 72.1% were the sole providers of their families. The elements related to the Physical (83.8%) and Environmental Domain (86.8%) were linked to a worse quality of life (average 1.96 and 1.76 of 5, respectively) and those related to Sensory Functioning (51.5%) and Death and Dying (47.1%) were linked to a better quality of life (average 2.43 and 2.28 of 5, respectively). Conclusion: The quality of life of the assessed population is worse than expected. The impact from heart disease and the increase in aging globally makes this study essential for the development of strategies to control the disease, improve the quality of life and reduce healthcare costs.

RESUMEN Objetivo: Evaluar la calidad de vida de las personas mayores diagnosticadas con insuficiencia cardíaca y en seguimiento en la clínica ambulatoria de un hospital universitario en Salvador, Estado de Bahía, Brasil. Material y Método: Estudio evaluativo, realizado con 68 personas mayores con insuficiencia cardíaca. Los datos fueron recolectados usando las escalas WHOQOL-OLD y BREF, y analizados con estadística descriptiva. Resultados: Hubo equivalencia entre los sexos de los participantes, la mayoría (64, 7%) tenía entre 60 y 69 años, 86, 8% jubilados, 83,8% con educación primaria, 92,6% ingresos de 1 a 3 salarios mínimos, 82,3% vivían con 1 o más personas y 72,1% eran proveedores exclusivos del hogar. Los factores relacionados con los dominios Físico (83,8%) y Medio Ambiente (86,8%) influyeron en una peor calidad de vida (promedio 1,96 y 1,76 de 5 respectivamente), y aquellos relacionados con la Función Sensorial (51,5%) y Muerte y morir (47,1%) para la mejor calidad de vida (promedio 2,43 y 2,28 de 5 respectivamente). Conclusión: La calidad de vida de estas personas mayores es menos que ideal. Mantener los impactos de las enfermedades cardíacas y aumentar el envejecimiento global hace que el conocimiento proporcionado por el estudio sea esencial para desarrollar estrategias para controlar la enfermedad, mejorar la calidad de vida y reducir los costos de salud.

Renda e hábito alimentar de pessoas hipertensas / Ingresos y hábitos alimenticios de las personas hipertensas / Income and eating habits of hypertensive people

Objetivo verificar associação entre renda e hábitos alimentares de pessoas hipertensas em Multicentro de Saúde na cidade de Salvador, Bahia. Método estudo transversal, com 221 hipertensos. Coletaram-se dados sociodemográficos e de hábitos alimentares, por meio de entrevista e instrumento padronizado, no período de julho a dezembro de 2017. Realizou-se análise bivariada utilizando teste Qui-quadrado de Pearson. O nível de significância estatístico adotado foi de 5%. Resultados predominou consumo de verduras ou legumes (69,1%) e frutas (57,6%) em frequência menor que cinco dias/semana, e uso de produtos substitutivos do sal (69,6%) por pessoas com renda inferior a um salário mínimo; constatadas associações estatisticamente significantes (p=0,027, p=0,003, p=0,043, respectivamente). Conclusão a associação entre renda e hábitos alimentares de pessoas hipertensas mostrou que aquelas com renda menor que um salário mínimo consumiam com menor frequência frutas e verduras ou legumes e faziam uso de produtos substitutivos do sal.

Objetivo verificar una asociación entre los ingresos y los hábitos alimenticios de las personas hipertensas en Multicentro de Saúde en la ciudad de Salvador, Bahía. Método estudio transversal con 221 pacientes hipertensos. Los datos sociodemográficos y de hábitos alimenticios se recopilaron a través de entrevistas y un instrumento estandarizado de julio a diciembre de 2017. El análisis bivariante se realizó mediante la prueba Chi-square de Pearson. El nivel de significación estadística adoptado fue del 5%. Resultados predominio del consumo de hortalizas (69,1%) y frutas (57,6%) menos de cinco días/semana, y el uso de productos sustitutos de la sal (69,6%) por personas con ingresos inferiores a un salario mínimo; se encontraron asociaciones estadísticamente significativas (p=0,027, p=0,003, p=0,043, respectivamente). Conclusión la asociación entre los ingresos y los hábitos alimenticios de las personas hipertensas demostró que aquellos con ingresos más lentos que un salario mínimo consumían frutas y verduras con menos frecuencia y usaban productos sustitutos de la sal.

Objective to verify an association between income and eating habits of hypertensive people in Health Multicenter (Multicentro de Saúde in Portuguese) in the city of Salvador, Bahia. Method cross-sectional study with 221 hypertensive patients. Sociodemographic and eating habits data were collected through interviews and a standardized instrument from July to December 2017. Bivariate analysis was performed using Pearson's Chi-square test. The level of statistical significance adopted was 5%. Results predominance of consumption of vegetables (69.1%) and fruits (57.6%) less than five days/week, and use of salt substitute products (69.6%) by people with an income of less than one minimum wage; statistically significant associations were found (p=0.027, p=0.003, p=0.043, respectively). Conclusion the association between income and eating habits of hypertensive people showed that those with income lower than a minimum wage consumed fruits and vegetables less frequently and used salt substitute products.

Sleep quality of Brazilian nursing students: a cross-sectional study

OBJECTIVE: to describe the sleep quality of nursing students according to the pittsburgh sleep quality index. METHODS: This is a cross-sectional study conducted with 286 nursing students from a public institution in Salvador, Bahia. Data gathering instruments were applied in classrooms and data were assessed in absolute and relative frequencies, means and standard deviation. RESULTS: The mean age of participants was 23.48 years (SD = 4.421). Most of students were female (90.2%), single with partner (90.9%), afro descendent (87.8%), unemployed (81.5%), total Family income below than four minimum wages (47.2%), enrolled between 6th and 10th semester (54.5%), attending academic activities in two or three shifts (80.8%). Sample showed poor sleep quality (86.4%), especially due to the sleep duration, sleep disturbances and daytime disfunction. CONCLUSIONS: Poor sleep quality was prevalent in the sample, what rises the need of further analysis of the associated factors and interventions to change this reality. (AU)