Effects of training Community Health Agents on dementia: a quasi-experimental study.

OBJECTIVES: to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease. METHODS: a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer's Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student's t-test for related samples was used, and the effect size was calculated. RESULTS: while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94. CONCLUSIONS: it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.

Effects of training Community Health Agents on dementia: a quasi-experimental study / Efectos de la capacitación de Agentes Comunitarios de Salud en la demencia: un estudio cuasi experimental / Efeitos da capacitação de Agentes Comunitários de Saúde na demência: um estudo quase experimental

ABSTRACT Objectives: to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease. Methods: a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer's Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student's t-test for related samples was used, and the effect size was calculated. Results: while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94. Conclusions: it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.

RESUMEN Objetivos: evaluar el conocimiento de los Agentes Comunitarios de Salud sobre la demencia antes y después de un taller de capacitación para la detección de signos de la enfermedad. Métodos: estudio cuasi experimental con 33 agentes comunitarios, en el que se recopilaron datos sociodemográficos y conocimiento sobre la demencia, evaluados mediante la Escala de Conocimiento de la Enfermedad de Alzheimer, antes y después del taller. Hubo 10 sesiones semanales en línea y sincrónicas. Se utilizó la prueba t de Student para muestras relacionadas y se calculó el tamaño del efecto. Resultados: mientras que la puntuación promedio en la evaluación inicial a través del instrumento de medición fue de 16,3, en la evaluación final fue de 21,24. Se observó un aumento en la puntuación de instrumento después de participar en el taller, con un valor de 4,94. Conclusiones: es urgente invertir en la educación continua de estos profesionales para aumentar la conciencia en la detección oportuna de casos de demencia en atención primaria y la concienciación sobre factores potencialmente modificables.

RESUMO Objetivos: avaliar o conhecimento dos Agentes Comunitários de Saúde sobre demência antes e após a oficina de capacitação para detecção de sinais da doença. Métodos: estudo quase-experimental com 33 agentes comunitários, no qual foram coletadas informações sociodemográficas e de conhecimento sobre demência, avaliadas pela Alzheimer's Disease Knowledge Scale, no pré e pós-oficina. Houve 10 encontros semanais, online e síncronos. Utilizou-se o teste t de Student para amostras relacionadas e calculou-se o tamanho do efeito. Resultados: enquanto a média de pontos na avaliação inicial, por meio do instrumento de medida, foi de 16,3, na avaliação final foi de 21,24. Observou-se aumento na pontuação na escala após a participação na oficina, com um valor de 4,94. Conclusões: é urgente investir na educação permanente desses profissionais para maior conscientização na detecção oportuna de casos de demência ainda na atenção básica e conscientização de fatores potencialmente modificáveis.

Use of Marijuana to Promote Well-Being: Effects of Use and Prohibition in the Daily Lives of Brazilian Adults.

Background: Marijuana is the most widely used illicit drug worldwide. From an occupational perspective, its use is paradoxical in that although it can be harmful to health and has criminal consequences, it can also promote well-being. This study examined predictors of well-being to determine the effects of marijuana use and its prohibition on the daily lives of Brazilian adults. Methods: This cross-sectional study used an anonymous online questionnaire with a final sample of 2637 respondents. Utilizing logistic regression, variables were selected pertaining to use and prohibition risks, benefits of use, and harm reduction associated with the socioeconomic characteristics of the respondents. Results: Using marijuana for fun was most likely among those self-identified as male, trans/non-binary people, college graduates, and those with higher incomes. Living with family members and using less frequently proved to be protective against the adverse effect of "getting high." Indigenous peoples and youth were more likely to report trouble with the police due to marijuana use; individuals with higher education and longer use of marijuana reported more frequent use of harm reduction strategies; people who identified their color as yellow were more likely to report daily use compared to people who identified their color as white; women and people with higher income were less likely to report daily use. Conclusions: Social class, race, gender, and generation were predictors of well-being associated with marijuana use and its prohibition, indicating an interaction between different dimensions involving the use of illicit substances. Identifying the effects of the use and prohibition of marijuana in promoting well-being, from the conception of drug use as a non-sanctioned occupation, can broaden the understanding of this complex human phenomenon, with health and criminal repercussions, subsidizing the development of approaches more equitable and adequate into occupational therapy to reduce personal and social harm.

Panorama of Intimate Partner Violence Against Women in Brazil and its Association With Self-Perception of Health: Findings From a National Representative Survey.

Intimate partner violence (IPV) is a challenge in Brazil. The country holds one of the highest rates of femicide in the world, most of which are preceded by IPV. We conducted a cross-sectional study with 34,334 women, aged 18 to 59 years, from the 2019 Brazilian National Health Survey to analyze the prevalence of IPV and its subtypes among the Brazilian adult women in the last 12 months, encompassing their health consequences and the use of health services resulting from IPV. We also used logistic regression models to estimate the association of sociodemographic characteristics and self-perceived health status with IPV. The prevalence of IPV among Brazilian adult women in the last 12 months was 7.6% (95% confidence interval [CI] [7.0, 8.2]). Women aged 18 to 39 years, not married, and with income of up to 1 minimum wage (MW), had higher odds of suffering IPV. Among those who reported health consequences due to IPV, 69% reported psychological consequences, and 13.9% sought health care, mostly in primary or secondary health care services in the Brazilian Unified Health System (41.9%). Regarding the self-perceived health variables, women who reported eating problems (odds ratio [OR] = 1.29; [1.01, 1.65]), lack of interest/absence of pleasure (OR = 1.41; [1.11, 1.79]), depressive feelings (OR = 1.39; [1.03, 1.88]), feeling of failure (OR = 1.75; [1.36, 2.24]), and suicidal thoughts (OR = 1.73; [1.25, 2.41]) had greater odds of reporting IPV compared to those who did not report these same perceptions. The results show that younger, divorced or single, low-income women with eating problems and mental health disorders were more likely to suffer IPV. IPV often led to health problems, and many abused women sought support from public health services. Health professionals must be trained to identify and care for these women, thereby acting as allies in preventing and reducing IPV.

Associations between Anthropometrics, Cardiorespiratory Fitness, and Metabolic Syndrome Components in Brazilian Adolescents with Obesity.

Purpose: To describe the presence of metabolic syndrome (MS) in Brazilian adolescents with obesity, and to compare anthropometric and cardiorespiratory fitness measurements in relation to the presence of MS. Methods: Sixty-seven adolescents (13-18 years, 36 girls) with obesity (body mass index z-score ≥2.0) were enrolled. The following were assessed for each participant: anthropometrics, body composition, lipid profile, glucose, serum insulin, insulin resistance, blood pressure (BP), and cardiorespiratory fitness. Results: The presence of MS was found in 47.76% of the sample. The following abnormal measurements were most frequently reported: waist circumference (WC) (100.0%), BP (85.07%), and triglycerides (TG) (50.75%). Boys with obesity were more likely to meet MS criteria when compared to girls (P = 0.040; odds ratio = 2.80 [1.04-7.56]). Conclusion: The presence of MS in Brazilian adolescents with obesity in this study was 47.76%. Among this sample, the most frequently reported MS variables above the established cutoffs were WC (100%), followed by altered BP (85%) and TG (50%). These data further support previously published studies that low levels of cardiorespiratory fitness may increase the risk of MS among adolescents with obesity.

Translation of the UK-Birth-Satisfaction-Scale-Revised (BSS-R) into Brazilian (Portuguese) and description of initial measurement properties.

RATIONALE: The concept of birth satisfaction embraces many factors, which include for example perceived quality of care provision, stress experienced, and personal coping strategies. A woman's birth experience has the power to affect her mental health, decisions surrounding future birth planning, and quality of relationships with her partner and family. The UK-Birth-Satisfaction-Scale-Revised (UK-BSS-R) is currently recommended as the tool of choice by the International Consortium for Health Outcome Measures (ICHOM) for measuring women's experiences of childbirth. It was therefore considered important to translate and validate this scale for use in a Brazilian context. OBJECTIVE: To translate and culturally adapt the UK-BSS-R into Brazilian (Portuguese) and validate its key measurement properties. METHODS: A repeated-measures survey was conducted for the purpose of examining factor structure, validity and reliability of the Brazilian (Portuguese)-BSS-R. PARTICIPANTS: Data was gathered from (n = 101) Brazilian Portuguese-speaking postnatal women. RESULTS: The initial measurement characteristics of the Brazilian (Portuguese)-BSS-R in terms of Intraclass Correlational Coefficient, Standard Error of Measurement and minimal detectable change were found to be excellent. CONCLUSION: The Brazilian (Portuguese)-BSS-R is now considered to be a valid and reliable multidimensional psychometric instrument for measuring birth satisfaction in a Brazilian Portuguese population of postnatal women. This translation was found to be conceptually consistent with the original English-language version (UK-BSS-R) and to have an excellent initial measurement characteristics profile. The direction of future research is indicated, specifically to undertake a thorough psychometric evaluation of the Brazilian (Portuguese)-BSS-R in a larger sample.

Perfil de trabalhadores com lombalgia atendidos em um serviço de saúde / Profile of workers with lumbar affections attended at a health service

As transformações no mundo do trabalho têm propiciado o acúmulo de tarefas, exigências de polivalência e aumento do ritmo de trabalho, ocasionando um aumento de lombalgias. OBJETIVO: Descrever o perfil de trabalhadores com lombalgia, atendidos em uma unidade especializada em Saúde do Trabalhador da Baixada Santista. MÉTODOS: Trata-se de um estudo observacional transversal e exploratório. Ocorreu análise documental de prontuários abertos de trabalhadores atendidos no Centro de Referência em Saúde do Trabalhador (CEREST) de Santos-SP, no período de julho de 2014 a julho de 2015, com queixa de lombalgia e diagnósticos nosológicos estabelecidos para "outras dorsopatias" (M51 a M54) segundo a CID-10. Foram obtidos os dados: demográficos, variáveis clínicas, categorias profissionais, entre outras. RESULTADOS: De 502 prontuários, 21,9% (n=110) apresentaram queixa de lombalgia e diagnóstico clínico pela CID-10. Houve predomínio do sexo feminino (58,2%), na faixa etária de 35 a 45 anos (50,9%) e baixa escolaridade, com ensino fundamental incompleto (35,4%). Ainda, 23,7% dos sujeitos estavam em situação de afastamento do trabalho e 85,0% com registro em carteira de trabalho (CLT). As categorias profissionais mais prevalentes foram de serviços domésticos, 28,3% (n=31) e atividades de limpeza, 19,1% (n=21). Dos sujeitos, 68,2% tiveram assistência de Fisioterapeutas. CONCLUSÃO: A prevalência foi maior no sexo feminino, de trabalhadores formais e afastados do trabalho, do setor de serviços domésticos e atividades de limpeza, de baixa escolaridade, e com a faixa etária considerada produtiva para o trabalho.

The changes in the world of work haved a significant impact on tasks, capturing versatility and increasing the pace of work, causing an increase in low back pain. OBJECTIVE: To describe the profile of workers with low back pain treated at a unit specialized in Occupational Health in Baixada Santista. METHODS: This is an observational cross-sectional and exploratory study. A documentary analysis of the open records of workers attended at the Reference Center for Occupational Health (CEREST), in Santos-SP, from July 2014 to July 2015 was carried out, with a list of low back pain and diagnosis in the following clinical methods for "Other dorsopathies" (M51 to M54) according to ICD-10. The data were selected: demographic, clinical variables, professional categories, among others. RESULTS: Of the 502 medical records, 21.9% (n = 110) reported complaints of low back pain and clinical diagnosis by ICD-10. There was a predominance of females (58.2%), aged between 35 and 45 years (50.9%) and low education, with incomplete primary education (35.4%). Still, 23.7% of individuals were absent from work and 85.0% were registered on the work card (CLT). The most prevalent professional categories were domestic services, 28.3% (n = 31) and cleaning activities, 19.1% (n = 21). Of the subjects, 68.2% had assistance from physiotherapists. CONCLUSION: The prevalence was higher in women, in workers trained and away from work, in the sector of domestic services and cleaning activities, in low education and in the age group considered productive for work.

Perfil de trabalhadores com doenças da coluna vertebral atendidos em um serviço de saúde / Profile of workers with spine cord diseases attended in an occupational health service

Objetivo: Descrever o perfil de trabalhadores com doenças da coluna vertebral (dorsopatias) atendidos em um serviço de Saúde do Trabalhador. Método: Estudo quantitativo com análise documental de prontuários abertos de pacientes atendidos no Centro de Referência em Saúde do Trabalhador (CEREST), Santos-SP, de janeiro de 2010 a dezembro de 2011, e seleção de prontuários de sujeitos com diagnóstico clínico conforme a Classificação Internacional de Doenças CID-10 de M50 a M54. Resultados: Foram analisados 431 prontuários e 15,7% (n=68) apresentaram diagnóstico pela CID-10 de M50 a M54, de pacientes de ambos os gêneros, faixa etária mais acometida entre 41 e 50 anos. A principal categoria acometida foi 'outras atividades de serviços', com 24,6% (n=16). Das análises, 27,9% (n=19) apresentaram também diagnóstico de transtornos dos tecidos moles (M60 a M79), 3,2% (n=09) apresentaram transtornos mentais, e 70,9% (n=39) se encontravam em situação de afastamento do trabalho. Conclusão: A faixa etária mais acometida se encontrava em fase produtiva, mais da metade dos sujeitos estavam em situação de afastamento do trabalho e alguns sujeitos apresentaram outros diagnósticos clínicos, reforçando a necessidade de intervenções interdisciplinares.

Aim: To describe the profile of workers with spine cord diseases attended in an Occupational Health Service. Method: A quantitative study with documentary analysis of open records of patients attended at the Occupational Health Reference Service (CEREST), in Santos-SP, and record selection of subject with clinical diagnosis of M50 to M54 according to the ICD-10. Results: We analyzed 431 records of patients from both genders, most affected age between 41 and 50 years, and 15.7% (n=68) were diagnosed with M50 to M54 according to the ICD-10. The most affected professional category was 'other activities services', with 24.6% (n=16). The analyses showed that 27.9% (n=19) presented also soft tissue injuries (M60 to M79), 3.2% (n=09) mental disorders, and 70.9% (n=39) were in absence from work. Conclusion: The most affected age was in the productive phase and more than half of the subjects were in absence from work situation, some subjects with other clinical diagnosis, reinforcing the need of interdisciplinary interventions.

Ansiedade e Qualidade de Vida entreEstudantes Universitários Ingressantes:Avaliação e Intervenção / Anxiety and Life Quality among Freshmen College Students:Evaluation and Intervention / Ansiedad e y Calidad de Vida Entre Estudiantes Universitariosde Primer Año: Evaluación y Intervención

O estudo avaliou ansiedade e qualidade de vida (QV) entre estudantes universitários ingressantes da área da saúde de uma universidade pública (estudo 1). Com base nos resultados, um programa de intervenção grupal foi desenvolvido (estudo 2). A intervenção consistiu de 8 sessões de 90 min. Em duas sessões foi utilizado um instrumento de biofeedback de variabilidade da frequência cardíaca. Os participantes foram avaliados pelo Inventário de Ansiedade Traço-Estado (IDATE) e pelo questionário que avalia qualidade de vida (QV) SF-36. As mulheres universitárias, independentemente do curso, apresentaram maior ansiedade e pior pontuação em diferentes domínios de mensuração da QV. Os homens do curso de educação física apresentaram melhores escores em diferentes domínios da QV. A intervenção reduziu significativamente a ansiedade e melhorou a saúde mental dos participantes. Estes dados reafirmam a importância do desenvolvimento de programas de intervenção psicoterápica na universidade.(AU)

The study evaluated anxiety and life quality (LQ) of undergraduate freshman students from health science courses of a public university (study 1). In light of the results, a group intervention study was performed (study 2). This intervention consisted of eight sessions, of 90 min each. In two of the sessions, a biofeedback training device, that monitors the variability of the heart rate, was employed. The subjects were evaluated before and after the intervention by the State-Trace Anxiety Inventory and by the Medical Outcomes Study 36 – Item short form health survey. Levels of anxiety were higher and LQ aspects were lower in female students, independently of the undergraduate course. Men from the course of Physical Education showed higher scores in different domains that measured LQ. The intervention significantly reduced levels of anxiety and improved mental health. These data reaffirm the importance of the development of psychotherapeutic programs by the university.(AU)

El estudio evaluó la ansiedad y calidad de vida (CV) entre los estudiantes universitarios de primer año de cursos de la salud en una universidad pública (estudio 1). Con base en los resultados, un programa de intervención grupal fue desarrollado (estudio 2). La intervención consistió en 8 sesiones de 90 min. En dos sesiones se utilizó un instrumento de retroalimentación biológica de la variabilidad del ritmo cardíaco. Los participantes fueron evaluados por el Inventario de Ansiedad Rasgo-Estado (STAI) y el cuestionario de evaluación de CV SF-36. Las mujeres universitarias, independientemente del curso, mostraron mayor ansiedad y peor puntuación en la CV. Hombres del curso de educación física mostraron puntuaciones más altas en diferentes ámbitos de la CV. La intervención redujo significativamente la ansiedad y mejoró la salud mental de los participantes. Estos datos reafirman la importancia del desarrollo de programas de intervención psicoterapéutica en la universidad.(AU)

Perfil de sujeitos com transtornos dos tecidos moles atendidos em um serviço de saúde do trabalhador e as LER/DORT / Profile of the subjects with soft tissue injuries attended at an occupational health service and the RSI

Objetivo: Investigar o perfil de sujeitos com transtornos dos tecidos moles atendidos no Centro de Referência em Saúde do Trabalhador ­ CEREST, Santos-SP, em 2010, e os benefícios previdenciários concedidos. Materiais e Métodos: Análise de prontuários de sujeitos atendidos em 2010, levantando os dados: gênero, idade, profissão, diagnósticos clínicos, queixas clínicas, situação de afastamento, entre outros. Os diagnósticos clínicos foram categorizados conforme a Classificação Internacional de Doenças CID-10 e selecionados os sujeitos com transtornos dos tecidos moles, bem como registrados diagnósticos relacionados a transtornos mentais. Os dados foram registrados no Programa Microsoft Excel e foi utilizado o sistema estatístico R Development Core Team. Resultados: Dos 206 prontuários, 18,0% (n=37) tinham diagnóstico entre transtornos dos tecidos moles, sendo 81,1% do gênero feminino e 18,9% do masculino, idade média de 43,24 anos (DP=8,76). A faixa etária mais acometida esteve entre 31 e 50 anos (70,2%). Entre as profissões mais acometidas estavam: auxiliares de limpeza, auxiliares de serviços gerais e bancários. Os diagnósticos clínicos mais prevalentes foram: sinovites e tenossinovites, bursite de ombro e síndrome do manguito rotador, sendo que 62,2% tinham mais de um diagnóstico clínico. Dos sujeitos, 13,5% tinham também transtornos mentais. Houve associação entre situação de afastamento do trabalho e diagnóstico clínico estabelecido para transtornos dos tecidos moles (p=0,032). Dos dados obtidos apenas 13,5% conseguiram comprovar o nexo causal com o trabalho.Conclusões: O perfil geral do trabalhador foi obtido: prevalência em mulheres, acometimentos em faixa etária produtiva, dificuldade em obter o nexo causal com o trabalho e necessidade de intervenções interdisciplinares.