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    A visita domiciliar como prática de ação integral à saúde da criança e do adolescente.
    (2021) Bresolini, Daniela Soares Rosa; Gaspar, Guilherme Rache; Reis, Luisa Diniz; Machado, Ludmila Stephanie Júlio; Queiroz, Mônica Versiani Nunes Pinheiro de; Araújo, Alisson; Faleiro, Rita de Cássia; Lasmar, Laura Maria de Lima Belizário Facury
    Introdução: a visita domiciliar (VD) é o instrumento de realização da atenção domiciliar (AD) e abrange atividades como promoção à saúde, prevenção de agravos e reabilitação. Em vários países há registros do uso da VD como estratégia de intervenção para diversos grupos, mostrando resultados de saúde positivos, no entanto, no âmbito infanto-juvenil ainda é pouco documentada. Objetivo: rever o conhecimento sobre a VD e as evidências de seu uso como prática de atenção integral à saúde de crianças e adolescentes. Metodologia: revisão de literatura por meio de pesquisa eletrônica na Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrievel System Online (MEDLINE) e ScienceDirect. Os descritores foram “Home Visit”, “Home Care Services”, “Home Nursing”, “Comprehensive Health Care”, “Child”, “Adolescent” e seus equivalentes em português. Foram incluídos trabalhos que abordassem crianças e adolescentes, publicados nos idiomas inglês e português, nos últimos 10 anos. Resultados: foram encontrados 216 artigos e após leitura dos resumos permaneceram 22. A VD foi utilizada para finalidades como prevenção de maus-tratos, cuidados à gestante e ao recém-nascido, promoção do desenvolvimento infantil e redução da morbidade da asma. Foram encontrados importantes resultados para melhora da saúde infantil, como redução de hospitalizações, redução de consultas de urgência e redução da taxa de mortalidade neonatal. Entretanto, alguns estudos não encontraram evidências de que o uso da VD possa ser benéfico. Conclusão: a visita domiciliar tem potencial impacto em vários indicadores da saúde pediátrica, mas mais estudos precisam ser realizados sobre sua eficácia, especialmente em adolescentes.
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    Epidemiologia do acidente vascular encefálico no Brasil.
    (2021) Margarido, Adriano Júnior Lucarelli; Gomes, Ana Flávia Salgado Rodrigues; Araújo, Gabriel Lucas Souza; Pinheiro, Marcella Ciotti; Barreto, Leonardo Brandão
    Objetivo: Analisar dados epidemiológicos do Acidente Vascular Encefálico (AVE) no Brasil nos últimos 5 anos. Métodos: Estudo ecológico de abordagem analítica entre agosto de 2015 a agosto de 2020 a partir de dados do Departamento de Informática do Sistema Único de Saúde (SUS) e Sistemas de Informações Hospitalares do SUS. Foram buscados dados acerca da morbidade e taxas de internação, além da produção hospitalar de tratamento do AVE. Ademais, foi feita revisão bibliográfica a partir das bases de dados PubMed e Scientific Eletronic Library Online (SciELO), para melhor interpretação dos dados. Resultados: Nos últimos cinco anos, houve um total de 422.638 internações por AVE. Observou-se maior internação masculina, entretanto, maior mortalidade feminina. Ademais, mostrou-se que o aumento da incidência e mortalidade é proporcional ao aumento da idade. Apesar da diminuição do número de óbitos, observou-se aumento da incidência da doença. Conclusão: Conclui-se que a taxa de incidência, internação por AVE e valor de serviços de saúde cresceram ao longo dos anos, se fazendo necessários pontos de melhoria na assistência à saúde no que diz respeito à prevenção e promoção.
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    Avaliação de fatores psicossociais no controle pressórico de pacientes hipertensos durante a pandemia de COVID-19.
    (2022) Dornellas, Leonardo Hosken; Vieira, Gabriella Carolyna Alves; Baba, João Pedro Domingos Nakamura; Sudério, Lucas Peixoto; Marinho, Matheus Lavigne; Ramos, Patrick Dias Albano; Freitas, Pedro Humberto Gomes de; Moura, Vinícius Gustavo de Carvalho; Silva, Vitor Peghin da; Tôrres, Henrique Oswaldo da Gama; Pimenta, Fausto Aloísio Pedrosa
    Objetivos: avaliar adesão ao tratamento, controle da pressão arterial (PA) e variáveis psicossociais em indivíduos hipertensos, antes e durante a pandemia de COVID-19. Métodos: estudo de coorte prospectiva com 96 adultos hipertensos para analisar as variáveis (instrumentos): sociodemográficas (entrevista); impacto psicológico da pandemia (questionário IES-R); sintomas de estresse, ansiedade e depressão (questionário EADS-21); adesão ao tratamento farmacológico (questionário BMQ); e controle da pressão arterial (medidas de PA). Para comparar escore BMQ e controle da PA foi utilizado o teste de McNemar’s, já para avaliar associação entre as variáveis: teste qui-quadrado, exato de Fisher, teste T e Mann-whitney. Resultados: houve significativa redução do controle pressórico com início da pandemia (McNemar's qui-quadrado=12,565, p=0.00567) e os fatores de risco associados foram: raça branca (OR=7,765; IC 95%=1,474–40,903, p=0,016), escolaridade menor que quatro anos (OR=7,531, IC 95%=1,200–47,258, p=0,031) e menos horas diárias dedicadas a assuntos relacionados à pandemia (OR=3,852, IC 95%=1,287–11,526, p=0,016). Nível reduzido de sintomas depressivos foi identificado como fator protetor contra descontrole da PA (OR=0,130, IC 95%=0,24 – 0,681, p = 0,018). Não houve variação significativa na adesão ao tratamento medicamentoso (McNemar's chi-squared=4.8979, p=0.557). Conclusão: a pandemia de COVID-19 aumentou a taxa de PA descontrolada, mas não comprometeu adesão ao tratamento.
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    Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.
    (2021) Menezes Junior, Luiz Antonio Alves de; Fajardo, Virgínia Capistrano; Nascimento Neto, Raimundo Marques do; Freitas, Silvia Nascimento de; Oliveira, Fernando Luiz Pereira de; Pimenta, Fausto Aloísio Pedrosa; Coelho, George Luiz Lins Machado; Meireles, Adriana Lúcia
    Background Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. Methods This cross-sectional study included male rotating shift workers, drivers of heavy of-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defned as an apnea–hypopnea index (AHI) of≥5 events/h. The Shapiro–Wilk test verifed the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann–Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specifcity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. Results Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI≥5), and 46% had moderate to severe sleep apnea (AHI≥15). For AHI≥5, the NoSAS score had higher sensitivity and specifcity than the BQ. For AHI≥15 and AHI≥30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. Conclusion In rotating shift workers, drivers of heavy of-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.
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    Diagnósticos diferenciais das deficiências cognitivas em idosos.
    (2021) Silva, Bruna de Sousa; Zanetti, Isabella dos Santos; Barros, Patrícia Peres de; Souza, Letícia Ton de; Barreto, Leonardo Brandão
    Objetivo: Realizar uma revisão bibliográfica a fim de identificar as possíveis etiologias das deficiências cognitivas em idosos e seus diagnósticos diferenciais. Revisão bibliográfica: A demência é caracterizada por comprometimento gradual da função cognitiva que interfere nas atividades sociais e profissionais, uma vez que, os indivíduos apresentam uma maior propensão ao desenvolvimento de incapacidades funcionais, podendo ser causa importante de redução na qualidade de vida dos idosos e de seus familiares. O estudo revela a existência de uma grande variedade de etiologias das deficiências cognitivas em idosos, sendo classificadas em demências degenerativas e demências não degenerativas. As demências degenerativas (ou primárias) incluem a doença de Alzheimer, a demência por corpos de Lewy e a demência frontotemporal, dentre outras. As demências não degenerativas (ou secundárias) abrangem inúmeros subtipos dentre os quais a demência vascular, deficiência de vitaminas, depressão e insuficiência renal. Considerações finais: As deficiências cognitivas representam um grande problema de saúde pública, com consequências significativas para os idosos e seus familiares. Diante da grande variedade de etiologias das deficiências cognitivas é fundamental o conhecimento de seus diagnósticos diferenciais.
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    Meditation, memory and learning : neurobiological studies.
    (2021) Gomides, Lindisley Ferreira; Lazzaroni, Júlio Henrique Dutra Gonçalves; Cupertino, Marli do Carmo; Rocha Filho, Iram Borges de Moraes; Nogueira, Raphael Sales; Dias Júnior, Sebastião Vieira; Carvalho, Virgínia Maria Motta de; Barreto, Leonardo Brandão; Batista, Rodrigo Siqueira
    Introduction. The role of meditation on different aspects of human neurobiology has received greater attention from the scientific community in recent years. Objective. This article aims to investigate the impacts of meditative practice on memory and on the teaching-learning process. Methods. A literature review with a defined search strategy was carried out in the PubMed and Scielo databases, using the descriptors of the MeSH and Boolean operators, in the following terms: “Meditation” AND “Memory” and “Meditation” AND “learning”, in English and Portuguese. Studies focusing on the role of meditation in the teaching-learning processes and in the neurobiologist aspects of memory were included. Results and discussion. The information obtained was organized into three sections: (1) basic concepts for the study of memory; (2) neural mechanisms of memory and learning, and (3) the practice of meditation, including the effects on memory and teaching-learning processes. Conclusion. The beneficial effects of meditative practice on the construction of teaching-learning processes were described, with emphasis on improving emotional balance, reducing stress and anxiety, in addition to increasing concentration, factors that promote the consolidation of long-term memory and, thus, help in the construction of learning.
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    Neuro-Covid-19 : neural changes in SARS-COV-2 infection.
    (2020) Motta, Oswaldo Jesus Rodrigues da; Gomes, Andréia Patrícia; Albuquerque, Gabriella Luísa Costa; Barreto, Leonardo Brandão; Gonçalves, Tayrine; Faber, Jean; Montenegro, Stefania Salvador Pereira; Braga, Luciene Muniz; Batista, Rodrigo Siqueira
    The actual COVID-19 pandemic – disease caused by the SARS-CoV-2 virus – has already caused thousands of death in the year 2020. Among the various disorders that may occur throughout the disease’s course, there are also disorders of the central nervous system. In order to investigate the potential effects of neural involvement in the novel coronavirus infection, Neuro-COVID-19, the present literature revision was carried out with a defined search strategy. Four descriptors were used: (i) “Brain”, (ii) “Central Nervous System”, (iii) “COVID-19”, (iv) “SARS-CoV-2”, which were combined to search for articles in the PubMed and ResearchGate databases. Of the 987 citations obtained, nine articles were selected. The contents extracted from these texts were organized into three categories, addressing (1) indirect, (2) direct and (3) post-infectious neurological complications. Awareness and management of neurological complications related to SARS CoV-2 infection are necessary in order to improve prognosis, especially in critically ill patients.
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    Body fat indicators for cardiometabolic risk screening among shift workers.
    (2020) Diniz, Amanda Popolino; Alves, Márcia Elivane; Fajardo, Virgínia Capistrano; Freitas, Silvia Nascimento de; Batista, Guilherme Augusto Sousa; Athadeu, Bruno Francia Maia; Coelho, George Luiz Lins Machado; Oliveira, Fernando Luiz Pereira de; Pimenta, Fausto Aloísio Pedrosa; Nascimento Neto, Raimundo Marques do
    Background: In view of the costly methods currently available for the assessment of body adiposity, anthropometric obesity indicators have proven effective in predicting cardiovascular risk. Objective: To investigate the discriminatory power of body fat indicators for cardiovascular risk screening among shift workers. Methods: Cross-sectional study with male employees of an iron ore extraction company. The predictive power of body fat indicators relative to cardiovascular risk was analyzed based on the Framingham risk score and metabolic syndrome by means of receiver operating characteristic curves, sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve and Youden’s index. Results: The prevalence of cardiovascular risk was 14.2% in the metabolic syndrome risk model. According to the Framingham score, 95.0%, 4.1% and 0.9% of the participants exhibited low, moderate and high risk, respectively. All the analyzed body fat indicators exhibited satisfactory discriminatory power for the tested cardiovascular risk models. Conclusion: Waist-height ratio exhibited the highest ability to predict cardiometabolic risk in both risk models.
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    Prevalence and risk factors for post-traumatic stress, anxiety, and depression in sepsis survivors after ICU discharge.
    (2021) Calsavara, Allan Jefferson Cruz; Costa, Priscila A.; Nobre, Vandack; Teixeira, Antônio Lúcio
    Objective: Sepsis survivors present a wide range of sequelae; few studies have evaluated psychiatric disorders after sepsis. The objective of this study was to define the prevalence of and risk factors for anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in sepsis survivors. Method: Anxiety, depression and post-traumatic stress symptoms in severe sepsis and septic shock survivors 24 h and 1 year after intensive care unit (ICU) discharge were assessed using the Beck Anxiety/Depression Inventories and the PTSD Checklist-Civilian Version. Differences in psychiatric symptoms over time and the influence of variables on these symptoms were calculated with marginal models. Results: A total of 33 patients were enrolled in the study. The frequencies of anxiety, depression and PTSD 24 h after ICU discharge were 67%, 49%, and 46%, respectively and, among patients re evaluated 1 year after ICU discharge, the frequencies were 38%, 50%, and 31%, respectively. Factors associated with PTSD included serum S100B level, age, and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) score. Factors associated with depression included patient age and cumulative dose of dobutamine. IQCODE score and cumulative dose of haloperidol in the ICU were associated with anxiety after ICU discharge. Conclusion: Patients who survive sepsis have high levels of psychiatric symptoms. Sepsis and asso ciated treatment-related exposures may have a role in increasing the risk of subsequent depression, anxiety, and PTSD.
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    A smoking prevention program delivered by medical students to secondary schools in Brazil called “Education Against Tobacco” : randomized controlled trial.
    (2019) Lisboa, Oscar Campos; Souza, Breno Bernardes; Xavier, Luiz Eduardo de Freitas; Almeida, Matheus Rocha; Corrêa, Paulo César Rodrigues Pinto; Brinker, Titus Josef
    Background: Smoking is the largest preventable cause of mortality in Brazil. Education Against Tobacco (EAT) is a network of more than 3500 medical students and physicians across 14 countries who volunteer for school-based smoking prevention programs. EAT educates 50,000 adolescents per year in the classroom setting. A recent quasi-experimental study conducted in Germany showed that EAT had significant short-term smoking cessation effects among adolescents aged 11 to 15 years. Objective: The aim is to measure the long-term effectiveness of the most recent version of the EAT curriculum in Brazil. Methods: A randomized controlled trial was conducted among 2348 adolescents aged 12 to 21 years (grades 7-11) at public secondary schools in Brazil. The prospective experimental design included measurements at baseline and at 6 and 12 months postintervention. The study groups comprised randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes in the same schools (no intervention). Data were collected on smoking status, gender, social aspects, and predictors of smoking. The primary endpoint was the difference in the change in smoking prevalence between the intervention group and the control group at 12-month follow-up. Results: From baseline to 12 months, the smoking prevalence increased from 11.0% to 20.9% in the control group and from 14.1% to 15.6% in the intervention group. This difference was statistically significant (P<.01). The effects were smaller for females (control 12.4% to 18.8% vs intervention 13.1% to 14.6%) than for males (control 9.1% to 23.6% vs intervention 15.3% to 16.8%). Increased quitting rates and prevented onset were responsible for the intervention effects. The differences in change in smoking prevalence from baseline to 12 months between the intervention and control groups were increased in students with low school performance. Conclusions: To our knowledge, this is the first randomized trial on school-based tobacco prevention in Brazil that shows significant long-term favorable effects. The EAT program encourages quitting and prevents smoking onset, especially among males and students with low educational background.
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    Adiposity indicators as a screening method for polysomnography in shift workers.
    (2019) Diniz, Amanda Popolino; Fajardo, Virgínia Capistrano; Freitas, Silvia Nascimento de; Oliveira, Fernando Luiz Pereira de; Nascimento Neto, Raimundo Marques do; Pimenta, Fausto Aloísio Pedrosa; Coelho, George Luiz Lins Machado
    Objective: to verify the discriminatory power of adiposity indicators in the prediction of obstructive sleep apnoea (OSA) in shift workers. Methods: a crosssectional study carried out in an iron ore extraction company, in Minas Gerais, Brazil. Anthropometric data were collected and polysomnography (PSG) was performed in 118 male shift workers who owned at least one overall risk factor for cardiovascular disease. Results: the OSA prevalence in the sample was 84.7%. Among the adiposity indicators used to predict OSA (≥ 5 events/hour), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and total body fat (TBF) showed sensitivity values higher than 70%. Visceral fat (VF), neck circumference (NC), and neck-to-height ratio (NHtR) were the most effective in correctly identifying workers without OSA (specificity values higher than 70%). The areas under the receiver operating characteristic (ROC) curves for WC and NHtR were greater than 0.7, which indicated the test was effective in discriminating individuals with OSA. Conclusions: alterations in abdomen and neck adiposity indicators have a significant relationship with the presence of OSA and showed effectiveness as a screening method for PSG. WC and NHtR are considered good indicators for OSA prediction.
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    Update on the approach to smoking in patients with respiratory diseases.
    (2019) Sales, Maria Penha Uchoa; Araújo, Alberto José de; Chatkin, José Miguel; Godoy, Irma de; Pereira, Luiz Fernando Ferreira; Castellano, Maria Vera Cruz de Oliveira; Minamoto, Suzana Erico Tanni; Almeida, Adriana Ávila de; Chatkin, Gustavo; Silva, Luiz Carlos Côrrea da Silva; Gonçalves, Cristina Maria Cantarino; Botelho, Clóvis; Santos, Ubiratan Paula; Viegas, Carlos Alberto de Assis; Sestelo, Maristela Rodrigues; Meireles, Ricardo Henrique Sampaio; Corrêa, Paulo César Rodrigues Pinto; Oliveira, Maria Eunice Moraes de; Reichert, Jonatas; Lima, Mariana Silva; Silva, Celso Antonio Rodrigues da
    Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with “healthy” smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.
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    EAT-Brazil award for tobacco control : a brief description of its first edition.
    (2019) Corrêa, Paulo César Rodrigues Pinto; Pereira, Rayanna Mara de Oliveira Santos; Temporão, José Gomes; Cavalcante, Tânia Maria; Lisboa, Oscar Campos; Azevedo, Lucas Guimarães de; Brinker, Titus Josef; Souza, Breno Bernardes
    Smoking is a major global risk factor for preventable death and disability. EAT is an acronym for Education Against Tobacco, a multinational network of physicians and medical students that aims to improve tobacco control by means of school-based prevention targeted at adolescents through counseling, use of software and support materials. The first EAT-Brazil Award, launched in March 2018, was a competition designed to encourage the proposal of objective solutions for tobacco control in Brasil, and identify new talents in the area. Brazilian undergraduate students from any field of study could submit a one-page essay on the subject, competing for the amount of R$ 1000.00 (one thousand reais). There were a total of 39 applicants (20 women and 19 men) from 9 Brazilian states and 18 undergraduate programs, with a mean age of 22.5 years (SD = 3.7). Data from an online anonymous questionnaire answered after the submission of their essays revealed that most applicants were students of institutions from in the state of Minas Gerais (n = 26/39; 66.6%), studied medicine (n = 20/39, 51.3%), and had no prior knowledge of the EAT-Brazil Network (n = 27/39, 69.2%). The winner of the award was Lucas Guimarães de Azevedo, a fourth-year medical student at Federal University of Western Bahia. The next editions of the award should focus on increasing the number of applicants and diversifying their geographical distribution.
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    Hipovitaminose D e índices glicêmicos em trabalhadores de turno alternante de empresa de mineração.
    (2019) Rocha, Débora de Oliveira Antunes; Barbosa, Polyana Almeida; Silveira, Gabriel Pessoa Herthel; Martins, Bianca Hellen Sousa; Fajardo, Virgínia Capistrano; Coelho, George Luiz Lins Machado; Nascimento Neto, Raimundo Marques do; Freitas, Silvia Nascimento de; Oliveira, Fernando Luiz Pereira de; Pimenta, Fausto Aloísio Pedrosa
    Objetivo: Demonstrar a prevalência da hipovitaminose D em trabalhadores de turno de uma empresa de mineração e verificar se, nesta população, há correlação entre as variáveis glicêmicas (hemoglobina glicada e glicemia de jejum) e os níveis séricos de vitamina D. Métodos: Estudo transversal observacional realizado por 2 anos consecutivos com trabalhadores de turno. No primeiro ano, foram analisados os níveis séricos de vitamina D (25(OH)D) e glicemia de jejum, excluindo indivíduos que realizavam tratamento para controle glicêmico, suplementação de vitamina D e/ou participantes do sexo feminino, totalizando 548 trabalhadores. No ano seguinte, foram selecionados da amostra anterior apenas os indivíduos que apresentaram hipovitaminose D (25(OH) D<30ng/mL). Nestes, foram analisados os níveis de 25(OH)D, glicemia de jejum e hemoglobina glicada. Foram aplicados o teste de normalidade Kolmogorov-Smirnov e a correlação de Spearman. Resultados: A idade média dos participantes foi de 38,2 anos. No primeiro ano, 80,8% dos trabalhadores apresentaram hipovitaminose D e 10,8% apresentavam glicemia de jejum fora dos níveis de normalidade. Dentre a amostra do ano seguinte, 81,1% permaneceram com hipovitaminose D, 18,2% apresentaram glicemia de jejum fora dos níveis de normalidade e 15,8% apresentaramhemoglobina glicada alterada. Não foram encontradas correlações significativas entre a 25(OH)D e a glicemia de jejum e hemoglobina glicada. Conclusão: Foi observada alta prevalência de hipovitaminose nos trabalhadores de turno. Diferentemente de outros estudos, não foram encontradas correlações significativas entre as variáveis glicêmicas e a concentração sérica da vitamina D.
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    Qualidade de vida e excesso de peso em trabalhadores em turnos alternantes.
    (2019) Pimenta, Fausto Aloísio Pedrosa; Alves, Rafaella Lemos; Oliveira, Fernando Luiz Pereira de; Nascimento Neto, Raimundo Marques do; Coelho, George Luiz Lins Machado; Freitas, Silvia Nascimento de
    Objetivo: identificar a percepção dos trabalhadores de turnos alternantes de uma mineradora da região dos Inconfidentes, Minas Gerais, sobre sua qualidade de vida (QV) e analisar sua associação com indicadores de excesso de adiposidade corporal. Métodos: estudo transversal com 437 trabalhadores em turnos alternantes com um ou mais fatores de risco cardiovascular. Dados sociodemográficos e clínicos foram analisados. A QV foi avaliada com o questionário SF-36 e a adiposidade corporal estimada a partir das medidas antropométricas e de composição corporal. Resultados: a pontuação para os domínios da QV variou de 67 a 100, no entanto, o aumento de gordura corporal apresentou correlação negativa com os domínios saúde geral, vitalidade e capacidade funcional. Foi observada, por análise de cluster, a formação de dois agrupamentos, um composto pelos domínios da QV e o outro constituído pelos indicadores de composição corporal. Não foi identificada associação entre os escores estimados de QV dos trabalhadores de turno e o tempo de trabalho. Conclusão: o declínio da QV apresentou associação com o excesso de adiposidade corporal. Recomenda-se a adoção de medidas visando reduzir o excesso de adiposidade corporal e melhorar a qualidade de vida dos trabalhadores em turno alternante da mineração.
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    Effects of vitamin D supplementation on cardiovascular risk factors in shift workers : study protocol for randomized, double-blind, placebo-controlled clinical trial.
    (2019) Fajardo, Virgínia Capistrano; Oliveira, Fernando Luiz Pereira de; Coelho, George Luiz Lins Machado; Pimenta, Fausto Aloísio Pedrosa; Freitas, Silvia Nascimento de; Ribeiro, Antônio Luiz Pinho; Soares, Maria Marta Sarquis; Lauria, Márcio Weissheimer; Farias, Rosielle da Costa; França, Ive Bahia; Nascimento Neto, Raimundo Marques do
    Objective: The present clinical study aims to describe protocol to evaluate the effects of vitamin D3 supplementation on the cardiovascular risk factors in a population of rotating shift workers. Design: A randomized, double-blind, placebo-controlled, parallel group clinical trial testing 2 oral dosages of cholecalciferol (14,000 IU and 28,000 IU per week) for 12 months. Setting: The primary outcome for evaluation is an 18% reduction in hypertriglyceridemia (≥150mg/dL) between pre and postintervention measurements. Baseline characteristics of the study population will be summarized separately within each randomized group, and will use tests for continuous and categorical variables. For all tests, a P<.05 will be considered significant. The analysis of primary and secondary outcomes will use an intention-to-treat population and a per-protocol population. The primary and secondary outcomes will be compared separately between each treatment group and placebo, using binary logistic regression or regressão de Poisson for proportions (for binary outcomes) and using linear regression for differences in means (for continuous endpoints), with 95% confidence intervals. Participants: Rotating shift workers, adults aged between 18 and 60 years, with hypovitaminosis D and alterations in at least 1 of the following parameters: fasting glucose, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, blood pressure, and waist circumference. Conclusion: This clinical trial aims to contribute to the gap in knowledge about the potential, dose, and time of vitamin D supplementation to generate beneficial effects on triglycerides in a population at increased risk for hypertriglyceridemia and vitamin D deficiency. Abbreviations: 25(OH)D = vitamin D, AUDIT = Alcohol Use Disorders Identification Test, BAI = body adiposity index, BMI = body mass index, C index = conicity index, CI = confidence interval, DMC = data monitoring committee, HDL = high-density lipoprotein, HOMA-IR = homeostatic model for insulin resistance, IPAQ = International Physical Activity Questionnaire, ITT = intention-to-treat, LDL = low-density lipoprotein, MMSE = Mini Mental State Examination, PP = per-protocol, PTH = parathyroid hormone, RR = relative risk, SF-36 = The Medical Outcomes Study 36-Item Short-Form Health Survey, TSC = Trial Steering Committee, WHOQOL = World Health Organization Quality Of Life Instrument, WHR = waist–hip ratio, WHtR = waist–height ratio.
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    Facial-aging mobile apps for smoking prevention in secondary schools in Brazil : appearance-focused interventional study.
    (2018) Souza, Breno Bernardes; Pires, Francisco Patruz Ananias de Assis; Madeira, Gustavo Moreira; Rodrigues, Túlio Felício da Cunha; Gatzka, Martina; Heppt, Markus V.; Omlor, Albert J.; Enk, Alexander H.; Groneberg, David A.; Seeger, Werner; Kalle, Christof von; Berking, Carola; Corrêa, Paulo César Rodrigues Pinto; Suhre, Janina Leonie; Alfitian, Jonas; Assis, Aisllan Diego de; Brinker, Titus Josef
    Background: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. Objective: In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. Methods: We used a free facial-aging mobile phone app (“Smokerface”) in three Brazilian secondary schools via a novel method called mirroring. The students’ altered three-dimensional selfies on mobile phones or tablets and images were “mirrored” via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. Results: The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. Conclusions: Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol.