To analyze the effects of two 16-week physical exercise programs (jazz dance [JD] and concurrent training [CT]) compared with a control group (CG), as well as the impact of detraining (6 mo and 12 mo follow-ups), on menopausal symptoms in postmenopausal women. This is a randomized clinical trial with follow-up at 6 and 12 months. A total of 70 postmenopausal women (mean age: 53.19 ± 3.39 y) were included. Participants were randomly allocated into 3 groups: jazz dance, concurrent training, and control. The severity of menopausal symptoms was assessed using the Menopause Rating Scale (MRS). A linear mixed-effect model with random effects was used for statistical analysis under 2 approaches: intention-to-treat (ITT) and protocol adherence. A paired t test analysis of score changes was also conducted as a complementary descriptive analysis, between baseline and subsequent time points. Significant time-related changes in somatic, psychological, urogenital, and total symptoms were observed in both the ITT and per-protocol analyses (P < 0.005), although no significant group×time interactions were identified. All 3 groups (JD, CT, and even the CG) showed improvements in menopausal symptoms over time, with benefits persisting during follow-up. Regarding changes over time, the CT group experienced the greatest reduction in symptoms over time, reducing the total questionnaire score by more than 7 points postintervention, more than 9 points at the 6-month follow-up, and maintaining the benefits even after one year. JD also reduced symptoms, but to a lesser extent compared with CT, by almost 4 points postintervention, and 6 points at the 6-month follow-up, with benefits also persisting after 1 year. Although the CG also showed some improvement, it was less pronounced compared with the intervention groups. Although improvements in menopausal symptoms were observed over time within all groups, including the control group, no significant group×time interactions were found. Therefore, this study did not demonstrate a superior effect of JD or CT compared with the CG, only the results that compare the interventions and CG over time are interpretable.
Neurites of sensory neurons innervate the skin and are embedded within it. These delicate structures are chronically exposed to mechanical strain and yet their integrity is maintained throughout life. In C. elegans, UNC-70/β-spectrin functions in synergy with the small GTPase RAB-35 within the skin to stabilize neuron-epidermal attachment against mechanical strain, and prevent movement-induced damage to mechanosensitive axons. However, the molecular pathway regulating these specialized attachments remains elusive. Here, through an unbiased genetic screen we have identified a guanine nucleotide exchange factor (GEF), AGEF-1, that impacts axonal maintenance. This molecule is known to function in endocytic-recycling and its human ortholog, BIG2, is associated with the development of the periventricular nodular heterotopia. We show that AGEF-1 functions selectively within the skin to regulate axonal integrity of mechanosensitive neurons. Mechanistically, we reveal that AGEF-1 binds to epidermal RAB-35 and regulates its activity, modulating neuron-epidermal attachment stability. Finally, we demonstrate that this GEF is highly conserved, with its human ortholog BIG2, capable of replacing AGEF-1. Together, we reveal the molecular machinery responsible for fine-tuning neuron-epidermal attachments and maintaining axonal integrity during life. Resumo Neuritos de neurônios sensoriais inervam densamente a pele e situam-se inseridos nela. Essas estruturas delicadas são cronicamente expostas a tensão mecânica, contudo sua integridade é mantida ao longo da vida. Em C. elegans, a β-espectrina UNC-70 atua em sinergia com a GTPase RAB-35 dentro da pele para estabilizar adesões neuro-epidermais contra tensão mecânica e protege axônios mecanosensitivos contra dano mediado pelo movimento. No entanto, não são conhecidos todos os componentes da maquinaria molecular que regula essas adesões. Através de uma mutagênese química, identificamos que AGEF-1, um fator de troca de nucleotídeos de guanina (GEF), impacta a manutenção axonal de neuronios mecanosensitivos. Essa molecula funciona no sistema de reciclagem endocítica e seu ortologo em humanos, BIG2, é associado ao desenvolvimento de heterotropia nodular periventricular. Aqui demostramos que essa proteína atua seletivamente na pele para essa função. Mecanisticamente, revelamos que AGEF-1 liga-se a RAB-35 epidermal regulando sua ativação e modulando a estabilidade de adesões neuro-epidermais. Por fim, demonstramos que AGEF-1 é altamente conservado, com o seu ortólogo humano BIG2 sendo capaz de substituir a molécula nematoide. Ao todo, revelamos a maquinária molecular responsável pelo ajuste delicado das adesões neuro-epidermais e da integridade axonal ao longo da vida.
This study critically examines post-disaster recovery policies in Brazil and their short- and long-term effects on marginalised populations, particularly those living in informal or precarious housing. Drawing on a mixed-methods investigation conducted in collaboration with the Movimento dos Atingidos por Barragens, the research analyses multi-site and multi-temporal climate-related disasters in Petrópolis (2011, 2022, 2024) and São Sebastião (2023). Through interviews, surveys, spatial analyses, and participatory timelines, it contrasts institutional recovery narratives with the lived experiences of disaster-affected communities. The findings demonstrate that dominant recovery frameworks-centred on rental subsidies and social housing-frequently reproduce displacement, exclusion, and renewed vulnerability. By prioritising the rapid provision of a 'roof' over community continuity, cultural adequacy, and territorial ties, these policies often generate post-disaster deterritorialisation. The study argues for redress-based recovery approaches that reconceptualise recovery not as a discrete policy stage, but as part of an ongoing transformative and context-sensitive disaster risk reduction project.
This work aimed to first validate the Portuguese version of the FANTASTIC questionnaire that allowed the assessment of lifestyle behaviors through a sample comprising 562 Portuguese subjects; second, through a quasi-experimental study, we tested the effectiveness of a physical exercise program designed specifically for people with type 2 diabetes based on subjective wellbeing and lifestyle changes. For 9 months, a total of 31 subjects (14 males and 17 females with type 2 diabetes aged between 58 and 79 years) were involved in a physical exercise program of moderate intensity three times per week for 75 min each session; the program included a combination of aerobic, resistance, agility, balance, and flexibility exercises (Diabetes em Movimento). Regarding the first goal of this study, the results show a reliable factorial solution with nine factors and 27 items from the FANTASTIC questionnaire. With regard to the second goal of this study, the results indicate that subjects involved in the exercise program show significantly improved positive affect, satisfaction with life, physical activity, sleep, stress, and nutrition behaviors, in addition to significantly diminished negative affect. However, these results should be interpreted with some caution as our study did not have a control group and the sample was one of convenience, which limits the capacity of inference of the results. The present results support evidence confirming the positive effects of Physical Exercise through the Diabetes em Movimento® program to foster SWB and promote healthier lifestyle behaviors among T2D subjects. Therefore, we intend to conduct further studies in the future to consolidate the findings of the present study.
The aging process is accompanied by physiological, biomechanical, and cognitive impairments. In this scenario, functional capacity tests and vertical jumps are used to assess muscle strength and power, which are performed in expensive equipment. Thus, this study analyzed the kinetic behavior of the 30-s chair test, the SJ and CMJ kinetic behavior, and the association between the 30-s with the SJ and CMJ. Twelve older adults (5 females and 7 males) performed the 30-s chair test, the squat jump (SJ), and the countermovement jump (CMJ) on two force platforms. The kinetic behavior of these actions was evaluated. For the 30-s chair test, it was calculated the vertical ground reaction force and linear impulse during the preparatory and lifting phases. The initial vertical forces and the maximal vertical forces, the rate of force development, and the jump height during the SJ and CMJ were calculated. The kinetics of the 30-s chair test is correlated with the kinetics of both SJ and CMJ. The kinetic analysis showed that the ninth repetition of the 30-s test was the cutoff point predictor of the muscle strength and power when compared to the SJ and CMJ tests.
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To evaluate brown adipose tissue (BAT) and white adipose tissue using Infrared Thermography (IRT) in children with different nutritional statuses and correlate findings with anthropometric variables. This cross-sectional observational study assessed body composition via bioelectrical impedance (BIA), skin temperature (supraclavicular and abdominal) through IRT, and anthropometric variables such as neck (NC), waist (WC), and hip (HC) circumferences. Calculations included waist-to-hip ratio (WHR) and conicity index (CI). Statistical analyses were performed in SPSS 20.0, with normality checked by the Shapiro-Wilk and homogeneity by Levene tests. Groups (eutrophic, overweight, obese) were compared using Pearson's Chi-square for categorical variables, Kruskal-Wallis, and ANOVA tests for quantitative data. Correlations were analyzed using Spearman's method. The significance level was set at p ≤ 0.05. Of 160 participants, 116 children were analyzed (eutrophic: N = 58; overweight: N = 26; obese: N = 32). Significant differences were noted between the eutrophic and obese groups. Supraclavicular temperature negatively correlated with BIA variables (total body water, fat-free mass, body fat percentage). IRT demonstrated inverse correlations between BAT temperature and BMI, NC, WC, and HC, underscoring its potential in obesity risk analysis. IRT also offers quantitative assessments of BAT activity and may estimate body fat percentages, suggesting its relevance for monitoring adipose tissue function and metabolic effects of physical exercise.
Exercise training is essential in pulmonary rehabilitation (PR) for individuals with chronic obstructive pulmonary disease (COPD). In Brazil, physical therapists typically deliver exercise in PR. This document presents ASSOBRAFIR recommendations for prescribing exercise training for patients with COPD. To provide evidence-based recommendations for structuring exercise training programs for people with COPD. The guideline panel followed the Guidelines International Network (GIN) principles and the Appraisal of Guidelines for Research & Evaluation (AGREE-II) to ensure methodological rigor. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to assess the certainty of evidence (CoE). This method assessed evidence quality and developed recommendations for five key questions addressing aspects of exercise training for people with stable COPD. Treatment effects were evaluated using systematic reviews and meta-analyses. The following conditional recommendations were drawn: 1. Combined exercise training (aerobic + resistance) is suggested over aerobic training alone (very-low CoE); 2. No suggestion for or against adding inspiratory muscle training, non-invasive ventilation, or supplemental oxygen to combined exercise training (moderate to very-low CoE); 3. Either interval or continuous training is suggested, with no preference for partitioned or nonlinear training (moderate to very-low CoE); 4. Maintenance exercise programs are suggested as an alternative to usual care after PR (very-low CoE); 5. Minimal resource exercise training, especially with elastic resistance, or conventional exercise training is suggested (very-low CoE). The results of the present guideline can aid clinicians in structuring exercise training for people with COPD.
To evaluate the efficacy and safety of daridorexant in women aged 47-55 years with insomnia disorder, an age group representative of the menopause transition. In this randomized, double-blind, placebo-controlled study (NCT03545191), conducted in 10 countries between May 2018 and May 2020, 930 patients with insomnia disorder were randomized using interactive response technology (1:1:1) to receive a single film-coated tablet of daridorexant 25 mg, 50 mg, or placebo every evening for 3 months. Subgroup analyses were performed among the 117 women aged 47-55 (25 mg n = 43; 50 mg n = 35; placebo n = 39). Efficacy endpoints included change from baseline to Month 3 of treatment in polysomnography-measured wake after sleep onset (WASO) and latency to persistent sleep (LPS), self-reported total sleep time (sTST), and insomnia-related daytime impairment, as recorded on the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ). Safety endpoints included adverse events and score on a visual analog scale for morning sleepiness. Efficacy was analyzed in all randomized subjects, and safety in all who received at least one treatment dose. At Month 3, daridorexant 50 mg vs placebo decreased WASO and LPS by a least-squares mean (LSM) of 13.8 min (95 % CI -29.0, 1.4) and 14.7 min (-30.0, 0.6) respectively, increased sTST by an LSM of 21.8 min (-3.9, 47.4) and decreased (improved) IDSIQ total score by an LSM of 4.1 (-14.4, 6.3). No marked deviations from the effect in the overall population were observed. The incidence of somnolence/fatigue was low and comparable across groups. Morning sleepiness improved in all groups. These analyses suggest that daridorexant 50 mg provides benefit in sleep outcomes and daytime functioning in women aged 47-55 with insomnia disorder. Daridorexant 50 mg is well tolerated in this population, with no increased risk of next-morning sleepiness or somnolence. NCT03545191.
Caregiving for older adults with Alzheimer's disease (AD) has intensified in Brazil, highlighting the emotional and physical burden faced by caregivers. Understanding the factors contributing to this burden is essential for developing more effective and sustainable support strategies. The aim of this study was to analyze the relationship between coping strategies, caregiver burden, and perceived stress using network analysis. This was a quantitative, analytical, observational, and cross-sectional study with a final sample of 126 formal and informal caregivers from different regions of Brazil. Data were collected via an online questionnaire, using the Perceived Stress Scale, Zarit Burden Interview, and the Coping Strategies Inventory (EMEP). Statistical analysis was conducted with JASP software. Data showed non-parametric distribution, and Spearman's correlation and LASSO network analysis were applied. Results revealed weak but significant positive correlations (p<0.05; r<0.40) among coping domains. Problem-focused coping was negatively correlated with burden (r=-0.34) and stress (r=-0.60), while emotion-focused coping showed positive correlations with both (r=0.40; r=0.42). Religious/fantasy coping and seeking social support were also positively associated with burden. The LASSO network highlighted emotion-focused and religious coping as central nodes. Problem-focused coping was negatively associated with stress, while emotional and religious strategies were linked to increased burden and stress. Centrality indices indicated emotional coping and religious practices as highly influential. These findings underscore the protective role of problem-focused coping and the need for targeted interventions to foster adaptive strategies and support caregiver well-being. O cuidado de idosos com doença de Alzheimer tem se intensificado no Brasil, revelando a sobrecarga emocional e física enfrentada pelos cuidadores. Analisar a relação entre estratégias de enfrentamento, sobrecarga do cuidador e estresse percebido utilizando análise de redes. Estudo transversal, com amostra final de 126 cuidadores formais e informais de diferentes regiões do Brasil. Os dados foram coletados por meio da Escala de Estresse Percebido, da Escala de Sobrecarga de Zarit e do Inventário de Estratégias de Enfrentamento. A análise estatística foi realizada pela correlação de Spearman e a análise de redes LASSO. O enfrentamento focado no problema apresentou correlação negativa com a sobrecarga (r=-0,34) e com o estresse (r=-0,60), enquanto o enfrentamento focado na emoção apresentou correlação positiva com ambos (r=0,40; r=0,42). As práticas religiosas/fantasiosas e a busca por suporte social também se associaram positivamente à sobrecarga. A análise de rede LASSO destacou o enfrentamento focado na emoção e o enfrentamento religioso como nós centrais. O enfrentamento focado no problema esteve negativamente associado ao estresse, enquanto as estratégias emocionais e religiosas se relacionaram ao aumento da sobrecarga e do estresse. Os índices de centralidade indicaram o enfrentamento emocional e as práticas religiosas como altamente influentes. Os achados reforçam o papel protetivo do enfrentamento focado no problema e a necessidade de intervenções direcionadas para promover estratégias adaptativas e apoiar o bem-estar dos cuidadores.
Conducting health systems assessments helps highlight weaknesses and strengths to be explored to improve care delivery. The Assessment of Chronic Illness Care (ACIC) considers the perspective of professionals who work in the care-providing institution. Its structure comprises seven dimensions that provide specific data about the care offered. Objectives: (1) evaluate the institutional capacity for Type 2 Diabetes Mellitus (T2DM) management in the interior of the State of Amazonas from the perspective of health professionals; (2) verify the association between socio-educational, work and geographic location variables with the dimensions of the ACIC. A cross-sectional study carried out between October 2020 and December 2022 in 36 Primary Health Units (PHUs) of the seven cities of the Amazonas, totaling 230 participants. Excel 2019 and R (4.2.1) were used for data analysis. The association between independent variables and ACIC dimensions was analyzed using multiple logistic regression analysis. The PHUs in the rural Amazonas have the basic capacity to care for patients with T2DM. Analysis of each dimension of the ACIC demonstrated that geographic location was the most relevant factor, showing an association with all instrument dimensions. Socioeducational variables showed an association with the dimensions of Decision Support, Design of the Service Delivery System, Clinical Information System, and Integration of components of the Care Model for Chronic Conditions. Work-related variables, on the other hand, were associated with the dimensions of Organization of Health Care, Community Resources, Support for Self-Management and Integration of the components of the Chronic Conditions Care Model.
Space is one of the main drivers of biodiversity, as it regulates the underlying processes affecting the distribution and dynamics of species and communities. It is a fundamental factor when considering the rapid climate and land cover changes occurring at local and global scales, which are linked to habitat loss and fragmentation, as well as their impacts on biodiversity. The Atlantic Forest of South America is among the world's biodiversity hotspots because of its exceptionally high species richness and endemism. Most of the threats to the Atlantic Forest's biodiversity stem from the expansion of urbanization and industry, extensive agricultural and livestock production, and mining. Here, we provide integrated and fine-scale spatial information (30-m resolution) for the entire extent of the Atlantic Forest for the years 2020 to 2022. The spatial data include different vegetation classes (forest, and forest combined with other non-forest vegetation), the effects of linear structures (roads and railways), and landscape metrics computed at multiple scales (radius buffers-moving window sizes-ranging from 50 to 2500 m, and up to 10 km for some metrics). The dataset comprises the Atlantic Forest delimitation vector and more than 500 rasters, available through a series of thematically grouped files in multiple Zenodo repositories. This data can also be accessed using the R package atlanticr, which we developed to facilitate data retrieval and organization from Zenodo. The dataset includes landscape, topographic, hydrological, and anthropogenic metrics. Landscape metrics were calculated for two vegetation classes-Forest Vegetation (which combined different forest cover classes) and Natural Vegetation (which combined forest and non-forest cover classes)-as well as for a heterogeneous, multi-class classification of the landscape (31 land cover classes). The landscape metrics include landscape morphology (classification as matrix, core, edge, corridor, branch, stepping stone, and perforation), fragment area and proportion, patch area and number, edge and core areas and proportions, structural and functional connectivity (for different organisms' gap-crossing capabilities), distance to and from fragment edges, fragment perimeter and perimeter-area ratio, and landscape diversity (heterogeneity). Topographic metrics include elevation, slope, aspect, curvature, and landform elements (peak, ridge, shoulder, spur, slope, hollow, footslope, valley, pit, and flat). Hydrological metrics comprise potential springs (and their kernel density) and streams (and distance to the nearest feature). Anthropogenic metrics include maps of roads, railways, protected areas, Indigenous territories, and quilombola territories (localities of self-defined Afro-Brazilian traditional communities), as well as the distance to each feature. This dataset facilitates the efficient integration of biodiversity and spatially explicit data for the Atlantic Forest, serving as a data source for studies, landscape planning, biodiversity conservation, and forest restoration programs. The data are released under a CC BY-NC 4.0: Creative Commons Attribution-Non-Commercial 4.0 International license and this data paper should be cited when the data are reused.
Lower Urinary Tract Dysfunction (LUTD) is a prevalent condition in childhood. Children with enuresis often exhibit delayed maturation of the motor cortex and disruptions in sensory-motor integration, suggesting possible deficits in the acquisition of gross motor skills. However, this association remains underexplored in literature. This cross-sectional observational study had two primary objectives: (1) to compare the gross motor performance of school-aged children with and without lower LUTD; and (2) to examine whether LUTD diagnosis, lower limb strength, body mass index (BMI), age, and sex were associated with gross motor performance in these children. The secondary objective was to compare lower limb strength, BMI, age, and sex between children with and without LUTD. A total of 77 neurotypical schoolchildren aged 5-11 years were recruited from local schools and stratified into two groups: The LUTD group (LUTD-G; n = 34), identified through the Dysfunctional Voiding Scoring System, and a control group (Control-G; n = 43) composed of asymptomatic children. Gross motor skills were assessed using the Test of Gross Motor Development-Third Edition yielding a Gross Motor Index (GMI), and lower limb strength was evaluated via horizontal jump test. Sociodemographic characteristics, BMI, physical activity levels, and urinary habits were also assessed. The sample was predominantly female (63.64 %), white (57.14 %) and within the normal BMI range (55.84 %). The two groups were comparable in sociodemographic characteristics, physical activity levels, and urinary habits. However, children in the LUTD-G showed significantly lower GMI scores (p < 0.001) and lower limb strength (p = 0.024) than the Control-G. Regression analysis identified LUTD (β = -0.62, p < 0.001) and lower limb strength (β = 0.41, p < 0.001) as the stronger predictors of gross motor performance, with age (β = -0.31, p = 0.002) and sex (β = 0.20, p = 0.036) also contributing to the model. Children with LUTD exhibited marked deficits in gross motor performance and lower limb strength, reinforcing the need for interdisciplinary collaboration among healthcare professionals. These findings highlight the importance of integrating motor assessments into LUTD evaluation protocols and support a comprehensive, functional approach to improve both urinary and motor outcomes in affected children.
Diabetes mellitus (DM) is associated with increased oxidative stress, which contributes to systemic dysfunction and respiratory muscle impairment. This study aimed to evaluate the effects of respiratory muscle training (RMT) on oxidative stress and antioxidant activity in diabetic rats induced by a high-fat diet and low-dose streptozotocin. Male Wistar rats (n = 30) were divided into four groups: sedentary-sham (Sed-Sham, n = 8), respiratory muscle trained-sham (RMT-Sham, n = 8), sedentary-DM (Sed-DM, n = 7), and respiratory muscle trained-DM (RMT-DM, n = 7). DM was induced using a high-energy diet followed by a low-dose streptozotocin injection. The RMT protocol consisted of 30 min/day, 5 days/week, for 6 weeks, whereas the sedentary animals did not exercise. Oxidative stress was assessed by measuring thiobarbituric acid reactive substances (TBARS) and dichlorofluorescein (DCF) levels, while antioxidant capacity was evaluated through superoxide dismutase (SOD) activity and non-protein thiol (NPSH) levels in plasma and selected tissues. In DM rats, RMT significantly reduced TBARS levels in plasma and gastrocnemius muscle, indicating a decrease in lipid peroxidation. Furthermore, RMT partially restored antioxidant capacity, as evidenced by increased SOD activity in the lungs and elevated NPSH levels in the liver. In Sham rats, RMT also demonstrated beneficial effects, reducing TBARS levels in the gastrocnemius muscle and enhancing SOD activity in the kidneys. RMT attenuated oxidative stress in DM rats by reducing lipid peroxidation and enhancing antioxidant defenses. These findings suggest RMT as a potential non-pharmacological strategy to improve oxidative balance in rats with diabetes.
This scoping review aimed to explore and map wheelchair outcome measurement instruments for children in the literature. A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. The review focused on children (≤18 years) manual or motorised wheelchair users, and included primary sources of literature on wheelchair outcome measurement instruments. A search was conducted in nine electronic databases, including grey literature. Data on general characteristics, psychometric properties (validity, reliability, responsiveness) were extracted and analysed descriptively. A total of 27 studies and 33 instruments were included, mostly focused on manual wheelchair users (n=23). Performance-based outcomes instruments were the most common (n=15). Construct validity (n=19) and test-retest (n=19) were the most assessed psychometric property. Responsiveness (n=3) and intra-rater (n=3) were the least reported. The most frequently conducted statistical analyses were: minimal detectable difference (MDD) (n=12), standard error of measurement (SEM) (n = 12), intraclass correlation coefficient (ICC) (n=16) and Pearson correlation (n=9). The most common construct was propulsion perfomance in a manual wheelchair (n=6). Wheelchair outcome measurement instruments for children mainly assess manual wheelchairs, emphasising propulsion perfomance as the primary outcome. Responsiveness and intra-rater are underreported, highlighting a gap for future research. Standardised methodologies and detailed reporting, including sample size specifications, are essential for advancing research and clinical practice. This scoping review informs healthcare professionals about wheelchair outcome measures, psychometric properties, statistical tests, and outcomes.The results can guide future research, clinical practice, and the development of wheelchair outcome measurement instruments by addressing existing gaps.Furthermore, it supports rehabilitation professionals in selecting outcome measures appropriate to the target population and cultural context.
Introduction: Photobiomodulation (PBM), initially called low-level light therapy (LLLT), is defined as the application of radiation in the form of light for healing since it can modify the cell's behavior to facilitate repair of the tissue. The objective of this review study was to research the known effects of the LLLT on oxidative stress, as well as mitochondrial activity, in the cutaneous healing process. Methods: We included experimental animal studies that evaluated the effects of the LLLT on the oxidative stress related to the cutaneous healing process. In December 2023, research into the literature was conducted in the following databases: PubMed, Embase, and Web of Science. The methodological quality of the studies was evaluated by the adapted PEDro scale. Additionally, a qualitative and descriptive analysis of the included studies was made. Results: Nine studies were included, and all the articles presented significant modulation of oxidative stress, with reductions in oxidizing markers (superoxide anion) and apoptosis activators (cytochrome c), and mainly, increases in antioxidant enzymatic defense (catalase, superoxide dismutase, and glutathione peroxidase). Conclusion: LLLT represents a technique with promising results in the improvement and acceleration of the cutaneous healing process, as well as in the regulation of biochemical reactions related to oxidative stress of the treated areas. Despite that, more studies focusing on the central role of mitochondria in explaining the therapeutic effects of LLLT are necessary.
Although pornography cravings can affect many aspects of a user's life, only the Pornography Craving Questionnaire has been developed to assess pornography cravings in adults. We aimed to culturally adapt and evaluate the measurement properties of the Brazilian version of the Pornography Craving Questionnaire (Br-PCQ) in adults, and create a psychometric cut-off point to identify higher levels of craving. This was an online study conducted with 1540 Brazilian people (813 females and 727 males) over 18 years (30.59 ± 10.30 years). According to COSMIN, we translated and assessed the content validity, structural validity, internal consistency, measurement invariance between biological sexes, construct validity, test-retest reliability, measurement error, and floor and ceiling effects of the Br-PCQ. Item response theory was used to create the cut-off point for the Br-PCQ. The Br-PCQ content was reported as a relevant, comprehensive, and understandable nine-item, one-factor structure with adequate internal consistency. There was no invariance between biological sexes and the instrument had a positive and strong correlation with the frequency of pornography use. The Br-PCQ also showed adequate values for test-retest and measurement error and no floor and ceiling effects. For the new score calculation, the cut-off point to identify higher levels of craving was 10.80 points. Br-PCQ is a reliable and valid measurement instrument for assessing craving for pornography in the Brazilian population.
The aim of this study was to verify the presence of chronic musculoskeletal pain and their associated factors, as well as aspects related to treatment in Primary Health Care users in six small cities in the state of Paraná. A cross-sectional, study was carried out with samples of 1,878 users of Primary Health Care in six municipalities with less than 20,000 inhabitants in the state of Paraná. Was identify users with chronic musculoskeletal pain. To analysis which were obtained using Poisson regression with robust variance. The prevalence of chronic pain was 55.8%, there was a higher prevalence among women, among the lower level of education, among those who had a negative self-perception of health and among users who reported the following diagnoses: hypertension, diabetes, hypercholesterolemia, rheumatic diseases, and depression and among the highest age groups. Among the subjects with chronic pain, most reported that it was of moderate or intense intensity (84.9%) and that the pain moderately or extremely affected the performance of daily activities (72.7%). The lumbar region was indicated as the most frequent (22.5%). Regarding treatment, the majority (57.1%) reported undergoing only pharmacological treatment and 15.8% carried out pharmacological treatment and non-pharmacological treatment. Objetivou-se verificar a presença de dor musculoesquelética crônica e seus fatores associados, bem como aspectos relacionados ao tratamento em usuários da Atenção Primária à Saúde (APS) de seis municípios de pequeno porte do Paraná. Foi realizado estudo transversal com amostra de 1.878 usuários da APS de seis municípios com menos de 20 mil habitantes. Para a análise dos dados foi utilizada regressão de Poisson com variância robusta. A prevalência de dor musculoesquelética crônica foi de 55,8%, sendo maior nas mulheres, nos com menor nível de escolaridade, nos que referiram autopercepção negativa de saúde e entre aqueles com hipertensão, diabetes, hipercolesterolemia, doenças reumáticas e depressão e aumentando conforme faixa etária. Entre os que referiram dor musculoesquelética crônica, a maioria indicou intensidade moderada ou intensa (84,9%), referiu que a dor afetava de maneira moderada ou extrema a realização das atividades diárias (72,7%) e a região lombar foi o local de dor mais frequente (22,5%). Em relação ao tratamento, a maioria (57,1%) referiu fazer somente tratamento farmacológico e 15,8% realizavam tratamento farmacológico e não farmacológico. El objetivo de este estudio fue verificar la presencia de dolor musculoesquelético crónico y sus factores asociados, así como aspectos relacionados al tratamiento en usuarios de la Atención Primaria de Salud (APS) en seis pequeños municipios del estado de Paraná. Se realizó un estudio transversal con una muestra de 1.878 usuarios de APS de seis municipios con menos de 20.000 habitantes. Se utilizó regresión de Poisson con varianza robusta para analizar los datos. La prevalencia de dolor musculoesquelético crónico fue del 55,8%, y fue mayor entre las mujeres, las personas con menor nivel de estudios, las que refirieron autopercepción negativa de la salud y diagnosticado con hipertensión, diabetes, hipercolesterolemia, enfermedades reumáticas y depresión. Entre los que declararon dolor musculoesquelético crónico, la mayoría indicaron una intensidad moderada o grave (84,9%), declararon que el dolor afectaba moderada o extremadamente a la realización de las actividades cotidianas (72,7%) y la zona lumbar era el lugar de dolor más frecuente (22,5%). En cuanto al tratamiento, la mayoría (57,1%) refirió tomar sólo tratamiento farmacológico y el 15,8% tomó tanto tratamiento farmacológico como no farmacológico.
The 2024 flooding in Rio Grande do Sul, Brazil, was the worst natural disaster in the history of the state. We aimed to examine the impact of flooding on individuals' lives and depressive and anxiety symptoms among residents of Rio Grande do Sul. We analyzed data from the Prospective Study on Mental and Physical Health in Adults (PAMPA), conducted with adults from Rio Grande do Sul. Participants completed an online questionnaire between September and November 2024. Depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale, in which scores above eight indicated moderate-to-severe symptoms. The flooding impact was measured via 12 questions on direct and indirect consequences (e.g., energy shortages, displacement, material losses) and categorized into tertiles: low, medium, and high burden. Among the 2,494 participants (mean age: 43.1 ± 15.1 years; 69.6% women), 83.8% reported being affected by the flooding, and 29.7% experienced a high burden. Displaced participants were more likely to report anxiety (PR = 1.24; 95%CI: 1.09, 1.41) and depressive symptoms (PR = 1.32; 95%CI: 1.10, 1.58). High burden was associated with anxiety (PR = 1.72; 95%CI: 1.49, 1.97) and depressive symptoms (PR = 1.52; 95%CI: 1.25, 1.86). Moderate-to-severe anxiety and depressive symptoms were 77% and 129%, respectively, higher than expected. The 2024 flooding had a profound impact on mental health, in which individuals who experienced a greater burden had higher rates of moderate-to-severe symptoms of anxiety and depression. A enchente de 2024 no Rio Grande do Sul, Brasil, foi o pior desastre natural da história do estado. Nosso objetivo foi examinar o impacto das enchentes na vida dos indivíduos e os sintomas depressivos e ansiosos entre os residentes do Rio Grande do Sul. Analisamos dados do Estudo Prospectivo sobre Saúde Mental e Física em Adultos (PAMPA), realizado com adultos do Rio Grande do Sul. Os participantes responderam a um questionário online entre setembro e novembro de 2024. Os sintomas depressivos e ansiosos foram avaliados usando a Escala Hospitalar de Ansiedade e Depressão, com pontuações acima de oito indicando sintomas moderados a graves. O impacto das enchentes foi medido por meio de 12 perguntas sobre consequências diretas e indiretas (p.ex.: escassez de energia, deslocamento, perdas materiais) e categorizadas em tercis: baixa, média e alta carga. Entre os 2.494 participantes (idade média: 43,1 ± 15,1 anos; 69,6% mulheres), 83,8% relataram ter sido afetados pelas enchentes e 29,7% sofreram uma grande sobrecarga. Os participantes deslocados foram mais propensos a relatar sintomas de ansiedade (RP = 1,24; IC95%: 1,09, 1,41) e sintomas depressivos (RP = 1,32; IC95%: 1,10, 1,58). Alta sobrecarga foi associada a sintomas de ansiedade (RP = 1,72; IC95%: 1,49, 1,97) e sintomas depressivos (RP = 1,52; IC95%: 1,25, 1,86). Sintomas de ansiedade e depressão moderados a graves foram 77% e 129%, respectivamente, maiores do que a prevalência esperada. A enchente de 2024 teve um impacto profundo na saúde mental, com indivíduos que experimentaram uma sobrecarga maior exibindo taxas mais altas de sintomas moderados a graves de ansiedade e depressão. Las inundaciones de 2024 en Rio Grande do Sul, Brasil, fueron el peor desastre natural en la historia del estado. Nuestro objetivo era examinar el impacto de las inundaciones en la vida de las personas y los síntomas de depresión y ansiedad entre los residentes de Rio Grande do Sul. Analizamos los datos del Estudio Prospectivo sobre Salud Mental y Física en Adultos (PAMPA), realizado con adultos de Rio Grande do Sul. Los participantes completaron un cuestionario en línea entre septiembre y noviembre de 2024. Los síntomas depresivos y de ansiedad se evaluaron utilizando la Escala de Ansiedad y Depresión Hospitalaria, en la que las puntuaciones superiores a ocho indicaban síntomas de moderados a graves. El impacto de las inundaciones se midió mediante 12 preguntas sobre las consecuencias directas e indirectas (por ejemplo, escasez de energía, desplazamientos, pérdidas materiales) y se clasificó en terciles: afectación baja, media y alta. De los 2.494 participantes (edad media: 43,1 ± 15,1 años; 69,6% mujeres), el 83,8% declaró haberse visto afectado por las inundaciones y el 29,7% experimentó un alto grado de afectación. Los participantes que se vieron desplazados eran más propensos a declarar síntomas de ansiedad (RP = 1,24; IC95%: 1,09, 1,41) y síntomas depresivos (RP = 1,32; IC95%: 1,10, 1,58). Una mayor afectación se asoció con síntomas de ansiedad (RP = 1,72; IC95%: 1,49, 1,97) y con síntomas depresivos (RP = 1,52; IC95%: 1,25, 1,86). La prevalencia de síntomas moderados-graves de ansiedad y depresión fue un 77% y un 129% superior, respectivamente, a la prevalencia esperada. Las inundaciones de 2024 tuvieron un impacto profundo en la salud mental, y las personas que sufrieron una mayor afectación presentaron tasas más elevadas de síntomas moderados-graves de ansiedad y depresión.
Adopting healthy behaviors is challenging in any context, especially related to physical activity in individuals with chronic conditions. In socially vulnerable settings, challenges are even greater. This study aimed to understand the barriers and facilitators to physical activity adherence in a vulnerable population with type 2 diabetes mellitus in the Brazilian Amazon setting. We conducted an exploratory qualitative study using a phenomenological approach. We used semi-structured interviews with participants with type 2 diabetes and the World Café group technique with community health workers. The meetings were recorded. In the organization and processing of the data, the recordings of the semi-structured interviews, the content of the tablecloths, and the videos were transcribed using the Reshape website, coded, and organized using the ATLAS.ti24 software. We used thematic analysis to identify the main facilitators and barriers. The ecological model was employed to guide data collection, analysis, and message development. The main barriers identified were physical limitations, financial difficulties, lack of knowledge, lack of trained and qualified professionals, distance from physical activity locations, and lack of motivation. The major facilitators included an appropriate location within the coverage area of the primary healthcare units, professional guidance, trained and qualified professionals, personal motivation, family support, and adequate financial conditions. Environmental factors, personal motivation, and qualified professional guidance were crucial for adherence to physical activity. Our findings underscore the need for public policies and health interventions tailored to vulnerable populations.