Search

Many countries have modified their policies on banning or deferring blood donation by men who have sex with men (MSM) in light of ethical concerns and new evidence about transfusion risks. In Brazil, MSM were not eligible to donate blood unless they had been celibate for the previous 12 months. However, in May 2020, the Brazilian Federal Supreme Court overturned this restriction. Many authors have attempted to stress possible risks of transfusion-transmitted infection under various scenarios of changes in bans or restrictions on donations by MSM using mathematical models, but we consider that it is a difficult task due to the wide variety of sexual behaviors, attitudes, and practices. Among these factors, we highlight sex under the influence of illicit drugs, and the fact that people with an undetectable human immunodeficiency virus viral load have the potential to transmit should their blood be transfused. Despite these possible risks, we believe that some MSM can donate blood regardless of the time elapsed since their last sexual contact, especially because blood donations by MSM were occurring even when there were time-based deferral rules. Blood banks should always seek to use screening algorithms to identify high-risk sexual behaviors using gender-neutral criteria, and education about transfusion risks should be offered to healthcare workers and MSM.

Background: Alternative approaches have been proposed to ensure a safe and equitable screening process for blood donation that treats all people equally, regardless of gender identity or sexual orientation. The terms ‘neutral approach’ and ‘individualized risk assessment’ have been used to describe this goal. To facilitate research and implementation of these concepts in blood donation contexts and health services in Brazil, we propose a Portuguese version of the ‘for the assessment of individualized risk screening criteria’ (FAIR) screening criteria. Methods: The FAIR screening criteria are 12 questions that assess sex, sexuality, ethnicity, and the extent to which participants engaged in each targeted sexual behavior. The aim of FAIR is to reduce error while increasing reliable and accurate reporting of sexual behaviors associated with both objective and subjective estimates of infection risk. The FAIR screening criteria were translated and cross-culturally adapted using a systematic approach with standardized procedures appropriate for adapting instruments that track behaviors. Results: A version that is appropriate for use with the Brazilian population was produced employing the following steps: expert translations, harmonization, consensus version, expert back-translation, revision, panel of experts, cognitive interviewing, and finalization. Conclusion: The Portuguese version of FAIR was proposed, and because of its straightforward, simple language and focus on specific and frequent behaviors in some populations, it has the potential to be used in a variety of contexts involving the screening of high-risk sexual behavior in Brazil.

Abstract Digital technologies change the healthcare environment, with several studies suggesting barriers and facilitators to using digital interventions by healthcare professionals (HPs). We consolidated the evidence from existing systematic reviews mentioning barriers and facilitators for the use of digital health technologies by HP. Electronic searches were performed in five databases (Cochrane Database of Systematic Reviews, Embase®, Epistemonikos, MEDLINE®, and Scopus) from inception to March 2023. We included reviews that reported barriers or facilitators factors to use technology solutions among HP. We performed data abstraction, methodological assessment, and certainty of the evidence appraisal by at least two authors. Overall, we included 108 reviews involving physicians, pharmacists, and nurses were included. High-quality evidence suggested that infrastructure and technical barriers (Relative Frequency Occurrence [RFO] 6.4% [95% CI 2.9–14.1]), psychological and personal issues (RFO 5.3% [95% CI 2.2–12.7]), and concerns of increasing working hours or workload (RFO 3.9% [95% CI 1.5–10.1]) were common concerns reported by HPs. Likewise, high-quality evidence supports that training/educational programs, multisector incentives, and the perception of technology effectiveness facilitate the adoption of digital technologies by HPs (RFO 3.8% [95% CI 1.8–7.9]). Our findings showed that infrastructure and technical issues, psychological barriers, and workload-related concerns are relevant barriers to comprehensively and holistically adopting digital health technologies by HPs. Conversely, deploying training, evaluating HP’s perception of usefulness and willingness to use, and multi-stakeholders incentives are vital enablers to enhance the HP adoption of digital interventions.

Summary: Systematic reviews have quantified the effectiveness, feasibility, acceptability, and cost-effectiveness of digital health technologies (DHTs) used by health-care workers. We aimed to collate available evidence on technologies’ effect on health-care workers’ competencies and performance. We searched the Cochrane Database of Systematic Reviews, Embase, MEDLINE, Epistemonikos, and Scopus for reviews published from database inception to March 1, 2023. Studies assessing the effects of DHTs on the organisational, socioeconomic, clinical, and epidemiological levels within the workplace, and on health-care workers’ performance parameters, were included. Data were extracted and clustered into 25 domains using vote counting based on the direction of effect. The relative frequency of occurrence (RFO) of each domain was estimated using R software. AMSTAR-2 tool was used to appraise the quality of reporting, and the Confidence in the Evidence from Reviews of Qualitative research approach developed by Grading of Recommendations Assessment, Development and Evaluation was used to analyse the certainty of evidence among included studies. The 12 794 screened reviews generated 132 eligible records for assessment. Top-ranked RFO identifiers showed associations of DHT with the enhancement of health-care workers’ performance (10·9% [95% CI 5·3–22·5]), improvement of clinical practice and management (9·8% [3·9–24·2]), and improvement of care delivery and access to care (9·2% [4·1–20·9]). Our overview found that DHTs positively influence the daily practice of health-care workers in various medical specialties. However, poor reporting in crucial domains is widely prevalent in reviews of DHT, hindering our findings’ generalisability and interpretation. Likewise, most of the included reviews reported substantially more data from high-income countries. Improving the reporting of future studies and focusing on low-income and middle-income countries might elucidate and answer current knowledge gaps.

Abstract Objectives To propose a Portuguese version of the Objective and Subjective Knowledge and HIV Testing Scale (OSK-HIV-TS), assess its content validity, and perform item analysis after administration to a sample of undergraduate students. Methods Three translators translated the OSK-HIV-TS into Portuguese. Judges evaluated each item of a consensus version of the translated instrument for semantic, idiomatic, cultural, and conceptual equivalence. A consensus committee reviewed a back-translation against the original version of the OSK-HIV-TS. Content validity was calculated with the content validity index (CVI) and item analysis was conducted using Classical Test Theory (CTT). Results The translated scale achieved semantic, idiomatic, conceptual, and cultural equivalence to the original version. A total of 491 undergraduate students participated and the distribution of students’ responses to the OSK-HIV-TS revealed a high proportion of correct answers. All items were classified as easy or very easy and only item 16 was classified having strong discrimination power according to the discrimination index. Conclusion The OSK-HIV-TS is a novel instrument in the Brazilian literature for assessing human immunodeficiency virus (HIV) knowledge and should inspire more research into HIV/acquired immunodeficiency syndrome (AIDS) behavior and associated factors, which, despite being essential and necessary, is still lacking in the Brazilian literature.

Introduction: This study reports on the translation, cultural adaptation, and validation of a Portuguese version of the Rotterdam Elderly Pain Observation Scale (REPOS), a Dutch scale to assess pain in patients who cannot communicate, with or without dementia. Methods: This is a multicenter study in pain and neurological units involving Brazil (clinical phase) and the Netherlands (training phase). We performed a retrospective cross-sectional, 2-staged analysis, translating and culturally adapting the REPOS to a Portuguese version (REPOS-P) and evaluating its psychometric properties. Eight health professionals were trained to observe patients with low back pain. REPOS consists of 10 behavioral items scored as present or absent after a 2-min observation. The REPOS score of ≥3 in combination with the Numerical Rating Scale (NRS) of ≥4 indicated pain. The Content Validity Index (CVI) in all items and instructions showed CVI values at their maximum. According to the higher correlation coefficient found between NRS and REPOS-P, it may be suggested that there was an adequate convergent validity. Results: The REPOS-P was administered to 80 patients with a mean age of 60 years (SD 11.5). Cronbach’s alpha coefficient showed a moderate internal consistency of REPOS-P (α = 0.62), which is compatible with the original study of REPOS. All health professionals reached high levels of interrater agreement within a median of 10 weeks of training, assuring reproducibility. Cohen’s kappa was 0.96 (SD 0.03), and the intraclass correlation coefficient was 0.98 (SD 0.02), showing high reliability of REPOS-P scores between the trainer (researcher) and the trainees (healthcare professionals). The Pearson correlation coefficient was 0.95 (95% confidence interval 0.94–0.97), showing a significant correlation between the total scores of REPOS-P and NRS. Conclusion: The REPOS-P was a valuable scale for assessing elderly patients with low back pain by different healthcare professionals. Short application time, ease of use, clear instructions, and the brief training required for application were essential characteristics of REPOS-P.

Background: The level of satisfaction of donors with the blood donation system is an important factor which influences their intent to return for future donation. A 25-item questionnaire on the satisfaction of blood donors has been recently proposed to assess the donor satisfaction with the service provided by a blood bank. The objective of this study was to present a proposal for application and interpretation of a BDSQ considering a sample of blood donors of a Brazilian blood bank. Methods: A sample of 1019 blood donors at the Regional Hemotherapy Center of Franca, Brazil, answered the BDSQ. A top-box analysis was used to assess the associations between the variables characterizing the profiles of blood donors and their overall satisfaction with the service provided by the blood bank. We proposed the use of a performance-importance plot (PIP) for the interpretation of the 25 items of the BDSQ. Results: Older donors are more likely to report lower overall satisfaction with the service provided by the blood bank. PIP allows us to classify the items of BDSQ into long- and short-term improvement opportunities as well as into motivational and hygiene factors. Motivational factors (i.e. attributes that promote overall satisfaction when present) tend to be associated with the treatment offered by the blood bank staff. Donors seem to give more importance to the interpersonal aspects than to the physical structure of the service and other aspects of convenience. Conclusions: Top-box analysis and PIP proved to be efficient strategies to interpret the results of the BDSQ.

Abstract Introduction The university period is often characterized as a critical period of vulnerability for smoking habit initiation. Objective The purpose of this cross-sectional study was to assess the relationship between religiosity and smoking among undergraduate students on health sciences courses. Methods A total of 336 students on four health sciences courses (occupational therapy, speech therapy, nutrition, and physiotherapy) completed a cigarette smoking questionnaire along with the Duke University Religion Index. Results Smoking prevalence was 8.3% among females and 12.7% among males. Prevalence among students who do not have a religion, but do believe in God, was higher than among those who do have a religion (16.3 and 6.3%, respectively). Organizational religious activity has a significant effect on smoking status. Conclusion The students have health habits that are not only motivated by the technical knowledge acquired on their undergraduate courses, since there was a possible influence of social norms stimulated by religious institutions on their attitudes, knowledge and practices in health.

Objective: To develop a self-reporting questionnaire, namely the Blood Donor Satisfaction Questionnaire (BDSQ) in Brazilian Portuguese, to assess the blood donor satisfaction with the service provided by a blood bank. Method: This study was carried out in three stages: 1) a preliminary version of the instrument was proposed, based on a revision of a previous questionnaire and consideration of the focus groups blood donor perceptions; 2) a content validation to assess the relevance of the items, clarity, domain structure and comprehensiveness of the satisfaction measurement, and; 3) a pre-test of the instrument using a sample of blood donors. All the stages of the research were performed at the Regional Hemotherapy Center in Franca, São Paulo, Brazil. Results: The 25-item BDSQ being proposed has an additional question on overall satisfaction. Responses to items are presented on a five-point scale, including a neutral answer. The BDSQ has three domains: accessibility and convenience, technical aspects, and interpersonal aspects. Conclusion: The application of the BDSQ has shown that it can be a useful tool in generating information for managers on specific aspects of blood bank services which need to be improved, monitored or maintained, aiming to provide a service which meets the blood donor expectations and makes him or her feel satisfied with the care received.

Background Health complexity includes biological, psychological, social, and health systems. Having complex health needs is associated with poorer clinical outcomes and higher healthcare costs. Care management for people with health complexity is increasingly recommended in primary health care (PHC). The INTERMED complexity assessment grid showed adequate psychometric properties in specialized settings. This study aimed to evaluate INTERMED’s validity and feasibility to assess health complexity in an adult PHC population. Method The biopsychosocial health care needs of 230 consecutive adult patients from three Brazilian PHC services were assessed using the INTERMED interview. Participants with a total score >20 were classified as “complex”. Quality of life was measured using the World Health Organization Quality of Life BREF (WHOQOL-BREF); symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); social support using the Medical Outcomes Study—Social Support Survey (MOS-SSS); comorbidity levels using the Charlson Comorbidity Index (CCI). We developed two questionnaires to evaluate health services use, and patient perceived feasibility of INTERMED. Results 42 participants (18.3%) were classified as “complex”. A moderate correlation was found between the total INTERMED score and the total scores of WHOQOL-BREF (rho = - 0.59) and HADS (rho = 0.56), and between the social domains of INTERMED and MOS-SSS (rho = -0.44). After adjustment, the use of PHC (β = 2.12, t = 2.10, p < 0.05), any other health care services (β = 3.05, t = 3.97, p < 0.01), and any medication (β = 3.64, t = 4.16, p < 0.01) were associated with higher INTERMED scores. The INTERMED internal consistency was good (ω = 0.83), and the median application time was 7 min. Patients reported satisfaction with the questions, answers, and application time. Conclusion INTERMED displayed good psychometric values in a PHC population and proved promising for practical use in PHC.

BackgroundHealth complexity includes biological, psychological, social, and health systems. Having complex health needs is associated with poorer clinical outcomes and higher healthcare costs. Care management for people with health complexity is increasingly recommended in primary health care (PHC). The INTERMED complexity assessment grid showed adequate psychometric properties in specialized settings. This study aimed to evaluate INTERMED's validity and feasibility to assess health complexity in an adult PHC population.MethodThe biopsychosocial health care needs of 230 consecutive adult patients from three Brazilian PHC services were assessed using the INTERMED interview. Participants with a total score >20 were classified as "complex". Quality of life was measured using the World Health Organization Quality of Life BREF (WHOQOL-BREF); symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); social support using the Medical Outcomes Study-Social Support Survey (MOS-SSS); comorbidity levels using the Charlson Comorbidity Index (CCI). We developed two questionnaires to evaluate health services use, and patient perceived feasibility of INTERMED.Results42 participants (18.3%) were classified as "complex". A moderate correlation was found between the total INTERMED score and the total scores of WHOQOL-BREF (rho = - 0.59) and HADS (rho = 0.56), and between the social domains of INTERMED and MOS-SSS (rho = -0.44). After adjustment, the use of PHC (β = 2.12, t = 2.10, p < 0.05), any other health care services (β = 3.05, t = 3.97, p < 0.01), and any medication (β = 3.64, t = 4.16, p < 0.01) were associated with higher INTERMED scores. The INTERMED internal consistency was good (ω = 0.83), and the median application time was 7 min. Patients reported satisfaction with the questions, answers, and application time.ConclusionINTERMED displayed good psychometric values in a PHC population and proved promising for practical use in PHC.

Background: This study investigated the attitudes and practices of Brazilian adults regarding the mandatory COVID-19 vaccination and their hesitancy towards the vaccination of children. Methods: Between March and May 2022, Brazilian adults answered an online questionnaire distributed through social media. The SAGE-WG questionnaire was adapted to measure hesitancy to the vaccination of children. Results: Of the 1007 participants, 67.4% believed that adult COVID-19 vaccination should be mandatory. Just over half of the participants (51.5%) believed that parents and/or guardians should decide if their children should be vaccinated against COVID-19 or not and 9.1% were unsure. Individuals who were younger, non-religious and had higher awareness of COVID-19 risks and critics of the federal government’s performance in combating the pandemic were more likely to agree with mandatory adult vaccination. However, less agreement among parents and/or guardians concerning children’s vaccination was observed, with lower scores for hesitancy to the vaccination of children. Conclusion: In Brazil, there is still far from a consensus on mandatory COVID-19 vaccination for adults and a significant proportion of the population believes that parents and/or guardians should be free to decide on their children’s vaccination. These views are associated with age, religion, knowledge of COVID-19 risks and political inclination.

Abstract Objective To assess the psychometric properties of the Medical Outcomes Study Social Support Survey (MOS-SSS) considering a sample of elderly users of the primary healthcare facilities of Ribeirão Preto, state of São Paulo, southeast Brazil. Methods The MOS-SSS is a widely used measurement of social support in different contexts, consisting of 19 items with answer categories that range on a 7-point rating scale. Data collection regarding the psychometric properties of the MOS-SSS was performed in a stratified sample of elderly users of primary healthcare facilities of Ribeirão Preto. Data were collected at five district basic health units located in the city through face-to-face interviews. Polychoric correlation matrix and exploratory (EFA) and confirmatory (CFA) factor analyses were performed. Results A total of 357 elderly subjects aged 60 years or older participated in the study (62.7% females). According to the polychoric correlation matrix, higher coefficients of correlation (> 0.90) were detected among 12 pairs of items and grouped into four factors, as suggested for EFA. The results of the CFA confirmed the construct validity of the four-factor structure of the MOS-SSS when applied to our sample, as well as the stability of this model in distinct subsamples. Conclusion The four-factor structure of the MOS-SSS was found to be suitable and presented adequate construct validity for the assessment of social support in elderly users of primary healthcare facilities.

Abstract Introduction: Instruments aimed to investigate general aspects of quality of life are scarce in the literature. Flanagan's Quality of Life Scale (QoLS) is an alternative instrument which provides a more comprehensive evaluation of quality of life in different contexts. Objective: To investigate some psychometric properties of the QoLS and discuss the measurement of quality of life using this scale in heterogeneous and large populations. Methods: The QoLS comprises 16 items divided into five dimensions. Responses were measured using a 7-point rating scale. Data were collected from a stratified sample of primary health care users in the municipality of Ribeirão Preto, state of São Paulo, Brazil. Polychoric correlation matrix and exploratory and confirmatory factor analyses were performed. Results: A total of 1,054 primary health care users in 12 health care facilities were interviewed: 79.7% female; mean age = 36.97 years (standard deviation = 15.1). Moderate to low correlation coefficients were observed between almost all pairs of QoLS items. Items 7 and 9 as well as items 14 and 15 were the pairs presenting the highest correlation coefficient. The original structure of the QoLS, with five dimensions, showed adequate psychometric properties regarding the data collected. The inclusion of a single item on life satisfaction was proposed. Conclusion: The original structure of the QoLS was validated and found to be reliable when applied to primary health care users. A new general item was suggested for future studies to improve the interpretations and associations regarding general aspects of quality of life in large and heterogeneous populations.

Abstract Background A number of studies have been reported on the role of religiosity in health beliefs and behaviors. Objective The objective of this cross-sectional study is to examine the association between religious involvement and patterns of alcohol consumption in a large representative sample of users of primary healthcare facilities in Ribeirão Preto, Southeast Brazil. Method Data were collected through personal interviews. Religiosity was measured using the Duke University Religion Index (DUREL) and the alcohol consumption was measured using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Multinomial logistic regression models were used to evaluate the associations between the participant characteristics, the AUDIT risk levels, and the drinking groups. Results The sample was composed of 841 women with a mean age of 39.5 years old and 214 men with a mean age of 45.1 years old. A significant relationship between patterns of alcohol consumption and the multiple dimensions of religiosity was detected, such as religious affiliation, religious practices, self-perception of the level of religiosity and the ORA, NORA and IR components of DUREL. Lower levels of drinking risk were detected among religious individuals and among those who practice their religions compared to individuals who have no religion and/or non-practicing individuals, respectively. Conclusion A lifestyle motivated by religious concerns is associated with alcohol use habits among the Brazilian users of the public healthcare facilities.

Reevaluation of the deferral from voluntary blood donation by men who have sex with men (MSM) is being discussed in several countries, motivated by the need to ensure a blood supply free from transfusion-transmissible infections (e.g., HIV, syphilis). Policies being considered include: permanent exclusion for any male-male sexual encounter, temporary deferral (3 months, 12 months, 5 years) from the last encounter, or specifying behaviors that differentiate MSM at high risk from those at low risk. Current Brazilian regulations defer MSM from blood donation for 12-months after the last male-male sexual encounter. Broad epidemiological evidence indicates that many MSM are at increased risk for HIV in the present era, and few data exist to distinguish which men are likely to be in the immunological window for detection of these infections. A multicenter study developed in Brazil demonstrated that the history of male-male sex was the most strongly associated with being an HIV-positive blood donor. Meanwhile, the blanket deferral of MSM from blood donation has generated considerable controversy. Rejection of the deferral policies stems in part from perspectives defending human rights, promoting equality and citizenship, and alleging bias and discrimination. The objective of this report is to discuss the current situation of blood donation among MSM in Brazil. We highlight the lack of evidence for a true risk profile for male-male sex in the context of blood donation upon which to base sound policy. We recommend research to establish effective and acceptable criteria for blood donation by MSM and other blood donors. Keywords: Men who have sex with men, Blood donation, Temporary deferral, HIV, Risk behaviors

Abstract Introduction Studies based on knowledge, attitude, and practice (KAP) theory are conducted to identify ways to improve strategies aimed at preventing and combatting certain conditions or diseases, to understand the way how behavioral changes are assimilated by the populations, and to reorient interventions. In view of the coronavirus disease 2019 (COVID-19) pandemic, studies based on KAP theory have been useful to better understand certain behaviors, such as adherence to prevention measures and control of the spread of the virus. Objective To describe the process of cross-cultural adaptation of two complementary instruments for assessing KAP regarding the COVID-19 pandemic in the Brazilian population. Methods Two independent translators proposed a first Brazilian Portuguese version of the scales. The cultural adaptation and pre-test of the Brazilian Portuguese versions occurred at different stages, using a panel of specialists and a subsample of the target population, respectively. Results The pre-test of the adapted instruments involved 30 Brazilian adults (mean age = 41.8 years; standard deviation = 4.24) and was carried out to assess instrument understanding and applicability. The participants informed they did not have difficulties to self-complete the instruments and reported a high level of clarity and understanding. Conclusion Both instruments can bring an opportunity to study behavioral constructs about COVID-19 in the Brazilian population, aiming to articulate strategies that enable the fulfillment of effective preventive measures.

Abstract INTRODUCTION This study investigated the prevalence of blood donors’ test-seeking behavior and related factors among health sciences undergraduate students. METHODS A total of 750 students were invited. Data regarding sociodemographic and behavioral characteristics, blood donation practices, and test-seeking behavior were collected. RESULTS: Of the invited students, 341 (45.5%) agreed to participate and answered questions regarding test-seeking behavior. The sample comprised 83.1% females, 96.8% singles, 87.2% heterosexuals, and 32.6% of them had previously donated blood. A high prevalence of blood donor test-seeking behavior (14.4%; 95% CI: 10.8%-18.5%) was observed and associated with blood donation practices. CONCLUSIONS: Test-seeking behavior was common among the interviewed students, thereby highlighting the importance of developing a better understanding of its determinants to prevent this behavior in key populations.

Background: To present the results of the application of the Blood Donation Knowledge Questionnaire in a large and representative sample of users of primary care services in order to extend the evaluation of the metrics of the items and to assess knowledge about blood donation in association with sociodemographic variables. Method: The Blood Donation Knowledge Questionnaire is composed of 24 items based on blood donation requirements of the Brazilian Ministry of Health and on some popular beliefs and concepts of the Brazilian population regarding the blood donation process. Data collection was carried out in 12 healthcare facilities of Ribeirão Preto, São Paulo. The analysis of items was performed using classical test theory with associations being assessed using the multivariate Tobit regression model. Results: A total of 1055 individuals participated (79.7% females and a mean age of 40.6 years). Previous blood donation was reported by 246 (23.3%) participants, 669 (63.4%) had never donated, and 140 (13.3%) reported being ineligible to donate blood. This questionnaire is comprised of items considered easy-to-understand, with a facility level of medium to high and generally an adequate capability of discrimination. Higher means of correct answers were detected among females, individuals with more schooling, and subjects who had already donated blood. Conclusion: The Blood Donation Knowledge Questionnaire is an instrument that aims to measure some general aspects of knowledge regarding blood donation and can be used in different contexts. There is evidence that knowledge of primary healthcare users regarding blood donation is correlated to sex, educational level, and previous blood donation. Keywords: Blood donation, Knowledge, Scales, Primary healthcare users, Blood donor beliefs

Abstract INTRODUCTION: Acquired immunodeficiency syndrome (AIDS) remains a major public health issue in Brazil. This ecological study aimed to evaluate the spatiotemporal distribution of notified new AIDS cases in Brazil between 2012 and 2016. METHODS: A Bayesian spatiotemporal model based on the Poisson distribution was used to obtain smoothed incidence estimates of AIDS in each of the 133 Brazilian intermediate regions. RESULTS: Spatial distribution of new AIDS cases is highly heterogeneous. Regions with higher gross domestic product per capita tend to have higher incidence rates of AIDS. CONCLUSIONS: Strategies to prevent and control AIDS should consider regional differences.

The aim of this cross-sectional study was to estimate the prevalence of self-reported hypertension and diabetes among elderly users of primary healthcare facilities in Ribeirão Preto, Brazil, and to investigate the association between these chronic conditions and physical activity and the degree of independence on the performance of activities of daily living. The study included 357 subjects aged 60 years or older. The classification of physical activity was based on the International Physical Activity Questionnaire (IPAQ) and the Pfeffer Functional Activities Questionnaire (PFAQ) was applied to assess activities of daily living. Prevalence of diabetes was associated with the level of physical activity, the self-perception of health and the degree of independence on the performance of activities of daily living. No significant associations were found between the prevalence of hypertension and these variables. These findings reinforce the relevance of continuous strategies of management of diabetes in the primary healthcare facilities based on the promotion of physical and occupational activities.

The objective of this cross-sectional study was to estimate the prevalence of self-reported hypertension and diabetes among the users of primary health care services of Southeast Ribeirão Preto, Brazil, and identify variables which may be associated with these chronic conditions. A stratified sample of 1,055 adult individuals surveyed. Associations were examined by log-binomial regression models and expressed as prevalence ratios (PRs). The prevalence of self-reported hypertension among women was 20.2% (95%CI: 17.5-23.1) and among men was 29.0% (95%CI: 22.9-35.5). The prevalence of self-reported diabetes among women was 6.9% (95%CI: 5.2-8.8) and among men was 12.2% (95% CI: 8.1-17.3). The prevalence of both conditions increases significantly with age. Crude and adjusted PRs indicate no association between socioeconomic status and the self-reported chronic conditions.

Os cirurgiões-dentistas durante sua formação profissional precisam ser conscientizados a respeito do risco a que estão expostos em seu ambiente de trabalho para que possam evitá-los. Assim, propôs-se elaborar e apresentar um telejornal intitulado “Ergonews” direcionado aos estudantes do 2º ano do curso de graduação da Faculdade de Odontologia de Araraquara - UNESP com o intuito de ampliar e reforçar os conhecimentos adquiridos na disciplina de Ergonomia em Odontologia I. O telejornal contou com uma repórter e também um “filósofo”, cuja função foi emitir opiniões filosóficas nem sempre corretas a respeito dos conceitos de ergonomia. Os assuntos abordados foram: i. importância da racionalização do trabalho para aumento da produtividade e da qualidade de vida do cirurgião-dentista; ii. requisitos de postura ergonômica, saúde ocupacional, importância do controle de infecção cruzada na prática odontológica; iii. equipamentos odontológicos e delegação de funções - trabalho a quatro mãos. O jornal foi gravado previamente à sua apresentação e todas as gravações foram editadas utilizando-se o Movie Maker. O telejornal foi apresentado aos estudantes em sala de aula, utilizando projeção multimídia, nas aulas de Ergonomia em Odontologia I e apresentou média de duração de 10 minutos e periodicidade quinzenal. Após a apresentação de cada “Ergonews” os estudantes avaliaram de forma crítica os conceitos de ergonomia emitidos pelo “filósofo” do telejornal, com o objetivo de fazê-los sedimentar o aprendizado adquirido durante a aula. Pode-se concluir que o “Ergonews” foi uma forma auxiliar de promover o aprendizado sobre ergonomia em Odontologia.

A religiosidade é uma variável importante para a pesquisa em saúde, considerando suas conhecidas associações com o processo saúde-doença e questões importantes sobre o bem-estar, atitudes, práticas e satisfação em relação a cuidados e serviços. No entanto, na pesquisa em Saúde Coletiva, é frequentemente usada a afiliação religiosa como única dimensão da religiosidade. O presente estudo objetivou investigar a adequação do uso do instrumento Duke Religious Index (DUREL) no âmbito da pesquisa em Saúde Coletiva, ao avaliar as capacidades psicométricas do instrumento quando aplicado a uma população representativa de usuários dos serviços de atenção primária à saúde de um município de porte médio do interior do Estado de São Paulo. Foi encontrada uma adequada consistência interna para o instrumento e validade convergente-discriminante. Os resultados sugerem que o uso do DUREL não é restrito à pesquisa em saúde mental e que sua utilização pode trazer novas perspectivas para o entendimento de eventos de interesse na área da Saúde Coletiva.

The aim of this study was to estimate the reliability, validity and factorial invariance of the Portuguese version of the Geriatric/General Oral Health Assessment Index (GOHAI) as applied to Brazilian women. A total 701 women over 18 years of age participated in this study. Telephone interviews were conducted. We evaluated the construct-related validity through factorial, convergent and discriminant validity. We carried out a confirmatory factor analysis using the χ2/df, CFI, GFI and RMSEA indexes. The invariance of the model in a second independent sample was estimated by multi-group analysis and internal consistency using Cronbach’s alpha coefficient. Items 5 and 9 presented factor weights below the adequate value and were removed. The three-dimensional and unifactorial model presented an adequate fit. We observed strong factorial invariance of the models in two independent samples (three-factor: ρλ = 0.62; pCov = 0.89, one-factor: ρλ = 0.81; pCov = 0.68) and weak factorial invariance between users and nonusers of dental prosthetics (three-factor: ρλ = 0.55; pCov = 0.01, one-factor: ρλ = 0.51; pCov = 0.02). The convergent validity was suboptimal. Internal consistency was adequate. The GOHAI applied to the study sample showed adequate reliability, factorial validity and stability in independent samples and between users and nonusers of dental prosthetics in both the three-dimensional and the unifactorial structures.

El objetivo de ese trabajo fue estimar el comportamiento de beber entre estudiantes de Odontología y comparar la efectividad de métodos de rastreo para detección del binge drinking. Participaron 284 estudiantes. Se utilizó el AUDIT completo y sus formas reducidas (AUDIT-3 y AUDIT-C). Se construyó la curva ROC y se estimó su área. De los estudiantes, 91,0% y 90,6% del sexo masculino y femenino, respectivamente, relataron consumir bebidas alcohólicas. El binge drinking ocurrió en un 69,2% de los niños y 52,4% de las niñas. Los tres métodos presentaron buena capacidad discriminatoria. En el sexo femenino, hubo diferencia entre el AUDIT-3 y el AUDIT-C. Se observó alta superioridad de binge drinking entre los estudiantes. La versión completa y las reducidas del AUDIT se mostraron efectivas para detección del binge drinking.

A Síndrome de Burnout caracteriza-se por esgotamento profissional e tem sido relatada em estudantes universitários. O objetivo desse estudo foi estimar a prevalência da Síndrome de Burnout em estudantes de Odontologia de uma universidade pública e sua relação com características sociodemográficas. Todos os estudantes (n = 300) foram convidados a participar. Utilizou-se o Inventário de Burnout de Maslach - versão estudantes (MBI-SS). Realizou-se análise das propriedades psicométricas do MBI-SS. Para comparação entre os escores médios das dimensões do Burnout realizou-se Análise de Variância Multivariada (MANOVA) seguida de Análise de Variância (ANOVA) e testes post-hoc de Tukey. Dos 235 participantes, 72,8% eram mulheres e a média de idade era de 21,0 ± 1,8 anos. O MBI-SS mostrou-se confiável e válido. Dos estudantes, 17,0% apresentaram a Síndrome de Burnout. Verificou-se relação significativa entre a Síndrome de Burnout e o desempenho do estudante no curso (F = 4,433, p < 0,001), o consumo de medicação devido aos estudos (F = 7,721, p < 0,001) e o pensamento de desistir do curso (F = 16,168, p < 0,001). Foram mais acometidos aqueles com desempenho ruim no curso, que consomem medicações devido aos estudos e que já pensaram em desistir do curso. Conclui-se que a prevalência da Síndrome entre os estudantes de Odontologia foi alta, sendo significativa a relação entre a Síndrome e o desempenho do estudante no curso, o consumo de medicação devido aos estudos e o pensamento de desistir do curso.The burnout syndrome is characterized by professional exhaustion and has been reported in college students. The aim of this study was to estimate the prevalence of Burnout Syndrome among dentistry students from a public university, and its relationship to socio-demographic characteristics. All students (n = 300) were invited to participate. We used the Maslach Burnout Inventory - Student Version (MBI-SS). We carried out an analysis of the MBI-SS' psychometric properties. Multivariate Analysis of Variance (MANOVA) was performed, followed by Analysis of Variance (ANOVA) and Tukey's post-hoc tests to compare the mean scores of burnout dimensions. Of the 235 participants, 72.8% were women and the mean age was 21.0 ± 1.8 years. The MBI-SS was reliable and valid. Of the students, 17.0% had Burnout Syndrome. There was a significant relation between Burnout Syndrome and a student's performance during the course (F = 4.433, p < 0.001), medication intake because of studies (F = 7.721, p < 0.001), and the thought of dropping the course (F = 16.168, p < 0.001). The students most affected were those with poor performance, those who took medication because of studies, and those with thoughts of dropping the course. We concluded that the prevalence of the syndrome among dentistry students was high, with a significant relation between the syndrome and a student's academic performance, use of medication because of studies, and thoughts of dropping the course.

OBJECTIVE: This study was proposed to estimate the effectiveness of different screening methods of the Burnout Syndrome among dental students. MATERIAL AND METHOD: The Burnout Syndrome assessment was performed using the Oldenburg Inventory-Student survey (OLBI-SS) and the Copenhagen Inventory-Student survey (CBI‑SS). The Maslach Burnout Inventory-Student survey (MBI-SS) was used as the gold standard. The psychometric properties of the instruments were measured. The second-order hierarchical model was estimated to calculate the overall scores for OLBI-SS and CBI-SS, and ROC curves were constructed and the areas were estimated (AUROC). RESULT: A total of 235 undergraduate students participated in this study. The instruments showed an adequate reliability and validity; however three questions had to be removed from OLBI-SS and one from CBI-SS. The Exhaustion dimension of OLBI-SS, and Personal Burnout and Study related Burnout of CBI-SS presented a good discriminating capacity. CONCLUSION: CBI-SS showed higher discriminating capacity, than OLBI-SS, to identify the Burnout Syndrome (DAUROC=.172 [.103-.240]; p

Abstract Background Blood/injection phobia may have important consequences for health. These phobic individuals, in most cases, avoid contact with health systems, postpone or avoid medical procedures, avoid invasive treatments and do not participate in health promotion and early detection of disease initiatives such as vaccination, consultations, preventive exams or blood donation. Thus, specific and validated instruments are necessary to assess this variable. In addition, a lack of studies on this theme may be associated with the low availability of instruments. This study aimed to propose a Portuguese version of the Blood/Injection Fear Scale (BIFS-P) and assess its psychometric properties. Methods Translation and back-translation were performed. Content validity was assessed in two steps by a panel of 20 experts. The psychometric properties were assessed in a stratified and representative sample of primary health care service users of Ribeirão Preto, southeastern Brazil. Exploratory and confirmatory factor analyses were conducted using a polychoric correlation matrix. Results A total of 1054 primary health care users participated; 79.7% were female and the mean age was 40.6 (standard deviation = 15.16) years. According to the exploratory factor analysis, the items can be grouped into three or five factors with best fits being detected for the three- and five-factor models in confirmatory factor analysis. Conclusion Blood/Injection Fear Scale (Portuguese version) is easy to understand and apply in the general population, showed adequate psychometric properties, and represents an alternative in the assessment of blood/injection phobia for future studies.

Abstract INTRODUCTION: Although congenital syphilis is preventable, its incidence has increased in Brazil. METHODS: In this ecological study, a Bayesian spatio-temporal model was used to estimate the attributable fraction of congenital syphilis cases due to the lack of prenatal care recorded between 2010 and 2015 in the state of São Paulo, Southeast Brazil. RESULTS: For the year 2016, it was estimated that between 79.4% and 95.3% of the congenital syphilis cases among women who did not have prenatal care could have been prevented. CONCLUSIONS: A significant proportion of congenital syphilis cases can be prevented if prenatal care coverage is expanded.