Base teórica: A doença de Parkinson (DP) é a segunda enfermidade neurodegenerativa mais frequente, crescendo proporcionalmente com o aumento da idade. É uma doença de comprometimento motor e não motor. Levodopa e agonistas dopaminérgicos (AD) são usados no tratamento da DP, permitindo um controle ótimo dos sintomas nos primeiros anos. Entretanto, em 5 anos, metade dos pacientes terão complicações motoras e nãomotoras induzidas pelo uso de antiparkinsonianos. Manifestações neuropsiquiátricas são frequentes, entre elas depressão, ansiedade, prejuízos cognitivos, sintomas psicóticos e transtorno de descontrole dos impulsos(DI). O DI é uma condição caracterizada pela falência em resistir a impulsos ou tentação de executar atos. O DI está associado ao uso de antiparkinsonianos, em especial, os agonistas dopaminérgicos A identificação desta condição é primordial para seu tratamento e estudo adequados. Na literatura atual, o questionário padrão-ouro foi validado na língua inglesa (QUIP), não existindo uma validação para língua portuguesa. Objetivo: Traduzir e validar o questionário QUIP-CS, em sua versão curta e aplicável no momento presente da DP, para lingua Portuguesa do Brasil Métodos: A versão curta da QUIP (QUIP-CS) foi traduzida para o Português por tradutor juramentado. Após, esta foi avaliada por 5 especialistas em DP no Brasil, sendo sugeridas pequenas correções. A versão corrigida em português foi retrotraduzida para o inglês por 2 tradutores juramentados nativos na língua original da escala (inglês), que compararam suas versões posteriormente, chegando-se a uma nova versão final neste idioma. Esta foi enviada ao autor da escala original, que concordou com esta versão, ou seja, foram mantidas as propriedades semânticas do instrumento. Após, a versão final em Português foi auto-aplicada em 65 indivíduos com diagnóstico de DP em tratamento no ambulatório especializado no HCPA, sendo que, de forma aleatória, para 30 foi aplicado um questionário de avaliação sobre o grau de dificuldade de compreensão de suas perguntas. Resultados: Em uma escala de 1 a 5 pontos, onde 1 era nenhuma compreensão das perguntas e 5, clara compreensão, a média de entendimento pelos pacientes foi de 4,06 +/- 0,69 DP. Conclusão: A avaliação desta versão foi considerada de fácil compreensão pelos próprios pacientes. O artigo para validação da tradução do conteúdo da versão em Português da QUIP-CS está em fase de revisão para publicação. / Background: Parkinson’s disease (PD) is the second most often neurodegenerative disease and proportionally growing with people aging. PD is a disease with motor and nonmotor clinical features. Levodopa and dopaminergic agonists (DA) are used for PD treatment, allowing an exquisite control of the motor symptoms during the first years. However, in five years, half patients will present motor or non-motor complications induced by cronic use of these medications. Neuropsychiatric symptoms are often, for example, depression, anxiety, cognitive impairment, psychotic symptoms and impulse control disorders (ICD). The ICD is characterized by failure on resisting an impulse or on performing an specific act. Identification of the PD affected patients is crucial for proper management and study of this condition. There is an already validated self-reported questionnaire for this purpose, the Parkinson's Disease Impulsive-Compulsive Disorders Questionnaire (QUIP), without equivalent in portuguese language. Objective: To translate and to validate the Portuguese short version of the gold-standard questionnaire for identifying ICDs PD affected patients, applicable at the current moment of PD Methods: QUIP-CS was first translated to Portuguese by a professional translator. This translated version was shown to 5 PD neurologist specialists. in Brazil, being suggested minor modifications on it. This new Portuguese revised version was back translated to English by two independent native English speakers. They were both asked to compare the version one another and checked for differences. Then, they contacted each other and got a final back translated version. This one was sent for the original author, that approved its new version comparing to his original and validated one, with no loss of it’s original properties. The Portuguese corrected version was applied to 65 patients in a random way at PD’s ambulatory at HCPA. From these, 30 were asked to answer a number that would represent their level of QUIP-CS questions’ comprehension. Results: In a 1 to 5 point scale, being 1 no comprehension and 5, total comprehension, the average was 4,06 +/- 0,69 DP. Conclusion: Our results on Portuguese version of QUIP-CS show that QUIP-CS translated and corrected version was easily understood and easily self-applied. The article is under revision to be submitted for publication.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-05-12T18:14:24Z No. of bitstreams: 1 leandrohermisdorffbernardo.pdf: 2471442 bytes, checksum: d3adf8f386800446bd62310452998a26 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-06-27T19:54:28Z (GMT) No. of bitstreams: 1 leandrohermisdorffbernardo.pdf: 2471442 bytes, checksum: d3adf8f386800446bd62310452998a26 (MD5) / Made available in DSpace on 2016-06-27T19:54:28Z (GMT). No. of bitstreams: 1 leandrohermisdorffbernardo.pdf: 2471442 bytes, checksum: d3adf8f386800446bd62310452998a26 (MD5) Previous issue date: 2013-03-25 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O foco específico na relação homem e saúde vêm ocorrendo, nos últimos anos, tanto nos meios acadêmicos quanto no âmbito dos serviços de saúde. Incluir a participação do homem nas ações de saúde é, no mínimo, um desafio, por diferentes razões. Apesar de avanços no campo da saúde do homem, muitas questões ainda precisam ser consideradas no cuidado destes com a própria saúde. Uma questão importante seria como esta população avalia seu próprio estado de saúde, bem como os fatores que estão associados a esta avaliação pois permite identificar o perfil desta população ainda pouco estudada, o que pode, assim, auxiliar no planejamento de medidas de prevenção e promoção de saúde, bem como subsidiar estratégias necessárias para o maior alcance destes homens em termos de saúde. O objetivo do presente estudo foi avaliar condições de saúde auto-referidas, e os possíveis fatores relacionados, da população masculina na cidade de Belo Horizonte (MG), nos anos de 2006 e 2011. Trata-se de um estudo epidemiológico longitudinal, que se propõe fazer a análise desta população em 2006 e 2011, através de inquérito telefônico (VIGITEL 2006 e 2011). As amostras foram compostas por 782 indivíduos em 2006 e 836 em 2011, com idades superiores a 18 anos. Os dados foram processados em um banco de dados criado por meio do software Statistical Package forthe Social Sciences (SPSS), versão 20.0, que permitiu verificar a associação entre cada uma das variáveis independentes com a variável dependente, através da utilização do teste Qui-quadrado (χ²). Houve uma significativa mudança na idade dos indivíduos entrevistados, onde a média passou de 41,9 em 2006 para 44,2 anos em 2011; diminuição significativa, de 59,2% para 51,7% (2006 e 2011, respectivamente), do consumo alcoólico;melhora nas condições de saúde auto-referidas, aumentando de 21,1% (0,18 – 0,23) para 28,1% (0,24 – 0,31) a proporção de indivíduos que referiram a saúde como excelente. Esses dados chamam a atenção para a necessidade de políticas públicas e ações de saúde voltadas para essa população, com ênfase em ações educativas, preventivas, e de promoção à saúde. Apesar de o VIGITEL constituir um importante instrumento de coleta de dados que favoreçam o entendimento acerca das doenças crônicas não transmissíveis, a inclusão de questões referentes às condições econômicas dos participantes seria importante para se traçar com maior clareza os fatores associados às morbidades nas populações estudadas. / The specific focus in the relationship between man and health has been occurring, in the last years, both in academic terms and in scope of health services. For many reasons, it's a challenge to include man's participation in care health. Although there are advances in the field of human health, many questions have to be considered in the care of man with own health. An important point would be how this population evaluates its own state of health, as well as the factors that are associated to this evaluation because it allows us to identify this population profile, which is still not very studied, which may, thus, help in the planning of prevention methods and health promoting, as well as support strategies, which are necessary to a higher reach of these men in terms of health. The objective of this study was to evaluate conditions of self-reported health and the possible factors related of the male population in Belo Horizonte (MG) in 2006 and 2011. This is a longitudinal epidemiological study which proposes to do an analysis of this population in 2006 and 2011 through telephonic survey (VIGITEL 2006 and 2011). The samples were composed of 782 people in 2006 and 836 in 2011 with more than 18 years. The data were processed on a database created through the software Statistical Package for Social Sciences (SPSS), version 20.0, which allowed to verify the association between each one of the independent variables with the dependent variable, through the use of qui-square test. There was a meaningful change in the interviewed individuals age, in which the average changed from 41.9 in 2006 to 44.2 years old in 2011; meaningful decrease, from 59.2% to 51.7% (2006 and 2011, respectively), in the alcoholical consume; self reported health condition improvement, increasing from 21.1% (0.18-0.23) to 28.1% (0.24-0.31) the individuals proportion that referred to the health as excellent. These data call our attention to the need for policies and health public actions focused on this population, with emphasis on educational actions, preventive and promotion to the health. Although VIGITEL be an important tool for data collection to encourage the understanding of chronic diseases, including questions relating to economic conditions of the participants would be important to more clearly delineate the factors associated with morbidity in the populations studied.

Cancer is the second leading cause of death in America. It’s been suggested that regular physical activity (PA) can improve health outcomes in cancer survivors. An estimate from BRFSS data (2009) suggested that 47% of all cancer survivors met recommended guidelines and that this estimate was not different from the population at large (48%). Several factors were examined from these BRFSS data to determine whether subgroups of survivors existed who might benefit from interventions aimed at improving their PA status. The purpose of this investigation was to obtain more recent estimates of adherence to established PA guidelines for cancer survivors. Data from 2015 NHIS were obtained from the CDC website. Of the survivors, 40% met PA guidelines. Additionally, 79% were 54 years or older, more likely to be female (60%), predominantly white (80%), with more than 2 comorbidities (41%), and with some form of functional limitation (66%). Compared to a study based on 2009 BRFSS data, an even smaller proportion of survivors met PA guidelines in this study. This might be due to differences in age distributions and no limitation of the analysis according to time since diagnosis. Targeted interventions to increase activity in cancer survivors continue to be warranted.

Objective: 1) Systematic review on the accuracy of Chronic Rhinosinusitis (CRS) identification in administrative databases; 2) Develop an administrative data algorithm to identify CRS patients who have endoscopic sinus surgery (ESS). Methods: A chart review was performed for all ESS surgical encounters at The Ottawa Hospital from 2011-12. Cases were defined as encounters in which ESS for performed for Otolaryngologist-diagnosed CRS. An algorithm to identify patients who underwent ESS for CRS was developed using diagnostic and procedural codes within health administrative data. This algorithm was internally validated. Results: Only three studies meeting inclusion criteria were identified in the systematic review and showed inaccurate CRS identification. The final algorithm using administrative and chart review data found that encounters having at least one CRS diagnostic code and one ESS procedural code had excellent accuracy for identifying ESS: sensitivity 96.0% sensitivity, specificity 100%, and positive predictive value 95.4%. Internal validation showed similar accuracy. Conclusion: Most published AD studies examining CRS do not consider the accuracy of case identification. We identified a simple algorithm based on administrative database codes accurately identified ESS-CRS encounters.

Concern beliefs in medicines are patients' anxieties about the harmful effects of a specific prescribed medication. Three papers examined the importance of concern beliefs in medicine, specifically its relationship to patient outcomes such as self-reported adverse drug events (ADEs) and symptom attribution, and the factors that might drive a change in concern beliefs over time. For the first and second paper, a cross-sectional internet survey of Medicare enrollees who were English speakers, 65 years and older and enrolled in the Medicare Part D program was done. In the third paper, a longitudinal internet survey of the same sample was done before Medicare Part D in 2005 and after Medicare Part D in 2007, and adults 40 years and older with physical limitations were interviewed using telephone. Multiple logistic regressions showed that having stronger concern beliefs in medicine and more symptoms was related to self-reported ADE, rather than using an inappropriate medicine or the number of inappropriate medicines used. Using independent sample t-tests, concern beliefs in medicine were found to be unrelated to symptom attribution for any causal reason, irrespective of whether there was patient-clinician agreement on attribution. Multiple linear regressions showed that concern beliefs changed over time for some older adults and having an ADE in the past year was related to this change. Among adults with physical limitations, though concern beliefs changed for some individuals; only one factor included in this study, changes in number of medicines, was related to this change. Establishing the importance of concern beliefs in medicines as a socio-psychological variable to consider in medication use outcomes will enhance the understanding of clinical researchers and practitioners concerning the mechanism of ADEs and symptom reporting.

The objectives of this research were to (1) characterize the demographics and vocal health history of collegiate-level singers, particularly those with a voice disorder and (2) describe and compare self-reported symptoms of singers across diagnostic categories of vocal fold disorders. Clinical reports of 56 collegiate-level singers (15 male and 41 female) who visited the Voice Diagnostic Clinic at the University of North Texas for voice evaluations between 2010 and 2015 were reviewed. Information was extracted from clinical records including demographic data, vocal health history, self-reported voice-related symptoms, and voice diagnosis confirmed by strobolaryngoscopic examinations and phonatory function testing. Diagnoses of voice disorders were grouped under three categories: normal (i.e., no perceptible pathology), benign lesions and irritation/inflammation. Seven singers were diagnosed as normal, 27 (51.8%) with benign lesions, and 22 (39.3%) with irritation/inflammation. All singers diagnosed as normal were females. Female singers have twice as many benign lesions as irritation/inflammation whereas males presented the opposite pattern. Nodules, polyps, cysts and irritation/inflammation were the most common voice disorders. Singers with allergies and a past history of voice problems demonstrated a higher incidence of voice disorders. The top five self-reported vocal symptoms were worse voice in the morning (50%), pain in throat (46.4%), voice worse with prolonged use (44.6%), vocal fatigue (42.9%), and breathiness (41.1%). Self-reported symptoms are not a reliable screening tool to determine presence or absence of vocal pathology. Voice teachers must be familiar with the singing and speaking voice of each student, so as to perceive early onset of vocal attrition symptoms and encourage the student in seeking medical attention.

Objective: Evaluate the association between self-reported bruxism and academic performance in students at a university in Lima, Peru. Materials and methods: A total of 203 students were evaluated in this study, between the ages of 19 to 35. Self-reported bruxism was measured using the 'Bruxism Assessment Questionnaire'. Likewise, academic performance was evaluated using the Approval Index Scale. In addition, other variables were included such as employment status, socioeconomic level, stress, anxiety, among others. The association of variables were factored in using the chi-square test and the logistic regression presented the unadjusted and adjusted analisis. Results: The frequency of self-reported awake bruxism and sleep bruxism was 53.20% and 36.45%, respectively. Evidence revealed there was a statistically significant association between awake bruxism with stress and anxiety, and sleep bruxism with anxiety. Students with high academic performance (OR=2.36; IC del 95%:1.06-5.23) and low academic performance (OR=5.72; IC del 95%:1.28-25.57) were found to be more likely to have awake bruxism than those with medium academic performance. Conclusions: This study revealed a statistically significant association between self-reported awake bruxism and academic performance. However, in the future it is suggested to carry out a study with focus only on students with bruxism and with a larger sample of participants with low academic performance to confirm the association found between these variables. / Objetivo: Evaluar la asociación entre bruxismo autorreportado y rendimiento académico en estudiantes de una universidad privada de Lima, Perú. Materiales y métodos: Un total de 203 estudiantes con edades comprendidas entre 18 a 35 años fueron encuestados en esta investigación. Para la evaluación del bruxismo autoreportado se aplicó el cuestionario ‘Bruxism Assessment Questionnaire’. Asimismo, el rendimiento académico se evaluó mediante la escala de Índice de Aprobación (IA). Además, se incluyeron otras variables como situación laboral, estrés, ansiedad, entre otros. La asociación de variables se realizó mediante la prueba Chi cuadrado y para el análisis crudo y ajustado se utilizó la regresión logística. Resultados: Se encontró una prevalencia de bruxismo de vigilia de 53.20% y de bruxismo de sueño de 36.45%. Se evidenció asociación estadísticamente significativa entre bruxismo de vigilia con estrés y ansiedad, y bruxismo de sueño con ansiedad. Se halló que los estudiantes con rendimiento académico alto (OR=2.36; IC del 95%:1.06-5.23) y rendimiento académico bajo (OR=5.72; IC del 95%:1.28-25.57) tienen más probabilidades de presentar bruxismo de vigilia que aquellos con rendimiento académico medio. Conclusiones: En el presente estudio se halló asociación estadísticamente significativa entre bruxismo de vigilia autorreportado y rendimiento académico. No obstante, a futuro se sugiere realizar un estudio a los estudiantes con presencia de bruxismo y con un mayor tamaño muestral de participantes con rendimiento académico bajo para afirmar la asociación encontrada entre dichas variables. / Tesis

This study is the first randomised controlled trial (RCT) of the safety effect of high-visibility bicycle clothing. The hypothesis was that the number of cyclist accidents can be reduced by increasing the visibility of the cyclists. The study design was an RCT with 6793 volunteer cyclists – 3402 test cyclists (with a yellow jacket) and 3391 control cyclists (without the jacket). The safety effect of the jacket was analysed by comparing the number of self-reported accidents for the two groups. The accident rate (AR) (accidents per person month) for personal injury accidents (PIAs) for the test group was 47% lower than that of the control group. For accidents involving cyclists and motor vehicles, it was 55% lower. The study was non-blinded, and the number of reported single accidents was significantly lower in the test group than in the control group. This is likely a result of a response bias, since the bicycle jacket was not expected to affect the number of single accidents. To compensate for this bias, a separate analysis was carried out. This analysis reduced the effect of the jacket from 47% to 38%.

No description available.

Integrating intersectionality theory with a quantitative design, this analysis investigates the intersectional dynamics of self-reported health inequalities among lone parents in England and Wales. This study examines the association between lone parenthood, gender, and migrant status simultaneously on health outcomes. It applies logistic regression using data from the 2011 Census Microdata Individual Safeguarded dataset. The findings demonstrate the presence of multiple identity factors that contribute to health inequality, which consequently highlights the impact of cumulative socioeconomic privilege and disadvantage, impacting the health of lone parents. Regardless of gender or migration status, being a lone parent has a negative effect on health. The healthy migrant effect is evident across intersected categories of migrants and socioeconomic groups, particularly among men, partnered parents, and immigrants from Western societies. These results emphasize the significance of considering additional dimensions of social positioning and adopting an intersectional perspective in monitoring health inequalities in the country.