Acta Scientiarum. Health Sciences

Challenges to access health faced by rural population and their perception regarding healthcare

Maria Maiely Bezerra Gomes — 2021-03-08

The Brazilian nation has rich population diversity, and this makes it responsible for guaranteeing the social rights of all. In this perspective, this research seeks to categorize which are the main challenges in access to health that the rural populations face and to understand how the execution of this health care is carried out by professionals from the perspective of rural people. This is a cross-sectional study with a qualitative approach, carried out at the Nossa Senhora Aparecida Settlement, located in the municipality of Pesqueira (Pernambuco state) in 2018. The results demonstrate that the challenges faced by settled families are due to the difficulty of access to health services. In view of this, the rural population chooses to keep their cultural practices focused on their health alive. Therefore, it is common to use herbal medicines and mystics related to religious beliefs in self-care practices. It was concluded that the current public policies have gaps in their implementation, especially in terms of accessibility, security, health education, equity and respect for cultural differences. In addition, there is precariousness at the national level of studies focused on the health determinants and determinants of the rural population, which makes it necessary that more research be carried out so that new public policies can emerge.

Perceived self-esteem, resilience and stress of students entering a nursing degree

Priscila Rodrigues Mendes — 2021-03-08

This study aimed to evaluate perceived self-esteem, resilience and stress of students entering a nursing degree. Cross-sectional study with 122 students (104 women and 18 men) of the first semester of a private institution in Distrito Federal. Evaluations were performed in March 2019. Rosenberg Self-Esteem Scale, Resilience in Higher Education and Perceived Stress, as well as a socio-economic questionnaire were used. All procedures were carried out using the software Statistical Package for the Social Sciences (SPSS) and GraphPad Prism 6. The comparison of perceived stress between groups demonstrated that less stressed individuals were younger (19.1 ± 1.9 years old vs 22.5 ± 7.4; p = 0.030) and presented higher resilience scores (147.0 ± 16.3 vs 125.0 ± 22.5; p < 0.001). The comparison of self-esteem tertiles showed that individuals with better self-esteem were more resilient (146.0 ± 17.65 vs 133.85 ± 24.84; p = 0.037). Spearman's correlation demonstrated a negative relation between resilience score and perceived stress (r = -0.415 p = < 0.001). Students had already entered university presenting psychical deficits, such as increased stress and low self-esteem and resilience.

Sexual dimorphism applying the mandibular canine index in a Brazilian sample: a pilot study

Luciana Vigorito Magalhães — 2021-03-08

The aim of this study was to apply the morphometric quantification of the canine index for sexual dimorphism in a Brazilian sample. The sample consisted of 90 participants (45 males and 45 females) aged between 18 and 35 years. With the aid of a digital caliper, the intraoral mesio-distal measurement of the permanent mandibular right canine (MD43) and the intercanine distance (IC) were taken by three examiners. The measurements were used in a formula established by Rao, Rao, Pai e Kotian (1989) to estimate sex based on morphometric features of the human canines. The applicability of this approach for sexual dimorphism was assessed based on the inherent mandibular canine index (MCI) calculated by the formula. The MCI was higher in males than females. The mean general accuracy rate of the MCI for sexual dimorphism in the total sample was 52.22%. In males, the MCI was able to properly distinguish sex in 82.22% of the sample, while in females the accuracy decreased to 22.22%. These outcomes raise the attention for the careful use of the MCI in practice – especially in the field of Forensic Anthropology. In particular, the accuracy of the method was close to random in a sample that contained both sexes. Thus, MCI should not be used as the only tool for sexual dimorphism.

Effect of lifestyle intervention holistic approach on blood glucose levels, health-related quality of life and medical treatment cost in type 2 diabetes mellitus patients

Girija Kumari — 2021-03-08

Type 2 Diabetes Mellitus (T2DM) is a costly, lifestyle-related disorder, its management is very critical and challenging hence lifestyle intervention may a cornerstone in the reversal and management of T2DM. This study designed to assess the impact of lifestyle intervention holistic (LIH) Model on blood glucose levels (BGL), Health-Related Quality of Life (HRQOL), and medical treatment cost in T2DM patients. This prospective, quasi-experimental study was conducted among 224 T2DM patients in Delhi Diabetes Research Center (DDRC), New Delhi. The study participants were allocated into two groups-Lifestyle Intervention Counseling (LIC) group received lifestyle-based counseling through the LIH model while the Usual-care group received only standard treatment. Study outcomes were assessed at baseline, 3rd, 6th, and 12th month and data were analyzed through SPSS. Study results revealed that LIC participants had decreased in fasting blood glucose 0.26 mg dL^-1 (-4.37 to 4.89), blood glucose postprandial -70.16 mg dL^-1 (-85.15 to - 55.16), HbA1C -2.82% (-5.26 to - 0.37), medicine cost (p < 0.004), hospitalization cost (p < 0.011), and cost of surgery (p < 0.0005). A significant improvement also observed in HRQOL and adherence towards a holistic model in LIC group. The study concludes that lifestyle-based counseling and its adherence was cost-effective and significantly improves BGL, HRQoL, and medical treatment in T2DM patients.

Epidemiological aspects of visceral leishmaniasis in the municipality of Montes Claros-MG

Fernanda Santana da Silva — 2021-03-08

Visceral leishmaniasis (VL), also known as ‘calazar’, is a serious chronic disease caused by Leishmania species from Leishmania (Leishmania) donovani complex, which the disease is characterized by abdominal swelling (hepatosplenomegaly) and may evolve to death in extreme cases. In this sense, the aim of our study was to assess the epidemiological profile of the cases found in Montes Claros (Minas Gerais state). A retrospective or cross-sectional study was carried out using secondary data provided by Health Information System (SINAN/HM) of Brazil from January 2010 to February 2020. Our data has shown that VL is an endemic disease in Montes Claros region, with 413 VL cases reported, 62.00% (252) male, average age ± standard deviation (years), and 93.46% (386) lived in Montes Claros city. The presence of comorbidities was observed in 13.70% (54) of the patients and in 7.26% (30). As for the evolution of the disease, 246 (59.56%) were cured, 30 (7.26%) died due to VL. Between 2010 and 2015, Glucantime^® stands out, in which 46 (11.13%) patients used the drug, followed by common Amphotericin B 24 (13.48%) and liposomal Amphotericin B 38 (21.34%). In the period between 2016 and 2020, the most prevalent drug was liposomal Amphotericin B, with 71 (29.83%) patients using it, followed by Glucantime^® 45 (18.9%). The condition evolved to death. We conclude that Montes Claros is still an endemic area for VL with an increased number of cases over time and a noticeable shift in patient profile towards children and young people. Joint efforts from different areas of scientific knowledge and public health services are needed to improve the effectiveness of visceral leishmaniasis surveillance and control actions. The population can contribute to this process of disease prevention and control, through educational actions in health and the environment.

Influence of Alzheimer’s disease on the relationship between nutritional status and risk of fall

Maria Vaitsa Loch Haskel — 2021-02-11

Although malnutrition and risk of falls in the elderly have increased in recent years, uncertainties exist as to whether these conditions are associated after controlling for sociodemographic variables, body composition, metabolic condition, and Alzheimer’s disease (AD). This study aimed to analyze the association between nutritional status and risk of fall in the elderly population. Participants were matched by gender and age, after they had been grouped on the basis of diagnosis of AD. The risk of falls, nutritional status, and mental status were assessed using the Downton Fall Risk Score (FRS), Mini Nutritional Assessment (MNA), and Mini Mental State Evaluation (MMSE), respectively. Logistic regression models adjusted for the main confounders were used in the analyses. Among the 68 elderly individuals studied, participants who were malnourished or at risk of malnutrition were more likely to fall (odds ratio = 8.29; 95% confidence interval = 1.49-46.04) than those with normal nutritional status, regardless of gender, age, education, body composition, and metabolic condition. This association did not remain significant after adjustment for AD, a potential confounder in this association. Malnutrition or its risk was independently associated with high risk of fall; thus, malnutrition should be considered in the prevention of falls among the elderly population.

Functional limitation on elderly people in the northeast and the feminization of eld in urban and rural areas of Brazil

Roberta Dayanny Soares — 2021-02-11

Population aging in Brazil increases on a large scale due to declining fertility and mortality. This phenomenon can be influenced by several factors (demographic, biological and social), making them determinants for the health conditions of the elderly populations residing in different geographic areas. The present study aims to identify the functional limitation in elderly residents of urban and rural areas of Brazil. This is a descriptive epidemiological study with a quantitative approach. It was evidenced that the functional limitation for activities of daily living and instrumental activities of daily living are concentrated in the northeast region, mainly in the urban area. The following states presented the highest proportions of daily life activity limitation in urban areas: Alagoas (11.60%), Rio Grande do Norte (10.95%), Pernambuco (10.36%) and Paraíba (9.62%). For activities of daily living in the rural area were found in the states of Paraíba (12.19%), Maranhão (8.93%), Piauí (8.85%) and then Pernambuco (7.24%). Data from the functional limitation for instrumental activities of daily living again highlighted the Northeast region, with the states of Rio Grande do Norte (26.01%), Paraíba (25.96%), Maranhão (25.72%) and Alagoas (24.57%). Lastly, it was verified that the elderly woman exhibits greater proportions of functional limitation in relation to the elderly of the masculine sex, standing out again the northeastern region of the country.

Effects of water pilates on urinary loss, genital self-image and sexual function of elderly women

Deise Iop Tavares — 2021-02-11

Descriptive, quasi experimental study with pre and post-test, which aimed to investigate the effects of Water Pilates (PA) on urinary incontinence, genital self-image and sexual function of elderly women. The sample consisted of seventeen elderly women aged 60 years or over, from a city in the interior of Rio Grande do Sul. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) was used as instruments to assess the impact of UI in quality of life and qualify urinary loss, the Female Sexual Function Index (FSFI) to assess sexual function and Female Genital Self-Image Scale (FGSIS) to assess women's perception of their own genitalia. The PA protocol was performed twice a week for 50 minutes performed for eight weeks, totaling 16 sessions. The protocol was divided into warm-up, strengthening exercises and stretching. It was observed that the sample was composed of young elderly women (69.5 ± 5.9 years), overweight and with low FSFI and FGSIS scores. There was no significant change in the mean values before and after the intervention of the ICIQ-SF, FGSIS and FSFI scores. It was concluded that the PA method had no effect on urinary loss, sexual function and genital self-image.

Prevalence of alcohol consumption and factors associated with binge drinking behavior among adolescents in the state of Pernambuco, Brazil, 2016

Claudio Monteiro Freitas — 2021-02-11

To investigate the prevalence of alcohol consumption and the factors associated with binge drinking behavior among adolescents in the state of Pernambuco, Brazil. A cross-sectional study with a probabilistic sample of 6,002 adolescents composed of students from public high schools in Pernambuco, Brazil, aged 14 to 19 years. Binge drinking behavior was used as a dependent variable. The following were evaluated as possible risk factors: sociodemographic variables (gender, maternal education, marital status, work, religion); indicators of psychosocial stress (feelings of sadness; suicidal thoughts; feelings of loneliness; friends) and health risk behaviors (physical inactivity; number of sexual partners; drug use; and involvement in fights in the last year). Logistic regression was used to estimate odds ratios (OR). A total of 6,002 adolescents participated, with 75% reporting having consumed alcoholic beverages at least once in their lives. The prevalence of binge drinking in the last month was 17%. Adolescents without a religion had 81% (95%CI: 1.51; 2.16) more chance of consuming alcohol in excess. Adolescents who felt sad were 29% more likely to binge drink (95%CI: 1.08; 1.54), and adolescents who had already thought about suicide had 41% (95%CI: 1.13; 1.76) more chance to drink excessively. Adolescents who used illicit drugs had 4.6 times the chance (95%CI: 3.51; 6.17) of excessive drinking. Adolescents who engaged in four or more fights during the year were twice as likely to binge drink as those who did not fight (95%CI: 1.36; 2.88). The prevalence of alcohol consumption and binge drinking behavior was high. Sociodemographic factors, psychosocial stress and health risk behaviors were associated with binge drinking.

The correlation between children’s own health control and their health perceptions and behaviours, and the associated factors

Yildirim Hilal — 2021-02-11

The study was conducted as a correlational descriptive study to determine the correlation between children’s own health control and their health perceptions and behaviours, as well as the associated factors. The sample of the study consisted of 963 children in the age group of 7-12 years studying at one primary schools affiliated with the Ministry of National Education. It was determined that age affected health control and health perception and behaviours in children. A positive significant correlation was found between the health locus of control and health perceptions and behaviours of the children. The children had positive health behaviours, and they had high internal control in their own health management. In accordance with these results, children’s own health management should be increased to increase their positive perceptions and behaviours.

Antioxidant activity and hypoglycemic effect assessment of the leaves from Syzygium cumini (L.) Skeels in Wistar rats

Leise Nascimento Moreira — 2021-02-11

Syzygium cumini (L.) Skeels was adapted to the climatic conditions and soil types in Brazil. Its fruits, leaves and inner bark are used in folk medicine due to their high antioxidant, anti-inflammatory, anticarcinogenic and antidiabetic activities mainly associated with the presence of phenolic compounds. It is estimated that at least 300 million people worldwide develop diabetes and approximately 11 million people are carriers of the disease in Brazil. The objective of this work was to evaluate the in vitro antioxidant activity, as well as the hypoglycemic action of hydroethanolic extract (HEE), the ethyl acetate (EAF) and hydromethanolic (HMF) fractions from leaves of S. cumini (L.) Skeels in rats. All assays were carried out in three replications. Data were expressed as mean ± SD and significance was evaluated by ANOVA and Bonferroni test (p < 0.05). The results indicate a significant (p < 0.05) total phenol content (207 ± 2.3 GAE mg g^-1) and antioxidant activity (EC₅₀ = 9.05 ± 0.170 µg mL^-1) for EAF. HEE and its fractions showed no significant (p > 0.05) action to modulate glucose by the OGTT assay in nondiabetic mice compared to control. Thus the use of the plant against diabetes in individuals is not proven.

Facilitating the gut brain axis by probiotic bacteria to modulate neuroimmune response on lead exposed zebra fish models

Arockiya Anita Margret — 2021-02-11

Unravelling the efficacy of gut biome has a major impact on health. An unbalanced microbiome composition is linked to many common illnesses such as gut dysbiosis, mental deformities and immunological imbalance. An optimistic influence on the gut biome can be made by consuming probiotics. This would stimulate neuroprotection and immunomodulation intended by heavy metals pollution. Lead is a major source of neurotoxin that can induce neural deformities. Lactobacillus species isolated from curd were characterized to confirm its specificity. Zebra fish was reared at standard conditions and preclinical assessment on the intensity of induced neurotoxin lead was performed. The embryo toxic assay, immunomodulation effects and animal behavioural models endorsed the consequence of neurotoxicity. Different concentrations of bacterial isolate with standard antidepressant was considered for analysing the vigour of toxicity and its influence on cognitive behaviour by novel tank diving method. The restrain in the animal behaviour was also conferred by all the test samples with a decreased bottom dwelling time which was authenticated with haematology and histopathological studies. The alterations in morphology of the lymphocytes were balanced by the treated test samples. This study paves a twofold potential of probiotic as neuroprotectant and immune modulator against heavy metal toxicity.

Effects of the 27.12 MHz magnetic field emitted by short-wave equipment on spermatogenesis

Márcio Botelho Pedrosa — 2021-02-26

Studies have shown the influence of magnetic fields on several biological systems. Some of these fields, such as shortwave (SW) magnetic fields, have been used for therapeutic purposes. However, the possible adverse effects caused by this treatment still need to be better understood. The present study aimed to ascertain whether a single daily exposure (15 min.), for 15, 30 and 60 days, to SW magnetic field (27.12 MHz) can impede spermatogenesis. Exposure to SW magnetic fields did not change the weight of body, testis, epididymis, prostate, seminal vesicle or the gonadosomatic index. The plasma testosterone levels and testicular component volumes (seminiferous tubules, lumen, lamina propria, connective tissue, blood vessels, intertubular tissue) also remained unchanged. Histopathological analysis and spermatogenesis markers showed no changes after exposure to SW magnetic fields. However, some analyses showed changes in the lamina propria, daily sperm production, individual volume and population of Leydig cells. In conclusion, exposure to SW magnetic field for up to 60 days seems to be safe for spermatogenesis, but this exposure caused minor testicular changes that need to be better understood in the long term. This is of particular interest to health professionals who handle such SW devices for long periods of time.

Interdisciplinarity and interprofessionality in teamwork: perceptions of multiprofessional residents in Hospital Care

Ana Paula de Sousa Silva Baquião — 2021-02-26

Multiprofessional Health Residency Programs were created to further align health training with the needs of the population and, through an emphasis on teamwork, have been contributing to the consolidation of the Brazilian Unified Health System. The present study sought to understand the perceptions of a group of multiprofessional residents in Hospital Care about interdisciplinarity and interprofessionality within the scope of teamwork. This is a qualitative study that had the participation of 29 multiprofessional residents in the ‘Hospital Care’ area of concentration, all female (six psychologists, six social workers, six nurses, six physiotherapists and five nutritionists). Data were collected by means of a semi-structured interview script. The corpus was subjected to thematic content analysis. Most of the participants: (1) reported that their first contact with the notion of interdisciplinarity occurred when they were in college, which led to them assimilating it as a synonym for joint action, and (2) claimed to have no knowledge of the notion of interprofessionality, but valued the horizontalization of relations between health professionals. Additionally, important conditions concerning both interdisciplinarity and interprofessionality were not emphasized by the participants. Further studies on the subject are needed, due to its importance for public health.

Cases of leprosy notified in the municipality of Parnaíba, state of Piauí, Brazil, 2007-2016

Joelson dos Santos Almeida — 2021-02-11

This study aimed to describe the epidemiological and clinical characteristics of leprosy cases reported in the municipality of Parnaíba, State of Piauí. This was a cross-sectional study of leprosy cases, living in Parnaíba, State of Piauí, reported to the National System of Notifiable Diseases (SINAN), from 2007 to 2016. There were 582 cases of leprosy with hyperendemic detection in the general population in 2008, 2009 and 2016; and under < 15 years of age in 2008, 2014 and 2016, with a predominance of females (53.1%), brown (62.2%), aged 20-64 years (74.7%), complete and incomplete elementary school (56.4%), housewives (20.7%), living in the urban area (87.1%), reported by primary care (69.2%). The most frequent clinical and therapeutic findings were: multibacillary operational classification (53.8%); clinical forms: undetermined (30.6%) and virchowian (24.3%); single lesion (34.8%); no affected nerves (86.7%); degree of disability zero (70.6%); bacilloscopy not performed (26.7%); therapeutic regimen 12 doses (53.7%) and no reaction (70.8%). Regarding the mode of input, predominated new case (88.8%); mode of output, cure (87.9%) and detection mode: spontaneous demand (45.8%). Out of 2,106 registered contacts, 60.6% were examined. Leprosy is endemic to Parnaíba, State of Piauí. It is noteworthy that the hyperendemic detection rates occurred during years when there was intensification of active search for contacts and cases in the population.