Is Internet use unhealthy? A cross-sectional study of adolescent Internet overuse.

OBJECTIVE: To assess whether problematic internet use is associated with somatic complaints and whether this association remains when checking for internet activity among a random sample of adolescents living in the canton of Vaud, Switzerland. METHODS: Cross-sectional survey of 3,067 8th graders (50.3% females) divided into average (n = 2,708) and problematic (n = 359) Internet users and compared for somatic complaints (backache, overweight, headaches, musculoskeletal pain, sleep problems and sight problems) controlling for sociodemographic and internet-related variables. Logistic regressions were performed for each complaint and for all of them simultaneously controlling variables significant at the bivariate level. RESULTS: At the multivariate level, when taken separately, problematic internet users were more likely to have a chronic condition (adjusted odds ratio [aOR] with 95% CI: 1.58 [1.11:2.23]) and to report back pain (aOR: 1.46 [1.04:2.05]), overweight (aOR: 1.74 [1.03:2.93]), musculoskeletal pain (aOR: 1.36 [1.00:1.84]) and sleep problems (aOR: 2.16 [1.62:2.88]). When considered in the full model, only sleep problems remained significant (aOR: 2.03 [1.50:2.74]). CONCLUSIONS: Our results confirm that problematic internet users report health problems more frequently, with lack of sleep being the most strongly associated and seeming to act as mediator regarding the other ones. Clinicians should remember to screen for excessive internet use their patients complaining of sleep-related problems, back or musculoskeletal pain or overweight. Clinicians should advise parents to limit the amount of time their adolescent children can spend online for leisure activities. Furthermore, limiting the number of devices used to connect to the internet could help warrant enough sleeping time.

Letter health consultation : Mason City coal gasification plant site, Mason City, Iowa EPA facility ID: IAD980969190 (2008)

This letter has been prepared as a consultation to EPA regarding the first five-year review of the Mason City Coal Gasification Plant Site, located in Mason City, Iowa to provide an evaluation of the public health status of the site.

Letter health consultation : Northwest States Portland Cement Company site, site, Mason City, Iowa EPA facility ID: IAD98053431 (2008)

This letter has been prepared as a consultation to EPA regarding the third five year review of the Northwestern States Portland Cement Company Site, located North of Mason City, Iowa in Cerro Gordo County to provide an evaluation of the public health status of the site.

Gonalgies: que faire en médecine de premier recours [Knee pain in ambulatory practice].

Knee pain is a frequent complaint in ambulatory practice. Because of its complexity, the knee is prone to trauma, arthritis and the impact of aging. Septic arthritis is an emergency and has to be suspected when important knee pain is associated with fever, an alteration of the general condition, or in a particular social context. In most cases the clinical examination can identify the type of pathology. Conservative treatment is beneficial in most cases and physiotherapy a major component of the prognosis.

Perceptions of health club exercise among middle-aged women

The goal of this Master’s Thesis is to investigate the typical perceptions of health club exercise among middle-aged women. This study is conducted for a Finnish health club Viva Wellness Club due to their interest to examine the perceived barriers of middle-aged women to exercise at their health club. In addition, the behavioral beliefs, normative beliefs, motivation and facilitating factors concerning health club exercise are studied. The social aspect of health clubs as social environments is taken into account. The study is conducted qualitatively with semi-structured interviews Eight customers from Viva Wellness Club are interviewed. The findings revealed that the consumers perceived health club exercise as important, effective, diverse and convenient. Despite the fact that some differences were found, the perceptions about exercise in general concurred with the contestants’ perceptions about health club exercise. The perceived barriers to health club exercise encompassed lack of time, tiredness, health restrictions, weather, family commitments and feelings of embarrassment about one’s appearance and condition.

Défi verbal et auto-analgésie : une étude psychophysiologique chez les Quichuas

La douleur est une expérience humaine des plus universelles et d’une riche variabilité culturelle. Néanmoins, il y a peu d’études sur ce sujet en général et qui plus est, la recherche sur la douleur chez les Amérindiens est presque inexistante. L’expérience de douleur de quelques 28 millions d’Amérindiens en Amérique du Sud, dont les Quichuas (Inca), est encore méconnue. Cette recherche interdisciplinaire, psychophysiologique et anthropologique, vise deux buts : (1) Étudier les effets de type analgésique du défi verbal culturellement significatif chez les Quichuas ; et (2) Faire un survol de leur système de croyances concernant la douleur, leur façon de la percevoir, de la décrire, et de la contrôler. Pour le volet expérimental, on a recruté 40 hommes en bonne santé. Les volontaires étaient assignés de façon alternée soit au groupe expérimental (20) soit au groupe contrôle (20). On a enregistré chez eux les seuils de la douleur, et celui de la tolérance à la douleur. Chez le groupe expérimental, on a, de plus, mesuré le seuil de la tolérance à la douleur avec défi verbal. La douleur était provoquée par pression au temporal, et mesurée à l’aide d’un algésimètre. Après chaque seuil, on a administré une échelle visuelle analogique. Pour le deuxième volet de l’étude, un groupe de 40 participants (15 femmes et 25 hommes) a répondu verbalement à un questionnaire en quichua sur la nature de la douleur. Celui-ci touchait les notions de cause, de susceptibilité, les caractéristiques de la douleur, les syndromes douloureux, les méthodes de diagnostic et de traitement, ainsi que la prévention. Notre étude a révélé que les participants ayant reçu le défi verbal ont présenté une tolérance accrue à la douleur statistiquement significative. Les valeurs de l’échelle visuelle analogique ont aussi augmenté chez ce groupe, ce qui indique un état accru de conscience de la douleur. L’expérience de la douleur chez les Quichuas est complexe et les stratégies pour la combattre sont sophistiquées. Selon leur théorie, le vécu d’émotions intenses, dues à des évènements de la vie, à l’existence d’autres maladies qui affectent la personne de façon concomitante, et aux esprits présents dans la nature ou chez d’autres personnes joue un rôle dans l’origine, le diagnostic et le traitement de la douleur. Les Quichuas accordent une grande crédibilité à la biomédecine ainsi qu’à la médecine traditionnelle quichua. Ils perçoivent la famille et le voisinage comme étant des sources supplémentaires de soutien. Il ressort également que les Quichuas préfèrent un service de santé de type inclusif et pluraliste. En conclusion, cette étude a révélé que des mots culturellement significatifs ayant une connotation de défi semblent augmenter la tolérance à la douleur chez les Quichuas. Il s’agit de la première étude à documenter les effets analgésiques de la parole. D’autre part, cette étude souligne également la potentielle utilité clinique de connaître le système quichua de croyances entourant la douleur et le contrôle de cette dernière. Ceci s’avère particulièrement utile pour les cliniciens soucieux d’offrir des soins de santé de meilleure qualité, culturellement adaptés, dans les Andes.

Effets du port continu de coquilles correctrices Invisalign® sur l’articulation temporo-mandibulaire et les muscles du complexe facial.

INTRODUCTION : L’articulation temporo-mandibulaire (ATM) est un système articulaire excessivement complexe. L'étiologie des désordres temporo-mandibulaires (DTM) est encore incertaine et le lien de cause à effet des traitements orthodontiques en tant que facteur de risque est une question qui a longuement été discutée. Cette étude clinique prospective vise à évaluer les effets à long terme du port continu de coquilles correctrices Invisalign® sur l’ATM et les muscles du complexe facial. MATÉRIELS ET MÉTHODES : L'étude incluait 43 adolescents et adultes âgés entre 13 et 51 ans (25 femmes et 18 hommes). Deux d'entre eux ont été exclus en raison de mauvaise coopération causant l’arrêt du traitement orthodontique. Les effets dans le temps des coquilles sur l'ATM et les muscles du complexe facial ont été évalués en utilisant l’examen du Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Le nombre de contractions musculaires durant le sommeil a été mesuré objectivement par enregistrements électromyographiques (EMG) et la fréquence de grincement et de serrement des dents à l’éveil a été rapportée subjectivement par les patients à l’aide de questionnaires. Des mesures répétées ont été effectuées aux temps suivants: avant le début du traitement pour les données contrôles (T1), deux semaines (T2), et six mois (T3) après le début du traitement. Les données numériques ont été analysées par l’analyse de variance (ANOVA) en mesures répétées et la méthode de Brunner-Langer, alors que les données nominales ont été évaluées par le test de Cochran-Mantel-Haenszel. Les résultats ont été considérés significatifs si p < 0.05. RÉSULTATS ET DISCUSSION : Le nombre de contractions musculaires par heure (index) durant le sommeil et leur durée moyenne n’ont pas été statistiquement différents entre les trois nuits d’enregistrement EMG (Brunner Langer, p > 0.005). Cependant, 67 % des participants ont rapporté avoir eu du grincement ou du serrement des dents la nuit au T2 et 64 % au T3 comparativement à 39 % au T1, ce qui était une augmentation significative (Cochran-Mantel-Haenszel, p = 0.0112). Quarante-quatre pour cent des patients ont signalé du grincement ou du serrement des dents pendant le jour au T1, tandis qu'un pourcentage nettement plus élevé de 66 % en a rapporté au T2 et 61 % au T3 (Cochran-Mantel-Haenszel, p = 0.0294). Au T1, 12 % des sujets ont indiqué qu'ils se sont réveillés avec une douleur musculaire, comparativement à 29 % au T2, ce qui était une augmentation significative (Cochran-Mantel-Haenszel, p = 0.0347). Au T2, il y avait une réduction significative des mouvements maximaux de la mandibule dans toutes les directions (ANOVA en mesures répétées, p < 0,05). De plus, il y a eu une augmentation significative du nombre de sites douloureux et de l'intensité de la douleur à la palpation de l'ATM et des muscles faciaux avec l'évaluation du RDC/TMD au T2 en comparaison aux T1 et T3 (Brunner Langer, p < 0,05). CONCLUSION : La présente étude n’a révélé aucun effet des coquilles sur l’activité oro-faciale durant le sommeil au fil du temps mesurée objectivement à l’aide des enregistrements EMG, mais une augmentation significative de la fréquence du grincement et du serrement des dents rapportée subjectivement par les patients au moyen des questionnaires aux T2 et T3. Au T2, il y avait une augmentation significative des symptômes de l'ATM et des muscles du complexe oro-facial, mais ces symptômes sont retournés au niveau initial avec le temps.

Increased spinal pain sensitization : a new explanation for highly prevalent painful somatic symptoms in major depressive disorder?

Objectifs: Malgré que les patients souffrant de dépression majeure (DM) rapportent souvent des symptômes douloureux, la relation entre la douleur et la dépression n’est pas encore claire. Ce n’est que récemment que des études employant des paradigmes de sommation temporelle ont pu offrir une explication préliminaire de la cooccurrence de la douleur et de la dépression. Notre étude vise à évaluer la contribution des procédés spinaux et surpraspinaux dans la sensibilisation de la douleur dans la DM en utilisant un paradigme de sommation temporelle. Participants : Treize sujets sains et quatorze patients souffrant de DM ont été inclues dans l’analyse finale. Méthodes : Pour induire une sommation temporelle, nous avons utilisé des stimulations intermittentes du nerf sural de basses et hautes fréquences. La sensibilisation spinale de la douleur a été quantifiée en mesurant la variation de l’amplitude du réflex de retrait nociceptif (NFR) entre les deux conditions de stimulations, ainsi que la sensibilisation supraspinale de la douleur a été obtenue en mesurant le changement dans l’appréciation verbale de la douleur entre ces deux conditions. Résultats : Nous avons observé une sensibilisation plus élevée de la réponse NFR chez les patients dépressifs durant la condition de stimulation à haute fréquence, un effet qui n’a pas été reflété par une sensibilisation amplifiée des appréciations subjectives de la douleur durant l’expérience. Néanmoins, nous avons observé une association entre la sensibilisation spinale et les symptômes somatiques douloureux chez les patients DM. Conclusion : Ces résultats suggèrent une sensibilisation spinale amplifiée dans la DM, ce qui pourrait expliquer la prévalence élevée des symptômes somatiques douloureux chez ces patients.

Imagem corporal e fatores de risco em praticantes de caminhada da cidade do Natal-RN

Body image is the figure of our bodies built in our minds and the degree of dissatisfaction is often associated with risk factors identified by anthropometric measures. The purpose of this descriptive study was to evaluate the risk factors associated to morphological and functional variables associate to the perception of auto-image in middle-aged walkers of the south zone of the city of Natal. A hundred and thirty volunteers had been evaluated in four groups in function of the gender and age group. As measurement evaluations were used an auto-image perception questionnaire proposed by Stunkart of nine silhouettes numbered for both gender was applied; a weighing machine equipped with stadiometer for the body mass (kg) and stature (m) and the body mass index (kg/m2) that was calculated with base in measures of the body weight and stature and classified according to norms of the National Institute of Health (2000) as well as the systolic and diastolic blood pressure by a electronic digital device (DIGITRONIC). A metal anthropometric tape was used for the waist to hip ratio (WHR). It was used Analyses of variance (ANOVA) one-way, post hoc of Tukey and correlation of Spearman for the nonparametric data adopting the level of ρ≤ 0,05 for rejection of the null hypothesis. The body mass index indicated high factors of risk in the consisting groups. In all the groups were registered the desire to reduce their silhouettes. The body weight shows reduced when compared with the younger group in the male group of superior age group, while in the female group the inverse one occurs. The autoimage perception is associated with the classification of the waist to hip ratio in the female gender in the age group of the 50 to the 59 years and in the classification of the body mass index of all constituted groups. Significant associations had not been found for classification of the systolic and diastolic blood pressure in relation to the auto-image 41 perception. This thesis presents relation of interdisciplinarity and its contents have application in the fields of Physical Education, Medicine, Physiotherapy and Nursing

Avaliação da capacidade de caminhar do portador de obesidade mórbida utilizando teste de caminhada de 6 minutos

Introduction: The ability to walk is impaired in obese by anthropometric factors (BMI and height), musculoskeletal pain and level of inactivity. Little is known about the influence of body adiposity and the acute response of the cardiovascular system during whole the 6-minute walk test (6mWT). Objective: To evaluate the effect of anthropometric measures (BMI and WHR waist-to-hip ratio), the effort heart and inactivity in ability to walk the morbidly obese. Materials and Methods: a total 36 morbidly obese (36.23 + 11.82 years old, BMI 49.16 kg/m2) were recruited from outpatient department of treatment of obesity and bariatric surgery in University Hospital Onofre Lopes and anthropometric measurements of obesity (BMI and WHR), pulmonary function, pattern habitual physical activity (Baecke Questionnaire) and walking capacity (6mWT). The patient was checking to measure: heart rate (HR), breathing frequency (BF), peripheral oxygen saturation, level of perceived exertion, systemic arterial pressure and duplo-produto (DP), moreover the average speed development and total distance walking. The data were analysed between gender and pattern of body adiposity, measuring the behavior minute by minute of walking. The Pearson and Spearmam correlation coefficients were calculated, and stepwise multiple Regression examined the predictors of walking capacity. All analyses were performed en software Statistic 6.0. Results: 20 obese patients had abdominal adiposity (WHR = 1.01), waist circumference was 135.8 cm in women (25) and 139.8 cm in men (10). Walked to the end of 6mWT 412.43 m, with no differences between gender and adiposity. The total distance walked by obesity alone was explained by BMI (45%), HR in the sixth minute (43%), the Baecke (24%) and fatigue (-23%). 88.6% of obese (31) performed the test above 60% of maximal HR, while the peak HR achieved at 5-minute of 6mWT. Systemic arterial pressure and DP rised after walking, but with no differences between gender and adiposity. Conclusion: The walk of obese didn´t suffers influence of gender or the pattern of body adiposity. The final distance walked is attributed to excess body weight, stress heart, the feeling of effort required by physical activity and level of sedentary to obese. With a minute of walking, the obeses achieved a range of intensity cardiovascular trainning

Interações físicas e psicossociais em mulheres com fibromialgia

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome of unknown etiology, with symptoms of diffuse musculoskeletal pain and presence of specific anatomic sites called tender points. The symptoms are often associated with fatigue, sleep disturbances, morning stiffness, alterations in pain perception, anxiety and depression. Fibromyalgia exhibits a correlation between physical and behavioral symptoms, which have a negative influence on the quality of life of patients. Emotional skills are important factors since they are related to subjective well-being, personal productivity, social interaction and interpersonal relationships. We aim to describe the physical and psychosocial interactions in women with FM, showing the association between perceived social support and affect with symptoms of pain, functionality and mood. We will also describe a body representation of pain in women with FM. Data were collected over 3 years and the sample size ranged between studies. This is an exploratory cross-sectional study conducted with a convenience sample of 63 women with FM and 42 healthy women as a control group (CT), aged 20-76 years, recruited through spontaneous demand at Onofre Lopes University Hospital (HUOL) and the Clinical School of Physiotherapy of Universidade Potiguar (UNP). The Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Social Support Scale (MOS), Hamilton Anxiety Scale and Scale of Positive and Negative Affect Schedule (PANAS), in addition to pressure algometry were used. For data analysis, we used parametric and non-parametric tests and a general linear model with adjustment variables and analysis of variance. A significant difference was found between pain threshold and tolerance, functionality, depression, anxiety, social support, and positive and negative affect between the groups. Affective states and social support were associated with anxiety, depression and functionality. A body was drawn representing pain with higher incidences in trapeze, supraspinatus and second ribs. The reason for studying sensory aspects, affective behavior and social support in FM patients opens perspectives for scientific and clinical research of this syndrome. Women with chronic pain such as FM appear to have altered mood states, less social support and affective dysfunctions, influencing the other symptoms of the syndrome

Sleep bruxism increases the risk for painful temporomandibular disorder, depression and non-specific physical symptoms

To explore the relationship between sleep bruxism (SB), painful temporomandibular disorders (TMD) and psychologic status in a cross-sectional study. The sample consisted of 272 individuals. The Research Diagnostic Criteria for TMD (RDC/TMD) was used to diagnose TMD; SB was diagnosed by clinical criteria proposed by The American Academy of Sleep Medicine. The sample was divided into four groups: (1) patients without painful TMD and without SB, (2) patients without painful TMD and with SB, (3) patients with painful TMD and without SB and (4) patients with painful TMD and with SB. Data were analysed by Odds Ratio test with a 95% confidence interval. Patients with SB had an increased risk for the occurrence of myofascial pain (OR = 5.93, 95% CI: 3.1911.02) and arthralgia (2.34, 1.583.46). Group 3 had an increased risk for moderate/severe depression and non-specific physical symptoms (10.1, 3.6727.79; 14.7, 5.3939.92, respectively), and this risk increased in the presence of SB (25.0, 9.6564.77; 35.8, 13.9491.90, respectively). SB seems to be a risk factor for painful TMD, and this in turn is a risk factor for the occurrence of higher depression and non-specific physical symptoms levels, but a causeeffect relationship could not be established.

Myofascial Pain Syndrome as a Contributing Factor in Patients with Chronic Headaches

Objectives: The purpose of this study was to evaluate the prevalence of active and latent trigger points [TrPs], as well as analyze the prevalence of different types of headaches in chronic headache patients. The active and latent TrPs in muscles of orofacial and cervical regions were also evaluated. Methods: There were 290 subjects who participated in this study. Trigger points were identified according to Simons et al.'s diagnostic criteria. Trigger points were considered active if subjects recognized the evoked referred pain as their familiar headache. If the evoked referred pain was not recognized as the familiar headache, the TrPs were considered latent. Differential diagnosis for headache was performed on the basis of International Headache Society criteria. Results: Trigger points could be diagnosed in 77 percent of patients and, in 89 percent of these, active TrPs were found. Muscle tenderness could be observed in 22 percent of patients, and only 1 percent patients were muscle-pain-free. The headache diagnosis showed that 26 percent had tension-type headache, 13 percent had migraine, and 61 percent had combined episodes of tension-type headache and migraine. The highest number of TrPs were found in temporalis [N = 159], masseter [N = 126], and occiptofrontalis [N = 113] muscles. Active TrPs were more frequent in temporalis and occiptofrontalis muscles. Conclusions: Subjects with chronic headaches had a higher prevalence of TrPs, and headache complaints could be reproduced during stimulation of active TrPs that were localized more frequently in temporalis and occiptofrontalis muscles. The presence of TrPs may be a contributing factor in the initiation and/or perpetuation of chronic headaches.

Doença periodontal em gestantes e nascimento de bebê prematuro e baixo peso

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Escolaridade e volume de produção têm associação com a percepção de risco de produtores de leite no uso de produtos veterinários

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)