Knowledge and practice of women regarding cervical cancer in a primary health care unit

Objectives: evaluating the level of information about the examination of uterine cervical cancer and its association with sociodemographic variables in women of a health care unit in the city of Bauru, São Paulo, Brazil. Methods: we conducted a cross-sectional descriptive study with 370 women aged 25 to 59, through structured interviews in their own homes; we used descriptive statistics and the χ2 test. Results: 40.5% of the women had not undergone the Papanicolaou test at the recommended frequency; 58.2% incorrectly defined the test, and 69.5% did not know about the risk factors for the development of cervical cancer; the knowledge about the test showed statistically significant association with schooling and family income of the studied population. Conclusions: women present deficiencies on the proper practice of the Papanicolaou test, on knowledge about the test, risk factors and prevention methods. Therefore, it is necessary to develop primary healthactions for the most vulnerable population

A Review of Direct Neck Measurement in Occupational Settings

No guidelines are available to orient researchers on the availability and applications of equipment and sensors for recording precise neck movements in occupational settings. In this study reports on direct measurements of neck movements in the workplace were reviewed. Using relevant keywords two independent reviewers searched for eligible studies in the following databases: Cinahal, Cochrane, Embase, Lilacs, PubMed, MEDLINE, PEDro, Scopus and Web of Science. After applying the inclusion criteria, 13 articles on direct neck measurements in occupational settings were retrieved from among 33,666 initial titles. These studies were then methodologically evaluated according to their design characteristics, exposure and outcome assessment, and statistical analysis. The results showed that in most of the studies the three axes of neck movement (flexion-extension, lateral flexion and rotation) were not simultaneously recorded. Deficiencies in available equipment explain this flaw, demonstrating that sensors and systems need to be improved so that a true understanding of real occupational exposure can be achieved. Further studies are also needed to assess neck movement in those who perform heavy-duty work, such as nurses and electricians, since no report about such jobs was identified

Registros de movimentos do pescoço: estado da arte, validação e aplicação e avaliação durante o trabalho de técnicos de enfermagem

Neck pain has been highly prevalent among workers. In occupational settings physical risk factors, especially posture, are considered fundamental in neck pain development. However, neck posture and movements have not been properly evaluated at workplace due to the use of not reliable measurement methods. Furthermore, most of the studies that evaluate posture during occupational activities have focused on the wrist and hand assessment. Thus, in order to contribute with information about neck movements recording in occupational settings, three related studies were developed. The aim of the first study was to investigate the applications and limitations of the systems for direct measurement of neck movement in the workplace. The results of this study showed that in most of the articles the three axes of neck movement were not simultaneously recorded. Deficiencies in available equipment explain this flaw, demonstrating that sensors and systems need to be improved so that a true understanding of real occupational exposure can be achieved. Further studies are also needed to assess neck movement in those who perform heavy‐duty work, such as nurses and electricians, since no report about such jobs was identified. Based on these results, an option to record three‐dimensional neck movements in occupational settings is the use of flexible electrogoniometers. But neither electrogoniometers, nor inclinometers (direct measurement most commonly used) were compared with a system considered more accurate and precise. Then, the objective of the second study was to assess concurrent validity between flexible electrogoniometers (EGM), inclinometers (INC) and a three‐dimensional analysis system based on video recording (IMG) in simultaneous and synchronized data collection. EGM presented high differences when compared with INC and IMG. Moreover, the EGM sensors physically restricted the full neck flexion‐extension range of motion. Inclinometers, which cannot record rotation movement, presented good concurrent validity in relation to IMG, except for flexion‐extension movement. Due to non‐optimal conditions during flexion‐extension movement, IMG underestimated these movements. The results of the studies described above designed the third study that aimed to quantify the head, upper back and upper arm postures of practical nurses while performing their occupational activities and to verify if there are differences between the postures of professionals with and without symptoms. The results showed that most of the activities of practical nurses involve considerable postural risk for the head, upper back and upper arms. The postural risk varied among tasks: there was more exposure for the neck region when separating medication and keeping medical records. In general, workers with symptoms in the neck and upper arm region presented greater amplitude of movement and a higher fraction of time spent in awkward postures than asymptomatic workers, but with no significant difference between these two groups.Universidade Federal de Minas GeraisA dor no pescoço tem sido altamente prevalece entre trabalhadores. Em ambiente ocupacional, fatores de risco físico, particularmente a postura, são considerados preponderantes no desenvolvimento de dor no pescoço. Contudo, as posturas e os movimentos dessa região não têm sido adequadamente avaliados no ambiente de trabalho, devido ao uso de métodos de medida não confiáveis. Além disso, a maioria dos estudos que avaliam a postura durante as atividades ocupacionais tem focado na avaliação do punho e da mão. Assim, para contribuir com o entendimento do registro dos movimentos do pescoço em ambiente de trabalho, três estudos foram desenvolvidos. O objetivo do primeiro estudo foi investigar as aplicações e limitações dos sistemas de medidas diretas para registro do movimento do pescoço em ambiente de trabalho. Os resultados desse estudo revelaram que na maioria dos artigos, os três eixos de movimento do pescoço não foram registrados simultaneamente. Deficiências nos equipamentos disponíveis explicam esta falha, demonstrando que os sensores e os sistemas precisam ser melhorados para que um entendimento da real exposição ocupacional do pescoço possa ser alcançado. Mais estudos também são necessários para avaliar os movimentos do pescoço em profissionais que realizam trabalho pesado, tais como enfermeiros e eletricistas, já que nenhum artigo avaliando essas ocupações foi identificado. Baseado nesses resultados, uma alternativa para o registro tridimensional dos movimentos do pescoço em ambiente ocupacional seria o uso de eletrogoniômetros flexíveis. Mas nem os eletrogoniômetros, nem os inclinômetros (medida direta mais comumente usada) foram comparados com um sistema considerado mais preciso e confiável. Assim, o objetivo do segundo estudo foi avaliar a validade concorrente entre eletrogoniômetros flexíveis (EGM), inclinômetros (INC) e um sistema de análise tridimensional baseado em registro de vídeo (IMG) numa coleta de dados simultânea e sincronizada. O EGM apresentou grandes diferenças quando comparado com o INC e com a IMG. Além disso, os sensores do EGM restringiram fisicamente a amplitude de movimento completa de flexo‐extensão do pescoço. Inclinômetros, os quais não podem registrar o movimento de rotação, apresentaram boa validade concorrente em relação à IMG, exceto para o movimento de flexo‐extensão. Devido a condições não‐ótimas durante o movimento de fluxo‐extensão, a IMG subestimou esses movimentos. Os resultados dos estudos descritos acima delinearam o terceiro estudo cujo objetivo foi quantificar as posturas da cabeça, tronco superior e braços de técnicos de enfermagem durante a realização de suas atividades ocupacionais e verificar se há diferenças entre as posturas dos profissionais com e sem sintomas. Os resultados mostraram que a maioria das atividades dos técnicos de enfermagem envolve considerável risco postural para a cabeça, tronco superior e braços. O risco postural variou entre as atividades: houve maior exposição para a região do pescoço nas tarefas de separar medicação e anotar em prontuário médico. Em geral, os trabalhadores com sintomas no pescoço e ombro apresentaram maior amplitude de movimento e maior fração do tempo gasto em posturas extremas do que os trabalhadores assintomáticos, mas sem diferença significativa entre esses dois grupos

Eletrogoniometria flexível : avaliação da simetria articular e dos efeitos dos sensores, das coletas e dos joelhos nos registros da marcha

Human movement recording is a fundamental tool for studies that perform movement analysis which is very useful for Physiotherapy and Biomechanics. However, to obtain high quality movement analysis, reliable and accurate equipments are necessary. In this way, flexible electrogoniometers have shown high reproducibility besides other advantages as low financial cost, readiness of working and bilateral data recording. Nevertheless, these equipments are exposed to errors like: the equipment itself, data acquisition procedures and the crosstalk effect. Thus, two studies (Studies I and II) were carried through. The aim of study (I) was to assess knee movement symmetry on sagittal and frontal planes based on Maupas criterion, absolute symmetry index and on statistical analysis. Nine healthy subjects have taken part in the study. Knee movements were recorded by flexible electrogoniometers attached on both knees. The subjects passed by a familiarization period in the treadmill and, after this, the movements were recorded during 90 seconds at 5,0 Km/h. The recording was partitioned as strides and normalized in time using a routine developed in MatLab. Movement curves were derived from 50 strides. Maximum angle and range of movement were also calculated. Based on Maupas criterion, subjects knees were considered symmetrical for the flexion-extension and valgus-varus movements. However the frontal plane movements showed more variability than sagittal plane movements, what can be due to some crosstalk effect. The aim of study (II) was to evaluate the effect from eletrogoniometer sensors, procedures (consecutive trials) and the knees during gait recordings. Knee flexion-extension and valgus-varus movements were recorded during treadmill walking. The recording was partitioned as strides and normalized in time using a routine developed in MatLab. Curves were derived from 50 strides, and seven conditions were evaluated: one for comparing two sensors; two for comparing two different trials (including variation due to sensor); and four for comparing right and left knee (including variation due to sensors and trials). Mean standard deviations of the differences were calculated. To estimate the variations due to trial and knee, the compound SDs were transformed into variances and split into its components. Differences between normal knees had more influence in determining variation on the results than sensors and trials for most of the subjects. Variation was much higher between knees for valgus-varus than for flexion-extension movements. Individual sensors showed the smaller source of variation. Thus, it is preferable to use different sensors in the same data recording (simultaneous) than use the same sensor in two different recordings (consecutive).Universidade Federal de Minas GeraisO registro do movimento humano é uma ferramenta fundamental para estudos que realizam análise de movimento, sendo muito utilizado pela Fisioterapia e Biomecânica. Entretanto, para se obter análises de movimento com qualidade, são necessários equipamentos confiáveis e válidos. Nesse sentido, os eletrogoniômetros flexíveis têm apresentado alta replicabilidade, além de outras vantagens como: baixo custo financeiro, facilidade de operação e registro bilateral de dados. Contudo, esses instrumentos são susceptíveis a erros, tais como: as características do próprio equipamento, os procedimentos de coleta de dados e o efeito crosstalk. Dessa forma, dois estudos (Estudo I e II) foram realizados. O objetivo do estudo (I) foi avaliar a simetria angular dos movimentos do joelho, nos planos sagital e frontal, através do critério estabelecido por Maupas, do índice absoluto de simetria e da análise estatística. Nove sujeitos saudáveis participaram do estudo. Os movimentos do joelho foram registrados por eletrogoniômetros flexíveis acoplados bilateralmente nessa articulação. Os sujeitos passaram por um período de familiarização e, em seguida, os movimentos do joelho foram registrados durante 90 segundos a uma velocidade de 5 km/h. O registro foi dividido em passadas e normalizado no tempo usando uma rotina desenvolvida em MatLab. As curvas de movimento foram derivadas de 50 passadas e os ângulos máximos bem como a amplitude de movimento articular foram calculados. A partir do critério proposto por Maupas, os joelhos dos sujeitos foram considerados simétricos para os movimentos de flexo-extensão e valgo-varo. Entretanto, os movimentos do plano frontal apresentaram maior variabilidade do que os movimentos do plano sagital, o que pode ser resultado de algum efeito crosstalk do sensor. O objetivo do estudo (II) foi avaliar o efeito dos sensores do eletrogoniômetro, dos procedimentos (coletas consecutivas) e da articulação do joelho nos registros da marcha. Os movimentos de flexo-extensão e valgo-varo do joelho foram registrados durante caminhada em esteira. Os registros foram divididos em passadas e normalizados no tempo usando uma rotina desenvolvida em MatLab. As curvas foram derivadas de 50 passadas e sete condições foram avaliadas: uma para comparação dos sensores; duas para comparação de duas diferentes coletas (incluindo a variação do sensor), e quatro para comparação entre os joelhos direito e esquerdo (incluindo a variação dos sensores e coletas). Os desvios padrão médios das diferenças foram calculados. Para estimar as variações devido às coletas e à articulação do joelho, os desvios padrão compostos foram transformados em variâncias e seus componentes isolados. Diferenças angulares entre joelhos direito e esquerdo foram responsáveis pela maior fonte de variação dos resultados quando comparados a sensores e coletas para a maioria dos sujeitos. A variação foi muito maior entre joelhos para os movimentos de varo-valgo do que para a flexo-extensão. Sensores individuais apresentaram a menor fonte de variação. Assim, é preferível usar diferentes sensores na mesma coleta de dados (simultânea) do que usar o mesmo sensor em dois registros diferentes (consecutivos)

Perception of barriers to physical exercise in women population over 60

Abstract Aims This study evaluated the possible barriers to the permanence of physical exercise (PE) of old women. Methods The study population comprised 61 old women participants for at least one year of a supervised PE program, who underwent anamnesis, and applied the Barriers Questionnaire to Physical Activity Practice in the Elderly (QBPAFI). Exploratory factorial analysis was used to evaluate QBPAFI data. The analysis of principal component was applied to the 22 questions through orthogonal rotation to analyze the correlation between the questions. The Kaiser-Meyer-Olkin test was applied to evaluate the suitability of the sample size, and the Bartlett's test to assess whether the original matrix correlation is an identity matrix. Eigenvalues greater than 1 were considered for analysis. Results The motivational factor was the major determinant of perceived barriers (43.3%), followed by psychosocial (12.29%), facilities and appearance (8.75%), and exercise conditions (8.10%) factors. Conclusion Knowing the benefits of physical activity, and the main barriers that prevent the permanence of active old people to physical exercise programs, new strategies must be taken to increase the rate of adherence of this group

Reflection on work, leisure, recreation and leisure in contemporary elderly

The study reflected on the issues of work, laziness, leisure and free time from the point of view of the elderly. It was realized conceived from the data of a survey conducted by Consulting Idea Brazil, to Instituto Trabalho e Vida, in 2010. It was noticed that the desire to retire is still present in the life of Brazilian workers, but the apparent longevity, requires from the individuals, society and government agencies, positioning on the values of different ways of living in labor activity

Neck/shoulders pain and its relation to the use of tv/computer/videogame and physical activity in school students from Bauru

Objective: The objective was to determine the prevalence of musculoskeletal pain in the neck/shoulders of school children and its relationship with the level of physical activity and sedentary activities (time spent on TV and computer and/or video game). Materials and methods: We conducted a cross-sectional study with a sample of 524 5th to 8th grade students (278 boys and 246 girls), enrolled in all five urban elementary schools in the municipality of Bauru (SP), aged between 10 and 14 years old. Sociodemographic data, sedentary activities time spent on TV and computer and/or videogame - and level of physical activity - was collected through a Physical Activity Questionnaire for Children (PAQ-C). Results: The results showed that the prevalence of localized pain in the neck/shoulders was of 30.1% for boys and girls. It was also found that there is a predominance of onset of pain reported in neck/shoulders in boys related to the frequency and amount of hours a day watching TV and hours on the computer, whereas in girls the association was with frequency and amount of hours they watch TV daily. Conclusions: It can be concluded that the pain in the neck/shoulders are common in children and that understanding the relationship between variables enables valuable elements of measures aimed at maintaining, improving and promoting the welfare of students

Neck/shoulders pain and its relation to the use of tv/computer/videogame and physical activity in school students from Bauru

Objective The objective was to determine the prevalence of musculoskeletal pain in the neck/shoulders of school children and its relationship with the level of physical activity and sedentary activities (time spent on TV and computer and/or video game). Materials and methods We conducted a cross-sectional study with a sample of 524 5th to 8th grade students (278 boys and 246 girls), enrolled in all five urban elementary schools in the municipality of Bauru (SP), aged between 10 and 14 years old. Sociodemographic data, sedentary activities – time spent on TV and computer and/or videogame - and level of physical activity - was collected through a Physical Activity Questionnaire for Children (PAQ-C). Results The results showed that the prevalence of localized pain in the neck/shoulders was of 30.1% for boys and girls. It was also found that there is a predominance of onset of pain reported in neck/shoulders in boys related to the frequency and amount of hours a day watching TV and hours on the computer, whereas in girls the association was with frequency and amount of hours they watch TV daily. Conclusions It can be concluded that the pain in the neck/shoulders are common in children and that understanding the relationship between variables enables valuable elements of measures aimed at maintaining, improving and promoting the welfare of students

Reliability of intra- and inter-rater palpation discrepancy and estimation of its effects on joint angle measurements

This study presents data on the intra- and inter-rater reliability of palpation on normal and overweight subjects and shows the influence of palpation discrepancy on angular variability for a collected data set, using computer simulation. Thirty healthy males were recruited. Two physiotherapists identified 12 anatomical landmarks that enabled measurement of eight joint angles. Palpation discrepancy was determined by photographic recordings under ultraviolet light. Angular discrepancies were determined from photos of the subject's orthostatic posture. A computer simulation was developed to predict expected angular variation according to observed palpation discrepancy. The results showed that the inter-rater reliability was lower than the intra-rater reliability for both palpation and angle measurements. Palpation of the greater trochanter (GT), anterior superior iliac spine (ASIS), seventh cervical vertebra (C7) and femoral epicondyle (FE) showed larger discrepancies. The overweight group presented a significant difference in palpation discrepancy for ASIS (P &lt; 0.03). Angular variations were associated with palpation discrepancies for trunk flexion (TF), hip flexion (HF) and pelvic inclination (PI). Therefore, measurements should be performed by a single rater, rather than by different raters, if reliable angular measurements are intended. Specific anatomical landmarks require careful identification. Simulation was useful for providing estimates of variations due to palpation discrepancy.</p