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INTRODUCTION: The study aimed to estimate the prevalence of vulnerability, and to identify the associated factors of vulnerability among rural community-dwelling older adults living in the municipality of Rio Grande, Rio Grande do Sul, Brazil. METHODS: This was a cross-sectional, population-based study of a sample of individuals aged 60 years or older. Data from the first follow-up of the EpiRural Cohort Study (2018-2019) were used. Vulnerability was assessed using the Vulnerable Elders Survey (VES-13). The maximum score is 10 and older adults with scores of 3 or more are classified as vulnerable. Poisson regression with robust adjustment of variance was used for crude and adjusted analyses. For the analysis of the associated factors, a theoretical model was constructed with three hierarchical levels. The variables were adjusted in relation to each other within each level; those with a significance level of 0.20 or less were included in the regression model and adjusted to a higher level, with a subsequent level of significance of 5%. RESULTS: The overall prevalence of vulnerability was 40.8% (95%CI 37.5-44.3). Vulnerability was more prevalent among women (PR=1.45; 95%CI 1.23-1.71), older adults who did not work (PR=1.70; 95%CI 1.17-2.45), those who lived without a partner (PR=1.26; 95%CI 1.07-1.47), those with diabetes (PR=1.23; 95%CI 1.03-1.48), those with depression (PR=1.21; 95%CI 1.02-1.42), those with osteoporosis (PR=1.38; 95%CI 1.15-1.66), and those with sarcopenia (PR=1.67; 95%CI 1.38-2.02). CONCLUSION: Vulnerability is common among rural community-dwelling older adults and is associated with sociodemographic and health characteristics.

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This article aims to investigate the association between remote work and Back Pain during the COVID-19 pandemic, and to analyze this relationship according to the body mass index. Population-based, cross-sectional study carried in two cities in southern Brazil, in individuals aged 18 years and over. Data were collected through household interviews from October to January 2020/21. Outcomes: back pain (cervical, thoracic, lumbar/acute, chronic) and pain intensity. Exposure variable: remote work. For the analyses, Poisson regression with robust adjustment for variance was used, stratified by BMI (eutrophic vs overweight/obese), and restricted to those who had worked in the past month. 1,016 had worked during the pandemic, average 42 years old (SD = 14), varying from 18 to 93 years. Remote work was performed by 7.7% of the individuals. Prevalence of back pain: 25.6% (95%CI: 19.5 to 31.7%). Overweight/obese remote workers felt pain acute cervical pain PR = 2.82 (95%CI: 1.15 to 6.92); chronic low back PR = 1.85 (95%CI: 1.04 to 3.29); acute thoracic PR = 1.81(95%CI: 3.76 to 8.68) compared to those who did not work. About one in four remote workers reported back pain during of the COVID-19 pandemic. BMI proved to be an important moderator between outcomes and exposure variable.

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Abstract This article aims to investigate the association between remote work and Back Pain during the COVID-19 pandemic, and to analyze this relationship according to the body mass index. Population-based, cross-sectional study carried in two cities in southern Brazil, in individuals aged 18 years and over. Data were collected through household interviews from October to January 2020/21. Outcomes: back pain (cervical, thoracic, lumbar/acute, chronic) and pain intensity. Exposure variable: remote work. For the analyses, Poisson regression with robust adjustment for variance was used, stratified by BMI (eutrophic vs overweight/obese), and restricted to those who had worked in the past month. 1,016 had worked during the pandemic, average 42 years old (SD = 14), varying from 18 to 93 years. Remote work was performed by 7.7% of the individuals. Prevalence of back pain: 25.6% (95%CI: 19.5 to 31.7%). Overweight/obese remote workers felt pain acute cervical pain PR = 2.82 (95%CI: 1.15 to 6.92); chronic low back PR = 1.85 (95%CI: 1.04 to 3.29); acute thoracic PR = 1.81(95%CI: 3.76 to 8.68) compared to those who did not work. About one in four remote workers reported back pain during of the COVID-19 pandemic. BMI proved to be an important moderator between outcomes and exposure variable.

Resumo O objetivo deste artigo é investigar a associação entre trabalho remoto e dores nas costas durante a pandemia da COVID-19 e analisar essa relação segundo o índice de massa corporal. Estudo transversal de base populacional realizado em duas cidades no sul do Brasil em indivíduos acima de 18 anos. Dados foram coletados por meio de entrevistas domiciliares entre outubro-janeiro de 2020-2021. Desfechos: dor nas costas (cervical, torácica, lombar/aguda, crônica) e intensidade da dor. Variável de exposição: trabalho remoto. Para as análises, foram utilizadas regressão de Poisson com ajuste robusto para variância, estratificadas pelo IMC (eutrófico vs. sobrepeso/obeso) e restritas àqueles que trabalharam no último mês. Durante a pandemia, 1.016 trabalharam, média 42 anos (DP = 14), entre 18 a 93 anos. Trabalho remoto foi realizado por 7,7% dos indivíduos. Prevalência de dor nas costas: 25.6% (IC95%:19,5 a 31,7%). Trabalhadores remotos com sobrepeso/obesidade sentiram dor aguda cervical RP = 2,82 (IC95%:1,15 a 6,92); torácica aguda RP = 1,81 (IC95%:3,76 a 8,68); lombar crônica RP = 1,85 (IC95%:1,04 a 3,29), comparados àqueles que não trabalharam. Cerca de um em cada quatro trabalhadores remotos reportou dor nas costas durante a pandemia. O IMC mostrou-se ser um importante moderador entre defechos e variável de exposição.

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BACKGROUND: Brazil is one of the world's largest pesticide consumers, but information on pesticide poisoning among workers is scarce. OBJECTIVE: To evaluate acute pesticide poisoning among tobacco growers, according to different criteria. METHODS: This was a two-step cross-sectional study with 492 pesticide applicators. It used a 25 question pesticide-related symptoms (PRS) questionnaire and medical diagnosis for comparison with toxicological assessment. Associations were evaluated using Poisson regression. RESULTS: 10.6% reported two or more PRS, while 8.1% reported three or more. Furthermore, 12.2% received a medical diagnosis of poisoning. According to toxicologists, possible cases accounted for 14.2% and probable cases for 4.3%. PRS increased during the period of greater exposure. Those exposed to dithiocarbamates, sulfentrazone, pyrethroids, fipronil and iprodione exhibited more PRS. The number of exposure types, multi-chemical exposure, clothes wet with pesticides and spillage on the body/clothes were associated with acute poisonings. All criteria showed sensitivity greater than 79% for probable cases but only greater than 70% for medical diagnosis when compared to possible cases, presenting substantial Kappa agreement. CONCLUSION: The prevalence of acute pesticide poisoning is much higher than officially recorded. Trained physicians can screen for pesticide poisoning. It is necessary to improve workers' education to reduce pesticide use and exposure to them.

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The aim of this study was to examine the association of social activities with cognitive performance in older adults in the southern area of Brazil, considering the important moderating role of physical vulnerability. A prospective population-based study was conducted in the rural area of Rio Grande, Rio Grande do Sul, Brazil. Self-reported social activities were collected at baseline. Cognitive performance and physical vulnerability were measured in the second wave of data collection. The association of social activities with cognitive performance was determined using robust generalized linear models. In adjusted analysis, the social activities were positively associated with cognitive performance in physically vulnerable older adults. However, this association was not found in those who were nonvulnerable. Our findings may contribute to future investigations of possible explanatory avenues for the association between social activities and cognitive performance as well as the development of interventions aimed at improving cognitive skills.

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OBJECTIVES: To describe the use of dental services in two periods and associated factors in older people residing in the rural area of a municipality in southern Brazil. METHODS: This was a cross-sectional study nested in a cohort study. A standardised questionnaire was used to collect the variables of interest. The dependent variables were the use of dental services in the 12 and 36 months prior to the interview. RESULTS: A total of 863 older people were interviewed, 24.7% of whom had visited a dentist in the previous year and 38.7% had visited a dentist in the previous 3 years. Skin colour, health insurance and self-rated health were associated with both outcomes. Individuals with non-white skin, those who did not have health insurance and those who considered their health to be poor or very poor were more likely to take a long time before seeking oral health services. Differences between the two outcomes were observed in oral health and the use of tobacco. The likelihood of having gone more than 3 years without visiting a dentist was greater among smokers and lower among those with dental caries. CONCLUSIONS: The prevalence of dental service use was low. Variables related to the adoption of unhealthy behaviours and the occurrence of oral diseases were only related to the use of dental services 36 months prior to the interview. Public policies must be reorganised to prioritise population groups with greater difficulties in the use of dental services.

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Resumo Introdução: a produção agrícola no Brasil tem crescido nas últimas décadas e os trabalhadores rurais estão expostos a vários riscos ocupacionais. Estudos epidemiológicos sobre o tema ainda são limitados, especialmente pela complexidade metodológica. Objetivos: apresentar os principais desafios metodológicos para a realização de estudos epidemiológicos ocupacionais rurais. Métodos: as considerações apresentadas neste artigo têm como base a literatura e a experiência dos autores como pesquisadores desta temática. Resultados: foram abordados conceitos sobre população alvo, local de moradia e trabalho, classificação dos trabalhadores e caracterização do contexto da produção agrícola. Foram exploradas as estratégias de amostragem; a caracterização dos indicadores econômicos, incluindo produção agrícola e nível de mecanização; a exposição aos agrotóxicos, como tipos químicos, formas e frequência de exposição; a intoxicação por agrotóxicos; e a disponibilidade e o uso de Equipamentos de Proteção Individual. Foram descritos os cuidados com amostras biológicas, bem como aspectos envolvendo entrevistadores, treinamentos, trabalho de campo, questões climáticas e logísticas. Conclusão: apesar dos desafios metodológicos e logísticos, com o planejamento adequado é possível realizar com êxito pesquisas de grande complexidade e de alto nível científico sobre a relação saúde-trabalho na atividade agropecuária.

Abstract Introduction: agricultural production in Brazil has grown in recent decades, and rural workers are exposed to many occupational risks. Epidemiological studies on the topic remain limited, especially regarding methodological complexity. Objectives: to present the main methodological challenges to carrying out occupational epidemiological studies in rural areas. Methods: the considerations presented in this article are based on the literature and on the experience of the authors as researchers of this thematic. Results: we approached concepts about target population, living and working place, workers classification, and agricultural production context characterization. We discussed sampling strategies, characterization of economic indicators, including agricultural production and mechanization level, pesticide exposure, such as chemical types, forms, and frequency of exposure, pesticide poisonings, and availability and use of personal protective equipment. We described the necessary care with biological samples and aspects involving interviewers, training, field work, and clinical and logistical issues. Conclusion: despite the methodological and logistical challenges, adequate planning enables successful research studies, of great complexity and high scientific level, about the health-work relationship in agricultural activity.

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BACKGROUND: Tuberculosis is a worldwide public health problem and is more prevalent in specific populations, such as prisoners. The aim of this study was to analyze the epidemiological and operational indicators of tuberculosis in prisoners in a southern region of Brazil. METHODS: This was a descriptive, observational study, utilizing secondary data from the Notifiable Diseases Information System on tuberculosis cases diagnosed in prisoners in the state of Rio Grande do Sul, southern Brazil, from 2014 to 2018. Prisoner data used to calculate incidence were extracted from reports by the National Penitentiary Department. RESULTS: From 2014 to 2018, 3,557 tuberculosis cases were reported in Rio Grande do Sul prisoners. The incidence rate of tuberculosis in prisoners was 1,235/100,000 individuals in 2014 and 1,430/100,000 individuals in 2018. The proportion of new TB cases tested for HIV was high, 83.4% in this period; among those tested, 12.9% were HIV coinfected. The proportion of new cases of pulmonary tuberculosis confirmed by laboratory criteria was 52.6% in this period. In total, 18.4% of new pulmonary tuberculosis cases were initiated on directly observed treatment in this period, and 36.4% of contacts of new cases of pulmonary tuberculosis with laboratory confirmation were examined. Among retreatment pulmonary tuberculosis cases, 82.4% were laboratory-confirmed. CONCLUSIONS: Tuberculosis incidence is increasing on a per-capita and absolute basis in Rio Grande do Sul. Laboratory confirmation, HIV testing, directly observed treatment, and contact investigation rates were all low, indicating the need to improve medical and public health measures for tuberculosis control in prisons.

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OBJECTIVE: To estimate the prevalence and factors associated with the search for folk healers for the treatment of health problems among elderly living in the rural area of the city of Rio Grande-RS. METHODS: Cross-sectional, p opulation-based study with random sampling, carried out in 2017. The outcome was analyzed in three categories (never used/used in the last 12 months/used for more than 12 months). Multinomial logistic regression was used to analyze theassociated factors. RESULTS: A total of 1,030 elderly individuals were interviewed. The prevalence of demand for folk healers in the last 12 months and for more than 12 months was 9.5% and 15.8%, respectively. In the adjusted analysis, the characteristics associated with the use of a folk healer for more than 12 months were: being in the age group of 80 years or more and having back problems and arthrosis. Following the evangelical religion was identified as a protective factor for using this resource. On the other hand, the demand for blessing in the last year was related to the age group of 70-79 years, following spiritual religions, presence of disease in the last 12 months, back problems and arthrosis, and preference for the use of urgency and emergency services. Being female was associated only with the use for more than 12 months. CONCLUSION: This study brings an original contribution to a topic poorly evaluated in epidemiological studies, because the knowledge of the frequency and determinants of the search for this type of popular therapy can be used to improve the quality and access to health services offered to the elderly population in rural areas.

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INTRODUCTION: This article presents the methods used to design a prospective cohort study with older adults from a rural area in the far south of Brazil (EpiRural Cohort Study), as well as to describe the cohort profile. METHODS: The cohort study began in 2017 and evaluated older adults (≥60 years) living in rural area. The first follow-up of the cohort was carried out between September 2018 and March 2019. Data collection at baseline and first follow-up was performed through an electronic questionnaire containing demographic, socioeconomic and health-related questions, such as alcohol and cigarette consumption, morbidities and self-perceived health status. RESULTS: At baseline, 1130 older adults were sampled, 1029 of whom were interviewed (91.1%). The age of almost 17% was 80 years or more, and 55.2% were male. At first follow-up, 862 individuals were followed (83.8%) and the characteristics of the older adults interviewed compared to those not interviewed at follow-up were similar. Between baseline and follow-up, the proportion of individuals aged 70-79 years increased, as well as the proportion of those who had consumed alcoholic beverages in the previous week and who had hypertension. The male-to-female ratio, those who were living alone, working, smokers, diabetics, who had stroke and who reported their health as being very good/good were comparable between the baseline and follow-up. CONCLUSION: With a reasonable follow-up rate, it was possible to transform a cross-sectional study into a prospective cohort study. However, new strategies will be needed to help locate participants more successfully and ensure a good response rate in future follow-ups.

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