ObjectiveTo evaluate the implementation of the Uruguayan healthy snacking initiative in primary and secondary schools in the capital, and to explore the factors underlying compliance from the perspective of school principals.DesignA mixed-method approach was used, which included semi-structured interviews with school principals and a survey of the foods and beverages sold and advertised in the schools.SettingPrimary and secondary schools in Montevideo (the capital city of Uruguay).ParticipantsSchool principals.ResultsThe great majority of the schools did not comply with the initiative. Exhibition of non-recommended products was the main cause for non-compliance, followed by advertising of non-recommended products through promotional activities of food and beverage companies. Although school principals were aware of the healthy snack initiative and showed a positive attitude towards it, the majority lacked knowledge about its specific content. Factors underlying compliance with the healthy snacking initiative were related to its characteristics, characteristics of the schools, and external factors such as family habits and advertising.ConclusionsResults showed that the rationale underlying the selling of products at schools favours the availability of ultra-processed products and constitutes the main barrier for the promotion of healthy dietary habits among children and adolescents. Strategies aimed at facilitating the identification of unhealthy foods and beverages and provision of incentives to canteen managers to modify their offer are recommended.

Patellofemoral pain syndrome (PFPS) is highly prevalent; it can cause severe pain and evolve into progressive functional loss, leading to difficulties performing daily tasks such as climbing and descending stairs and squatting. This systematic review aimed to find evidence, in the literature, of squat movements that can cause or worsen PFPS. This work was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and its protocol was registered in PROSPERO (CRD42019128711). From the 6570 collected records, 37 were included. From these 37 articles, 27 present a causal relationship between knee flexion and PFPS, 8 describe a relationship, considering the greater existence of muscle contractions, and one article did not describe this relationship in its results. The main limitations stem from the fact that different studies used different evaluation parameters to compare the force exerted on the patellofemoral joint. Furthermore, most studies are focused on sports populations. After analysing the included works, it was concluded that all squat exercises can cause tension overload in the knee, especially with a knee flexion between 60° and 90° degrees. The main causal/worsening factors of PFPS symptoms are the knee translocation forward the toes (on the same body side) when flexing the knee, and the muscle imbalance between the thigh muscles.

No abstract

Occupational-specific classifications of musculoskeletal disorders (MSD) are scarce and do not answer specific clinical questions. Thus, a specific classification was developed and proposed, covering criteria applicable to daily clinical activity. It was considered that the disorder development process is the same across all work-related MSDs (WRMSDs). Concepts of clinical pathology were applied to the characteristics of WRMSDs pathophysiology, cellular and tissue alterations. Then, the correlation of the inflammatory mechanisms with the injury onset mode was graded into four levels (MSDs 0–3). Criteria of legal, occupational and internal medicine, semiology, physiology and orthopaedics, image medicine and diagnostics were applied. Next, the classification was analysed by experts, two occupational physicians, two physiatrists and occupational physicians and one orthopaedist. This approach will allow WRMSD prevention and improve therapeutic management, preventing injuries from becoming chronic and facilitating communication between occupational health physicians and the other specialities. The four levels tool relate aetiopathogenic, clinical, occupational and radiological concepts into a single classification. This allows for improving the ability to determine a WRMSD and understanding what preventive and therapeutic measures should be taken, avoiding chronicity. The developed tool is straightforward, easy to understand and suitable for WRMSDs, facilitating communication between occupational physicians and physicians from other specialities.

Background: Medicine and Physical Education can work together to solve many health problems. Bodybuilding is a multidisciplinary area whose goals can range from body development to the correction of postural problems and the resolution of various pathologies related to human movement. In the case in analysis, the patient presented (at rest) localized pain (twinges) in the anterior face of the left knee, with an intensity of five (0-10 scale), without phlogistic signs, which worsens when performing the squat, hindering him from leaving the bed without pain. Symptoms were exacerbated when descending stairs. Through anamnesis and directed physical examination, it were considered the possible differential diagnosis of pain in the anterior portion of the knee: Diseases in menisci,  anterior and posterior cruciate ligament injuries,  diseases of  knee  collateral  ligaments,  diseases of  knee  cartilage,  diseases of  patellar tendon tendinitis and patellar chondromalacia. After a correct diagnosis of patellofemoral pain  syndrome, a conservative treatment was performed using bodybuilding. The results were positive after four months of treatment. From this case, it can be concluded that bodybuilding can be an alternative solution for the conservative treatment of Patellofemoral Pain Syndrome