Assessment of the Brazilian Version of the Epworth Sleepiness Scale Using Item Response Theory: A Psychometric Study.

There seems to be a consensus that adolescents worldwide are not getting enough sleep. This study aimed to evaluate the psychometric properties of the Epworth Sleepiness Scale (ESS) in adolescents using the item response theory. A psychometric study was conducted with 2206 adolescents aged 18 and 19 years in the city of São Luís, Maranhão, Brazil. The dimensionality of the ESS was assessed by principal component analysis. A Samejima's graded response model (SGRM) was fitted to it. The findings of this study showed a good internal consistency and the unidimensionality of the ESS. Considering the latent trait continuum, we obtained three levels, with anchor items. For the item 'Sitting still in a public place', the adolescents presented a small possibility of dozing in level 1, and a medium and great possibility in level 2. The item 'Sitting around talking to someone' presented small, medium, and great possibilities of dozing in level 3. The ESS with five items showed satisfactory psychometric properties. In addition, the results from the SGRM showed that adolescents with high levels of sleepiness are likely to nod off or sleep sitting up while talking to someone. This study allows us to understand excessive daytime sleepiness in adolescents.

Association between dental caries and molar-incisor hypomineralisation in first permanent molars: A hierarchical model.

OBJECTIVE: To assess whether the prevalence of dental caries is associated with the presence of molar-incisor hypomineralisation (MIH) in first permanent molars (FPMs). METHODS: A cross-sectional study was conducted with a sample of 5368 FPMs from 1342 children aged 8-10 years from Florianopolis, Brazil. Dental caries was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index and MIH was assessed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The sociodemographic data were obtained with a questionnaire sent to caregivers. A hierarchical repeated measures Poisson regression, considering dependency among observations, was performed, since the unit of analysis was the tooth. RESULTS: The presence of MIH was associated with a 6.15 times higher prevalence of dental caries in FPMs (PR: 6.15; 95%CI: 4.18-9.04). A monthly family income ≤2 minimum wages and the caries experience in the primary teeth were also significantly associated with greater prevalence rates of dental caries in FPMs. CONCLUSION: The presence of MIH showed a significant association with the prevalence of dental caries in FPMs. Thus, dentists should be alert to cases of MIH. Once the condition is detected, preventive measures should be taken to prevent enamel breakdown and the development of dental caries lesions.

Factors Associated With Driving Status Among Brazilian Older Adults.

This study analyzed the factors associated with driving status among older adults in Brazil. The sample consisted of 15,221 older adults (≥65 years) residing in Brazilian capitals in 2018. The following question established the participants' driving status: "Do you drive a car, motorcycle, and/or another vehicle?" Sociodemographic, health conditions, and health-related behaviors were derived through standard procedures. Poisson regression analysis was performed to estimate prevalence ratios and 95% confidence interval. The prevalence of drivers was 28.83%. We found that being physically active during leisure time and higher daily recreational screen time (>3 h/day) were associated with driving status. Self-perceived negative health and being physically active by commuting showed an inverse association with driving status. The high prevalence of older drivers and the characteristics associated with driving reinforces the importance of public policy strategies for these individuals.

Impact of primary dentition malocclusion on the oral health-related quality of life in preschoolers.

BACKGROUND: Malocclusion is a condition frequently seen in primary dentition due to the interaction of environmental, genetic and behavioural factors. The occurrence of some types of malocclusions can have an impact on oral health-related quality of life in children. Hence, the present study aimed to verify the impact of primary dentition malocclusion on oral health-related quality of life in preschool children. METHODS: A population-based cross-sectional study was conducted in Florianopolis, Brazil, with a representative sample of 1050 preschoolers aged between 2 and 5 years, randomly selected. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale and also to a questionnaire on socio-economic indicators. Data obtained from the questionnaire were obtained by item response theory based on model of gradual response. The malocclusion assessed was: anterior open bite, increased overjet and posterior crossbite. Poisson regression model was employed for multivariate analysis (P < 0.05). RESULTS: Malocclusion was observed in 36.7% of the children. Of these, 11.4% were anterior open bite, 67.2% were increased overjet, and 21.4% were posterior crossbite. Malocclusion's impact on oral health-related quality of life was 28.6%. In children aged 4-5 years, the prevalence of malocclusion's impact on quality of life was 49.5% higher than in children aged 2-3 years. Statistical analysis showed that preschool children with malocclusion showed no significant impact on quality of life. CONCLUSIONS: The findings of the present study indicate that the occurrence of primary dentition malocclusion has no impact on the quality of life of children aged 2-5 years.

Obesogenic Clusters Associated with Weight Status in Brazilian Adolescents of the Movimente School-Base Intervention.

BACKGROUND: the relationship between behavior clusters and weight status, mainly in low- and middle-income countries, remains unclear. This study aimed to examine the association between profiles of physical activity (PA), diet and sedentary behavior (SB) with weight status in adolescents from a southern Brazilian city, according to sex. METHODS: data from the Movimente Intervention study were analyzed (n = 812 / mean age 13.0 years (sd 1.04). Data on SB hours per day, PA minutes per week and weekly consumption frequencies of fruits, vegetables, salty snacks, candies and soda were self-reported on the validated Movimente questionnaire. Classes of healthy and unhealthy behaviors were derived by latent class analysis. Logistic regression analysis was used to estimate the associations between adolescents' weight status and classes. RESULTS: two classes were identified for the whole sample and for boys and girls. All classes had high probabilities of engaging high time in SB. Male adolescents in the unhealthy class had low probabilities of being active and high probability of consuming a low-quality diet. In contrast, girls' healthiest profile presented lower probabilities of being active compared to boys' healthiest profiles. No association was found between weight status and classes. CONCLUSION: All classes had at least one unhealthy behavior, for both the whole sample, and for girls and boys. Girls' profiles were unhealthier compared to boys' profiles. Hence, it is recommended that intervention strategies to change behaviors need to be distinct according to sex, targeting more than one obesogenic behavior at the same time.

Development of a Food-Based Diet Quality Scale for Brazilian Schoolchildren Using Item Response Theory.

Item response theory (IRT) is a psychometric method that provides probabilistic model-based measurements. Its use is relatively recent in the assessment of food consumption, especially through dietary assessment tools. This study aims (1) to develop a food-based diet quality scale for Brazilian schoolchildren using IRT, and (2) to apply the scale to a representative sample of schoolchildren from a Southern Brazilian city. The scale was developed with daily consumption frequency of foods from 835 students who completed the Food Intake and Physical Activity of Schoolchildren questionnaire. Questionnaire foods were grouped into 10 items according to their nutritional similarities and were evaluated by full-information factor analysis that indicated a dominant factor explaining 28% of the variance. Psychometric item analysis was performed using Samejima's model. The scale covered all levels of diet quality, from "very poor" (scores < 95) to "very good" (scores ≥ 130). Children who had higher diet quality scores consumed beans, meat, fish, eggs, fruits, vegetables, dairy products, and water more frequently, while reducing the consumption of ultraprocessed sugary foods, ultraprocessed savoury snacks and sausages, and sugary drinks. Of 6323 children, an average of less than 10% consumed the highest diet quality scores (good or very good diet quality) and about 60% of children consumed low diet quality scores. The scale can be applied to other schoolchildren with the same measure precision.

Psychometric analysis of the Brazilian-version Kidscreen-27 questionnaire.

BACKGROUND: The objective of this study was to verify the reliability, discriminatory power and construct validity of the Kidscreen-27 questionnaire in Brazilian adolescents. METHODS: Adolescents that participated of the pilot study (210 adolescents; 52.9% boys; 13.7 years old) and of the baseline (816 participants; 52.7% girls; 13.1 years old) of the Movimente Project in 2016/2017 composed the sample of the present study. This project was carried out in six public schools in the city of Florianópolis, Santa Catarina, Brazil. Test-retest reproducibility was assessed by the intraclass correlation coefficient and Gwet coefficient; internal consistency through McDonald's Omega; Hankins' Delta G coefficient verified the scale's discriminatory power and; confirmatory factor analysis to assess construct validity. RESULTS: Reproducibility values ranged from 0.71 to 0.78 for the dimensions (ICC), and ranged from 0.60 to 0.83 for the items (Gwet). McDonald's Ômega (0.82-0.91) for internal consistency measures. Discriminatory power ranging from 0.94 for the dimension Social Support and Friends to 0.98 for Psychological Well-Being. The factorial loads were > 0.40, except for item 19 (0.36). The fit quality indicators of the model were adequate (X2[df] = 1022.89 [311], p < 0.001; RMSEA = 0.053 (0.049-0.087); CFI = 0.988; TLI = 0.987), confirming the five-factor structure originally proposed. CONCLUSIONS: The Brazilian-version Kidscreen-27 achieved good levels of reproducibility, internal consistency, discriminatory power and construct validity. Its use is adequate to measure the health-related quality of life of adolescents in the Brazilian context.

Mat pilates method improve postural alignment women undergoing hormone therapy adjunct to breast cancer treatment. Clinical trial.

The purpose of the study is to analyze the effects of a mat Pilates intervention on the postural alignment and balance of breast cancer women receiving hormone therapy. A two-arm randomized clinical trial included 34 breast cancer survivors divided randomly between a mat Pilates group (n = 18), that performed 16 weeks of mat Pilates exercises, and a control group (n = 16), who were invited to maintain their daily routine activities and received three educational sessions. Data collection occurred at baseline and at post-intervention time. The postural alignment was assessed using the Postural Assessment Software (SAPO) and the balance was assessed by the MINIBESTest. When the two-way ANOVA was performed on postural alignment results, a significant statistical difference was found in the angle between acromions and the anterior-superior iliac spines of the mat Pilates group (p = 0.036). When compared to the post-intervention period, the mat Pilates method had an improved horizontal alignment of the anterior-superior iliac spines (p = 0.039) and vertical alignment of the acromion head on the right side (p = 0,016). Also, the participants of the Pilates group showed a significant statistical difference in the balance (p = 0.034). The control group had an improved vertical trunk alignment on the left side (p = 0,048). The control group and the mat Pilates method group improved in some aspects, however the mat Pilates method was effective in improving the postural alignment and the balance of breast cancer survivors receiving hormone therapy and may be recommended in oncological rehabilitation as a type of complementary therapy.

Body Image Dissatisfaction, Eating Disorders, and Associated Factors in Brazilian Professional Ballroom Dancers.

The search for movement plasticity causes dancers to seek to achieve and maintain low body weight, which can lead to dissatisfaction with their body image and to eating disorders. The purpose of this study was to analyze body image satisfaction and the presence of eating disorders and associated factors in professional ballroom dancers in Brazil. Three hundred and twenty dancers took part via a self-reported questionnaire. The majority of the dancers proved to be dissatisfied with their body image; the increase with age of body mass index (BMI) influenced the dissatisfaction due to excess weight. It is concluded that body image is associated with eating disorders, age, and BMI in ballroom dancers.

[Fatigue and quality of life among professional ballroom dancers in Brazil]. / Fadiga e qualidade de vida em bailarinos profissionais de dança de salão no Brasil.

The scope of this study was to analyze the relationship between quality of life, fatigue and injuries among professional Brazilian ballroom dancers. A total of 320 professionals from the five regions of Brazil participated, and the data were collected through a self-administered online questionnaire concerning general information, WHOQOL-bref, Yoshitake Fatigue Questionnaire and Injury Identification in Dancers Questionnaire. For data analysis, descriptive statistics were used, followed by inferential analysis and the Multiple Linear Regression test. The results show that greater fatigue is associated with a negative quality of life, revealing that, for each additional increment in total fatigue, the quality of life is expected to decrease by 0.218 points in the physical domain; 0.226 points in the psychological domain; 0.420 points in the social domain; and 0.304 points in the environmental domain. In contrast, the incidence and intensity of injuries were not associated with quality of life. The conclusion drawn is that the context of professional ballroom dance can influence both the presence of fatigue and the quality of life. It is suggested that health professionals working with these dancers perform multifactorial interventions in order to reduce fatigue, attenuating its effects on quality of life.

Objetivou-se analisar a relação entre a qualidade de vida, a fadiga e as lesões em bailarinos brasileiros profissionais de dança de salão. Participaram 320 profissionais das cinco regiões do Brasil, sendo a coleta de dados realizada por meio de um questionário online autoaplicável acerca das informações gerais, WHOQOL-bref, Questionário de Fadiga de Yoshitake e Questionário de Identificação de Lesões em Bailarinos. Para análise dos dados utilizou-se a estatística descritiva, seguida da análise inferencial e do teste de Regressão Linear Múltipla. Os resultados demonstram que uma maior fadiga está associada a uma qualidade de vida negativa, evidenciando-se que, a cada valor a mais na fadiga total, espera-se que a qualidade de vida diminuísse 0.218 pontos no domínio físico; 0.226 pontos no domínio psicológico; 0.420 pontos no domínio social; e 0.304 pontos no domínio ambiental. Em contrapartida, a incidência e a intensidade de lesões não foram associadas com a qualidade de vida. Conclui-se que o contexto da dança de salão profissional pode influenciar tanto na presença de fadiga quanto na qualidade de vida. Sugere-se aos profissionais de saúde que atuam com estes bailarinos através de intervenções multifatoriais objetivando diminuir a fadiga, atenuando os efeitos desta na qualidade de vida.

Fadiga e qualidade de vida em bailarinos profissionais de dança de salão no Brasil / Fatigue and quality of life among professional ballroom dancers in Brazil

Resumo Objetivou-se analisar a relação entre a qualidade de vida, a fadiga e as lesões em bailarinos brasileiros profissionais de dança de salão. Participaram 320 profissionais das cinco regiões do Brasil, sendo a coleta de dados realizada por meio de um questionário online autoaplicável acerca das informações gerais, WHOQOL-bref, Questionário de Fadiga de Yoshitake e Questionário de Identificação de Lesões em Bailarinos. Para análise dos dados utilizou-se a estatística descritiva, seguida da análise inferencial e do teste de Regressão Linear Múltipla. Os resultados demonstram que uma maior fadiga está associada a uma qualidade de vida negativa, evidenciando-se que, a cada valor a mais na fadiga total, espera-se que a qualidade de vida diminuísse 0.218 pontos no domínio físico; 0.226 pontos no domínio psicológico; 0.420 pontos no domínio social; e 0.304 pontos no domínio ambiental. Em contrapartida, a incidência e a intensidade de lesões não foram associadas com a qualidade de vida. Conclui-se que o contexto da dança de salão profissional pode influenciar tanto na presença de fadiga quanto na qualidade de vida. Sugere-se aos profissionais de saúde que atuam com estes bailarinos através de intervenções multifatoriais objetivando diminuir a fadiga, atenuando os efeitos desta na qualidade de vida.

Abstract The scope of this study was to analyze the relationship between quality of life, fatigue and injuries among professional Brazilian ballroom dancers. A total of 320 professionals from the five regions of Brazil participated, and the data were collected through a self-administered online questionnaire concerning general information, WHOQOL-bref, Yoshitake Fatigue Questionnaire and Injury Identification in Dancers Questionnaire. For data analysis, descriptive statistics were used, followed by inferential analysis and the Multiple Linear Regression test. The results show that greater fatigue is associated with a negative quality of life, revealing that, for each additional increment in total fatigue, the quality of life is expected to decrease by 0.218 points in the physical domain; 0.226 points in the psychological domain; 0.420 points in the social domain; and 0.304 points in the environmental domain. In contrast, the incidence and intensity of injuries were not associated with quality of life. The conclusion drawn is that the context of professional ballroom dance can influence both the presence of fatigue and the quality of life. It is suggested that health professionals working with these dancers perform multifactorial interventions in order to reduce fatigue, attenuating its effects on quality of life.

Mediating role of screen media use on adolescents' total sleep time: A cluster-randomized controlled trial for physical activity and sedentary behaviour.

BACKGROUND: The present study aimed to analyse the effect of an intervention for increasing physical activity (PA) and reducing sedentary time on adolescents' total sleep time (TST) and to examine whether the effect on adolescents' TST was mediated by the intervention changes on screen-based sedentary time. METHODS: This study was a school-based cluster-randomized controlled trial conducted with Brazilian adolescents in Grades 7 to 9 (in 2017). Three schools participated in each of the intervention group (IG) and control group (CG). The intervention involved the following three strategies designed to increase PA and reduce sedentary time: (a) teacher training, (b) environmental improvements, and (c) health educational component. TST and screen-based sedentary time (television use, cell phone use, playing on computer/video game, and computer use that is not for gaming purposes) on weekdays and weekends were assessed using a standardized questionnaire. Generalized linear mixed models were conducted to verify the effect of the intervention on TST. Mediation analyses were used to examine the mediator role of changes in screen-based sedentary time in the relationship between the intervention and TST. RESULTS: Overall, 597 students participated in this study (mean age: 13.0 ± 1.0 years; IG: n = 351; CG: n = 246). The intervention had no effect on TST on weekdays and weekends. Adolescents in the IG were more likely to report ≤2 hr of television viewing per day on weekdays at follow-up. Mediated effects by screen media use were not significant. CONCLUSIONS: The school-based intervention for increasing PA and reducing sedentary time had no effect on adolescents' TST.

Smoking among industrial workers in Brazil: association with sociodemographic factors, alcohol consumption, and stress levels.

OBJECTIVE: To determine the prevalence of smoking, as well as its association with sociodemographic factors, alcohol consumption, and stress levels, among industrial workers in Brazil. METHODS: This was a nationwide survey, conducted in 24 capitals in Brazil through the application of a pre-tested questionnaire. The response to the question "What is your smoking status?" was the outcome variable. To determine the associations, we performed Poisson regression analyses in which the inputs were blocks of variables: block 1 (age and marital status); block 2 (level of education and gross family income); block 3 (geographic region); and block 4 (alcohol consumption and stress level). All analyses were stratified by gender. RESULTS: The sample consisted of 47,328 workers ≥ 18 years of age, of whom 14,577 (30.8%) were women. The prevalence of smoking was 13.0% (15.2% in men and 7.9% in women). Advancing age, alcohol consumption, and a high stress level were positively associated with smoking. A lower risk of smoking was associated with being married, having a higher level of education, and living in the northeastern region of the country (versus the southern region). CONCLUSIONS: The prevalence of smoking was greater in men than in women. Alcohol consumption and high stress levels appear to promote smoking.

Associated factors and profile of injuries in professional ballroom dancers in Brazil: a cross-sectional study

Abstract Aims: Ballroom dance consists of a modality characterized by fast and dynamic movements performed in pairs, aiming at technical and artistic excellence. Objective: To analyze the prevalence, characteristics, and factors associated with injuries in professional ballroom dancers, considering possible differences between sexes. Method: 320 professional dancers of both sexes with a mean age of 31.48±8.63 years, who were in professional companies and/or dance schools from five regions of Brazil. The measurement was performed through an online self-administered questionnaire about general information and injuries. Results: A high frequency of musculoskeletal injuries (80.0%) was observed, especially osteoarticular ones (52.4%). In women, the lower limbs were the anatomical location most reported (31.1%) and the knee in male dancers (28.7%). Overweight men, with more than 11 years of dance practice, who danced in companies and also performed other physical activities, were more likely to have injuries. However, women were less likely to have injuries when they were overweight and more likely when they practiced other dance modalities besides ballroom dancing. Conclusions: Approximately 64.1% of ballroom dancers suffered an injury throughout their professional careers. For men, being overweight as well as the search for complementary activities to the physical training routine for both sexes, seem to influence the occurrence of injuries. Identification of the factors associated with injuries in ballroom dancers contributes both to preventive actions and to rehabilitation processes, favoring a healthy and safe career for professionals involved in this practice.

Factors associated with depression symptoms in women after breast cancer.

OBJECTIVE: To analyze the factors associated with the presence of depression symptoms in women after breast cancer. METHODS: Cross-sectional study with 181 women with breast cancer, aged 57.0 years (SD = 9.5), who were undergoing treatment or after treatment in the Oncology Research Center in Florianópolis, state of Santa Catarina, Brazil. The questionnaire comprised items addressing general and health information, economic level, anthropometric measures, depression symptoms (Beck Depression Inventory), self-esteem (Rosenberg Self-Esteem Scale), and body image (Body Image After Breast Cancer Questionnaire). Descriptive and inferential statistical analysis were performed by chi-square and Fisher's exact tests to verify association, Mann-Whitney U test to compare the groups and Poisson regression to identify the prevalence ratio of the factors associated with presence of depression symptoms (p < 0.05). RESULTS: We found an association between the presence of depression symptoms and the group of younger women (aged 40-60 years), those who had another disease besides cancer, those who had mastectomy surgery, those who suffered from lymphedema, and those who presented low-medium self-esteem. Less educated women presented more depressive symptoms, as did women with worse body image on the subscales of limitations, transparency, and arm concerns. CONCLUSIONS: Age, educational attainment, diagnosis of other diseases, type of surgery, lymphedema, self-esteem, and body image were factors associated with the presence of depression symptoms in Brazilian women after breast cancer. Health professionals should be aware of these relationships and try to detect depression symptoms earlier and improve the care they provide to these women.

Association between perception of bodily discomfort and individual and work organisational factors in Brazilian slaughterhouse workers: a cross-sectional study.

OBJECTIVE: Brazil is the world's second largest poultry meat producer and leading exporter. Many poultry processing tasks are physically demanding and involve factors that increase the risk of developing a work-related musculoskeletal disorder (WMSD). However, little is known about the assessment of bodily discomfort in these workers. The aim of this study was to evaluate the association between perception of bodily discomfort and individual and work organisational factors in poultry slaughterhouse workers. DESIGN: Descriptive, cross-sectional study. SETTING: Three poultry slaughterhouses in the South of Brazil. PARTICIPANTS: This paper included 925 workers of 3 poultry slaughterhouses, 575 women and 350 men. The selection of the participants was random. MAIN OUTCOME MEASURE: Workers were asked about individual factors, work organiation, perception of bodily discomfort and cold, as well as ingestion of pain medication. Crude and adjusted ORs were estimated and 95% CIs were derived from binary logistic regression analysis for perception of bodily discomfort. RESULTS: There was a significant association (p<0.05) between perception of bodily discomfort and female gender (OR=1.77; 95% CI 1.30 to 2.41), performance of repetitive tasks (OR=1.81; 95% CI 1.12 to 2.91) and perception of cold (OR=2.05; 95% CI 1.44 to 2.91). CONCLUSIONS: The findings of this research demonstrated that the sector of occupational safety and health management in poultry slaughterhouses should monitor the symptoms of WMSD among their workers, especially female workers, workers who perform repetitive tasks, as well as those who perform tasks in cold environments because these groups are more likely to experience bodily discomfort.

Empirically derived dietary patterns through latent profile analysis among Brazilian children and adolescents from Southern Brazil, 2013-2015.

The aims of this study were to identify dietary patterns (DPs) of children and adolescents participating in three cross-sectional surveys (2013-2015) and to test their associations with sociodemographic variables, physical activity (PAS), screen-based sedentary activity (SA), and weight status. One-day data were obtained from 5,364 schoolchildren (7-12 years) from public schools of Florianopolis (South of Brazil), using the validated questionnaire Web-CAAFE (Food Intake and Physical Activity of Schoolchildren). DPs were derived from the frequency of daily consumption of 32 foods/beverages by latent profile analysis. Multinomial logistic regression analysis was used to estimate the association of the DPs with sociodemographic variables, physical activity, screen activity and weight status. 'Traditional', 'Monotonous', and 'Mixed' DPs were identified. The percentages of children and adolescents within these profiles were 41.3, 36.3, and 22.4%, respectively. Children and adolescents in the highest tertiles of both PAS and daily frequency of SA had a higher probability to present a 'Mixed' DP compared to peers with less PAS and SA. Children and adolescents who reported having a school meal were significantly more likely to present the 'Traditional'DP, while boys who did not report having a school meal had a higher probability to present the 'Monotonous' DP. The DPs were not associated with the year of survey, age, family income, or weight status.

Patterns of risk behaviors in Brazilian older adults: A latent class analysis.

AIM: The aim of the present study was to describe the clustering of diet, physical activity, television viewing, and tobacco and alcohol use among Brazilian older adults (aged ≥60 years). METHODS: We carried out a secondary analysis of the Brazilian National Health Survey of 2013. Brazilian older adults (n = 11 177) reported their consumption of fruit and vegetables, leisure physical activity, television viewing, tobacco smoking, and alcohol intake. Latent class analysis was used to identify behavior patterns. RESULTS: Three classes of behaviors were identified. The "Healthy" class (34.8%) had the highest probability of meeting recommendations for physical activity, and fruit and vegetable consumption; the "Poor diet and PA" class (46.5%) presented low probabilities of meeting recommendations for physical activity and alcohol consumption; and the "Smoking and binge drinking" class (18.7%) had the highest probability of smoking and binge drinking. CONCLUSIONS: Three behavioral patterns were identified in the Brazilian older population. Even in the "Healthy" class, less than half of the older adults were considered physically active, suggesting that there is no completely healthy profile. Nevertheless, physical activity and fruit and vegetable consumption behaviors clustered, as did smoking and binge drinking. Geriatr Gerontol Int 2019; 19: 245-248.

Factors associated with depression symptoms in women after breast cancer

ABSTRACT OBJECTIVE: To analyze the factors associated with the presence of depression symptoms in women after breast cancer. METHODS: Cross-sectional study with 181 women with breast cancer, aged 57.0 years (SD = 9.5), who were undergoing treatment or after treatment in the Oncology Research Center in Florianópolis, state of Santa Catarina, Brazil. The questionnaire comprised items addressing general and health information, economic level, anthropometric measures, depression symptoms (Beck Depression Inventory), self-esteem (Rosenberg Self-Esteem Scale), and body image (Body Image After Breast Cancer Questionnaire). Descriptive and inferential statistical analysis were performed by chi-square and Fisher's exact tests to verify association, Mann-Whitney U test to compare the groups and Poisson regression to identify the prevalence ratio of the factors associated with presence of depression symptoms (p < 0.05). RESULTS: We found an association between the presence of depression symptoms and the group of younger women (aged 40-60 years), those who had another disease besides cancer, those who had mastectomy surgery, those who suffered from lymphedema, and those who presented low-medium self-esteem. Less educated women presented more depressive symptoms, as did women with worse body image on the subscales of limitations, transparency, and arm concerns. CONCLUSIONS: Age, educational attainment, diagnosis of other diseases, type of surgery, lymphedema, self-esteem, and body image were factors associated with the presence of depression symptoms in Brazilian women after breast cancer. Health professionals should be aware of these relationships and try to detect depression symptoms earlier and improve the care they provide to these women.

Physical activity and quality of life in women with breast cancer - a cross-sectional study / Atividade física e qualidade de vida em mulheres com câncer de mama - um estudo transversal / Actividad física y calidad de vida en mujeres con cáncer de mama - un estudio transversal

INTRODUCTION: Breast cancer treatment can cause different side effects on the quality of life of women. Physical activity, in turn, can reduce these side effects. OBJECTIVE: To investigate the physical activity and quality of life of women during and after breast cancer treatment. METHODS: Sample of 174 women (57.0±9.5 years) during or after clinical treatment for breast cancer. Interview questionnaire composed of general information, physical activity (IPAQ short version) and quality of life (EORTC QLQ-C30 and BR23). For statistical analysis chi-squared test or Fisher's exact test, student's t-test for independent samples, Mann-Whitney U test and multiple logistic regression analyses (p <0.05). RESULTS: Most women did not achieve the physical activity guidelines, particularly those undergoing clinical treatment. Results showed longer walking time, moderate physical activity, vigorous physical activity, moderate + vigorous physical activity, and total physical activity among the women following completion of treatment. The quality of life scores were also higher among women after clinical treatment. Logistic regression indicated that every 10-minute increment to walking time results in a 19% decrease in the probability of worse functional capacity and a 26% decrease in the probability of worse symptoms associated with treatment side effects. CONCLUSION: During treatment, women with breast cancer undertake less physical activity and have worse quality of life. Walking appears to be an effective type of physical activity for these women, improving quality of life during and after breast cancer treatment. Level of evidence II; Prognostic studies - Investigation of the effect of patient characteristics on the disease outcome.

INTRODUÇÃO: O tratamento do câncer de mama pode causar diferentes efeitos colaterais na qualidade de vida das mulheres. A atividade física, por sua vez, pode diminuir esses efeitos colaterais. OBJETIVO: Investigar a atividade física e a qualidade de vida de mulheres durante e após o tratamento para câncer de mama. MÉTODOS: Amostra de 174 mulheres (57,0 ± 9,5 anos) durante e depois do tratamento de câncer de mama. Questionário de entrevista composto de informações gerais, atividade física (versão curta do IPAQ) e qualidade de vida (EORTC QLQ-C30 e BR23). Para a análise estatística foram usados Qui-quadrado ou Exato de Fisher, teste T de Student para amostras independentes, teste U de Mann-Whitney e análises de regressão logística múltipla (p < 0,05). RESULTADOS: A maioria das mulheres não atingiu as recomendações de atividade física, com destaque para as mulheres que estavam em tratamento clínico. Os resultados mostraram mais tempo de caminhada, atividade física moderada, atividade física vigorosa, atividade física moderada + vigorosa e atividade física total em mulheres após o término do tratamento. Os escores de qualidade de vida também foram mais altos entre as mulheres após o término do tratamento. A regressão logística indicou que cada acréscimo de 10 minutos no tempo de caminhada resulta em diminuição de 19% da probabilidade de capacidade funcional mais baixa e de 26% de desenvolver mais sintomas mais graves associados aos efeitos colaterais do tratamento. CONCLUSÃO: Durante o tratamento, as mulheres com câncer de mama praticam menos AF e têm pior qualidade de vida. A prática de caminhada parece ser um tipo efetivo de atividade física para essas mulheres, melhorando a qualidade de vida durante e depois do tratamento de câncer de mama. Nível de evidência II; Estudos prognósticos - Investigação do efeito das características do paciente sobre o desfecho da doença.

INTRODUCCIÓN: El tratamiento del cáncer de mama puede promover diferentes efectos secundarios en la calidad de vida de las mujeres. A su vez, la actividad física puede disminuir estos efectos colaterales. OBJETIVO: Investigar la actividad física y la calidad de vida de las mujeres durante y después del tratamiento contra el cáncer de mama. MÉTODOS: Muestra de 174 mujeres (57,0 ± 9,5 años) que se encontraban en tratamiento y post tratamiento para el cáncer de mama. Cuestionario de entrevista compuesto de información general, actividad física (versión corta IPAQ) y calidad de vida (EORTC QLQ-C30 y BR23). Para análisis estadístico Chi-cuadrado o Exacto de Fisher, Test T Student para muestras independientes, U de Mann-Whitney y análisis de regresión logística múltiple (p < 0,05). RESULTADOS: La mayoría de las mujeres no alcanzaron las recomendaciones de actividad física, destacando para las mujeres que se encontraban en tratamiento. Los resultados mostraron más tiempo de caminata, actividad física moderada, actividad física vigorosa, actividad física moderada + intensidad vigorosa y actividad física total en mujeres post tratamiento. La calidad de vida también se mostró mejor entre las mujeres después de finalizar el tratamiento. La regresión logística apuntó que cada agregado de 10 minutos en el tiempo de caminata resulta en una disminución del 19% en la probabilidad de una peor capacidad funcional de la calidad de vida, y en un 26% de desarrollo de una peor sintomatología en relación a los efectos colaterales del tratamiento. CONCLUSIÓN: Durante el tratamiento, las mujeres con cáncer de mama practican menos actividad física y presentan peor calidad de vida. La práctica de caminar parece un tipo efectivo de actividad física para mujeres con cáncer de mama, mejorando la calidad de vida durante y después del período de tratamiento. Nivel de evidencia II; Estudios pronósticos - Investigación del efecto de característica de un paciente sobre el desenlace de la enfermedad.