[Factors associated with leisure-time physical activity: analysis of Brazilians with chronic diseases]. / Fatores associados à prática de atividade física no lazer: análise dos brasileiros com doenças crônicas.

The scope of this study was to analyze the prevalence and the factors associated with sufficient leisure-time physical activity (LTPA) among Brazilians diagnosed with hypertension, diabetes and/or hypercholesterolemia. It involved a representative, cross-sectional population-based study for the entire Brazilian territory. Adults aged 20 years and over were interviewed. Prevalences were estimated and, by means of logistic regression, the crude and adjusted odds ratios (OR) of the outcome were calculated in accordance with each of the exploratory variables. The prevalence of sufficient LTPA was 15.9%, 15.3% and 21.4% among people with hypertension (n=12,228), diabetes (n=3,577) and hypercholesterolemia (n=7,124), respectively. These values were lower than those observed among adults who did not report one of the three diseases. Adjusted analysis showed that individuals with positive self-perception of health and with more schooling, who reported a public space near their homes for physical activity, the existence in the city of public programs that encourage physical activity and the recommendation of health professionals to practice LTPA, were associated with a greater chance of being sufficiently active.

O objetivo desse estudo foi analisar a prevalência e os fatores associados à prática de atividade física no lazer (PAFL) suficiente em brasileiros com diagnósticos de hipertensão arterial, diabetes e/ou hipercolesterolemia. Trata-se de um estudo transversal de base populacional com representatividade para todo o território brasileiro. Foram entrevistados adultos com 20 ou mais anos de idade. Foram estimadas prevalências e, por meio de regressão logística, calculadas as razões de chance (OR) bruta e ajustada do desfecho segundo cada uma das variáveis exploratórias. A prevalência de PAFL suficiente foi de 15,9%, 15,3% e 21,4% entre as pessoas com hipertensão arterial (n=12.228), diabetes (n=3.577) e hipercolesterolemia (n=7.124), respectivamente. Tais valores foram inferiores ao observado entre os adultos que não referiram uma das três doenças. Análise ajustada mostrou que indivíduos com autopercepção positiva da saúde, com maior escolaridade, que referiram espaço público próximo ao domicílio para a realização de atividade física, presença no município de programas públicos que estimulem a prática de atividade física e recomendação de profissional de saúde para a PAFL estiveram associados a maior chance de serem suficientemente ativos.

Fatores associados à prática de atividade física no lazer: análise dos brasileiros com doenças crônicas / Factors associated with leisure-time physical activity: analysis of Brazilians with chronic diseases

Resumo O objetivo desse estudo foi analisar a prevalência e os fatores associados à prática de atividade física no lazer (PAFL) suficiente em brasileiros com diagnósticos de hipertensão arterial, diabetes e/ou hipercolesterolemia. Trata-se de um estudo transversal de base populacional com representatividade para todo o território brasileiro. Foram entrevistados adultos com 20 ou mais anos de idade. Foram estimadas prevalências e, por meio de regressão logística, calculadas as razões de chance (OR) bruta e ajustada do desfecho segundo cada uma das variáveis exploratórias. A prevalência de PAFL suficiente foi de 15,9%, 15,3% e 21,4% entre as pessoas com hipertensão arterial (n=12.228), diabetes (n=3.577) e hipercolesterolemia (n=7.124), respectivamente. Tais valores foram inferiores ao observado entre os adultos que não referiram uma das três doenças. Análise ajustada mostrou que indivíduos com autopercepção positiva da saúde, com maior escolaridade, que referiram espaço público próximo ao domicílio para a realização de atividade física, presença no município de programas públicos que estimulem a prática de atividade física e recomendação de profissional de saúde para a PAFL estiveram associados a maior chance de serem suficientemente ativos.

Abstract The scope of this study was to analyze the prevalence and the factors associated with sufficient leisure-time physical activity (LTPA) among Brazilians diagnosed with hypertension, diabetes and/or hypercholesterolemia. It involved a representative, cross-sectional population-based study for the entire Brazilian territory. Adults aged 20 years and over were interviewed. Prevalences were estimated and, by means of logistic regression, the crude and adjusted odds ratios (OR) of the outcome were calculated in accordance with each of the exploratory variables. The prevalence of sufficient LTPA was 15.9%, 15.3% and 21.4% among people with hypertension (n=12,228), diabetes (n=3,577) and hypercholesterolemia (n=7,124), respectively. These values were lower than those observed among adults who did not report one of the three diseases. Adjusted analysis showed that individuals with positive self-perception of health and with more schooling, who reported a public space near their homes for physical activity, the existence in the city of public programs that encourage physical activity and the recommendation of health professionals to practice LTPA, were associated with a greater chance of being sufficiently active.

Recommendation and physical activity practice in Brazilians with chronic diseases.

OBJECTIVE: To analyze the prevalence and factors associated with professional recommendation and leisure-time physical activity (LTPA) in Brazilian individuals diagnosed with hypertension (HBP), diabetes, and/or hypercholesterolemia. METHODS: This is a cross-sectional population-based study with a representative sample of the Brazilian population (aged ≥20 years) in 2013, with self-reported HBP (n=11.098), diabetes (n=3.176), and/or hypercholesterolemia (n=7.252). Prevalence and gross odds ratios were estimated and adjusted for both outcomes. RESULTS: Professional recommendation and LTPA were more prevalent in individuals who received recommendation and presented with hypercholesterolemia (85.9 and 23.4%, respectively). Adjusted analysis showed an association in people 40 to 59 years of age and public programs in most diseases. Higher educational level was associated with receiving recommendations in all non-communicable diseases (NCDs). LTPA was associated in people 40 to 59 years of age for HBP and diabetes and in all investigated NCDs, higher educational level, positive perception of health, and a favorable environment in those who received recommendation. CONCLUSIONS: Education presented the greatest magnitude in the associations, clearly showing the need for equitable methods to increase recommendation and LTPA levels for the most vulnerable population. Further studies analyzing other variables and NCD are needed, corroborating the Ministry of Health.

Evaluation of the Use of Sterilized and Non-Sterilized Peruibe Black Mud in Patients with Knee Osteoarthritis.

This study aimed to evaluate the effects of treatment with Peruíbe Black Mud (PBM) on the clinical parameters and quality of life of patients with knee osteoarthritis and to compare the effects of PBM samples simply matured in seawater and PBM sterilized by gamma radiation. A controlled, double-blind trial was conducted with 41 patients divided into two treatment groups composed of 20 and 21 patients: one group was treated with matured PBM and the other with sterilized PBM. Evaluations were done using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study Short Form 36 (SF-36) questionnaires, the Kellgren and Lawrence (KL) radiographic scale, and the quantification of the serum levels of inflammatory biomarkers. An improvement in pain, physical functions, and quality of life was observed in all of the patients who underwent treatment with both simply matured and sterilized PBM. Nine patients showed remission in the KL radiographic scale, but no statistically significant differences were observed in the serum levels of inflammatory mediators before or after treatment. Peruíbe Black Mud proves to be a useful tool as an adjuvant treatment for knee osteoarthritis (OA), as shown by the results of the WOMAC and SF-36 questionnaires and by the remission of the radiographic grade of some patients on the Kellgren and Lawrence scale.

Physical Education Professionals in the Unified Health System: an analysis of the brazilian registry of health institutions between 2013 and 2017 / Inserção do Profissional de Educação Física no Sistema Único de Saúde: análise do cadastro nacional de estabelecimentos de saúde entre 2013 e 2017

The objective this study was to describe the distribution of Physical Education Professionals (PEP) registered in the Unified Health System (UHS) between 2013 and 2017 in Brazil. A descriptive study was carried out, based on data from the Brazilian Registry of Health Institutions (BRHI) and from the 2010 Demographic Census. The distribution was analyzed according to Brazilian macro-regions and states, considering the Brazilian Occupational Classification (BOC). A total of 6,797 PEP re-cords were identified, distributed in eight BOC categories, of which 89.0% were registered Physical Education Professionals in Health (PEPH).There was an increase of 140.8% in the number of PEPH in the period analyzed. The largest increase was in the Southern region of the country (229.2%). The most favorable ratio between number of inhabitants and PEPH in 2017 was in the Northeastern region (24,300 inhab/PEPH) and the least favorable one was in the Northern region (46,100 inhab/PEHS). When the same ratio is analyzed according to state, Piauí showed the most favorable figure (16,341 inhab/PEHS) and the Federal District was the least favorable one (303,944 inhab/PEHS). Although the PEP is responsible for the adequate guidance of physical activity practice, clearly beneficial to health when well oriented, the results of this study pointed to an unequal distribution in the different regions and states of Brazil, although an absolute increase was observed in the registry of professionals in the period

O objetivo deste estudo foi descrever a distribuição dos profissionais de Educação Física (PEF), registrados no Sistema Único de Saúde (SUS), entre 2013 e 2017. Realizou-se um estudo descritivo, com base nos dados do Cadastro Nacional de Estabelecimentos de Saúde (CNES) e dados do Censo Demográfico de 2010. Analisou-se a distribuição de acordo com as macrorregiões e estados brasileiros, considerando a Classificação Brasileira de Ocupações (CBO). Foram identificados 6.797 cadastros de PEF, distribuídos em oito CBO, sendo que 89,0% registrados como PEF na saúde (PEFS). Houve um aumento médio de 140,8% no número de PEFS no período analisado. O maior aumento foi na região Sul do país (229,2%). A relação de habitantes por PEFS mais favorável, em 2017, se deu na região Nordeste (24.300 hab/PEFS) e a menos favorável na região Norte (46.100 hab/PEFS). Ao analisar a mesma relação nos estados, Piauí apresentou a relação mais favorável (16.341 hab/PEFS) e o Distrito Federal a menos favorável (303.944 hab/PEFS). Mesmo sendo o PEF o responsável pela orientação adequada da prática de atividade física, e que a mesma é eviden-temente benéfica à saúde quando bem orientada, os resultados do estudo apontaram para uma distribuição desigual nas diferentes regiões e estados brasileiros, ainda que observado um aumento absoluto no cadastro de profissionais no período

Redução das desigualdades no uso de consultas médicas no Brasil: análise das regiões Nordeste e Sudeste entre 2003 e 2008 / Reduction of inequalities in medical visits in Brazil: analysis of the Northeastern and Southeastern regions between 2003 and 2008

OBJETIVO: Analisar as desigualdades socioeconômicas na utilização de consultas médicas (CM) no último ano no Brasil. MÉTODOS: Dados da Pesquisa Nacional por Amostra de Domicílios (≥ 20 anos de idade) das Regiões Nordeste (2003, n = 75.652 e 2008, n = 79.779) e Sudeste (2003, n = 76.029 e 2008, n = 79.356) foram analisados segundo CM. Compararam-se as prevalências de CM segundo as variáveis exploratórias demográficas e de saúde no primeiro (D1) e último (D10) decil de renda familiar per capita. As análises consideraram o desenho amostral complexo. RESULTADOS: A proporção de pessoas com CM aumentou no período na Região Nordeste (61,2 para 66,9%) e Sudeste (67,9 para 73,5%). A diferença absoluta de CM, segundo D1 e D10 no período, foi de 6,4 pontos percentuais (pp) no Nordeste e 4,2 pp no Sudeste. Houve importante redução das desigualdades entre os homens; naqueles sem doenças crônicas; naqueles que tinham uma percepção positiva da sua saúde e naqueles sem plano de saúde com direito a CM. A Região Sudeste ainda apresentou redução entre aqueles com apenas uma morbidade autorreferida (8 pp) e com percepção negativa da saúde (6 pp). CONCLUSÃO: Houve aumento de CM no Brasil. Observa-se ainda persistente desigualdade entre os mais pobres e os mais ricos, maior no Nordeste do que no Sudeste. Políticas para a redução da desigualdade em saúde mais eficazes e equânimes devem ser adotadas no Brasil. .

OBJECTIVE: To analyze the socioeconomic inequalities in medical visits (MV) in the past year in Brazil. METHODS: Data from adults aged ≥ 20 years old who participated in the Brazilian National Household Surveys and living in the Northeastern (2003; n = 75,652 and 2008, n = 79,779) and Southeastern (2003; n = 76,029 and 2008; n = 79,356) regions were analyzed according to MV. We compared MVs according to demographic and health variables in the first (D1) and last (D10) per capita family income deciles. All analyses considered the complex cluster design. RESULTS: The proportion of people who had MV during this period increased in the Northeastern (from 61.2 to 66.9%) and the Southeastern (from 67.9 to 73.5%) regions. The absolute difference (AD) in the use of MV, according to D1 and D10 in this period, was equal to 6.4 percentage points (pp) in the Northeastern and 4.2 pp in the Southeastern regions. Significant reduction in inequalities was observed among men without chronic diseases, in those who had a positive perception of their health, and among those without health insurance which included MV. The Southeastern region has also showed significant reduction among those with chronic disease (8 pp) and with negative health self-perception (6 pp). CONCLUSION: The increasing number of MVs was found in Brazil. However, persistent inequalities were observed between the poorest and the richest, higher in the Northeastern than in the Southeastern region. More effective and equitable policies to reduce health inequalities should be adopted in Brazil. .

Reduction of inequalities in medical visits in Brazil: analysis of the Northeastern and Southeastern regions between 2003 and 2008.

OBJECTIVE: To analyze the socioeconomic inequalities in medical visits (MV) in the past year in Brazil. METHODS: Data from adults aged ≥ 20 years old who participated in the Brazilian National Household Surveys and living in the Northeastern (2003; n = 75,652 and 2008, n = 79,779) and Southeastern (2003; n = 76,029 and 2008; n = 79,356) regions were analyzed according to MV. We compared MVs according to demographic and health variables in the first (D1) and last (D10) per capita family income deciles. All analyses considered the complex cluster design. RESULTS: The proportion of people who had MV during this period increased in the Northeastern (from 61.2 to 66.9%) and the Southeastern (from 67.9 to 73.5%) regions. The absolute difference (AD) in the use of MV, according to D1 and D10 in this period, was equal to 6.4 percentage points (pp) in the Northeastern and 4.2 pp in the Southeastern regions. Significant reduction in inequalities was observed among men without chronic diseases, in those who had a positive perception of their health, and among those without health insurance which included MV. The Southeastern region has also showed significant reduction among those with chronic disease (8 pp) and with negative health self-perception (6 pp). CONCLUSION: The increasing number of MVs was found in Brazil. However, persistent inequalities were observed between the poorest and the richest, higher in the Northeastern than in the Southeastern region. More effective and equitable policies to reduce health inequalities should be adopted in Brazil.

Distribuição dos planos de saúde dm Santa Catarina e variáveis associadas: análise da pesquisa nacional por amostra de domicílios 2003 e 2008 / Distribution of health plans in Santa Catarina and associated variable analysis of pnad 2003 and 2008

O Sistema Único de Saúde (SUS), desde que foi criado, visa garantir o acesso universal aos serviços de saúde à sociedade brasileira. Decorrente da excessiva demanda, vem havendo uma maior inteiração de outros atores, que embora já previstos no SUS, passaram a ocupar maior espaço nesta relação. A saúde suplementar no Brasil, com seus planos de saúde, apresenta-se com um importante papel neste cenário. Este artigo objetiva analisar a distribuição dos planos de saúde em Santa Catarina e suas variáveis associadas, nos períodos de 2003 e 2008. Trata-se de um estudo transversal, onde foram analisados os dados da Pesquisa Nacional por Amostra de Domicílios, realizadas nos anos de 2003 e 2008. Foi encontrada uma maior distribuição entre os homens; com mais de 20 anos de idade; mais ricos (Q5); com 12 ou mais anos de estudos; moradores da zona urbana; e que autorreferiram ter 2 ou mais doenças crônicas. Verificou-se ainda um aumento na desigualdade entre os beneficiários segundo o sexo e a renda familiar per capita e uma diminuição na desigualdade entre os beneficiários segundo a escolaridade, região de moradia e número de doenças crônicas, nos períodos analisados. Contudo, decorrente da necessidade de melhor mapear os diferentes subsistemas presentes no SUS e da falta de estudos versando sobre a realidade de Santa Catarina, sugere-se a realização de mais pesquisas sobre o tema.

The SUS, since it was created, has been trying to ensure universal access to health services to Brazilian society. Resulting from excessive demand, there is a greater interaction between the different actors, that although provided in the SUS, came to occupy more space in this relationship. The supplemental health, with their health plans, presents with an important role in this scenario. The aim of this study was investigate the distribution of health plans in Santa Catarina and its associated variables in 2003 and 2008. This is a cross-sectional study, where was analyzed the dataset from the National Survey by Household Sample, 2003 and 2008. Was found a higher prevalence of individuals with health plans entitled to medical consultation among men, among those with more than 20 years, among the richest (Q5), among those with 12 or more years studies; among those living in the urban area, and among those who self-reported having 2 or more chronic diseases. There was also an increase in inequality between the beneficiaries according to gender and per capita income and a decrease in inequality between the beneficiaries according to schooling, region of residence and number of chronic diseases in period analyzed. However, due to the need to better map the different subsystems present in SUS and the lack of studies dealing about the reality of Santa Catarina, it is suggested that further studies with the approach proposed here.