Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study.

OBJECTIVE: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. METHOD: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. RESULTS: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. CONCLUSION: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

Hand hygiene knowledge among nursing professionals during a pandemic: insights from a cross-sectional study in Brazil / Conhecimento sobre higiene das mãos entre profissionais de enfermagem durante uma pandemia: insights de um estudo transversal no Brasil / Conocimiento de higiene de manos entre profesionales de enfermería durante una pandemia: perspectivas de un estudio transversal en Brasil

Background and Objectives: hand hygiene (HH) is a crucial safety practice, but lack of knowledge can hinder compliance. The objective was to measure and assess the knowledge of nursing professionals who provided care during the COVID-19 pandemic regarding HH and to verify the association between HH knowledge and professional category and regions in Brazil. Methods: an observational study was conducted from November 2020 to December 2021 involving 493 nursing professionals from all regions of Brazil. Data collection was carried out using Google Forms® and social media platforms. The Hand Hygiene Knowledge Test for Healthcare Professionals was used, and results were analyzed descriptively. Pearson's chi-square test (x2) and Fisher's exact test were employed to assess associations. Results: among the participants, the majority (74.7%) had limited or subpar knowledge of HH. Nurses had a higher level of knowledge compared to nursing assistants and licensed practical nurses. Associations were found between professional category and correct answers regarding microorganism destruction time and the type of HH to be used. Conclusion: Brazilian nursing professionals had limited knowledge of HH, with nurses displaying a higher level of knowledge compared to nursing assistants and licensed practical nurse. Continuous education and guidance are necessary to improve HH practices among the nursing staff.(AU)

Justificativas e Objetivos: a higiene das mãos (HM) é uma prática crucial para a segurança, mas a falta de conhecimento pode prejudicar a adesão. Este estudo avaliou o conhecimento dos profissionais de enfermagem que prestaram cuidados durante a pandemia de Covid-19 em relação à HM e explorou a associação entre o conhecimento de HM, categoria profissional e regiões no Brasil. Métodos: um estudo observacional foi conduzido de novembro de 2020 a dezembro de 2021 envolvendo 493 profissionais de enfermagem de todas as regiões do Brasil. A coleta de dados foi realizada usando o Google Forms® e plataformas de mídia social. Foi utilizado o Teste de Conhecimento de Higiene das Mãos para Profissionais de Saúde, e os resultados foram analisados descritivamente. O teste qui-quadrado de Pearson (x2) e o teste exato de Fisher foram empregados para avaliar as associações. Resultados: entre os participantes, a maioria (74,7%) tinha conhecimento limitado ou insuficiente sobre HM. Os enfermeiros apresentaram um nível mais elevado de conhecimento em comparação com os auxiliares e técnicos de enfermagem. Foram encontradas associações entre a categoria profissional e respostas corretas sobre o tempo de destruição de microrganismos e o tipo de HM a ser utilizado. Conclusão: os profissionais de enfermagem brasileiros possuíam conhecimento limitado sobre HM, sendo que os enfermeiros apresentaram um nível mais elevado de conhecimento em comparação com os auxiliares e técnicos de enfermagem. Educação contínua e orientação são necessárias para melhorar as práticas de HM entre a equipe de enfermagem.(AU)

Justificación e Objetivos: la higiene de manos (HM) es una práctica de seguridad crucial, pero la falta de conocimiento puede dificultar el cumplimiento. Este estudio evaluó el conocimiento de los profesionales de enfermería que brindaron atención durante la pandemia de Covid-19 en relación con la HM y exploró la asociación entre el conocimiento de HM, la categoría profesional y las regiones en Brasil. Métodos: se realizó un estudio observacional desde noviembre de 2020 hasta diciembre de 2021 que incluyó a 493 profesionales de enfermería de todas las regiones de Brasil. La recopilación de datos se realizó utilizando Google Forms® y plataformas de redes sociales. Se utilizó el Test de Conocimiento de Higiene de Manos para Profesionales de la Salud, y los resultados se analizaron de manera descriptiva. Se emplearon la prueba chi-cuadrado de Pearson (x2) y la prueba exacta de Fisher para evaluar las asociaciones. Resultados: entre los participantes, la mayoría (74,7%) tenía conocimiento limitado o deficiente de HM. Las enfermeras tenían un nivel de conocimiento más alto en comparación con los auxiliares y técnicos de enfermería. Se encontraron asociaciones entre la categoría profesional y las respuestas correctas sobre el tiempo de destrucción de microorganismos y el tipo de HM que debía utilizarse. Conclusión: los profesionales de enfermería brasileños tenían un conocimiento limitado de HM, siendo que las enfermeras mostraban un nivel de conocimiento más alto en comparación con los auxiliares y técnicos de enfermería. Se requiere educación continua y orientación para mejorar las prácticas de HM entre el equipo de enfermería(AU)

Perceptions of the nursing team during the covid-19 pandemic: cross-sectional study / Percepções da equipe de enfermagem durante a pandemia por covid-19: estudo transversal / Percepciones del equipo de enfermería durante la pandemia de covid-19: estudio transversal

Background and Objectives: to identify the perceptions of nursing professionals who worked during the covid-19 pandemic regarding Healthcare-Associated Infections (HAIs) and Hand Hygiene (HH), categorizing them by profession and region in Brazil. Method: An observational study was conducted from November 2020 to December 2021, involving 493 nursing professionals from all regions of Brazil. The Google Forms® platform, disseminated through social media was used. A questionnaire titled "Basic Questionnaire on Healthcare Professionals' Perception of Healthcare-Associated Infections and Hand Hygiene" was administered. The results were analyzed descriptively, presenting absolute and relative frequencies, divided by groups of nursing professionals (nurses, technicians, and assistants) and by regions of Brazil. Results: The results showed that 43.9% of nurses reported a significant impact of HAIs on the clinical progression of patients, whereas only 26.7% of nursing technicians and assistants shared this perception. Regarding HH, 50.8% of nurses considered a substantial effort necessary to perform it adequately, while 68.9% of nursing technicians and assistants agreed with this statement. Conclusion: most nursing professionals had a high perception of HAIs and HH, considering their profession and geographic region. These findings can contribute to the development of future strategies aimed at improving HH practices in nursing care, particularly during outbreaks of infectious diseases such as covid-19.(AU)

Justificativa e Objetivos: identificar as percepções dos profissionais de enfermagem que atuaram durante a pandemia de covid-19 em relação às Infecções Relacionadas à Assistência à Saúde (IRAS) e à Higienização das Mãos (HM), classificando-os por profissão e regiões brasileiras. Método: estudo observacional foi conduzido de novembro/2020 a dezembro/2021, com a participação de 493 profissionais de enfermagem de todas as regiões do Brasil. Utilizou-se o formulário do Google Forms®, divulgado em redes sociais. Foi aplicado um questionário intitulado "Questionário básico sobre a percepção de profissionais de saúde sobre infecções relacionadas à assistência à saúde e à higienização das mãos". Os resultados foram analisados de forma descritiva, apresentando frequências absolutas e relativas, divididos por grupos de profissionais de enfermagem (enfermeiros, técnicos e auxiliares) e por regiões do Brasil. Resultados: Os resultados mostraram que 43,9% dos enfermeiros relataram um impacto muito alto das IRAS na evolução clínica dos pacientes, enquanto apenas 26,7% dos auxiliares e técnicos de enfermagem compartilharam essa percepção. Em relação à HM, 50,8% dos enfermeiros consideraram que é necessário um grande esforço para realizá-la adequadamente, enquanto 68,9% dos auxiliares e técnicos de enfermagem concordaram com essa afirmação. Conclusão: a maioria dos profissionais de enfermagem apresentou uma alta percepção sobre HM e IRAS, levando em consideração a profissão e a região geográfica. Esses resultados podem contribuir para o desenvolvimento de estratégias futuras com o objetivo de aprimorar as práticas de HM na assistência de enfermagem, principalmente durante surtos de doenças infecciosas, como a covid-19.(AU)

Justificación y Objetivos: identificar las percepciones de los profesionales de enfermería que trabajaron durante la pandemia de COVID-19 en relación con las Infecciones Relacionadas con la Atención de la Salud (IRAS) y la Higiene de las Manos (HM), clasificándolos por profesión y región. Métodos: se llevó a cabo un estudio observacional desde noviembre/2020 hasta diciembre/2021, con la participación de 493 profesionales de enfermería de las 5 regiones de Brasil. El formulario de Google® fue difundido en redes sociales. Se aplicó un cuestionario: "Cuestionario básico sobre la percepción de los profesionales de la salud sobre infecciones relacionadas con la atención de la salud y la higiene de las manos". Los resultados se analizaron de manera descriptiva, presentando frecuencias absolutas y relativas, divididos por enfermeros, técnicos y auxiliares y por regiones. Resultados: 43,9% de los enfermeros informaron impacto muy alto de IRAS en la evolución de los pacientes, mientras que solo 26,7% de los auxiliares y técnicos compartieron esta percepción. En cuanto a la HM, 50,8% de los enfermeros consideraron que se requiere gran esfuerzo para llevarla a cabo adecuadamente, mientras que 68,9% de los auxiliares y técnicos de enfermería estuvieron de acuerdo con esta afirmación. Conclusión: la mayoría de los profesionales de enfermería tuvo una percepción alta sobre las IRAS y la HM, teniendo en cuenta la profesión y la región. Esto puede contribuir al desarrollo de estrategias para mejorar las prácticas de HM en la enfermería, especialmente durante enfermedades infecciosas como el covid-19.(AU)

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study / Qualidade do sono e quedas em adultos de meia-idade e idosos: Estudo ELSI-Brasil / Calidad del sueño y caídas en adultos de mediana edad y mayores: Estudio ELSI-Brasil

ABSTRACT Objective: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. Method: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. Results: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. Conclusion: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

RESUMO Objetivo: Verificar a associação entre baixa qualidade do sono autorrelatada (BQS) e quedas em adultos de meia-idade e idosos a cada meia década de vida. Método: Um estudo transversal foi conduzido utilizando dados da primeira onda (2015-2016) do Estudo Longitudinal Brasileiro do Envelhecimento (ELSI-Brasil), que é nacionalmente representativo. A população consistiu em 8.950 participantes que foram alocados em oito grupos etários: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 e ≥ 85 anos. Os questionários utilizados incluíram qualidade do sono autorrelatada e o Questionário Internacional de Atividade Física versão curta. O teste exato de Fisher seguido pela análise de regressão logística binária foi conduzida para identificar a razão de chances da BQS para ocorrência de queda, controlando por variáveis de confusão. Resultados: Pessoas com idades entre 50 e 105 anos (63,6 ± 10,2 anos), sendo 57,0% do sexo feminino e 43,0% do sexo masculino, participaram deste estudo. No geral, 21,5% dos participantes experimentaram pelo menos uma queda. A frequência relativa de participantes classificados como tendo BQS ou alta permaneceu constante em cada meia década de vida. A BQS exibiu uma OR (p < 0,05) notável para quedas em grupos etários até 84 anos, mesmo após o ajuste para variáveis de confusão. Conclusão: A BQS está significativamente associada a uma maior ocorrência de queda em adultos com mais de 50 anos, mas não para ≥ 85 anos, independentemente do sexo e do nível de atividade física.

RESUMEN Objetivo: Verificar la asociación entre la baja calidad del sueño autorreportada (BCS) y las caídas en adultos de mediana edad y mayores cada media década de vida. Método: Se realizó un estudio transversal utilizando datos de la primera oleada (2015-2016) del Estudio Longitudinal Brasileño sobre el Envejecimiento (ELSI-Brasil), que es representativo a nivel nacional. La muestra consistió en 8,950 participantes que fueron asignados a ocho grupos de edad: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 y ≥ 85 años. Los cuestionarios utilizados incluyeron calidad del sueño autorreportada y el Cuestionario Internacional de Actividad Física versión corta. Se realizó una prueba exacta de Fisher seguida por un análisis de regresión logística binaria para identificar la razón de probabilidades de la calidad del sueño para la ocurrencia de caídas, controlando las variables de confusión. Resultados: Participaron en este estudio individuos con edades entre 50 y 105 años (63,6 ± 10,2 años), siendo el 57,0% mujeres y el 43,0% hombres. En general, el 21,5% de los participantes experimentaron al menos una caída. La frecuencia relativa de participantes clasificados como con alta calidad de sueño o baja calidad de sueño (BCS) se mantuvo constante a lo largo de cada media década de vida. La BCS mostró un OR (p < 0,05) notable para las caídas en grupos de edad hasta los 84 años, incluso después de ajustar por variables de confusión. Conclusión: La BCS está significativamente asociada con una mayor ocurrencia de caídas en adultos mayores de 50 años, pero no para ≥ 85 años, independientemente del sexo y del nivel de actividad física.

Proceso de vestirse y desvestirse de los profesionales de enfermería durante la pandemia de covid-19: estudio transversal / Paramentação e desparamentação de profissionais de enfermagem durante a pandemia por covid-19: estudo transversal / Sequence of dressing and undressing by nursing professionals during the covid-19 pandemic: a cross-sectional study

Introducción: Durante la pandemia del covid-19 se implementaron protocolos de seguridad que contribuyeron a la protección de pacientes y profesionales de enfermería. Objetivo: Evaluar el conocimiento sobre el proceso de vestirse y desvertirse de los profesionales de enfermería que actuaron en la asistencia durante la pandemia de covid-19 y verificar la asociación entre ese conocimiento y las características sociodemográficas y de desempeño de los profesionales de enfermería. Método: Estudio transversal, realizado de noviembre de 2020 a diciembre de 2021 con profesionales de enfermería que actúan en el cuidado en las cinco regiones de Brasil. El cuestionario fue desarrollado considerando la Nota Técnica GVIMS/GGTES/ANVISA N° 04/2020. Consta de 10 preguntas, que van de 0 a 10 puntos. Se estableció el punto de corte ≥ 75 puntos y < 74 puntos para indicar conocimiento suficiente y conocimiento insuficiente, respectivamente. La recolección de datos se realizó mediante formularios de Google®, utilizando diferentes redes sociales. Resultados: De los 493 profesionales de enfermería, 157 tenían entre 30 y 39 años, 374 eran del sexo femenino y 358 trabajaban como enfermeros. En cuanto al conocimiento sobre el processo de vestirse y desvestirse, 370 tenían conocimiento suficiente y 123 conocimiento insuficiente. No hubo asociación entre el conocimiento sobre el proceso de vestirse y quitarse con características sociodemográficas y desempeño profesional. Conclusión: Los profesionales de enfermería demostraron conocimientos adecuados sobre el proceso de vestirse y desvestirse y no hubo asociación entre conocimiento y caracterización de los participantes (AU)

Introdução: Durante a pandemia por covid-19 foram implementados de protocolos de segurança que contribuiram para a proteção de pacientes e profissionais de enfermagem. Objetivo: Avaliar o conhecimento sobre a sequência da paramentação e desparamentação por profissionais de enfermagem que atuaram na assistência durante a pandemia por covid-19 e verificar a associação entre esse conhecimento e características sociodemográficas e de atuação dos profissionais de enfermagem. Método: Estudo transversal, realizado de novembro de 2020 a dezembro de 2021 com profissionais de enfermagem atuantes na assistência nas cinco regiões do Brasil. O questionário foi desenvolvido considerando a Nota Técnica GVIMS/GGTES/ANVISA Nº 04/2020. E conta com 10 questões, variando de 0 a 10 pontos. Foi estabelecido o ponto de corte ≥ 75 pontos e < 74 pontos para indicar conhecimento suficiente e conhecimento insuficiente, respectivamente. A coleta de dados foi realizada pelo Google forms®, utilizando diferentes redes sociais. Resultados: Dos 493 profissionais de enfermagem, 157 tinham idade entre 30 a 39 anos, 374 eram do sexo feminino, e 358 atuavam como enfermeiros. Em termos de conhecimento sobre a sequência de paramentação e desparamentação, 370 apresentaram conhecimento suficiente e 123 conhecimento insuficiente. Não teve associação entre o conhecimento sobre paramentação e desparamentação com as características sociodemográficas e de atuação dos profissionais. Conclusão: Os profissionais de enfermagem demonstraram conhecimento adequado sobre a paramentação e desparamentação e não houve associação entre o conhecimento e a caracterização dos participantes. (AU)

Introduction: During the covid-19 pandemic, safety protocols were implemented that contributed to the protection of patients and nursing professionals. Objective: To evaluate the knowledge about the sequence of dressing and undressing by nursing professionals who worked in assistance during the covid-19 pandemic and to verify the association between this knowledge and sociodemographic and performance characteristics of nursing professionals. Method: Cross-sectional study, carried out from November 2020 to December 2021 with nursing professionals working in care in the five regions of Brazil. The questionnaire was developed considering the Technical Note GVIMS/GGTES/ANVISA No. 04/2020. It has 10 questions, ranging from 0 to 10 points. The cutoff point ≥ 75 points and < 74 points was established to indicate sufficient knowledge and insufficient knowledge. Data collection was performed using Google forms®, using different social networks. Results: Of the 493 nursing professionals, 157 were aged between 30 and 39 years, 374 were female, and 358 worked as nurses. In terms of knowledge about the dressing and undressing sequence, 370 had sufficient knowledge and 123 had insufficient knowledge. There was no association between knowledge about dressing and undressing with sociodemographic characteristics and professional performance. Conclusion: Nursing professionals demonstrated adequate knowledge about dressing and undressing and there was no association between knowledge and characterization of the participants. (AU)

Adherence to standard precautions by nursing professionals in a public university hospital: a cross-sectional study.

INTRODUCTION: The aim of this study was to analyze the adherence to standard precautions by nursing professionals in a public university hospital, and to identify associated factors. METHODOLOGY: This was a cross-sectional study with the nursing staff of a public university hospital. The participants provided sociodemographic and immunization data, training data on standard precautions and occupational accident history, and responded to the questionnaire on adherence to standard precautions (QASP). Descriptive data analysis and Pearson's Chi-square test (χ²) were performed, followed by Fisher's exact test to verify the association between the adherence to standard precautions (total score ≥ 76 points) and the sample characterization variables. Additionally, binary logistic regression indicated the odds ratio (OR) of the sample characterization variables for adherence to standard precautions. A p value ≤ 0.05 was considered statistically significant. RESULTS: The average score for adherence to standard precautions, through QASP, by nursing professionals evaluated was 70.5 points. Association between the adherence to standard precautions and the professionals' sample characterization variables was not identified. However, it was observed that experienced professionals (≥15 years of experience in the institution) were more likely to adhere to standard precautions (OR 0.062; IC95% [0.006-0.663]; p = 0.021). CONCLUSIONS: In general, the adherence to standard precautions by nursing professionals working in health service in this study can be considered inadequate, highlighting major weaknesses in hand hygiene practices, use of personal protective equipment (PPE), recapping of used needles, and conduct after suffering occupational accidents. Experienced professionals were more likely to adhere to standard precautions.

Multicompartment body composition analysis in older adults: a cross-sectional study.

BACKGROUND: During aging, changes occur in the proportions of muscle, fat, and bone. Body composition (BC) alterations have a great impact on health, quality of life, and functional capacity. Several equations to predict BC using anthropometric measurements have been developed from a bi-compartmental (2-C) approach that determines only fat mass (FM) and fat-free mass (FFM). However, these models have several limitations, when considering constant density, progressive bone demineralization, and changes in the hydration of the FFM, as typical changes during senescence. Thus, the main purpose of this study was to propose and validate a new multi-compartmental anthropometric model to predict fat, bone, and musculature components in older adults of both sexes. METHODS: This cross-sectional study included 100 older adults of both sexes. To determine the dependent variables (fat mass [FM], bone mineral content [BMC], and appendicular lean soft tissue [ALST]) whole total and regional dual-energy X-ray absorptiometry (DXA) body scans were performed. Twenty-nine anthropometric measures and sex were appointed as independent variables. Models were developed through multivariate linear regression. Finally, the predicted residual error sum of squares (PRESS) statistic was used to measure the effectiveness of the predicted value for each dependent variable. RESULTS: An equation was developed to simultaneously predict FM, BMC, and ALST from only four variables: weight, half-arm span (HAS), triceps skinfold (TriSK), and sex. This model showed high coefficients of determination and low estimation errors (FM: R2adj: 0.83 and SEE: 3.16; BMC: R2adj: 0.61 and SEE: 0.30; ALST: R2adj: 0.85 and SEE: 1.65). CONCLUSION: The equations provide a reliable, practical, and low-cost instrument to monitor changes in body components during the aging process. The internal cross-validation method PRESS presented sufficient reliability in the model as an inexpensive alternative for clinical field use.

Instruments to assess adherence to medication in people living with HIV: a scoping review.

OBJECTIVE: To compile the instruments validated in Brazil for assessing adherence of people living with HIV to antiretroviral therapy. METHODS: Scoping review using the Web of Science, Scopus, Medline (via PubMed), Embase, BDENF, CINAHL and Lilacs databases. In addition, the Preprints bioRxiv, Google Scholar and OpenGrey servers were checked. There was no language restriction for the search, and it considered articles published from the year 1996 onwards. RESULTS: Three publications were included in the qualitative synthesis. Following were the instruments identified "Questionário para Avaliação da Adesão ao Tratamento Antirretroviral" (Questionnaire for Assessment of Adherence to Antiretroviral Treatment) developed in Porto Alegre (RS) and published in 2007; the "Escala de autoeficácia para adesão ao tratamento antirretroviral em crianças e adolescentes com HIV/Aids" (Self-efficacy Scale for Adherence to Antiretroviral Treatment in Children and Adolescents with HIV/Aids) developed in São Paulo (SP) and published in 2008; and the "WebAd-Q, um instrumento de autorrelato para monitorar a adesão à terapia antirretroviral em serviços de HIV/Aids no Brasil" (WebAd-Q, a self-report instrument to monitor adherence to antiretroviral therapy in HIV/Aids services in Brazil) developed in São Bernardo do Campo (SP) and published in 2018. The instruments were validated in Brazil, and presented statistically acceptable values for psychometric qualities. CONCLUSION: The instruments to assess adherence of people living with HIV to antiretroviral therapy are validated strategies for the Brazilian context. However, their (re)use in different settings and contexts of the nation should be expanded. The use of these instruments by health professionals can improve the understanding of factors that act negatively and positively on antiretroviral therapy adherence, and the proposition of strategies intended to consolidate good adherence and intervene in the treatment of people with low therapeutic engagement.

Physical activity and sitting time in adults after positive diagnosis for COVID-19: a cross-sectional study / Atividade física e tempo sentado em adultos após diagnóstico positivo para COVID-19: um estudo transversal

This study aimed to: a) investigate the most common signs and symptoms reported by people infect-ed by the COVID-19, b) compare total time and weekly level of physical activity of people between pre- and post-infection period, and c) examine the association between physical activity levels and signs and symptoms reported during the disease cycle. Twenty-two adult people (14 males and 8 females, mean age 37.9 ± 16.8 years) living in Ribeirão Preto, Brazil participated in this study. Par-ticipants received a positive diagnosis for COVID-19 by PCR. Physical activity and sitting time was assessed using the International Physical Activity Questionnaire. Variables such as body mass index and the clinical condition of the disease (signs and symptoms) were collected. The most frequent signs and symptoms reported by active and inactive individuals, respectively, were loss of taste (77.8% and 25%), headache (66.7% and 25%), coughing (66.7% and 25%), difficulty breathing (61.1% and 25%), and sore throat (61.1% and 75%). A 120-minute reduction (p = 0.010) in the total time of weekly physical activity and a 155-minute reduction (p = 0.003) of weekly moderate physical activity was observed in the pre- and post-diagnostic COVID-19 infection comparison. There was further an association between difficulty breathing and being physically inactive (odds ratio = 0.222; 95%CI: 0.094 ­ 0.527). Our findings suggest that COVID-19 had a negative impact on physical activity and that being physically active may reduce the likelihood of presenting with difficulty breathing if infected with the SARS-CoV-2 and associated disease COVID-19

Este estudo teve como objetivo: a) investigar os sinais e sintomas mais comuns relatados por pessoas infectadas por COVID-19, b) comparar o tempo total e o nível semanal de atividade física das pessoas no período pré e pós-infecção, c) examinar a associação entre os níveis de atividade física e os sinais e sintomas relatados du-rante o ciclo da doença. Participaram deste estudo 22 pessoas (14 do sexo masculino e oito do feminino, idade média 37,9 ± 16,8 anos) residentes na cidade de Ribeirão Preto, Brasil. Todos receberam diagnóstico positivo para COVID-19 via PCR. A atividade física e o tempo sentado foram avaliados por meio do Questionário Internacional de Atividade Física. Variáveis como índice de massa corporal e o quadro clínico da doença (sinais e sintomas), foram coletadas. Os sinais e sintomas mais frequentes foram perda do paladar (77,8% e 25%), dor de cabeça (66,7% e 25%), tosse (66,7% e 25%), dificuldade para respirar (61,1% e 25%) e dor gar-ganta (61,1% e 75%), para indivíduos ativos e inativos, respectivamente. Uma redução de 120 minutos (p = 0,010) no tempo total de atividade física semanal e de 155 minutos (p = 0,003) de atividade física moderada semanal foi observada na comparação pré e pós-diagnóstico por COVID-19. Houve associação entre dificul-dade para respirar e ser fisicamente inativo (odds ratio = 0,222; IC95%: 0,094 ­ 0,527). Nossos resultados sugerem que a COVID-19 teve impacto negativo na atividade física e que pessoas fisicamente ativas podem reduzir a probabilidade de apresentar dificuldade para respirar quando diagnosticadas por COVID-19

Influence of glucose supplementation on biofilm formation of Candida albicans and Candida glabrata isolated from diabetic and non-diabetic individuals.

OBJECTIVE: This study evaluated the effect of different glucose concentration on biofilm formation of Candida albicans and Candida glabrata strains isolated from diabetic and non-diabetic individuals. METHODS: The study was divided into two stages: (I) selection and identification of 48 C. albicans and C. glabrata strains by polymerase chain reaction followed by restriction fragment length polymorphism analysis (PCR/RFLP); (II) evaluation of biofilm formation by means of viability rates (colony-forming units), biofilm dry matter (mg) and biofilm-covered areas (µm2). Statistical comparisons were performed through nonparametric analysis of longitudinal data in factorial experiments with pairwise comparisons using Friedman Conover's test (α = 0.05). RESULTS: All the Candida spp. had their identifications confirmed by PCR/RFLP. C. albicans biofilm of strains from diabetic individuals cultivated in different glucose concentration showed higher viability rates than strains from non-diabetic individuals. No difference was observed on viability of C. glabrata biofilm. Regarding biofilm dry matter, C. albicans biofilm of strains from diabetic individuals cultivated in different glucose concentration showed lower amount in weight than strains from non-diabetic individuals. In C. glabrata strains, this result was only observed in biofilms cultivated with no glucose supplementation. With regard to biofilm-covered areas, only glucose supplementation and non-diabetic condition showed a positive effect on C. albicans biofilm development, and no condition affected C. glabrata biofilm formation. CONCLUSION: The strain type (C. albicans and C. glabrata) isolated from diabetic and non-diabetic individuals influenced on biofilm formation, but glucose supplementation did not.

Instruments to assess adherence to medication in people living with HIV: a scoping review / Instrumentos para avaliar a adesão medicamentosa em pessoas vivendo com HIV: uma revisão de escopo

ABSTRACT OBJECTIVE To compile the instruments validated in Brazil for assessing adherence of people living with HIV to antiretroviral therapy. METHODS Scoping review using the Web of Science, Scopus, Medline (via PubMed), Embase, BDENF, CINAHL and Lilacs databases. In addition, the Preprints bioRxiv, Google Scholar and OpenGrey servers were checked. There was no language restriction for the search, and it considered articles published from the year 1996 onwards. RESULTS Three publications were included in the qualitative synthesis. Following were the instruments identified "Questionário para Avaliação da Adesão ao Tratamento Antirretroviral" (Questionnaire for Assessment of Adherence to Antiretroviral Treatment) developed in Porto Alegre (RS) and published in 2007; the "Escala de autoeficácia para adesão ao tratamento antirretroviral em crianças e adolescentes com HIV/Aids" (Self-efficacy Scale for Adherence to Antiretroviral Treatment in Children and Adolescents with HIV/Aids) developed in São Paulo (SP) and published in 2008; and the "WebAd-Q, um instrumento de autorrelato para monitorar a adesão à terapia antirretroviral em serviços de HIV/Aids no Brasil" (WebAd-Q, a self-report instrument to monitor adherence to antiretroviral therapy in HIV/Aids services in Brazil) developed in São Bernardo do Campo (SP) and published in 2018. The instruments were validated in Brazil, and presented statistically acceptable values for psychometric qualities. CONCLUSION The instruments to assess adherence of people living with HIV to antiretroviral therapy are validated strategies for the Brazilian context. However, their (re)use in different settings and contexts of the nation should be expanded. The use of these instruments by health professionals can improve the understanding of factors that act negatively and positively on antiretroviral therapy adherence, and the proposition of strategies intended to consolidate good adherence and intervene in the treatment of people with low therapeutic engagement.

RESUMO OBJETIVO Compilar os instrumentos validados no Brasil para avaliação da adesão de pessoas vivendo com HIV à terapia antirretroviral. MÉTODOS Revisão de escopo, utilizando as bases de dados Web of Science, Scopus, Medline (via PubMed), Embase, BDENF, CINAHL e Lilacs. Em complementação, os servidores Preprints bioRxiv, Google Scholar e OpenGrey foram verificados. Para a busca, não houve restrição de idioma e considerou artigos publicados a partir do ano de 1996. RESULTADOS Três publicações foram incluídas na síntese qualitativa. Os instrumentos identificados foram o "Questionário para Avaliação da Adesão ao Tratamento Antirretroviral", desenvolvido em Porto Alegre (RS) e publicado em 2007; a "Escala de autoeficácia para adesão ao tratamento antirretroviral em crianças e adolescentes com HIV/Aids", desenvolvida em São Paulo (SP) e publicada em 2008; e o "WebAd-Q, um instrumento de autorrelato para monitorar a adesão à terapia antirretroviral em serviços de HIV/Aids no Brasil", desenvolvido em São Bernardo do Campo (SP) e publicado em 2018. Os instrumentos foram validados no Brasil e apresentaram valores estatisticamente aceitáveis para as qualidades psicométricas. CONCLUSÃO Os instrumentos para avaliar a adesão de pessoas vivendo com HIV à terapia antirretroviral são estratégias validadas para o contexto do Brasil. Todavia há que se expandir a (re)utilização em diferentes cenários e contextos da nação. A utilização desses instrumentos por profissionais da saúde pode melhorar a compreensão dos fatores que atuam negativa e positivamente na adesão à terapia antirretroviral, e a proposição de estratégias com o objetivo de consolidar a boa adesão e intervir no tratamento das pessoas com baixo engajamento terapêutico.

Classification of nutritional status by fat mass index: does the measurement tool matter? / Classificação do estado nutricional pelo índice de massa gorda: o instrumento de medição importa?

Abstract Assessment of the Nutritional Status (NS) allows screening for malnutrition and obesity, conditions associated with chronic non-communicable diseases. The fat mass index (FMI) stands out concerning traditional NS indicators. However, proposals that define thresholds for FMI are not sensitive to discriminate extreme cases (degrees of obesity or thinness). Only one proposal (NHANES), determined by total body densitometry (DXA), established eight categories of NS classification (FMI). However, DXA is expensive and not always clinically available. Our study aims to test the validity of the NHANES method using electrical bioimpedance (BIA) and skinfold thickness (ST) to classify NS. The FMI of 135 (69 women) university students aged 18 to 30 years old was determined using DXA, BIA, and ST. The agreement between the instruments (Bland-Altman) and the agreement coefficient in the NS classifications (Chi-square and Kappa index) were tested. The agreement test against DXA indicated that ST underestimated the FMI (-1.9 kg/m2) for both sexes and BIA in women (-2.0 kg/m2). However, BIA overestimated FMI (1.4 kg/m2) in men, although with less bias. There was no agreement between the NS classifications (NHANES) by FMI between DXA and BIA, or DXA and ST. The exception occurred between DXA and BIA in men who showed a slightly better consensus, considered "fair" (k = 0.214; p = 0.001). In conclusion, ST and BIA did not show enough agreement to replace DXA for NS classification, within NHANES thresholds. The FMI measurement tools for the NHANES classification of the categories of NS matters.

Resumo Avaliar o Estado Nutricional (EN) permite rastrear desnutrição e obesidade, condições associadas a doenças crônicas não transmissíveis. O índice de massa gorda (IMG) destaca-se em relação aos indicadores tradicionais de EN. No entanto, propostas que definem limiares para IMG não são sensíveis para discriminar casos extremos (graus de obesidade ou magreza). Apenas uma proposta (NHANES) estabeleceu oito categorias de classificação EN (IMG), mas foi determinada por densitometria corporal total (DXA). Porém, DXA é caro e nem sempre disponível. O objetivo foi testar a validade do método NHANES usando bioimpedância elétrica (BIA) e dobras cutâneas (DOCs) para classificar o EN. O IMG de 135 (69 mulheres) universitários com idade entre 18 e 30 anos foi obtido por DXA, BIA e DOCs. A concordância foi testada entre os instrumentos (Bland-Altman) e classificações de EN (Qui quadrado e índice Kappa). O teste de concordância com a DXA indicou as DOCs subestimarem o IMG (-1,9 kg/m2) para ambos os sexos e a BIA em mulheres (-2,0 kg/m2). No entanto, as BIA superestimaram o IMG (1,4 kg/m2) nos homens, embora com menos viés. Não houve concordância entre as classificações de EN (NHANES) pelo IMG entre DXA e BIA/DOCs. A exceção ocorreu entre DXA e BIA em homens que apresentaram concordância "razoável" (k = 0,214; p = 0,001). Em conclusão, DOCs e BIA não mostraram concordância suficiente para substituir DXA pela classificação de EN, dentro dos limites NHANES. As ferramentas diferem para medir IMG e classificar categorias de EN (NHANES).

Cross-validation of 20 anthropometric prediction equations for appendicular muscle mass in older Brazilian women: a cross-sectional study / Validação cruzada de 20 equações antropométricas de massa muscular apendicular para idosas brasileiras: um estudo transversal

Objective: To test the cross-validation of anthropometric prediction equations for appendicular muscle mass (AMM) in older Brazilian women. Methods: Sixty-seven older women (69.84 ± 5.95 years old) underwent anthropometric measurements. AMM (kg) reference values obtained by dual-energy X-ray absorptiometry (AMMDXA) were compared to 20 anthropometric equations for estimating AMM in older adults. A paired t-test (p > 0.05), standard error of estimate (SEE < 3.50 kg), and r2 > 0.70 confirmed the validity of the equations. The agreement between predictions and the reference was also verified (Bland-Altman analysis of agreement between methods). Results: Four American equations and one Mexican equation were not statistically different from AMMDXA (p > 0.05) but did not present suitable r2 values for validation. The American equation from the National Health and Nutrition Examination Survey (NHANES), AMM (kg) = (-0.04 × age [years]) + (0.46 × calf circumference [cm]) + (0.32 × arm circumference [cm]) + (0.11 × thigh circumference [cm]) ­ (0.27 × body mass index [BMI, kg/m2 ]) + (0.07 × waist circumference [cm]) ­ 13 119 showed the best performance (r2 = 0.64; SEE = 3.24 kg), with minimal mean difference (0.26 kg), no heteroscedasticity for extreme values, and with high agreement with the Brazilian sample (-3.90 to 3.40 kg). Conclusion: When specific equations for a given population are not available, the use of generic equations of greater sample representativeness with scientifically and reliably analyzed data is allowed.

Objetivo: Testar a validação cruzada das equações antropométricas preditivas da massa muscular apendicular (MMA) em idosas brasileiras. Metodologia: Sessenta e sete idosas (69,84 ± 5,95 anos) foram submetidas a medidas antropométricas. Os valores de referência da MMA (kg) fornecida pela absorciometria de raios X de dupla energia (MMADXA) foi comparada com 20 equações antropométricas preditivas para estimar a MMA para idosos. Teste t pareado (p > 0,05), erro padrão de estimativa (EPE) < 3,50 kg e r2 > 0,70 confirmaram a validade das equações. A concordância entre as previsões e a referência também foi verificada (análise de concordância entre métodos de Bland-Altman). Resultados: Quatro equações americanas e uma equação mexicana não foram estatisticamente diferentes da MMADXA (p > 0,05), mas nenhuma delas apresentou r2 adequado para validação. A equação americana dos dados do National Health and Nutrition Examination Survey (NHANES), MMA (kg) = (-0,04 × idade [anos]) + (0,46 × circunferência da panturrilha [cm]) + (0,32 × circunferência do braço [cm]) + (0,11 × circunferência da coxa [cm]) ­ (0,27 × índice de massa corporal-IMC [kg/m2 ]) + (0,07 × circunferência da cintura [cm]) ­ 13,12 apresentou o melhor desempenho (r2 = 0,64; EPE = 3,24 kg): com diferença média mínima (0,26 kg), sem heterocedasticidade para valores extremos e alta concordância com a amostra brasileira (-3,90 a 3,40 kg). Conclusão: Quando não existem equações específicas para uma determinada população, é permitida a utilização de equações genéricas de maior representatividade amostral, cujos dados tenham sido analisados de forma científica e confiável

Normalizing calf circumference to identify low skeletal muscle mass in older women: a cross-sectional study / Normalización de la circunferencia de la pantorrilla para identificar la masa muscular esquelética baja en las mujeres mayores: un estudio transversal

Introduction: functional limitation is a result of sarcopenia and is associated with loss of skeletal muscle mass (SMM). Cost-effective methods are important for the identification of sarcopenia. Objective: to propose cutoff points for normalized calf circumference (CC) in order to identify low SMM in older women based on their functional limitation.Methods: in this descriptive, cross-sectional study the CC values of a young female sample (n = 78) were used to establish cutoff points (-2 SD) for low SMM in older women (n = 67). Functional limitation was identified by the six-minute walk test (≤ 400 m). CC was normalized by body mass, height, and BMI. The diagnostic accuracy of CC was calculated with a ROC curve, using functional limitation as standard. Results: cutoff points and area under the curve (AUC) were: CC (≤ 28.5; 0.62); CC·body mass-1 (≤ 0.40; 0.63); CC·height-2 (≤ 8.52; 0.55) and CC·BMI-1 (≤ 1.10; 0.73). Only CC·BMI-1 achieved a desirable accuracy (AUC > 0.7) to distinguish functional limitation. Conclusion: the accuracy attained supports the use of CC·BMI-1 to identify low SMM in older women. In the clinical context it is possible to predict the risk of sarcopenia when sophisticated methods for determining SMM are not available. (AU)

Introducción: la limitación funcional es consecuencia de la sarcopenia y se asocia con la pérdida de masa muscular esquelética (MME). Los métodos rentables son importantes para la identificación de la sarcopenia. Objetivo: proponer puntos de corte para la circunferencia de la pantorrilla (CP), normalizada para identificar un MME bajo en mujeres mayores en función de su limitación funcional. Métodos: en este estudio descriptivo de carácter transversal se utilizaron los valores de CP de una muestra de mujeres jóvenes (n = 78) para establecer los puntos de corte (-2 DS) de la MME baja en las mujeres mayores (n = 67). La limitación funcional se identificó mediante la prueba de la marcha de seis minutos (≤ 400 m). La CP se normalizó por la masa corporal, la altura y el IMC. La precisión diagnóstica de la CP se calculó con la curva ROC, utilizando como estándar la limitación funcional. Resultados: los puntos de corte y el área bajo la curva (AUC) fueron: CP (≤ 28,5; 0,62); CP·masa corporal-1 (≤ 0,40; 0,63); CP·altura-2 (≤ 8,52; 0,55) y CP·IMC-1 (≤ 1,10; 0,73). Solo el CP·IMC-1 logró la precisión deseable (AUC > 0,7) para distinguir la limitación funcional. Conclusión: la precisión alcanzada respalda el uso de CP·IMC-1 para identificar la MME baja en las mujeres mayores. En el contexto clínico es posible predecir el riesgo de sarcopenia cuando no se dispone de métodos sofisticados para determinar la MME. (AU)

Normalizing calf circumference to identify low skeletal muscle mass in older women: a cross-sectional study.

INTRODUCTION: Introduction: functional limitation is a result of sarcopenia and is associated with loss of skeletal muscle mass (SMM). Cost-effective methods are important for the identification of sarcopenia. Objective: to propose cutoff points for normalized calf circumference (CC) in order to identify low SMM in older women based on their functional limitation. Methods: in this descriptive, cross-sectional study the CC values of a young female sample (n = 78) were used to establish cutoff points (-2 SD) for low SMM in older women (n = 67). Functional limitation was identified by the six-minute walk test (≤ 400 m). CC was normalized by body mass, height, and BMI. The diagnostic accuracy of CC was calculated with a ROC curve, using functional limitation as standard. Results: cutoff points and area under the curve (AUC) were: CC (≤ 28.5; 0.62); CC·body mass-1 (≤ 0.40; 0.63); CC·height-2 (≤ 8.52; 0.55) and CC·BMI-1 (≤ 1.10; 0.73). Only CC·BMI-1 achieved a desirable accuracy (AUC > 0.7) to distinguish functional limitation. Conclusion: the accuracy attained supports the use of CC·BMI-1 to identify low SMM in older women. In the clinical context it is possible to predict the risk of sarcopenia when sophisticated methods for determining SMM are not available.

INTRODUCCIÓN: Introducción: la limitación funcional es consecuencia de la sarcopenia y se asocia con la pérdida de masa muscular esquelética (MME). Los métodos rentables son importantes para la identificación de la sarcopenia. Objetivo: proponer puntos de corte para la circunferencia de la pantorrilla (CP), normalizada para identificar un MME bajo en mujeres mayores en función de su limitación funcional. Métodos: en este estudio descriptivo de carácter transversal se utilizaron los valores de CP de una muestra de mujeres jóvenes (n = 78) para establecer los puntos de corte (-2 DS) de la MME baja en las mujeres mayores (n = 67). La limitación funcional se identificó mediante la prueba de la marcha de seis minutos (≤ 400 m). La CP se normalizó por la masa corporal, la altura y el IMC. La precisión diagnóstica de la CP se calculó con la curva ROC, utilizando como estándar la limitación funcional. Resultados: los puntos de corte y el área bajo la curva (AUC) fueron: CP (≤ 28,5; 0,62); CP·masa corporal-1 (≤ 0,40; 0,63); CP·altura-2 (≤ 8,52; 0,55) y CP·IMC-1 (≤ 1,10; 0,73). Solo el CP·IMC-1 logró la precisión deseable (AUC > 0,7) para distinguir la limitación funcional. Conclusión: la precisión alcanzada respalda el uso de CP·IMC-1 para identificar la MME baja en las mujeres mayores. En el contexto clínico es posible predecir el riesgo de sarcopenia cuando no se dispone de métodos sofisticados para determinar la MME.

Population specificity affects prediction of appendicular lean tissues for diagnosed sarcopenia: a cross-sectional study / La especificidad de la población impacta en la predicción de los tejidos magros apendiculares para la sarcopenia diagnosticada: un estudio transversal

INTRODUCTION: sarcopenia is a disease characterized by reduced musculoskeletal tissue and muscle strength. The estimation of appendicular lean soft tissue by DXA (ALSTDXA) is one of the criteria for the diagnosis of sarcopenia. However, this method is expensive and not readily avaiable in clinical practice. Anthropometric equations are low-cost and able to accurate predict ALST, but such equations have not been validated for male Brazilian older adults between the ages of 60 to 79 years. To this end, this study sought to validate the existing predictive anthropometric equations for ALST, and to verify its accuracy for the diagnosis of sarcopenia in male Brazilian older adults. METHODS: this cross-sectional study recruited and enrolled 25 male older adults (69.3 ± 5.60 years). ALSTDXA and anthropometric measures were determined. ALST estimations with 13 equations were compared to ALSTDXA. The validity of the equations was established when: p > 0.05 (paired t-test); standard error of the estimate (SEE) < 3.5 kg; and coefficient of determination r² > 0.70. RESULTS: two Indian equations met the criteria (Kulkarini 1: 22.19 ± 3.41 kg; p = 0.134; r² = 0.78; EPE = 1.3 kg. Kulkarini 3: 22.14 ± 3.52 kg; p = 0.135; r² = 0.82; SEE = 1.2 kg). However, these equations presented an average bias (Bland-Altman: 0.54 and 0.48 kg) and 'false negative' classification for the ALST index. Thus, three explanatory equations were developed. The most accurate equation demonstrated a high level of agreement (r2 adj = 0.87) and validity (r²PRESS = 0.83), a low predictive error (SEEPRESS = 1.53 kg), and an adequate ALST classification. CONCLUSION: anthropometric models for predicting ALST are valid alternatives for the diagnosis and monitoring of sarcopenia in older adults; however, population specificity affects predictive validity, with risks of false positive/negative misclassification

INTRODUCCIÓN: la sarcopenia es una enfermedad caracterizada por una reducción del tejido musculoesquelético y la fuerza muscular. Uno de los criterios utilizados para su diagnóstico es la determinación de tejido blando magro apendicular por DXA (TBMADXA), método costoso que no siempre está disponible en la práctica clínica. Las ecuaciones antropométricas suponen un bajo coste y predicen bien el TBMA, pero con una validez desconocida para los varones brasileños de 60 a 79 años. Por lo tanto, nuestro objetivo fue validar las ecuaciones antropométricas existentes predictivas del TBMA y verificar su precisión para el diagnóstico de sarcopenia en varones brasileños de edad avanzada. MÉTODOS: participaron en este estudio transversal 25 hombres de edad avanzada (69,3 ± 5,60 años). Se determinaron el TBMADXA y las medidas antropométricas. Las ecuaciones predictivas del TBMA se compararon con el TBMADXA. La validez de las ecuaciones en las comparaciones se confirmó cuando: p > 0,05 (prueba de la "t" pareada); error estándar estimado (EEE) < 3,5 kg; coeficiente de determinación r² > 0,70. RESULTADOS: dos ecuaciones indias cumplieron los criterios (Kulkarini 1: 22,19 ± 3,41 kg; p = 0,134; r² = 0,78; EEE = 1,3 kg. Kulkarini 3: 22,14 ± 3,52 kg; p = 0,135; r² = 0,82; EEE = 1,2 kg). Sin embargo, presentaron sesgo promedio (Bland-Altman: 0,54 y 0,48 kg) y clasificación de 'falso negativo' para el índice de TBMA. Por lo tanto, se crearon tres ecuaciones explicativas. La ecuación más precisa mostró un alto acuerdo (r2 adj = 0,87), uma alta validez (r²PRESS = 0,83), um bajo error predictivo (EEEPRESS = 1,53 kg) y uma clasificación del TBMA adecuada. CONCLUSIÓN: los modelos antropométricos para predecir el TBMA son alternativas válidas para el diagnóstico y el seguimiento de la sarcopenia en los ancianos. Pero la especificidad de la población afecta a su validez predictiva, con riesgos de incorrección por clasificación falsa positiva/negativa

Population specificity affects prediction of appendicular lean tissues for diagnosed sarcopenia: a cross-sectional study.

INTRODUCTION: Introduction: the estimation of appendicular lean soft tissue by DXA (ALSTDXA) is one of the criteria for the diagnosis of sarcopenia. However, this method is expensive and not readily avaiable in clinical practice. Anthropometric equations are low-cost and able to accurate predict ALST, but such equations have not been validated for male Brazilian older adults between the ages of 60 to 79 years. To this end, this study sought to validate the existing predictive anthropometric equations for ALST, and to verify its accuracy for the diagnosis of sarcopenia in male Brazilian older adults. Methods: this cross-sectional study recruited and enrolled 25 male older adults (69.3 ± 5.60 years). ALSTDXA and anthropometric measures were determined. ALST estimations with 13 equations were compared to ALSTDXA. The validity of the equations was established when: p > 0.05 (paired t-test); standard error of the estimate (SEE) < 3.5 kg; and coefficient of determination r² > 0.70. Results: two Indian equations met the criteria (Kulkarini 1: 22.19 ± 3.41 kg; p = 0.134; r² = 0.78; EPE = 1.3 kg. Kulkarini 3: 22.14 ± 3.52 kg; p = 0.135; r² = 0.82; SEE = 1.2 kg). However, these equations presented an average bias (Bland-Altman: 0.54 and 0.48 kg) and 'false negative' classification for the ALST index. Thus, three explanatory equations were developed. The most accurate equation demonstrated a high level of agreement (r2adj = 0.87) and validity (r²PRESS = 0.83), a low predictive error (SEEPRESS = 1.53 kg), and an adequate ALST classification. Conclusion: anthropometric models for predicting ALST are valid alternatives for the diagnosis and monitoring of sarcopenia in older adults; however, population specificity affects predictive validity, with risks of false positive/negative misclassification.

INTRODUCCIÓN: Introducción: uno de los criterios utilizados para el diagnóstico de la sarcopenia es la determinación de tejido blando magro apendicular por DXA (TBMADXA), método costoso que no siempre está disponible en la práctica clínica. Las ecuaciones antropométricas suponen un bajo coste y predicen bien el TBMA, pero con una validez desconocida para los varones brasileños de 60 a 79 años. Por lo tanto, nuestro objetivo fue validar las ecuaciones antropométricas existentes predictivas del TBMA y verificar su precisión para el diagnóstico de sarcopenia en varones brasileños de edad avanzada. Métodos: participaron en este estudio transversal 25 hombres de edad avanzada (69,3 ± 5,60 años). Se determinaron el TBMADXA y las medidas antropométricas. Las ecuaciones predictivas del TBMA se compararon con el TBMADXA. La validez de las ecuaciones en las comparaciones se confirmó cuando: p > 0,05 (prueba de la "t" pareada); error estándar estimado (EEE) < 3,5 kg; coeficiente de determinación r² > 0,70. Resultados: dos ecuaciones indias cumplieron los criterios (Kulkarini 1: 22,19 ± 3,41 kg; p = 0,134; r² = 0,78; EEE = 1,3 kg. Kulkarini 3: 22,14 ± 3,52 kg; p = 0,135; r² = 0,82; EEE = 1,2 kg). Sin embargo, presentaron sesgo promedio (Bland-Altman: 0,54 y 0,48 kg) y clasificación de 'falso negativo' para el índice de TBMA. Por lo tanto, se crearon tres ecuaciones explicativas. La ecuación más precisa mostró un alto acuerdo (r2adj = 0,87), uma alta validez (r²PRESS = 0,83), um bajo error predictivo (EEEPRESS = 1,53 kg) y uma clasificación del TBMA adecuada. Conclusión: los modelos antropométricos para predecir el TBMA son alternativas válidas para el diagnóstico y el seguimiento de la sarcopenia en los ancianos. Pero la especificidad de la población afecta a su validez predictiva, con riesgos de incorrección por clasificación falsa positiva/negativa.

The relative age effect in Brazilian soccer: so what? / El efecto relativo de la edad en el fútbol brasileño: ¿y qué? / O efeito da idade relativa no futebol brasileiro: e daí?

OBJECTIVEː our purpose was a) to describe the Relative Age Effect occurrence in Brazilian elite youth soccer players; b) to identify the association between Relative Age Effect and technical skills and c) to examine how Relative Age Effect can affect Physical Fitness. METHOD: Eighty-one Brazilian elite soccer players from three age-group teams (U-15, U-17 and U-20) were classified by birth quartiles according to their date of birth. Relative Age Effect was determined when there was a statistically significant difference between players who were born in BQ1 (January through March) to the other birth quartiles (Chi-Square). The association between Relative Age Effect and Technical Rankings was verified by the correlation. The partial correlation controlled for date of birth and for maturity offset was also performed. Relative Age Effect on Physical Fitness was verified by the variance (ANOVA) of its components on each team's birth quartiles. RESULTS: Players born in BQ1 were the most selected in U-15 (60%) and U-17 (35%) teams, but not in U-20 (25%). A low to moderate (Rho = 0.04 to 0.53) correlation was found between birth quartiles and Technical Rankings, while date of birth and maturation (partial correlation) effects were identified in the U-15 team. Although birth quartiles do not affect Physical Fitness (ANOVA), it may favour some Physical Fitness components (p < 0.05). CONCLUSIONS: The greater risk of Relative Age Effect in younger teams is due to the greater emphasis on technical skills. When date of birth and maturation are controlled for, the association between Technical Rankings and birth quartiles is reduced. There was no evidence that Relative Age Effect affected the players' game performance

OBJETIVOː nuestro propósito fue a) describir la ocurrencia del efecto de la edad relativa en jugadores de fútbol juveniles brasileños; b) identificar la asociación entre el efecto de la edad relativa y habilidades técnicas, y c) examinar cómo el efecto de la edad relativa puede afectar la aptitud física. MÉTODO: Ochenta y un jugadores de fútbol de élite brasileños de tres grupos de edad (U-15, U-17 y U-20) fueron clasificados por cuartiles de nacimiento. El efecto de la edad relativa se determinó cuando hubo diferencia estadísticamente significativa entre los nacidos en QN1 (enero a marzo) con los otros cuartiles de nacimiento (Chi-Cuadrado). La asociación entre el efecto de la edad relativa y las clasificaciones técnicas se verificó mediante correlación. También se realizó la correlación parcial controlada por fecha de nacimiento y por madurez. El efecto de la edad relativa en aptitud física se verificó (ANOVA) en sus componentes de los cuartiles de nacimiento. RESULTADOS: Los jugadores nacidos en QN1 fueron los más seleccionados en los equipos U-15 (60%) y U-17 (35%), pero no en U-20 (25%). La correlación fue de baja a moderada (Rho = 0.04 a 0.53) entre cuartiles de nacimiento y las clasificaciones técnicas, mientras que los efectos de fecha de nacimiento o madurez (correlación parcial) se identificaron en el equipo U-15. Aunque los cuartiles de nacimiento no afectan a la aptitud física (ANOVA), puede favorecer algunos componentes de aptitud física (p <0.05). CONCLUSIONES: El mayor riesgo del efecto de la edad relativa en el equipo más joven es debido al mayor énfasis en la habilidad técnica. Cuando se controla la fecha de nacimiento así que la madurez, la asociación entre las clasificaciones técnicas y cuartiles de nacimiento baja. No hubo evidencia de que el efecto de la edad relativa afectara a la aptitud física ni el rendimiento de los jugadores

OBJETIVOː Nosso propósito foi: a) descrever a ocorrência do Efeito da Idade Relativa em equipes de base do futebol brasileiro; b) identificar a associação entre o Efeito da Idade Relativa e habilidades técnicas, e c) examinar como o Efeito da Idade Relativa pode afetar a Aptidão Física. MÉTODO: Oitenta e um jogadores da base de elite (sub-15, sub-17 e sub-20) foram classificados por Quartis de Nascimento. O Efeito da Idade Relativa foi determinado quando houve diferença (p < 0.05) entre nascidos no QN1 (janeiro a março) em relação aos demais (Chi-Quadrado). A associação entre o Efeito da Idade Relativa e o Ranqueamento Técnico foi determinada por teste de correlação (Rho). Também foi realizada a correlação parcial controlada pela data de nascimento e maturação (Maturity Offset). O efeito da Efeito da Idade Relativa na Aptidão Física foi verificado pela variação (ANOVA) de seus componentes nos Quartis de Nascimento de cada equipe. RESULTADOS: Os jogadores nascidos no QN1 foram os mais selecionados nos times Sub-15 (60%) e Sub-17 (35%), mas não no Sub-20 (25%). A correlação foi de baixa a moderada (correlação = 0.04 a 0.53) entre os Quartis de Nascimento e Ranqueamento Técnico, enquanto o maior efeito do nascimento ou maturação (correlação parcial) ocorreu para Sub-15. Embora o Quartis de Nascimento não afete a Aptidão Física (ANOVA), pode favorecer alguns componentes da a Aptidão Física (p < 0.05) em qualquer equipe. CONCLUSÕES: O maior risco de o Efeito da Idade Relativa nas equipes mais jovens é devido à maior ênfase nas habilidades técnicas. Quando a data de nascimento ou maturação é controlada a associação entre Ranqueamento Técnico e Quartis de Nascimento reduz. Não ficou evidente que o Efeito da Idade Relativa afete a Aptidão Física no desempenho do jogo desses atletas

Cut-off points of appendicular lean soft tissue for identifying sarcopenia in the older adults in Brazil: a cross-sectional study / Puntos de corte de la masa muscular apendicular esquelética para identificar la sarcopenia en los adultos mayores de Brasil: un estudio transversal

INTRODUCTION: appropriate appendicular lean soft tissue (ALST) parameters to identify sarcopenia in Brazil are scarce. The use of international references may lead to a false positive diagnosis. The objective was to propose cut-off points to identify sarcopenia in older men and women using DXA-derived ALST values from a young adult population. METHODS: this was an observational study with a cross-sectional analysis. University students of both sexes (n = 125), aged 20 to 30 years, underwent anthropometric measurements and DXA scanning to obtain their ALST (kg). Cut-off points for sarcopenia were set at -2 standard deviations (-2SDs) away from the mean ALST of a young sample. Absolute values and index (ALST/height2, ALST/weight, and ALST/body mass index [BMI]) were considered as recommended by international consensus. RESULTS: compared to women, men presented higher values of weight, height, BMI, bone mineral content, lean soft tissue, ALST, and ALST index (kg/m²). Only fat mass was higher in women, and age was not different between genders. The -2SD ALST index obtained were = 6.56 kg/m² for men and = 4.67 kg/m² for women. They were below international and national values, which tended to classify false positives. CONCLUSIONS: the -2SD ALST values proposed here are validated cut-offs for identifying low muscle in older adults and to prevent misdiagnosis with sarcopenia. In addition, they contribute to efficient monitoring and control of this disease in geriatric populations

INTRODUCCIÓN: los parámetros apropiados de masa muscular esquelética apendicular (MMEA) para identificar la sarcopenia en Brasil resultan escasos. Ello se debe al uso de referencias internacionales, lo cual puede conducir a un diagnóstico falso positivo. El objetivo del presente trabajo es proponer puntos de corte para determinar la sarcopenia en hombres y mujeres mayores empleando valores de MMEA derivados de las DXA de una población de adultos jóvenes. MÉTODOS: estudio observacional con análisis transversal. Estudiantes universitarios de ambos sexos (n = 125), de 20 a 30 años de edad, se sometieron a mediciones antropométricas y DXA para obtener el MMEA (kg). Los puntos de corte de la sarcopenia se establecieron en -2 desviaciones estándar (-2SD) de la media de MMEA de una muestra joven. Se consideraron los valores absolutos e índices (MMEA/altura2, MMAE/ peso y MMAE/índice de masa corporal [IMC]), según lo recomendado por el consenso internacional. RESULTADOS: los hombres, en comparación con las mujeres, presentaron valores superiores de peso, altura, IMC, contenido mineral óseo, masa magra, MMEA e índice MMEA (kg/m²). Por otro lado, solo la masa grasa fue mayor en las mujeres, no habiendo diferencias de edad entre ambos géneros. El índice MMAE -2SD obtenido fue = 6,56 kg/m² para los hombres y = 4,67 kg/m² para las mujeres. Dichos resultados, al encontrarse por debajo de los valores internacionales y nacionales, tienden a clasificar los falsos positivos. CONCLUSIONES: los MMAE -2SD propuestos aquí son valores de corte validados para identificar las cuantificaciones musculares bajas en los adultos mayores y para prevenir el diagnóstico erróneo de sarcopenia. Además, contribuyen a la monitorización y el control eficiente de esta enfermedad en las poblaciones geriátricas

Cut-off points of appendicular lean soft tissue for identifying sarcopenia in older adults in Brazil: a cross-sectional study.

INTRODUCTION: Introduction: appropriate appendicular lean soft tissue (ALST) parameters to identify sarcopenia in Brazil are scarce. The use of international references may lead to a false positive diagnosis. The objective was to propose cut-off points to identify sarcopenia in older men and women using DXA-derived ALST values from a young adult population. Methods: this was an observational study with a cross-sectional analysis. University students of both sexes (n = 125), aged 20 to 30 years, underwent anthropometric measurements and DXA scanning to obtain their ALST (kg). Cut-off points for sarcopenia were set at -2 standard deviations (-2SDs) away from the mean ALST of a young sample. Absolute values and indices (ALST/height2, ALST/weight, and ALST/body mass index [BMI]) were considered as recommended by international consensus. Results: compared to women, men presented higher values of weight, height, BMI, bone mineral content, lean soft tissue, ALST, and ALST index (kg/m²). Only fat mass was higher in women, and age was not different between genders. The -2SD ALST indices obtained were ≤ 6.56 kg/m² for men and ≤ 4.67 kg/m² for women. They were below international and national values, which tended to classify false positives. Conclusions: the -2SD ALST values proposed here are validated cut-offs for identifying low muscle in older adults and to prevent misdiagnosis with sarcopenia. In addition, they contribute to efficient monitoring and control of this disease in geriatric populations.

INTRODUCCIÓN: Introducción: los parámetros apropiados de masa muscular esquelética apendicular (MMEA) para identificar la sarcopenia en Brasil resultan escasos. Ello se debe al uso de referencias internacionales, lo cual puede conducir a un diagnóstico falso positivo. El objetivo del presente trabajo es proponer puntos de corte para determinar la sarcopenia en hombres y mujeres mayores empleando valores de MMEA derivados de las DXA de una población de adultos jóvenes. Métodos: estudio observacional con análisis transversal. Estudiantes universitarios de ambos sexos (n = 125), de 20 a 30 años de edad, se sometieron a mediciones antropométricas y DXA para obtener el MMEA (kg). Los puntos de corte de la sarcopenia se establecieron en -2 desviaciones estándar (-2SD) de la media de MMEA de una muestra joven. Se consideraron los valores absolutos e índices (MMEA/altura2, MMAE/peso y MMAE/índice de masa corporal [IMC]), según lo recomendado por el consenso internacional. Resultados: los hombres, en comparación con las mujeres, presentaron valores superiores de peso, altura, IMC, contenido mineral óseo, masa magra, MMEA e índice MMEA (kg/m²). Por otro lado, solo la masa grasa fue mayor en las mujeres, no habiendo diferencias de edad entre ambos géneros. El índice MMAE -2SD obtenido fue ≤ 6,56 kg/m² para los hombres y ≤ 4,67 kg/m² para las mujeres. Dichos resultados, al encontrarse por debajo de los valores internacionales y nacionales, tienden a clasificar los falsos positivos. Conclusiones: los MMAE -2SD propuestos aquí son valores de corte validados para identificar las cuantificaciones musculares bajas en los adultos mayores y para prevenir el diagnóstico erróneo de sarcopenia. Además, contribuyen a la monitorización y el control eficiente de esta enfermedad en las poblaciones geriátricas.