Craniocervical Pain, Sleep Quality, Depressive Symptoms, and Physical Activity in Healthcare Workers During COVID-19 Pandemic.

BACKGROUND: An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE. AIMS: To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil. DESIGN: Cross-sectional study. PARTICIPANTS: Healthcare workers. SETTINGS: An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report). METHODS: The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p < .05 was adopted as statistical significance. RESULTS: Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05). CONCLUSION: Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period.

Relato de experiência e resultados preliminares do estudo pro-eva: uma proposta para o manejo da caderneta de saúde da pessoa idosa / Experience report and preliminary results of the pro-eva study: a proposal for the management of the health book of the elderly person

Introdução: a Política Nacional de Saúde da Pessoa Idosa estabelece a importância da realização de estratégias voltadas para a saúde, principalmente em relação à preservação da capacidade funcional. No conjunto de iniciativas estabelecidas por essa política, encontra-se a implementação da Caderneta de Saúde da Pessoa Idosa (CSPI). Objetivo: relatar a experiência de implantação e desenvolvimento do estudo "Pro-Eva" e apresentar seus resultados preliminares quanto à aplicação da CSPI. Métodos: o estudo está sendo desenvolvido em cinco Unidades Básicas de Saúde (UBS) em Parnamirim (RN). Foi criada uma versão digital da CSPI, em formato de sistema on-line, com o intuito de inserir as informações coletadas por meio da caderneta, seguindo uma metodologia própria de preenchimento do instrumento. Os critérios de inclusão são: ter pelo menos 60 anos de idade; estar cadastrado em uma das UBS participantes do estudo; aceitar participar da avaliação do estudo em sua totalidade. Resultados: 996 pessoas idosas já participaram do processo de preenchimento da CSPI e tiveram seus dados lançados no sistema de monitoramento on-line. A média de idade da amostra foi de 70,3 (±7,1), sendo a maioria composta por mulheres (61,3%). Aproximadamente metade dos idosos eram pardos (49,5%) e estavam em uma união estável (51,2%). Conclusão: o presente artigo possui pertinência por conduzir um relato de experiência da implementação e do fortalecimento da CSPI, enquanto política de saúde, em um município do Nordeste brasileiro e por ter desenvolvido um fluxograma de preenchimento da caderneta que poderá ser base para futuros estudos nesta temática.(AU)

Introduction: National health policy for the elderly establishes the importance of carrying out strategies aimed at health, especially about preservation of functional capacity. Among the set of initiatives established by this policy there is the implementation of the Health Book of the Elderly Person. Purpose: To report the experience of implementation and development of the "Pro-Eva" study and present its preliminary results, regarding the application of the book. Methods: The study is being developed in five basic health units in Parnamirim (RN). A digital version of the health book was created, in an online system format, to insert the information collected, following a specific methodology for filling in the instrument. The inclusion criteria are: be at least 60 years old; be registered in one of the health units participating in the study; accept to participate in the evaluation of the study in its entirety. Results: 996 elderlies have already partici- pated in the process of fill the health book and had their data posted in the online monitoring system. The average age was 70.3 (± 7.1) years, with the majority being women (61.3%). Approximately half of the elderly were brown (49.5%) and were in a stable union (51.2%). Conclusion: This article is pertinent for conducting an experience report on the implementation and strengthening of the health book, in a city in the Brazilian Northeast, and for having developed a flow- chart for filling out the book that may be the basis for future studies in this thematic.(AU)

Diagnostic Accuracy of the Short Physical Performance Battery in Detecting Frailty and Prefrailty in Community-Dwelling Older Adults: Results From the PRO-EVA Study.

BACKGROUND AND PURPOSE: The Short Physical Performance Battery (SPPB) is widely used for older adults since it has a high level of validity, reliability, and responsiveness in measuring function in this population. However, only a few studies of diagnostic accuracy have assessed SPPB capacity in detecting frailty and prefrailty by estimating more detailed measurement properties. Thus, the present study aimed to evaluate the SPPB's diagnostic accuracy in detecting frailty and prefrailty, in addition to identifying cut-off points for walking time and chair stand time. METHODS: This is a cross-sectional study composed of 786 community-dwelling older adults 60 years or older, in which sociodemographic and anthropometric data, frailty phenotype, and total SPPB score, as well as walking time and chair stand time, were assessed. Analysis of a receiver operating characteristic curve was performed to identify the cut-off point, sensitivity, and specificity in the total SPPB score, as well as the walking time and chair stand time for frailty and prefrailty screening. Accuracy and positive and negative predictive values were subsequently calculated. RESULTS AND DISCUSSION: The cut-off points identified for the total SPPB score, walking time, and chair stand time were 9 points or less (accuracy of 72.6%), 5 seconds or less, and 13 seconds or less, respectively, for frailty screening and 11 points or less (accuracy of 58.7%), 4 seconds or less, and 10 seconds or less, respectively, for prefrailty screening. The walking time showed greater frailty discriminatory capacity compared with the chair stand time (effect size = 1.24 vs 0.64; sensitivity = 69% vs 59%; and specificity = 84% vs 75%). CONCLUSIONS: The total SPPB score has good diagnostic accuracy to discriminate between nonfrail and frail older adults using a cut-off point of 9 or less, being better to identify the true negatives (older adults who are not frail). Although the SPPB's diagnostic accuracy measures for detecting prefrailty were low to moderate, this instrument can help in screening prefrail older adults from the cutoff point of 11 or less in the total SPPB score. Identification of prefrail older adults enables implementing early treatment in this target audience and can prevent their advance to frailty.

Frailty biomarkers under the perspective of geroscience: A narrative review.

Cellular and molecular aging biomarkers might contribute to identify at-risk individuals for frailty before overt clinical manifestations appear. Although studies on the associations of aging biomarkers and frailty exist, no investigation has gathered this information using a structured framework for identifying aging biomarkers; as a result, the evidence on frailty and aging biomarkers is diffuse and incomplete. Therefore, this narrative review aimed to gather information on the associations of the hallmarks of aging and frailty under the perspective of geroscience. The literature on human studies on this topic is sparse and mainly composed of cross-sectional investigations performed in small study samples. The main putative aging biomarkers associated to frailty were: mitochondrial DNA copy number (genomic instability and mitochondrial dysfunction), telomere length (telomere attrition), global DNA methylation (epigenetic alterations), Hsp70 and Hsp72 (loss of proteostasis), IGF-1 and SIRT1 (deregulated nutrient-sensing), GDF-15 (mitochondrial dysfunction, cellular senescence and altered intercellular communication), CD4 + and CD8 + cell percentages (cellular senescence), circulating osteogenic progenitor (COP) cells (stem cell exhaustion), and IL-6, CRP and TNF-alpha (altered intercellular communication). IGF-1, SIRT1, GDF-15, IL-6, CRP and TNF-alpha presented more evidence among these biomarkers, highlighting the importance of inflammation and nutrient sensing on frailty. Further longitudinal studies investigating biomarkers across the hallmarks of aging would provide valuable information on this topic.

Mapping instruments for assessing and stratifying frailty among community-dwelling older people: a scoping review.

OBJECTIVE: To map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the perspective of the Brazilian context. DESIGN: Scoping review. STUDY SELECTION: The selection of studies took place between March and April 2020. Includes electronic databases: Medline, Latin American and Caribbean Literature in Health Sciences, Scopus, Web of Science and Cumulative Index of Nursing and Literature Health Alliance, in addition to searching grey literature. DATA EXTRACTION: A data extraction spreadsheet was created to collect the main information from the studies involved, from the title to the type of assessment and stratification of frailty. RESULTS: In summary, 17 frailty assessment and stratification instruments applicable to community-dwelling older people were identified. Among these, the frailty phenotype of Fried et al was the instrument most present in the studies (45.5%). The physical domain was present in all the instruments analysed, while the social, psychological and environmental domains were present in only 10 instruments. CONCLUSIONS: This review serves as a guideline for primary healthcare professionals, showing 17 instruments applicable to the context of the community-dwelling older people, pointing out advantages and disadvantages that influence the decision of the instrument to be used. Furthermore, this scoping review was a guide for further studies carried out by the same authors, which aim to compare instruments.