Non-rigorous versus rigorous home confinement differently impacts mental health, quality of life and behaviors. Which one was better? A cross-sectional study with older Brazilian adults during covid-19 first wave.

BACKGROUND: The implementation of social distancing measures during covid-19 influenced health outcomes and population´s behaviors, and its rigidity was very different across countries. We aimed to verify the association between the rigidity of social distancing measures of covid-19 first wave with depression symptoms, quality of life and sleep quality in older adults. METHODS: This is a cross-sectional study including 1023 older adults (90% women; 67.68 ± 5.92 years old) of a community-based program in Fortaleza (Brazil). Dependent variables (depression symptoms, sleep quality, and quality of life) were measured through phone calls along June 2020, during the first covid-19 wave. Confinement rigidity (non-rigorous and rigorous) was considered as independent variable. Sociodemographic characteristics (sex, marital status, scholarity, and ethnicity), number of health conditions, nutritional status, movement behavior (physical activity and sitting time), technological skills, and pet ownership were considered as confounding variables. A binomial logistic regression (odds ratio [OR]) was performed to verify the association of confinement rigidity and depression symptoms, sleep quality, and quality of life, adjusted by confounding variables. RESULTS: Older adults who adopted a less rigid lockdown had a higher frequency of depression symptoms, worse perception of quality of life, and bad sleep quality (p < 0.001). Confinement rigidity was able to explain the probability of depression symptoms occurrence (OR: 2.067 [95% CI: 1.531-2.791]; p < 0.001), worse quality of life (OR: 1.488 [95% CI: 1.139-1.944]; p < 0.05), and bad sleep quality (OR: 1.839 [95% CI: 1.412-2.395]; p < 0.001). Even adjusted by confounding variables, confinement rigidity was able to explain the poor outcomes analyzed in older adults. CONCLUSION: Our findings showed that less rigid lockdown was associated with a superior frequency of depression symptoms, worse sleep quality, and lower perception of quality of life in older adults. Therefore, our study could improve comprehension regarding the impact of social distancing measures rigidity in health-related conditions and in the context of covid-19 and other similar pandemic situations.

Appendicular Skeletal Muscle Mass Prediction in People Living With HIV: A Cross-sectional Study.

ABSTRACT: People living with HIV (PWH) experience an accelerated aging process. There is no anthropometric predictive model for appendicular skeletal muscle mass (ASM) in PWH. This study develops anthropometric models to predict and validate ASM measured by dual energy x-ray absorptiometry (DXA) in PWH; DXA scans were obtained for 125 PWH (male = 74; age >18 years) on antiretroviral therapy. Fat mass ratio was used for lipodystrophy diagnosis. A multiple stepwise linear regression considered ASM DXA as the dependent variable and validated by PRESS method. A high power of determination and low standard estimate error were found for ASM DXA -predicted (adjusted r2 = 0.84 to 0.87, standard estimate error = 1.7-1.6 kg) and high PRESS validation coefficients (Q 2PRESS = 0.84-0.86, S PRESS = 1.7-1.6 kg). The variables included were lipodystrophy diagnosis, medial calf circumference, sex, and total body weight. We present novel, reliable, and validated anthropometric models to predict ASM DXA in PWH.

Anthropometric equations to estimate appendicular muscle mass from dual-energy X-ray absorptiometry (DXA): A scoping review.

BACKGROUND: Appendicular skeletal muscle mass (ASM) obtained from dual-energy x-ray absorptiometry (DXA) is recommended to quantify sarcopenia, but has limited availability in disadvantaged-income countries, moreover in an epidemiological context. Predictive equations are easier and less costly to apply, but a review of all available models is still lacking in the scientific literature. The objective of this work is to map, with a scoping review, the different proposed anthropometric equations to predict ASM measured by DXA. METHODS: Six databases were searched without restriction on publication date, idiom, and study type. A total of 2,958 studies were found, of which 39 were included. Eligibility criteria involved ASM measured by DXA, and equations proposed to predict ASM. RESULTS: predictive equations (n = 122) were gathered for 18 countries. The development phase involves sample size, coefficient of determination (r2), and a standard error of estimative (SEE) varying between 15 and 15,239 persons, 0.39 and 0.98, 0.07 and 3.38 kg, respectively. The validation phase involves a sample size, accuracy, and a SEE between 15 and 3,003 persons, 0.61 and 0.98, 0.09 and 3.65 kg, respectively. CONCLUSIONS: The different proposed predictive anthropometric equations of ASM DXA were mapped, including validated pre-existing equations, offering an easy-to-use referential article for clinical and research applications. It is necessary to propose more equations for other continents (Africa and Antarctica) and specific health-related conditions (e.g., diseases), once the equations can only have sufficient validity and accuracy to predict ASM generally when applied to the same population.

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.

Handgrip strength asymmetry cut points to identify slow gait speed in six low- and middle-income countries: A cross-sectional analysis with 12,669 older adults.

BACKGROUND: Handgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness. METHODS: A cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0-10.0% (reference group), 10.1-20.1%, 20.1-30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index "[(HGS asymmetry*HGS)/(BMI*Age)]*100" cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%). RESULTS: Compared to HGS reference group, those with HGS asymmetry of 10.1-20%, 20.1-30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men). CONCLUSIONS: HGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity.

Being Physically Active Leads to Better Recovery Prognosis for People Diagnosed with COVID-19: A Cross-Sectional Study.

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.

The role of physical activity in the clinical outcomes of people diagnosed with Covid-19: A systematic review.

Objective: This review aimed to compile the evidence on PA and clinical outcomes of people receiving a positive diagnosis of covid-19. Design: Systematic review. Methods: The search was performed in five databases: EMBASE, MEDLINE via PubMed portal, Scopus, SPORTDiscus via EBSCO platform, and Web of Science. In addition, the "gray" literature was searched through Google Scholar and medRxiv published between January 2020 and July 2022. Studies were assessed for risk of bias, with the extraction of relevant data. Our search revealed a total of 10,028 studies. Results: After applying the eligibility criteria 32 studies were included. Thirty-one studies were at low to moderate risk of bias. Physically active individuals, who were diagnosed with covid-19, presented attenuation of clinical outcomes, such as decreased risk of hospitalization, recovery time, number of symptoms, severity, and ICU and death when compared to individuals with low levels of PA or classified as sedentary. Conclusions: Physically active individuals when diagnosed with covid-19 may have decreased risk of several clinical outcomes related to covid-19, including but not limited to hospitalization and number of symptoms. Public health authorities should develop strategies and initiatives that promote safe PA environments to improve the clinical prognosis of people diagnosed with covid-19. Study registration: Open Science Framework (OSF), DOI registry 10.17605/OSF.IO/PV6NF. It can be consulted through the access link: https://doi.org/10.17605/OSF.IO/PV6NF, October 07, 2021.

Bone Mineral Content Estimation in People Living with HIV: Prediction and Validation of Sex-Specific Anthropometric Models.

People living with HIV (PWH) experience an accelerated reduction in bone mineral content (BMC), and a high risk of osteopenia and osteoporosis. Anthropometry is an accurate and low-cost method that can be used to monitor changes in body composition in PWH. To date, no studies have used anthropometry to estimate BMC in PWH. To propose and validate sex-specific anthropometric models to predict BMC in PWH. This cross-sectional study enrolled 104 PWH (64 males) aged >18 years at a local university hospital. BMC was measured using dual energy X-ray absorptiometry (DXA). Anthropometric measures were collected. We used linear regression analysis to generate the models. Cross-validations were conducted using the "leave one out", from the predicted residual error sum of squares (PRESS) method. Bland-Altman plots were used to explore distributions of errors. We proposed models with high coefficient of determination and reduced standard error of estimate for males (r2 = 0.70; SEE = 199.97 g; Q2PRESS = 0.67; SEEPRESS = 208.65 g) and females (r2 = 0.65; SEE = 220.96 g; Q2PRESS = 0.62; SEEPRESS = 221.90 g). Our anthropometric predictive models for BMC are valid, practical, and a low-cost alternative to monitoring bone health in PWH.

Association between classic and specific bioimpedance vector analysis and sarcopenia in older adults: a cross-sectional study.

BACKGROUND: To verify (1) the association between classic and specific bioelectrical impedance vector analysis (BIVA) with body composition, hydration, and physical performance in older adults with and without sarcopenia; (2) which BIVA most accurately distinguishes sarcopenia. METHODS: A sample of 94 older adults with and without sarcopenia (29 men and 65 women, 60-85 years) was evaluated. The classic and specific BIVA procedures, Dual energy X-ray absorptiometry (DXA), and deuterium dilution were performed. Sarcopenia was defined by muscle weakness and low skeletal muscle index, while severity was indicated by low physical performance. RESULTS: The BIVA's potential to monitor hydration and muscle mass loss in older adults seems feasible. Classic and specific BIVA were able to distinguish sarcopenia in women (p < 0.001), but not in men. When the sarcopenia criteria were individually analyzed, both classic and specific BIVA were able to distinguish low skeletal muscle index in women, while only classic BIVA did for men. For the criterion of slow physical performance, only the classic BIVA showed severity differences for women. The vectors of adults without sarcopenia of both sexes tended to be positioned in the left region of the ellipses, revealing a predominance of soft tissues. CONCLUSIONS: Classic BIVA has a distinct sarcopenic association with body composition, hydration, and physical performance in older adults, while specific BIVA was similar between groups. Both BIVAs are sensible to detect female morphological changes (skeletal muscle index) but not for functional (handgrip, 6-min walk test) sarcopenia criteria. These procedures are promising tools for monitoring sarcopenia risks during aging.

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

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.

The relationship between onset of blood lactate accumulation, critical velocity, and maximal lactate steady state in soccer players.

The objective of this study was to analyze the validity of the velocity corresponding to the onset of blood lactate accumulation (OBLA) and critical velocity (CV) to determine the maximal lactate steady state (MLSS) in soccer players. Twelve male soccer players (21.5 +/- 1.0 years) performed an incremental treadmill test for the determination of OBLA. The velocity corresponding to OBLA (3.5 mM of blood lactate) was determined through linear interpolation. The subjects returned to the laboratory on 7 occasions for the determination of MLSS and CV. The MLSS was determined from 5 treadmill runs of up to 30-minute duration and defined as the highest velocity at which blood lactate did not increase by more than 1 mM between minutes 10 and 30 of the constant velocity runs. The CV was determined by 2 maximal running efforts of 1,500 and 3,000 m performed on a 400-m running track. The CV was calculated as the slope of the linear regression of distance run versus time. Analysis of variance revealed no significant differences between OBLA (13.6 +/- 1.4 km.h(-1)) and MLSS (13.1 +/- 1.2 km.h(-1)) and between OBLA and CV (14.4 +/- 1.1 km.h(-1)). The CV was significantly higher than the MLSS. There was a significant correlation between MLSS and OBLA (r = 0.80), MLSS and CV (r = 0.90), and OBLA and CV (r = 0.80). We can conclude that the OBLA can be utilized in soccer players to estimate the MLSS. In this group of athletes, however, CV does not represent a sustainable steady-state exercise intensity.