Physical Activity Levels in Leisure Time, Sociodemographic Characteristics, and Chronic Non-Communicable Diseases in Brazilian Older Adults: National Health Survey, 2019.

Health interventions for elderly people must understand the association between physical activity, sociodemographic factors, and non-communicable diseases. This study aimed to verify the association between physical activity in leisure time, sociodemographic factors, and NCDs in Brazilian older people. This is a descriptive study, with a cross-sectional design, carried out using secondary data from the 2019 National Health Survey-Brazil. It used data from 23,144 subjects aged over 60 years. Statistical analyses included descriptive and quantile regression with cutoff points 0.25, 0.50 (Median), 0.75, and 0.90 to verify the association between the variables. The statistical software R version 4.1.3 was used. Older people aged between 60 and 79 years were highlighted up to the 50th quantile. Females showed lower values in all quantiles, with emphasis from quantile 50 onwards. Subjects who self-declared as "white" showed significant differences up to quantile 50, not indicating significant values from this cutoff point. Residents of the rural area had lower values than residents of the urban area in all quantiles, with emphasis starting from the median. For cardiovascular diseases, it was found that subjects who did not report having this type of disease had better results for the amount of physical activity during leisure time, especially from the 75th quantile. It was concluded that there is a direct relationship between time spent in leisure-time performing physical activity, sociodemographic variables, and NCDs. It is necessary to review and validate cutoff points according to each category viewed, which can favor the adjustment of interventions according to each population. Actions of this nature can favor adherence by groups of older people to the weekly practice of physical activity.

Differential Factors Are Associated with Physical Activity in Older Adults in Brazil with and without Non-Communicable Chronic Diseases: A Cross-Sectional Analysis of the 2019 National Health Survey.

This study analyzed whether sociodemographic factors, health perception, dietary habits, and screen time are related to physical activity (PA) in older people with and without non-communicable chronic diseases (NCDs). This cross-sectional study analyzed data from the 2019 Brazilian National Health Survey; the sample was older adults (≥60 years old; n = 22,726). The outcome of this study was being physically active or inactive during leisure time, and NCD was used as a moderating variable. The correlates investigated were sociodemographic and health-related variables. According to the logistic regression analysis, it was observed that being male had an association only in the group with NCDs (OR = 1.25 (1.05-1.48)), as well as residing in the northeastern region (OR = 1.26 (1.04-1.53)). On the other hand, high levels of education (OR = 4.09 (2.92-5.2); OR = 1.92 (1.48-2.49)) and income (OR = 1.64 (1.09-2.48); OR = 1.86 (1.33-2.60)) were associated with PA in both groups, as well as dietary habits (OR = 1.03 (1.01-1.05); (OR = 1.05 (1.04-1.07)). Advanced age (OR = 0.96 (0.94-0.97); OR = 0.97 (0.96-0.98)) and reporting a regular health perception (OR = 0.53 (0.43-0.66); OR = 0.61 (0.52-0.73)) were factors associated with physical inactivity in both groups. Gender, education, and income were unequally associated with an active lifestyle in both groups, and therefore, barriers to PA may arise.

Effect of agility ladder training with a cognitive task (dual task) on physical and cognitive functions: a randomized study.

Introduction: Agility training (AT) is used to improve neuromuscular performance and dynamic balance, which are crucial for the physical function of older adults. Activities of daily living, which decrease with age, involve tasks that simultaneously require motor, and cognitive abilities and can be considered dual tasks. Methods: This study investigates a training program's physical and cognitive effects using an agility ladder on healthy older adults. This program consisted of 30-min sessions twice per week and lasted for 14 weeks. The physical training included four different sequences with progressive difficulty levels, while the cognitive training (CT) included different verbal fluency (VF) tasks for each physical task. Sixteen participants (mean age of 66.9 ± 5.0 years) were allocated to two groups: AT alone (AT) and dual-task training (AT combined with CT [AT + CT]). Assessments were performed before and after 14 weeks of interventions using physical functional tests (e.g., Illinois agility test, five times sit-to-stand test, timed up and go [TUG], and one-leg stand) and cognitive tests (cognitive TUG, verbal fluency, attention, and scenery picture memory test). Results: After this period, both groups had significant differences in physical performance, muscle power, agility, static and dynamic balance, and short-term memory, whereas only the AT + CT group improved phonological verbal fluency, executive function (TUG combined with a cognitive task), attention (trail-making test-B), and short-term memory (scenery picture memory test). Conclusion: Indicating that only the group that received direct cognitive training had better enhanced cognitive function. Clinical trial registration: www.ClinicalTrials.gov, identifier: RBR-7t7gnjk.

Outdoor gyms and physical function: A cross-sectional comparative study between active and sedentary older adults.

Outdoor gyms (OG) are public places designed for physical activity, especially for older adults. This is a cross-sectional study that aimed to compare morphofunctional characteristics of sedentary and active older adults regarding OG. The participants consisted of 194 older people divided into three groups: sedentary (n = 76, mean age = 70.5 ± 6.4 years, 38.7% male); OG + walking (n = 86; mean age = 69 ± 6.1 years; male 50.6%); and OG (n = 32; mean age = 70.3 ± 8.3 years; male 56.3%). Socioeconomic and morphofunctional characteristics, anthropometric measurements, body composition, and functional tests were collected. For comparison among groups ANOVA, for categorical variables the chi-square test or Fisher's exact test, and to verify factors related to gait speed logistic regression were used. We found that sedentary older adults had lower educational level and lower prevalence of polypharmacy. OG + walking participants had lower waist circumference and fat percentage, and better gait speed. Older people in the OG + walking were less likely to show gait difficulty (i.e., <1.0 m/s) in reference to the sedentary group. In addition, strength and better performance on the Timed Up and Go were also associated with gait speed >1 m/s. It is understood that the higher volume of physical activity performed by OG + walking may be one of the reasons why they obtained better indicators in health aspects. The findings, especially regarding the characterization of profiles of older adults who use OG, leads to the definition of public policies aimed at the real needs of this public.

Correlates of Physical Activity in Brazilian Older Adults: The National Health Survey 2019.

Engagement in physical activity (PA) depends on intrapersonal, interpersonal/cultural, organizational, physical environment and political factors. Considering that it is important to understand this phenomenon in different populational contexts, this study aimed to investigate the factors related to engagement in PA according to sociodemographic aspects, eating habits, self-rated health, activities of daily living, noncommunicable diseases, mental health and public policies in Brazilian older people. This study had a cross-sectional design and used data from the Brazilian National Health Survey, 2019. Sample size was composed of 22,726 participants, aged 60 years or older, of both sexes, and all the data were collected by interview/questionnaire. According to the adjusted logistic regression, males were more active than females (OR = 1.59 (95% CI 1.40-1.80)), and those living in northern and northeastern Brazil were more likely to be inactive when compared to the southeastern region. Moreover, those with a higher educational level and income (OR = 1.36 (1.06-1.73) and OR = 1.60 (1.22-2.11)); with healthy eating habits (OR = 1.05 (1.03-1.06)); with positive self-rated health (OR = 2.67 (95% CI 1.51-4.71)); with better functional autonomy (OR = 1.22 (1.17-1.27)); and who reported that there was some public place (square, park, closed street, beach) to go for a walk, exercise or practice sport close to their home were more likely to be active (OR = 1.49 (1.34-1.67)). Sociodemographic factors, healthy eating habits, positive self-rated health, higher functioning in activities of daily living and living close to places where PA is practiced were associated with regular engagement in PA (i.e., ≥150 min/week).

Acute Neuromuscular, Physiological and Performance Responses After Strength Training in Runners: A Systematic Review and Meta-Analysis.

BACKGROUND: Strength training (ST) is commonly used to improve muscle strength, power, and neuromuscular adaptations and is recommended combined with runner training. It is possible that the acute effects of the strength training session lead to deleterious effects in the subsequent running. The aim of this systematic review and meta-analysis was to verify the acute effects of ST session on the neuromuscular, physiological and performance variables of runners. METHODS: Studies evaluating running performance after resistance exercise in runners in the PubMed and Scopus databases were selected. From 6532 initial references, 19 were selected for qualitative analysis and 13 for meta-analysis. The variables of peak torque (PT), creatine kinase (CK), delayed-onset muscle soreness (DOMS), rating of perceived exertion (RPE), countermovement jump (CMJ), ventilation (VE), oxygen consumption (VO2), lactate (La) and heart rate (HR) were evaluated. RESULTS: The methodological quality of the included studies was considered reasonable; the meta-analysis indicated that the variables PT (p = 0.003), DOMS (p < 0.0001), CK (p < 0.0001), RPE (p < 0.0001) had a deleterious effect for the experimental group; for CMJ, VE, VO2, La, FC there was no difference. By qualitative synthesis, running performance showed a reduction in speed for the experimental group in two studies and in all that assessed time to exhaustion. CONCLUSION: The evidence indicated that acute strength training was associated with a decrease in PT, increases in DOMS, CK, RPE and had a low impact on the acute responses of CMJ, VE, VO2, La, HR and submaximal running sessions.

Uric Acid and Cortisol Levels in Plasma Correlate with Pre-Competition Anxiety in Novice Athletes of Combat Sports.

Pre-competition anxiety is very prevalent in novice athletes, causing stress and drastic decreases in their performances. Cortisol plays a central role in the psychosomatic responses to stress and also in the physiology of strenuous exercise. Growing evidence links uric acid, an endogenous antioxidant, with oxidative stress and anxiety, as observed in many depressive-related disorders. We here compared anxiety inventory scores (BAI and CSAI-2), cortisol and biomarkers of oxidative stress in the plasma of novice combat athletes (white and blue belts) before and after their first official national competition, when levels of stress are presumably high. Although the novice fighters did not reveal high indexes of anxiety on questionnaires, significant correlations were confirmed between cortisol and cognitive anxiety (Pearson's r = 0.766, p-value = 0.002, and a 'strong' Bayesian inference; BF10 = 22.17) and between pre-post changes of plasmatic uric acid and somatic anxiety (r = 0.804, p < 0.001, and 'very strong' inference; BF10 = 46.52). To our knowledge, this is the first study to report such strong correlations between uric acid and pre-competition anxiety in novice combat athletes. The cause-consequence association between these indexes cannot be directly inferred here, although the interplay between uric acid and anxiety deserves further investigation.

COVID-19 infection rate and time spent at home: analysis of the beginning of the pandemic / Taxa de infecção por COVID-19 e tempo gasto em casa: análise do começo da pandemia / Tasa de infección por COVID-19 y tiempo en casa: análisis del inicio de la pandemia

Background and Objectives: Evidence suggests that the failure of epidemiological control impedes the resumption of socioeconomic activities. Therefore, this study aimed to describe epidemiological aspects and the pattern of mobility on each continent and to verify the association between the COVID-19 infection rate and time spent at home. Methods: We analyzed reports from Global Positioning System of 97 countries and their epidemiological indicators until May 27, 2020. Results: Cases of COVID-19 ranged from 22 to 1,745,803, and deaths ranged from 0 to 102,107. The highest rates per 100,000 population were observed in Europe and America. Approximately 54% of COVID-19 cases occurred in America and 51% of deaths in Europe. Countries reduced mobility in retail and recreation (-43.45%±20.42%), grocery and pharmacy (-17.95%±20.82%), parks (-18.77%±37.34%), transit stations (-43.09%±20.31%), workplaces (-21.74%±19.92%), and increased time spent at home (13.00%±8.80%). Linear regression showed that European inhabitants stayed at home less when compared those on the American continent (ß=-4.933, SE=0.976, p<.001). In addition, every unit increase in the infection rate per 100,000 population increased 0.005 points in the mean time spent at home (ß=0.005, SE=0.001, p<.001). Conclusions: We provide evidence that increased infection rate of COVID-19 is associated with increased length of stay at home. As a main lesson, COVID-19 showed that in the absence of pharmacological resources, government authorities need to act quickly to contain the spread of infectious diseases.(AU)

Justificativa e objetivos: Evidências sugerem que as dificuldades no controle epidemiológico impedem a retomada das atividades socioeconômicas. Diante disso, tivemos os objetivos de descrever aspectos epidemiológicos e o padrão de mobilidade em cada continente e verificar a associação entre a taxa de infecção por COVID-19 e o tempo de permanência em casa. Métodos: Analisamos relatórios de Global Positioning System de 97 países e seus indicadores epidemiológicos até 27 de maio de 2020. Resultados: Casos de COVID-19 variaram de 22 a 1.745.803, e as mortes variaram de 0 a 102.107. Maiores taxas por 100.000 habitantes foram observadas na Europa e América. Aproximadamente 54% dos casos de COVID-19 ocorreram na América e 51% dos óbitos na Europa. Os países reduziram a mobilidade no varejo e recreação (-43,45% ± 20,42%), mercearia e farmácia (-17,95%±20,82%), parques (-18,77%±37,34%), estações de trânsito (-43,09%±20,31%), locais de trabalho (-21,74%±19,92%), e aumentaram o tempo em casa (13,00% ± 8,80%). A regressão linear mostrou que os habitantes europeus ficaram menos tempo em casa do que os habitantes do continente americano (ß=-4,933, EP=0,976, p<0,001). Além disso, cada unidade de aumento na taxa de infecção por 100.000 habitantes aumentou 0,005 pontos no tempo médio de permanência em casa (ß=0,005, EP=0,001, p<0,001). Conclusões: Fornecemos evidências de que o aumento da taxa de infecção por COVID-19 está associado ao aumento do tempo de permanência em casa. Como lição principal, a COVID-19 mostrou que, na ausência de recursos farmacológicos, as autoridades governamentais precisam agir rapidamente para conter a propagação de doenças infecciosas.(AU)

Justificación y Objetivos: Dificultades en el control epidemiológico dificultan la reactivación de actividades socioeconómicas. Nuestros objetivos fueron describir aspectos epidemiológicos y el patrón de movilidad en cada continente y verificar la asociación entre tasa de infección por COVID-19 y duración de estancia en casa. Métodos: Examinamos informes del Global Positioning System de 97 países y sus indicadores epidemiológicos hasta 27 de mayo de 2020. Resultados: Casos de COVID-19 oscilaron entre 22 y 1.745.803, y muertes entre 0 y 102.107. Tasas más altas por 100.000 habitantes ocurrieron en Europa y América. Aproximadamente 54% de los casos de COVID-19 ocurrieron en América y 51% de las muertes en Europa. Los países redujeron la movilidad en comercio y recreación (-43,45%±20,42%), tienda de comestibles y farmacia (-17,95%±20,82%), parques (-18,77%±37,34%), estaciones de tránsito (-43,09%±20,31%), lugares de trabajo (-21,74%±19,92%), y aumentaron la duración de la estancia en casa (13,00%±8,80%). La regresión lineal (R²=0,906) mostró que los europeos permanecían menos tiempo en casa en comparación con los del continente americano (ß=-4,933, EE=0,976, p<0,001). Además, cada unidad de aumento de la tasa de infección por 100.000 habitantes aumentó la duración media de la estancia en casa en 0,005 puntos (ß=0,005, EE=0,001, p<0,001). Conclusiones: Mostramos que el aumento de la tasa de infección de COVID-19 se asocia con una mayor duración de la estancia en casa. Como lección clave, COVID-19 demostró que, en ausencia de recursos farmacológicos, las autoridades gubernamentales deben actuar rápidamente para contener la propagación de enfermedades infecciosas.(AU)

Molecular phylogeny and systematics of bald uakaris, genus Cacajao (Primates: Pitheciidae), with the description of a new species.

Bald uakaris, genus Cacajao, are Amazonian primates currently classified as one species and four subspecies based on the patterns of pelage coloration. In this study, we test if their current taxonomy is represented by the phylogenetic relationship of the main lineages retrieved from molecular data. We included, for the first time, all bald uakari taxa in a mitochondrial (cytochrome b) and genome-wide (ddRAD) phylogenetic analyses. We also examined the pattern of pelage colouration in specimens from zoological collections. Having determined the number of lineages using Maximum Likelihood and the species tree using coalescent analyses, we test their divergence time using a Bayesian approach. While the cytochrome b analysis only recovered two clades, the ddRAD analysis supported the reciprocal monophyly of five lineages of bald uakaris, with all clades including only individuals with distinct and exclusive diagnostic phenotypic characters. We found that species diversification in Cacajao occurred during the last 300 Kya and may have been influenced by the formation of rivers and flooded forests in western Amazonia. We propose that the four bald uakari subspecies currently recognised can be upgraded to species level and we describe the white uakaris from the basin of the Rio Tarauacá as a new species.

How were we before? An analysis of the potential supply and inequality in the geographic access to critical resources for the COVID-19 treatment. / Como estávamos antes? Uma análise da oferta potencial e desigualdade de acesso geográfico aos recursos críticos para tratamento de COVID-19.

The objective was to analyze the situation of the Metropolitan Area of Brasília (AMB) before the onset of the COVID-19 pandemic, focusing on the availability and geographical accessibility of critical resources for the treatment of acute respiratory crises caused by the SARS-CoV-2 virus. Geographic mapping of the population within the territory and geolocation of health facilities and resources, construction of a relationship network between the potential demand simulated to the public health system and the supply of resources available in December 2019. The relationship analysis is based on the theory of complex networks crossing socioeconomic data available in the CENSUS and information from the National Registry of Health Establishments (CNES) and analyzing the micro relationship of census tracts with the stock and availability of health resources concerning Adult ICU Bed Type II/III and Respirators/Ventilators. The Federal District (DF) health facilities concentrate more than 75% of the relationships of potential access to critical resources for the treatment of COVID-19. Although the regions surrounding the DF, belonging to Goiás state, have the greatest relative vulnerability in the studied territory, they are also the most lacking in spatial accessibility and availability of resources, evidencing a care imbalance within the AMB region.

O objetivo deste artigo é analisar a situação da Área Metropolitana de Brasília (AMB) antes do início da pandemia de COVID-19 com foco na disponibilidade e acessibilidade de recursos críticos para o tratamento da crise aguda respiratória causada pelo vírus SARS-CoV-2. Mapeamento geográfico da população e geolocalização dos estabelecimentos e recursos de saúde, construção de rede de relacionamentos entre a demanda potencial ao sistema de saúde público e a oferta de recursos existente em dez/2019. Análise baseada na teoria de redes complexas cruzando dados socioeconômicos disponíveis no CENSO, dados do Cadastro Nacional de Estabelecimentos de Saúde (CNES) e o micro relacionamento dos setores censitários e suas populações com o estoque e disponibilidade de recursos do tipo Leito de UTI Adulto Tipo II/III e Respiradores Mecânicos. Estabelecimentos do Distrito Federal (DF) concentram mais de 75% dos relacionamentos de acesso potencial aos recursos críticos para o tratamento de COVID-19. Embora as regiões do entorno do DF, pertencentes ao Goiás, apresentem a maior vulnerabilidade relativa no território estudado, são também as mais carentes de acessibilidade e disponibilidade de recursos, evidenciando um desequilíbrio assistencial dentro da região da AMB.

Como estávamos antes? Uma análise da oferta potencial e desigualdade de acesso geográfico aos recursos críticos para tratamento de COVID-19 / How were we before? An analysis of the potential supply and inequality in the geographic access to critical resources for the COVID-19 treatment

Resumo O objetivo deste artigo é analisar a situação da Área Metropolitana de Brasília (AMB) antes do início da pandemia de COVID-19 com foco na disponibilidade e acessibilidade de recursos críticos para o tratamento da crise aguda respiratória causada pelo vírus SARS-CoV-2. Mapeamento geográfico da população e geolocalização dos estabelecimentos e recursos de saúde, construção de rede de relacionamentos entre a demanda potencial ao sistema de saúde público e a oferta de recursos existente em dez/2019. Análise baseada na teoria de redes complexas cruzando dados socioeconômicos disponíveis no CENSO, dados do Cadastro Nacional de Estabelecimentos de Saúde (CNES) e o micro relacionamento dos setores censitários e suas populações com o estoque e disponibilidade de recursos do tipo Leito de UTI Adulto Tipo II/III e Respiradores Mecânicos. Estabelecimentos do Distrito Federal (DF) concentram mais de 75% dos relacionamentos de acesso potencial aos recursos críticos para o tratamento de COVID-19. Embora as regiões do entorno do DF, pertencentes ao Goiás, apresentem a maior vulnerabilidade relativa no território estudado, são também as mais carentes de acessibilidade e disponibilidade de recursos, evidenciando um desequilíbrio assistencial dentro da região da AMB.

Abstract The objective was to analyze the situation of the Metropolitan Area of Brasília (AMB) before the onset of the COVID-19 pandemic, focusing on the availability and geographical accessibility of critical resources for the treatment of acute respiratory crises caused by the SARS-CoV-2 virus. Geographic mapping of the population within the territory and geolocation of health facilities and resources, construction of a relationship network between the potential demand simulated to the public health system and the supply of resources available in December 2019. The relationship analysis is based on the theory of complex networks crossing socioeconomic data available in the CENSUS and information from the National Registry of Health Establishments (CNES) and analyzing the micro relationship of census tracts with the stock and availability of health resources concerning Adult ICU Bed Type II/III and Respirators/Ventilators. The Federal District (DF) health facilities concentrate more than 75% of the relationships of potential access to critical resources for the treatment of COVID-19. Although the regions surrounding the DF, belonging to Goiás state, have the greatest relative vulnerability in the studied territory, they are also the most lacking in spatial accessibility and availability of resources, evidencing a care imbalance within the AMB region.

Occurrence of potential wild hosts of Echinococcus vogeli in the forests of southwestern Brazilian Amazonia / Ocorrência de potenciais hospedeiros silvestres de Echinococcus vogeli nas florestas do sudoeste da Amazônia brasileira

Abstract The helminth Echinococcus vogeliRausch & Bernstein, 1972 is a causative agent of Neotropical Echinococcosis, a chronic zoonotic disease which is endemic to the Neotropical region. This parasite is transmitted from bush dogs (Speothos venaticus) to their prey, which include lowland pacas (Cuniculus paca) and agoutis (Dasyprocta spp.). In Brazil, most human cases of Neotropical Echinococcosis have been recorded in the Amazonian states of Acre and Pará, although few data are available on the occurrence of the potential definitive or intermediate hosts of E. vogeli in the Amazon region. In the present study, we surveyed the forests surrounding 46 human communities located within and around of outside six sustainable-use protected areas in the southwestern Amazon basin of Brazil. The forests were surveyed using camera traps to determine the local presence of potential wild hosts of E. vogeli, and the exploitation of these hosts for game meat was evaluated through interviews with 136 subsistence hunters resident in the local communities. We recorded pacas, agoutis, and bush dogs, as well as domestic dogs (Canis familiaris), all potential reservoirs of Neotropical Echinococcosis, using the same habitats. We also confirmed the frequent consumption of paca and agouti meat by subsistence hunters and their families in the study communities. Our data contribute to the understanding of the occurrence of E. vogeli in Brazilian ecosystems.

Resumo O helminto Echinococcus vogeliRausch & Bernstein, 1972 é o agente causador da Equinococose Neotropical, uma doença zoonótica crônica e endêmica da região Neotropical. Este parasito é transmitido entre o cachorro-vinagre (Speothos venaticus) e suas presas, como pacas (Cuniculus paca) e cutias (Dasyprocta spp.). No Brasil, a maioria dos casos humanos de Equinococose Neotropical é registrada nos estados do Acre e Pará, embora existam poucos dados disponíveis sobre a ocorrência de potenciais hospedeiros definitivos e intermediários de E. vogeli na Amazônia. No presente estudo, foram investigadas áreas de floresta ao redor de 46 comunidades humanas localizadas no interior e entorno de seis unidades de conservação de uso sustentável no sudoeste da bacia amazônica brasileira e, por meio de armadilhas fotográficas, foram avaliadas as presenças de potenciais hospedeiros silvestres de E. vogeli. Adicionalmente, foram avaliados o padrão de consumo da carne dos hospedeiros silvestres por meio de entrevistas com 136 moradores dessas comunidades. Foram registradas pacas, cutias e cachorros-vinagre, bem como cães domésticos (Canis familiaris) utilizando os mesmos habitats, todos potenciais reservatórios da Equinococose Neotropical. Além disto, confirmamos a alto consumo de paca e cutia nas comunidades. Os dados do presente trabalho contribuem para pesquisas em andamento sobre a presença dos potenciais reservatórios de E. vogeli em ambientes brasileiros.

[Theoretical-methodological model based on Complex Network Theory for the analysis of the potential provision of health services]. / Modelo teórico-metodológico baseado na Teoria de Redes Complexas para análise da oferta potencial dos serviços de saúde.

The scope of this article is to present a theoretical-methodological model as the basis for the analysis of the potential provision of Brazilian public health services (SUS) using an approach based on complex network theory. The model sought to analyze the potential provision of health services through the relationship of Euclidean distance between census sectors and services offered by health facilities, as defined in the National Register of Health Establishments (CNES). Two types of metrics are proposed for the analysis of the relationship network: the average distance of health services to the census sectors and the importance of the health unit in the potential provision of each type of service based on the centrality and availability of this service. To demonstrate the application of the model, a network was built based in the Metropolitan Area of Brasilia, including the Federal District and 12 surrounding municipalities. The model was able to map and analyze CNES data with census sectors defined in the CENSUS, opening up the possibility of constructing new perspectives of analysis in the understanding of the potential distribution of health resources and services according to socioeconomic variables, as well as an important evidence-based management tool.

O objetivo deste artigo é apresentar um modelo teórico-metodológico como base para a análise da oferta potencial de serviços de saúde pública brasileira a partir de uma abordagem baseada na teoria de redes complexas. O modelo analisou a oferta potencial de serviços de saúde através da relação da distância euclidiana entre setores censitários e serviços/classificadores oferecidos pelos estabelecimentos de saúde, conforme definidos no Cadastro Nacional de Estabelecimentos de Saúde (CNES). São propostos dois tipos de métrica para análise dos relacionamentos: a distância média dos serviços de saúde para com os setores censitários e a importância da unidade de saúde na oferta potencial de cada tipo de serviço com base na centralidade e na disponibilidade deste serviço. Para demonstrar a aplicação do modelo foi construída uma rede com base na Área Metropolitana de Brasília, incluindo o Distrito Federal e 12 municípios do entorno. O modelo demostrou-se capaz de mapear e analisar os dados do CNES com os setores censitários definidos no Censo, abrindo a possibilidade de construção de novas óticas de análise na compreensão da distribuição potencial de recursos e serviços em função de variáveis socioeconômicas, bem como, uma importante ferramenta de gestão informada por evidências.

Comparison of exergames versus conventional exercises on the cognitive skills of older adults: a systematic review with meta-analysis.

PURPOSE: To compare the effects of exergames versus conventional physical training on the cognitive skills of older adults. MATERIALS AND METHODS: Scientific studies published in PubMed, Web of Science, and Cochrane Library databases were searched. Individual studies were assessed using the Cochrane Risk-of-bias tool for randomized trials (RoB 2). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE Pro). The cognitive outcomes were Trail Making Test (TMT)-A, TMT-B, Stroop Word-Color test, Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). RESULTS: We identified 256 studies, in which 13 studies were included in the systematic review and 11 in the meta-analysis. The majority of the exergame interventions were based on the Xbox 360's Kinect, followed by the Impact Dance Platform, Nintendo Wii, and the Bike Labyrinth. We observed heterogeneity in the conventional exercise group and in the duration of training, which ranged from 12 to 52 sessions. There was no statistically significant difference between groups in TMT-A (p=0.083), TMT-B (p=0.122), and Stroop (p=0.191). There were differences in favor of exergames in MMSE (raw mean difference=-1.58, 95% CI: -2.87 to -0.28, p<0.001) and MoCA (raw mean difference=-1.22, 95% CI: -2.24 to -0.20, p=0.019). CONCLUSIONS: Despite statistical differences in MMSE and MoCA, these results should be interpreted with caution due to methodological heterogeneity. Some studies reported possible neurophysiological benefits induced by exergames, which should be explored in future investigations.

How may the reduction of some cardiovascular diseases affect Brazilian population's life expectancy? / Como a redução de algumas doenças cardiovasculares pode afetar a expectativa de vida da população brasileira? / ¿Cómo puede afectar la reducción de algunas enfermedades cardiovasculares la esperanza de vida de la población brasileña?

This study aimed to analyze the impact of cardiovascular diseases (CVDs) on life expectancy (LE) in the Brazilian population; and to identify how the hypothetical reduction in mortality from 5 to 30%, as well as the hypothetical scenario with no deaths (i.e., elimination) of these diseases would affect LE. This is a simulation study using national cross-sectional data. To identify the impact of CVDs on LE, we used multiple decrement life table models, considering hypothetical CVDs reductions in mortality from 5 to 30% and their elimination. The estimated overall potential gains in LE [years (%)] from the elimination of ischemic disease, hypertensive disease, and cerebrovascular disease were 1.44y (2%) and 1.31y (1.7%), 0.51y (0.7%) and 0.75y (1%), and 1.28y (1.8%) and 1.62y (2.1%), for males and females, respectively. The largest gains in LE were observed among those who live in Brazil's Northeast region. For the overall population, the estimated gains in LE linked to a 5% reduction in CVD mortality for males and females were 0.07y (0.1%) and 0.06y (0.08%) for ischemic disease, 0.02y (0.03%) and 0.04y (0.05%) for hypertensive disease, and 0.06y (0.08%) and 0.07y (0.09%) for cerebrovascular disease. A hypothetical decrease of 30% in mortality by CVDs would lead to gains in LE, for males and females, of 0.41y (0.6%) and 0.37y (0.5%) for ischemic disease, 0.15y (0.2%) and 0.22y (0.3%) for hypertensive disease, and 0.36y (0.5%) and 0.45y (0.6%) for cerebrovascular disease. Thus, investment towards improving CVDs, including CVD prevention efforts, would increase LE in Brazil, especially in less developed regions.

O presente estudo objetiva analisar o impacto das doenças cardiovasculares (DCV) na expectativa de vida (EV) da população brasileira e identificar como a EV seria afetada pela redução hipotética de 5% a 30% e pela eliminação da mortalidade por essas doenças. Trata-se de um estudo de simulação que utiliza dados transversais a nível nacional. A análise foi realizada por meio do modelo de tábuas de vida de múltiplo decremento, considerando reduções na mortalidade por DCV de 5% a 30%, assim como a sua eliminação. Os ganhos potenciais estimados na EV, em anos e porcentagem, por meio da eliminação das doenças isquêmica, hipertensiva e cerebrovascular foram de, respectivamente, para homens e mulheres, 1,44 (2%) e 1,31 (1,7%), 0,51 (0,7%) e 0,75 (1%), 1,28 (1,8%) e 1,62 (2,1%). Os maiores ganhos ocorrem entre os residentes na região Nordeste. Além disso, para a população em geral, os ganhos estimados em EV a partir de uma redução de 5% na mortalidade por DCV, em homens e mulheres, foram de 0,07 (0,1%) e 0,06 (0,08%), para doença isquêmica, 0,02 (0,03%) e 0,04 (0,05%), para doença hipertensiva, e 0,06 (0,08%) e 0,07 (0,09%), para doença cerebrovascular. Já uma redução hipotética de 30% na mortalidade por DCV foi acompanhada de ganhos na EV, para homens e mulheres, de 0,41 (0,6%) e 0,37 (0,5%), para doença isquêmica, 0,15 (0,2%) e 0,22 (0,3%), para doença hipertensiva, e 0,36 (0,5%) e 0,45 (0,6%), para doença cerebrovascular. Assim, mais investimentos e esforços orientados para a prevenção de DCV aumentariam a EV no Brasil, principalmente nas regiões menos desenvolvidas.

Los objetivos de este estudio fueron analizar el impacto de las enfermedades cardiovasculares (ECV) en la esperanza de vida (EV) de la población brasileña e identificar cuánto afectarían a la EV una hipotética reducción del 5 al 30% o la eliminación de la mortalidad por estas enfermedades. Este es un estudio de simulación que utiliza datos transversales nacionales. El análisis de datos se hizo utilizando modelos de tablas de vida de múltiples decrementos, considerando reducciones en la mortalidad por ECV del 5% al 30% así como su eliminación. Las ganancias potenciales estimadas para la EV [años (%)] vinculadas a la eliminación de la enfermedad isquémica, enfermedad hipertensiva, y la enfermedad cerebrovascular fueron 1,44 (2%) y 1,31 (1,7%), 0,51 (0,7%) y 0,75 (1%), y 1,28 (1,8%) y 1,62 (2,1%), para varones y mujeres, respectivamente. Las mayores ganancias en la EV fueron observadas en la población de la región noreste de Brasil. Las ganancias estimadas en EV ligadas a una reducción del 5% en la mortalidad por ECV en hombres y mujeres fueron 0,07 (0,1%) y 0,06 (0,08%) para enfermedad isquémica, 0,02 (0,03%) y 0,04 (0,05%) para enfermedad hipertensiva, y 0,06 (0,08%) y 0,07 (0,09%) para enfermedad cerebrovascular. Una disminución hipotética del 30% en la mortalidad por ECV se acompañaría de ganancias en EV, para hombres y mujeres, de 0,41 (0,6%) y 0,37 (0,5%) para enfermedad isquémica, 0,15 (0,2%) y 0,22 (0,3%) para enfermedad hipertensiva, y 0,36 (0,5%) y 0,45 (0,6%) para enfermedad cerebrovascular. Esfuerzos orientados a la prevención de las ECV aumentarían la EV en Brasil, especialmente en las regiones menos desarrolladas.

Structure for the practice of physical activities in Brazilian schools, Human Development Index and Basic Education Development Index: contributions to the Report Card Brazil / Estrutura para a prática de atividades físicas nas escolas brasileiras, Índice de Desenvolvimento Humano e Índice de Desenvolvimento da Educação Básica: contribuições para o Report Card Brasil

ABSTRACT The purpose of this study was to identify structures for the practice of physical activities (PA) in Brazilian Schools and relate them to the Human Development Index (HDI), Basic Education Development Index (IDEB) and quality indicators from the Report Card Brazil (RCB). This is a descriptive study that used secondary data from INEP-Brazil to identify and classify structures for the practice of PA in Brazilian schools based on the presence of "schoolyards", "sports courts" and "sporting materials", organized by elementary and high schools. Data were organized by Macroeconomic Region and related to HDI, IDEB and Report Card Brazil Quality Classification Criteria. Thus, for "Elementary School", positive and significant relationship was observed between HDI and the presence of "schoolyards" (r=0.53; p=0.004), "sports courts" (r=0.855; p<0, 01) and "sporting materials"(r=0.764; p<0.01), while for IDEB, values ​​followed the same logic, associated to the presence of "schoolyards" (r=0.475; p=0.01), "sports courts" (r=0.676; p<0.01) and "sporting materials" (r=0.535; p<0.01). For "High School", relationship was observed between HDI and the presence of "sports courts" (r=0.517; p<0.01) and "sporting materials" (r=0.499; p<0.01), while for IDEB, relationship was only observed with the presence of "sporting materials" (r=0.508; p<0.01). It could be concluded that the Northern and Northeastern regions of Brazil have schools with lower presence of structure for the practice of Physical Activity and that there is positive relationship of this structure with HDI, IDEB and quality indicators of the Report Card Brazil.

RESUMO O objetivo do estudo foi identificar as estruturas para atividades físicas (AF) nas escolas brasileiras e relacioná-las ao Índice de Desenvolvimento Humano (IDH), Índice de Desenvolvimento da Educação Básica (IDEB) e indicadores de qualidade do Report Card Brasil (RCB). Trata-se de estudo descritivo que utilizou dados secundários do INEP-Brasil para a identificação e classificação da estrutura para prática de AF nas escolas brasileiras, a partir da existência de "pátio", "quadras" e "materiais esportivos", organizadas por escolas do nível "fundamental" e "médio". Os dados foram organizados por Região Macroeconômica e relacionados com os Índices IDH, IDEB e os Critérios de Classificação de Qualidade do RCB. Assim, para o "Ensino Fundamental", verificou-se relação positiva entre o IDH e a existência de "pátio" (r=0,53; p=0,004), "quadra" (r=0,855; p<0,01) e material esportivo (r=0,764; p<0,01), o IDEB também apresentou relação positiva com a existência de "pátio" (r=0,475; p=0,01), "quadra esportiva" (r=0,676; p<0,01) e "material esportivo" (r=0,535; p<0,01). Para o "Ensino Médio", verificou-se relação entre o IDH e a existência de quadras (r=0,517; p<0,01) e materiais esportivos (r=0,499; p < 0,01), enquanto para o IDEB, apenas houve relação com a existência de materiais esportivos (r=0,508; p<0,01). Conclui-se que as Regiões Norte e Nordeste possuem escolas com menores frequências de estrutura para Atividade Física e que há relação positiva desta estrutura com o IDH, IDEB e classificação de qualidade RCB.

School physical activity and mental health in school-aged Brazilian adolescents: a systematic review / Atividade física e saúde mental em adolescentes brasileiros escolarizados: uma revisão sistemática

ABSTRACT The aim of this study was to identify evidence regarding associations between School Physical Activity (PA) and Mental Health (MH) in Brazilian school-aged adolescents. This is a systematic review study. Studies were selected in Portuguese and English and identified by a systematic search in six electronic databases: PubMed, Web of Science, SPORTDiscus / Ebsco, ScIELO, ERIC, and LILACS, which comprised publications until 2019. Inclusion criteria were: studies with cohort, descriptive, cross-sectional or qualitative design; performed with children and adolescents; studies that analyzed the relationship between PA and MH; studies that investigated adolescents who practiced PA in schools; studies carried out in Brazil; and studies that reached minimum of 60% of methodological quality criteria according to STROBE. Physical education, as curricular activity in basic education, has protective effect on MH in the school setting. In addition, more than 300 min/week of PA was positively associated with MH; while associations between PA and excessive TV time; social isolation; and body weight dissatisfaction were negatively associated. School PA is positively associated with MH as it promotes physical and psychological well-being, impacting on the reduction of insomnia rates, attenuating loneliness and improving physical appearance.

RESUMO Objetivou-se identificar a evidência quanto às associações entre atividade física (AF) e saúde mental (SM) em adolescentes escolarizados brasileiros. Trata-se de um estudo de Revisão Sistemática. Os estudos foram selecionados em português e inglês e identificados por meio de uma busca sistemática em seis bases de dados eletrônicas: PubMed, Web of Science, SPORTDiscus/Ebsco, ScIELO, ERIC, e LILACS, que compreendeu publicações até o final de 2019. Os critérios de inclusão foram: estudos com um desenho de coorte, descritivo de caráter exploratório, transversal, ou qualitativos; realizados com crianças e adolescentes; estudos que analisaram a relação entre AF e SM; estudos que investigaram adolescentes que praticavam AF nas escolas; estudos realizados no Brasil e os que obtiveram a pontuação mínima estabelecida de 60% conforme os critérios da qualidade metodológica do instrumento STROBE. A Educação Física oferecida no currículo da educação básica tem um efeito protetor sobre a SM no ambiente escolar. Além disso, mais de 300 min/semana de AF foi associado positivamente com a SM. Algumas associações foram negativas entre a AF e a SM, tais como: tempo excessivo de TV; isolamento social; insatisfação com o peso corporal. A AF escolar está associada positivamente à SM por promover bem-estar físico e psicológico, impactando na redução dos índices de problema de insônia, atenuando a solidão e melhorando a aparência física.

Physical activity level in overweight adolescents at school: a systematic review / Nível de atividade física em jovens escolarizados com excesso de peso: uma revisão sistemática

Abstract - The objective of this systematic review was to identify the association between overweight/obesity and level of physical activity in Brazilian children and adolescents in the school setting. For search strategy, the main reference databases (PubMed, LILACS, SciELO, SPORTDiscus, Web of Science, ERIC) were used. Baseline searches resulted in 3,265 potentially relevant titles (2,775 titles after removal of duplicate studies); 21 studies met all inclusion criteria and were included for analysis. Studies were carried out from 2007 to 2019; 47.6% of them were conducted in Southern Brazil, and only one study had nationwide approach. Prevalence from 5.4% to 21% was identified for overweight, 3.5% to 16.9% for obesity and 11.8% to 40.1% for overweight + obesity. According to results, 64.3% of overweight, 69.8% of obese and 37.7% of young overweight people were considered insufficiently active. The non-standardization of instruments to assess levels of physical activity and the lack of information regarding other Brazilian regions were classified as important limitations. The results reinforce the increase in the prevalence of overweight in Brazilian children and adolescents, and the high prevalence of physical inactivity among them. For every ten overweight children/adolescents, six are reported to be insufficiently active.

Resumo - O objetivo desta revisão sistemática foi identificar a associação entre excesso de peso, obesidade e nível de atividade física em crianças e adolescentes brasileiros, no ambiente escolar. A busca eletrônica foi realizada nas principais bases de dados de referência (PubMed, LILACS, SciELO, SPORTDiscus, Web of Science, ERIC). A pesquisas nas bases resultaram em 3265 títulos potencialmente relevantes (2775 títulos após análise duplicada); 21 estudos preencheram todos os critérios de inclusão e foram analisados. Os estudos foram realizados entre 2007 e 2019, 47,6% deles foram realizados no sul do Brasil, e apenas uma pesquisa foi realizada a nível nacional. Foi identificado prevalências de 5,4% a 21% para sobrepeso, 3,5% a 16,9% para obesidade e 11,8% a 40,1% para excesso de peso (obesidade + sobrepeso). De acordo com os resultados, 64,3% dos jovens com sobrepeso, 69,8% dos obesos e 37,7% daqueles com excesso de peso foram considerados insuficientemente ativos. A não padronização dos instrumentos para avaliar os níveis de atividade física e a pouca representatividade de outras regiões brasileiras foram classificadas como lacunas importantes. Os resultados reforçam o aumento da prevalência de excesso de peso em crianças e adolescentes no Brasil, e a alta prevalência de inatividade física entre estes jovens. A cada dez jovens acima do peso, seis são insuficientemente ativos.

Disponibilidade para educação interprofissional em cursos orientados por métodos ativos de ensino-aprendizagem / Readiness for interprofessional education in undergraduate courses based on active learning methods

Resumo: Introdução: A educação interprofissional (EIP) desenvolve competências colaborativas, aprimora a segurança do paciente e melhora a qualidade da atenção à saúde. A disponibilidade para aprendizagem compartilhada relaciona-se diretamente com a EIP. Objetivo: Este estudo teve como objetivo analisar a disponibilidade dos estudantes para a EIP, de acordo com os ciclos e cursos. Método: Trata-se de estudo transversal, descritivo, de abordagem quantitativa. Utilizou-se a Readiness for Interprofessional Learning Scale (RIPLS) via formulário eletrônico. Os testes Mann-Whitney e qui-quadrado foram utilizados para analisar respectivamente variáveis contínuas e categóricas. Nas análises para verificar as diferenças nas pontuações dos fatores 1. trabalho em equipe e colaboração (TEC), 2. identidade profissional (IP) e 3. atenção à saúde centrada no paciente (ACP), além da pontuação global da RIPLS, os cursos e ciclos foram comparados por meio do teste Kruskal-Wallis. Resultado: Participaram do estudo 506 estudantes, com taxa de respostas de 32,6%, dos cursos de Enfermagem, Farmácia, Fisioterapia, Fonoaudiologia, Medicina, Nutrição, Odontologia e Terapia Ocupacional de uma universidade pública brasileira. As pontuações dos fatores 1, 2 e 3 e a pontuação global da RIPLS não apresentaram diferenças entre os sexos. Os estudantes do curso de Farmácia apresentaram menor disponibilidade para o fator 3 (ACP) quando comparados com os alunos de Enfermagem, Fisioterapia, Medicina, Odontologia e Terapia Ocupacional (p = 0,007). Os discentes de Fonoaudiologia e Nutrição apresentaram menor pontuação no mesmo fator em comparação com os de Odontologia e Terapia Ocupacional (p = 0,007). Os estudantes de Farmácia (p = 0,004) e Medicina (p = 0,016) foram menos propícios a obter maior pontuação no fator 1 (TEC), enquanto os de Terapia Ocupacional obtiveram maior chance para maior disponibilidade no mesmo fator (p = 0,024). No fator 2 (IP), os estudantes do quinto ciclo foram menos propensos a atitudes positivas (p = 0,046). Observou-se que os estudantes de Terapia Ocupacional apresentaram atitude mais favorável para a EIP expressa tanto no fator 3 (p = 0,034) quanto na pontuação global (p = 0,027), enquanto os alunos do curso de Farmácia apresentaram menor chance para melhor disponibilidade no fator 3 (p = 0,003) e na pontuação global (p = 0,003). Conclusão: Considerando a relevância da EIP no processo de reorientação da formação de profissionais de saúde para a construção da integralidade do cuidado e alinhamento com o Sistema Único de Saúde, este estudo pretende contribuir para a reflexão acerca das diferenças na disponibilidade para EIP entre cursos de graduação na área da saúde.

Abstract: Introduction: Interprofessional Education (IPE) helps develop collaborative skills, enhance patient safety and improve the quality of health care. Readiness for shared learning is directly related to IPE. Objective: To analyze Readiness for IPE among students, according to the cycles and courses. Method: This cross-sectional, descriptive study adopted a quantitative approach and used the Readiness for Interprofessional Learning Scale (RIPLS) via an electronic form. Mann-Whitney and chi-square tests were used to analyze the continuous and categorical variables, respectively. Analyses to ascertain differences between scores for the factors (1) Teamwork and Collaboration (TEC), (2) Professional Identity (IP), (3) Patient-Centered Health Care (ACP), and the overall RIPLS score, used the Kruskal-Wallis test to compare courses and cycles. Result: A response rate of 32.6% was attained from a sample of 506 students from the Nursing, Pharmacy, Physiotherapy, Speech Therapy, Medicine, Nutrition, Dentistry and Occupational Therapy courses of a Brazilian public university. The scores for factors 1, 2 and 3, and the overall RIPLS score did not differ between genders. Pharmacy students reported a lower Readiness for factor 3 (ACP) compared to students in Nursing, Physiotherapy, Medicine, Dentistry and Occupational Therapy (p=0.007). Speech therapy and Nutrition reported lower scores for the same factor compared to Dentistry and Occupational Therapy (p=0.007). Pharmacy students (p=0.004) and medicine students (p=0.016) were less likely to obtain a higher score in factor 1(TEC), while Occupational Therapy students were more likely to report greater Readiness in the same factor (p=0.024). In factor 2 (IP), fifth grade students were less likely to have positive attitudes (p=0.046). It was observed that Occupational Therapy students showed a more favorable attitude towards IPE expressed both in factor 3 (p=0.034) and in the overall score (p=0.027), while students in the Pharmacy course were less likely to report better readiness in factor 3 (p=0.003) and in the overall score (p=0.003). Conclusion: Considering the relevance of IPE in the process of redirecting health care training to build comprehensive care and ensure alignment with the Unified Health System, this study aims to reflect on the differences in readiness for IPE between undergraduate courses in health area.