[Interventions with physical activity counseling for adults without diagnosed diseases - a systematic review]. / Intervenção com aconselhamento de atividade física para adultos sem doenças diagnosticadas - uma revisão sistemática.

Counseling interventions have been broadly used to modify the level of physical activity in the population. The scope of this study was to conduct a systematic review on physical activity counseling interventions. Original intervention studies with physical activity counseling as an outcome were included and published between January 2010 and April 2020 in the Medline/PubMed, BVS, and Scielo databases, in English and Portuguese, with an adult population without diagnosed diseases. Methodological quality was assessed using the PEDro scale. We found 2,152 articles and after screening, eight manuscripts remained, writtem in seven countries. Regarding the evaluation of the quality of the work, the scores vary between 4/10 and 8/10 on the PEDro scale. The measures with counseling for PA, lasted one month and were effective in seven of the eight selected studies. The studies use the following forms of counseling: calls, SMS, cell phone apps, face-to-face counseling, e-mail, materials posted on websites, handouts, booklets and telegrams. The results of this review showed that counseling for PA practice increases the PA level of healthy adults, irrespective of the heterogeneity of methods.

Intervenções com aconselhamento têm sido amplamente usadas para modificar o nível de atividade física das populações. O presente estudo teve como objetivo realizar uma revisão sistemática sobre intervenções com aconselhamento de atividade física (AF). Foram incluídos estudos originais de intervenção com aconselhamento tendo como desfecho a atividade física, publicados nas bases de dados do Medline/PubMed, BVS e SciELO entre janeiro de 2010 e abril de 2020, nos idiomas inglês e português e com população de adultos sem doenças diagnosticadas. A qualidade metodológica foi avaliada utilizando-se a escala PEDro. Foram encontrados 2.152 artigos, após a triagem restaram oito manuscritos, produzidos em sete países. Em relação à avaliação da qualidade dos trabalhos, as pontuações variaram entre 4/10 e 8/10 na escala PEDro. As intervenções com aconselhamento para AF tiveram duração de um a seis meses e foram efetivas em sete das oito pesquisas selecionadas. Os estudos utilizaram como formas de aconselhamento: ligações, SMS, aplicativo de celular, aconselhamento face a face, e-mail, materiais postados em website, apostila, cartilhas e telegrama. Os resultados desta revisão demonstraram que o aconselhamento à prática de AF aumenta o nível de AF de adultos saudáveis, mesmo com a heterogeneidade de métodos.

Structure for the work and composition of Family Health Support Unit teams: national survey - Program for Improving Primary Health Care Access and Quality (PMAQ), 2013. / Estrutura para o trabalho e composição de equipes do Núcleo de Apoio à Saúde da Família: pesquisa nacional - Programa de Melhoria do Acesso e da Qualidade (PMAQ), 2013.

OBJECTIVE: to describe the structure of Family Health Support Unit (FHSU) teams with regard to physical space, training received, continuing education and professionals that support Primary Health Care (PHC) teams in Brazil, in 2013. METHODS: this is a descriptive study using data from the external evaluation stage of the Program for Improving Primary Health Care Access and Quality (PMAQ). RESULTS: the 1,773 FHSU teams mainly used shared clinics at primary health care centers (85.7%); 63.4% of professionals were offered specific training when they started work at their FHSU, while 67.4% were offered continuing education; the teams received support mainly from physiotherapists (87.4%) and Physical Education professionals (87,0%). CONCLUSION: the structure available for FHSU teams is in accordance with the guidelines; some FHSU professionals have not received any specific training for the job.

Family Health Support Center: health promotion, physical activity, and chronic diseases in Brazil - national PMAQ survey 2013. / Núcleo de Apoio à Saúde da Família: promoção da saúde, atividade física e doenças crônicas no Brasil - inquérito nacional PMAQ 2013.

OBJECTIVE: to describe reported health promotion actions directed towards chronic non-communicable disease (CNCD) patients, the support of physical education professionals (PEP) and the implementation of actions to promote body practices and physical activity (BPPA) by the Family Health Support Center (FHSC) teams, according to Brazilian municipality context variables. METHODS: this was a cross-sectional study, forming part of the 2013/2014 National Primary Health Care Access and Quality Improvement Program (PMAQ), by means of interviews with FHSC professionals. RESULTS: the action most reported by the teams was evaluation and rehabilitation of psychosocial conditions (90.8%); promotion of BPPA was the sixth most performed action, and was more prevalent in the Brazilian Southeast region (89.6%), in medium-sized municipalities (88.7%), with medium human development index (HDI) (86.7%); PEP provided support to 87% of the teams. CONCLUSION: FHSC were found to make an important contribution to BPPA.

[Epidemiological and socio-demographic profile of primary care workers in the South and Northeast of Brazil]. / Perfil sócio-demográfico e epidemiológico dos trabalhadores da atenção básica à saúde nas regiões Sul e Nordeste do Brasil.

In order to describe the profile of primary health care teams in 41 municipalities with more than 100 thousand inhabitants each, a total of 4,749 health workers in two States from the South (1,730) and five from the Northeast (3,019) of Brazil were included from a sample of traditional primary care units and the Family Health Program (FHP). After providing informed consent, the health workers answered a self-applied questionnaire with demographic, work-related, and their own health-related data. The principal differences between the two models involved the structuring of the teams, with the FHP including more community health agents, more women, more young workers, fewer hired on the basis of formal admissions exams, more with a single job, more precarious employment arrangements, less employment satisfaction, less time on the job, larger workloads, greater specialization in the area, and better pay. The FHP also showed worse self-perceived health and more medical appointments. Management efforts are needed to support these workers, who form the basis of the health system and are key protagonists in the development and consolidation of primary care.

[Access to continuous-use medication among adults and the elderly in South and Northeast Brazil]. / Acesso a medicamentos de uso contínuo em adultos e idosos nas regiões Sul e Nordeste do Brasil.

This study aimed to evaluate the prevalence of access to continuous-use medicines for treatment of systemic arterial hypertension, diabetes mellitus, and/or mental health problems, and the associated factors. A cross-sectional study was developed under the Project for the Expansion and Consolidation of the Family Health Program in 41 cities in South and Northeast Brazil. The sample included 4,060 adults and 4,003 elderly living in the coverage areas for primary health care clinics. Prevalence of access to continuous-use medicines was 81% in non-elderly adults and 87% in the elderly. Greater access was associated with the following factors: adults in South Brazil - older age, higher socioeconomic status, type of chronic disease, and participation in support groups in the primary health clinic area; adults in the Northeast - systemic arterial hypertension with or without diabetes mellitus; elderly in the South - more schooling; and elderly in the Northeast - older age, more schooling, non-smoking, enrollment in the primary health care clinic coverage area, and the family health care model. The results show important inequity in health, reinforcing the need for policies to expand access, mainly for lower-income population groups.

[Evaluation of the effectiveness of Primary Health Care in South and Northeast Brazil: methodological contributions]. / Avaliação de efetividade da Atenção Básica à Saúde em municípios das regiões Sul e Nordeste do Brasil: contribuições metodológicas.

The article presents the methodology used in the Baseline Study that evaluated the effectiveness of the Family Health Strategy as compared to traditional primary health care units. The study included 41 municipalities with more than 100 thousand inhabitants each, 21 from the South and 20 from the Northeast of Brazil. As the principal dependent variable and underlying premise for sampling in the Baseline Study, the effectiveness of program activities in the primary care units was analyzed in the population within the respective coverage areas, using an epidemiological survey. The health care model in the primary care units was the principal independent variable. Its effect on program activities was controlled according to geopolitical region, metropolitan area, and population size in the municipalities. Coverage of the activities was characterized according to socioeconomic, demographic, and health-related factors. The use of comparison groups, multiple-stage samples, standardized measures, adjustment for geographic and socio-demographic characteristics, and well-defined criteria for judging the findings are contributions by the methodology employed here for designing future studies to evaluate primary health care.

Prevalência de transtornos mentais e fatores associados em usuários da Atenção Primária / Mental disorders prevalence and associated factors among primary care users

Resumo Introdução Inúmeras pessoas são afetadas por transtornos mentais ao longo da vida, acarretando diminuição da expectativa de vida saudável e redução da saúde geral. Objetivo Descrever a prevalência de transtornos mentais e sua associação com variáveis demográficas, econômicas, comportamentais e de saúde de usuários da Atenção Primária à Saúde (APS). Método Estudo transversal realizado em 35 unidades básicas de saúde da zona urbana da cidade de Pelotas-RS. Foram entrevistados 525 pessoas com 18 anos ou mais. O desfecho do estudo foi os transtornos mentais, verificado pela seguinte questão: "Em alguma consulta, algum médico lhe disse que o Sr.(a) possui alguma doença? Se sim, quais?". Considerou-se com transtorno mental os usuários que relataram as seguintes doenças: depressão, ansiedade, transtorno bipolar, problemas psicológicos e problemas emocionais. Resultados A prevalência de transtornos mentais foi de 12,1%. A depressão foi a doença mais relatada pelos usuários (74,6%). Indivíduos fumantes apresentaram prevalência de transtornos mentais duas vezes maior quando comparados a indivíduos que nunca fumaram. Pessoas que ingeriam três ou mais medicamentos de maneira contínua tinham probabilidade de possuir transtornos mentais sete vezes maior do que os indivíduos que não utilizavam medicamentos. Conclusão Apresentaram transtornos mentais 12,1% dos usuários das unidades básicas de saúde, sendo a depressão a doença mais prevalente. Uso de medicamentos de forma contínua e fumo foram associadas à maior prevalência de transtornos mentais.

Abstract Background Many people are affected by mental disorders throughout their lives, resulting in a healthy life expectancy decrease and a reduction in general health. Objective To describe mental disorders and their association with demographic, economic, behavioral, and health variables among primary care users. Method A cross-sectional study was carried out in 35 health basic units in an urban area in Pelotas-RS, Brazil. 525 people aged 18 years or more were interviewed. The outcome was the mental disorders, verified by the question: "In some consultation, some doctor told you that the Mr./Mrs. have some disease? If yes, which ones?". It was considered with mental disorders the users who said the following diseases: depression, anxiety, bipolar disorder, psychological problems, and emotional issues. Results The prevalence of mental disorders was 12.1%. Depression was the most commonly reported disease among the users (74.6%). Smokers had a prevalence of mental disorders twice as high when compared to those who never smoked. People who consumed three or more continuous medicines had seven times the probability of having mental disorders than people who did not use continuous medicines. Conclusion 12.1% of users of basic health units had mental disorders, with depression being the most prevalent disease. Continuous use of medication and smoking were associated with a higher prevalence of mental disorders.

[Evolution of the epidemiological research on physical activity in Brazil: a systematic review]. / Evolução da pesquisa epidemiológica em atividade física no Brasil: revisão sistemática.

OBJECTIVE: To describe the evolution of the epidemiological research on physical activity in Brazil. METHODS: A systematic review of the literature was carried out in electronic databases (Medline/PubMed, Lilacs, Ovid, Science Direct, BioMed Central and High Wire), non-indexed Brazilian journals, query by specific authors, and contact with other researchers. The inclusion criteria were: the sample should be representative of a defined population; sample size equal to or greater than 500 individuals; data collection in Brazil; measurement of physical activity; and report of data on this variable. RESULTS: A total of 42 studies were reviewed. The first study was published in 1990, and there has been a clear growth in the number of publications since 2000. Great regional disparities were seen and most studies were carried out in the Southeast and South regions. Almost all studies (93%) used questionnaires but operational definitions of sedentary lifestyle and questionnaires used varied markedly across studies preventing result comparisons. CONCLUSIONS: Although the literature on physical activity in Brazil has quantitatively increased, methodological limitations make it difficult to compare study results. Therefore, standardization of instruments and definitions is essential for the improvement of scientific knowledge in the area.

Acesso a locais para a prática de atividade física entre usuários de Unidades Básicas de Saúde / Access to places for physical activity among users of Basic Health Units

O objetivo desse estudo foi descrever a prevalência de acesso a locais para a prática de atividade física (AF) por usuários de Unidade Básica de Saúde (UBS) da zona urbana da cidade de Pelotas, Rio Grande do Sul. Foi realizado um estudo de delineamento transversal, de base populacional comunitária, com usuários de 18 anos ou mais, que alguma vez tenham recebido aconselhamento para a prática de AF na UBS e que estivessem aguardando atendimento na sala de espera da UBS. Foram coletadas variáveis socioeconômicas, demográficas, comportamentais, de saúde e de acesso a AF. O desfecho, acesso a algum local para prática de AF, foi operacionalizado pela seguinte pergunta: "Após o aconselhamento para a prática de atividade física, o(a) Sr(a) teve acesso a algum local em que fosse possível realizar atividade física?". Foram entrevistados 248 usuários em 31 UBS visitadas. A prevalência de acesso a locais para a prática de AF foi de 52,8%, sendo os locais públicos os mais acessados (63,4%). Entre quem não teve acesso, 46,2% não procuraram por um local e 29,2% relataram não existir local público adequado. Concluímos que apesar dos usuários de UBS considerarem a AF como importante para a saúde e apesar de ter recebido aconselhamento para a prática de AF, pouco mais da metade dos entrevistados teve acesso a locais de prática de AF

The aim of the study was to describe the prevalence of access to places for physical activity (PA) practice among users of Primary Health Care Unit (PHCU) in the urban area of Pelotas, Rio Grande do Sul. A cross-sec-tional, community-based study was carried out with users aged 18 years or older who had ever received PA counseling at the PHCU and who were in the waiting rooms of the services. Socioeconomic, demographic, behavioral, health and access to PA variables were analyzed. To verify the outcome, access to PA facilities/spaces, we used the following question: "After physical activity counseling, did you had access to some place where you could perform physical activities?". In the 31 PHCU visited, 248 users were interviewed. The prevalence of access to places for PA practice was 52.8%, the public places were the most accessed (63.4%). Among those who did not have access, 46.2% did not look for a place and 29.2% reported that there was no adequate public place. It was concluded that although PHCU users consider PA as important for health and despite having received counseling for PA, just over half of interviewees have access to PA practice places

Intervenção com aconselhamento de atividade física para adultos sem doenças diagnosticadas - uma revisão sistemática / Interventions with physical activity counseling for adults without diagnosed diseases - a systematic review

Resumo Intervenções com aconselhamento têm sido amplamente usadas para modificar o nível de atividade física das populações. O presente estudo teve como objetivo realizar uma revisão sistemática sobre intervenções com aconselhamento de atividade física (AF). Foram incluídos estudos originais de intervenção com aconselhamento tendo como desfecho a atividade física, publicados nas bases de dados do Medline/PubMed, BVS e SciELO entre janeiro de 2010 e abril de 2020, nos idiomas inglês e português e com população de adultos sem doenças diagnosticadas. A qualidade metodológica foi avaliada utilizando-se a escala PEDro. Foram encontrados 2.152 artigos, após a triagem restaram oito manuscritos, produzidos em sete países. Em relação à avaliação da qualidade dos trabalhos, as pontuações variaram entre 4/10 e 8/10 na escala PEDro. As intervenções com aconselhamento para AF tiveram duração de um a seis meses e foram efetivas em sete das oito pesquisas selecionadas. Os estudos utilizaram como formas de aconselhamento: ligações, SMS, aplicativo de celular, aconselhamento face a face, e-mail, materiais postados em website, apostila, cartilhas e telegrama. Os resultados desta revisão demonstraram que o aconselhamento à prática de AF aumenta o nível de AF de adultos saudáveis, mesmo com a heterogeneidade de métodos.

Abstract Counseling interventions have been broadly used to modify the level of physical activity in the population. The scope of this study was to conduct a systematic review on physical activity counseling interventions. Original intervention studies with physical activity counseling as an outcome were included and published between January 2010 and April 2020 in the Medline/PubMed, BVS, and Scielo databases, in English and Portuguese, with an adult population without diagnosed diseases. Methodological quality was assessed using the PEDro scale. We found 2,152 articles and after screening, eight manuscripts remained, writtem in seven countries. Regarding the evaluation of the quality of the work, the scores vary between 4/10 and 8/10 on the PEDro scale. The measures with counseling for PA, lasted one month and were effective in seven of the eight selected studies. The studies use the following forms of counseling: calls, SMS, cell phone apps, face-to-face counseling, e-mail, materials posted on websites, handouts, booklets and telegrams. The results of this review showed that counseling for PA practice increases the PA level of healthy adults, irrespective of the heterogeneity of methods.

Intervenção com profissionais de saúde sobre aconselhamento à atividade física na atenção primária / Intervention with health professionals about physical activity counseling in primary health care

O estudo teve como objetivo avaliar o efeito de uma intervenção focada no aumento do aconse-lhamento dos profissionais de saúde sobre atividade física para os usuários de Unidades Básicas de Saúde (UBS) da cidade de Pelotas, Rio Grande do Sul. Trata-se de um ensaio comunitário rando-mizado, com 17 UBS participando do grupo intervenção (GI), onde os profissionais de saúde foram submetidos a uma intervenção com duas palestras de 50 minutos cada e recebimento de folders sobre o tema. Fizeram parte do grupo controle (GC) outras 17 UBS. Foi determinada a prevalência de aconselhamento à atividade física (realizado por profissional de saúde dentro da UBS e por agente comunitário de saúde no domicílio) através de entrevistas com 30 usuários de cada UBS, totalizando 510 entrevistados em cada grupo. Foram calculadas as proporções e intervalos de confiança de 95% (IC95%) de todas as variáveis, sendo utilizado o teste Exato de Fisher. As UBS do GI contavam com 259 profissionais de saúde no momento da intervenção, dos quais 218 participaram de, no mínimo, um encontro. Não foram observadas diferenças nas prevalências de aconselhamento para a prática de atividade física, tanto realizado por profissionais de saúde nas UBS (linha de base: 35,8%, IC95% 31,8 ­ 40,1; Pós-intervenção - GI: 39,4%, IC95% 35,2 ­ 43,7; GC: 38,0%, IC95% 33,9 ­ 42,3), quanto o aconselhamento feito pelos agentes comunitários de saúde nos domicílios (Pós-intervenção - GI: 29,1%, IC95% 23,5 ­ 35,5; GC: 24,9%, IC95% 19,4 ­ 31,3). Conclui-se que a intervenção não foi efetiva para modificar a prevalência de aconselhamento à atividade física nas UBS

The study aimed to evaluate the effect of an intervention focused on increasing health professionals' coun-seling on physical activity for users of Basic Health Units (BHU) in the city of Pelotas, Rio Grande do Sul. It is a randomized community trial, with 17 BHU participating in the intervention group (IG), being health professionals subjected to an intervention with two lectures of 50 minutes each and receiving folders on the topic. Another 17 BHU were part of the control group (CG). The prevalence of physical activity counseling (carried out by health professional within the BHU and by community health agent at home) was determined through interviews with 30 users from each BHU, totaling 510 respondents in each group. The proportions and 95% confidence intervals (95%CI) of all variables were calculated, using Fisher's Exact test. IG had 259 health professionals at the time of the intervention, of which 218 participated in at least one meeting. There were no differences in the prevalence of physical activity counseling, either performed by health professionals in the BHU (baseline: 35.8% CI95% 31.8 - 40.1; Post-intervention - IG: 39.4% 95%CI 35.2 - 43.7; CG: 38.0% 95%CI 33.9 - 42.3), as for the advice given by community health agents at home (Post-intervention - IG: 29.1% 95%CI 23.5 - 35.5; CG: 24.9% 95%CI 19.4 - 31.3). It is concluded that the intervention was not effective to modify the prevalence of physical activity counseling in the BHU

The burden of fractures in Brazil: a population-based study.

INTRODUCTION: The elderly population is growing fast worldwide, and therefore, investigation of health outcomes peculiar to these individuals is a public health priority nowadays. The decade between 2000 and 2010 is denominated as the Bone and Joint Decade, and researchers are encouraged to quantity the burden of musculo-skeletal disorders worldwide. This is particularly relevant to developing countries, where the burden of these diseases is not well known. This study aims to evaluate the prevalence of fractures (lifetime and previous year) and its association with socio-demographic variables and medical diagnosis of osteoporosis. MATERIALS AND METHODS: Population-based cross-sectional study including a multiple-stage sample of individuals aged 20 years or more living in Pelotas, a southern Brazilian city. Both the lifetime prevalence of fractures and the proportion of fractures in the year prior to the interview were investigated. Sex, age, skin color, socioeconomic level, schooling level and medical diagnosis of osteoporosis were used as independent variables. After descriptive and crude analyses, a Poisson regression was carried out in order to provide prevalence ratios including adjustment for confounding. RESULTS: The lifetime prevalence of fractures was 28.3%, and 2.3% of the individuals broke a bone in the year prior to the interview. Among men, most fractures were caused by sports practice and happened in leisure-time outside home. Among women, most fractures occurred inside home and were caused by falls. The lifetime prevalence of fractures was positively associated with male sex and white or mixed skin color. The prevalence of fractures in the year prior to the interview was greater among poor individuals and those with a medical diagnosis of osteoporosis. Among all fractures happened in older adults (60 years or more) in the 12 months prior to the interview, 83.3% were caused by falls. CONCLUSIONS: Data of this investigation might help policy makers to reduce the burden of fractures, particularly among women and older adults, by stimulating prevention against household falls and osteoporosis. Special attention should be given to the poorest individuals, who have a greater likelihood of developing several negative health outcomes and presented a higher risk of fractures in the present study.

Epidemiology of physiotherapy utilization among adults and elderly.

OBJECTIVE: To analyze the prevalence of physiotherapy utilization and to explore the variables associated to its utilization. METHODS: A population-based cross-sectional study, including 3,100 subjects aged 20 years or more living in the urban area of Pelotas, southern Brazil, was carried out. The sample was selected following a multiple-stage protocol; the census tracts delimited by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics) were the primary sample units. Following descriptive and crude analyses, Poisson regression models taking the clustering of the sample into account were carried out. Data were collected through face-to-face interviews using a standardized and pre-tested questionnaire. RESULTS: The lifetime utilization of physiotherapy was 30.2%; and physiotherapy utilization in the 12 months prior to the interview was reported by 4.9%. Women, elderly subjects, and those from higher socioeconomic levels were more likely to use physiotherapy. Restricting analysis to subjects who attended physiotherapy, 66% used public health services, 25% used insurance health services and 9% had private sessions. CONCLUSIONS: This is the first population-based study on physiotherapy utilization carried out in Brazil. Utilization of physio therapy was lower than reported in both developed and developing countries. The study findings might help public health authorities to organize healthcare service in terms of this important demand.

Adult Physical Activity Counseling by Health Professionals in Brazil: A National Urban Population Survey.

BACKGROUND: Physical activity counseling is an attribution of health professionals. As such, this paper aims to analyze the receipt of this form of counseling. METHODS: Cross-sectional national study interviewing 12,402 adults living in the urban area of 100 Brazilian municipalities. RESULTS: Overall counseling prevalence was 30%, falling to 20% when considering only counseling provided by health professionals. Counseling was significantly more frequent among women and among individuals who were older, married, had higher socioeconomic status, were former smokers, physically active, and reporting hypertension, diabetes, and excess weight. CONCLUSIONS: Little counseling was found to be done, this being a missed opportunity for health promotion. Health services and professionals therefore need to be trained and encouraged to provide adequate information to all health service users on the benefits of leading healthy lifestyles.

Intervenções com profissionais de saúde da atenção primária sobre aconselhamento à atividade física: revisão sistemática / Interventions with health professionals of primary care about physical activity counseling: sistematic review

RESUMO O objetivo do estudo foi descrever as intervenções realizadas com profissionais de saúde na atenção primária com o foco no aumento do aconselhamento à prática de atividade física. Foi realizada uma revisão sistemática da literatura nas bases de dados PubMed, Lilacs, Scopus, SciELO e Bireme, com as seguintes palavras-chave: primary health care; intervention; physical activity; exercise; health promotion; counseling; advice; health professionals; health workers. Foram incluídos oito estudos, sendo a maioria de metodologia quantitativa e publicado na última década. As intervenções foram realizadas em três países, com amostras heterogêneas de profissionais de saúde e usuários da atenção primária. Quanto ao efeito da intervenção sobre o aumento do aconselhamento à atividade física, metade dos estudos mostrou ser positivo, enquanto a outra metade não apresentou diferença. Os resultados apresentam que ainda são poucas as intervenções com profissionais de saúde na atenção primária relacionadas ao aconselhamento à atividade física e metade delas mostraram efeito positivo. São necessárias novas intervenções abrangendo diferentes profissionais da saúde em um número maior de unidades de saúde.

ABSTRACT The aim of this study was to describe the interventions conducted with health professionals in the primary care with the focus in the increase of physical activity counseling. It was conducted a sistematic review in the PubMed, Lilacs, Scopus, SciELO and Bireme, with the following keywords: primary health care; intervention; physical activity; exercise; health promotion; counseling; advice; health professionals; health workers. Eight studies were included, the majority with quantitative methodology and published in the last decade. The interventions were conducted in three countries, with different samples of health professionals and users of primary care. Concerning the efect of intervention about the increase physical activity counseling, half of the studies showed to be positive, while the other half didn't show difference. The results showed that there are few interventions with health professionals in the primary care associated with physical activity counseling and half of them showed positive effect. New interventions are necessary including different health professionals in a larger number of health units.

Dor crônica e nível de atividade física em usuários das unidades básicas de saúde / Chronic pain and level of physical activity in users from basic health units

O objetivo do estudo foi descrever a prevalência de dor crônica dos usuários das unidades básicas de saúde da zona urbana da cidade de Pelotas, Rio Grande do Sul, Brasil, e verificar o nível de atividade física e os fatores associados à dor crônica. Foi realizado um estudo transversal com amostra de 540 adultos com 18 anos ou mais, usuários de 36 unidades básicas de saúde. Considerou-se dor crônica aos que relataram o tempo referido de algum tipo dor de três meses ou mais. Foram estimadas razões de prevalência ajustada por meio da regressão de Poisson, com variância robusta. A prevalência de dor crônica entre os usuários foi de 41,5% (IC95%: 37,4 ­ 45,7). Na análise ajustada, as mulheres tiveram 50% maior probabilidade ao desfecho em relação aos homens; indivíduos de 40-59 anos e 60-90 anos, tiveram maior probabilidade de 44% e 61%, respectivamente, do que os de 18-39 anos; aqueles que perceberam sua saúde negativamente, tiveram 5,4 vezes mais probabilidade ao desfecho; utilizar três ou mais medicamentos aumentou 43% a probabilidade ao desfecho e; sujeitos que pra-ticavam atividade física de lazer tiveram menor probabilidade de apresentar dor crônica. Conclui-se que, a prevalência de dor crônica em usuários de unidades básicas de saúde foi elevada (41,5%), sendo que a atividade física de lazer foi fator de proteção para o surgimento de dor crônica. Contudo, para o tratamento da dor crônica nas unidades básicas de saúde, a prática de atividade física torna-se de fundamental importância

The aim of the study was to describe the prevalence of chronic pain among users of basic health units in the urban area of the city of Pelotas, Brazil, and to verify the level of physical activity and the associated factors with chronic pain. A cross-sectional study was performed with 540 adults 18 years and older, users of 36 basic health units. Considered chronic pain was referred time of some kind of pain of three months or more. Adjusted prevalence ratios were estimated using Poisson regression, with robust variance. The prevalence of chronic pain among users was 41.5% (CI95% 37.4 ­ 45.7). In the adjusted analysis women had 50% more likely of outcome compared to men; individuals aged 40-59 years and 60-90 years had more likely of 44% and 61%, respectively, than those aged 18-39 years; those who perceived their health negatively were 5.4 times more likely to the outcome; using three or more drugs increased the likely of outcome by 43% and; leisure physical activity was a protective factor for the onset of chronic pain. It is concluded that the prevalence of chronic pain in user of basic health units was elevated (41,5%), being that the leisure physical activity was protection factor for the onset of chronic pain. However, for the treatment of chronic pain in basic health units, the practice of physical activity becomes of fundamental importance

Teaching of health-related physical activity in medical schools: the Brazilian scenario / Ensino de atividade física relacionada à saúde nos cursos de medicina: O cenário brasileiro

Physical activity engagement is a key strategy to improve population health and quality of life. How-ever, studies show that physical activity counseling by physicians is low, and one of the main barriers reported is lack of specific knowledge. The aim of this study is to describe the existence of health-related physical activity content in the curricula of Brazilian Medicine undergraduate courses. A census-type descriptive study was carried out. Online documentation available in institutional websites of all Brazilian Medicine courses curricula were assessed and, when not available, faculty members were contacted. In 2015 we identified 233 medicine courses in Brazil, using data from the Brazilian Ministry of Education. We assessed the documentation in detail of 158 courses (67.8%). We ob-served that only 12% of curricula presented health-related physical activity and/or physical exercise contents. This proportion was higher in public Medical schools compared to private ones (21.5% vs. 5.4%; p = 0.002). Teaching of health-related physical activity in Brazilian Medicine courses is scarce. We highlight the need for adjustment of curricula considering the well-established benefits of physical activity for public health.

A prática de atividade física é uma estratégia fundamental para melhorar a saúde e a qualidade de vida populacional. No entanto, estudos mostram que o aconselhamento de atividade física por parte dos médicos é baixo e uma das principais barreiras relatadas é a falta de conhecimento específico. O objetivo deste estudo é descrever a existência de conteúdo de atividade física relacionada à saúde nos currículos dos cursos de graduação em Medicina no Brasil. Foi realizado um estudo descritivo do tipo censo, avaliando a documentação on-line disponível em sites institucionais de todos os currículos dos cursos de Medicina do país e quando esta documentação não estava disponível, foi feito contato com os coordenadores. Em 2015 foram identificados 233 cursos de medicina no Brasil, utilizando dados do Ministério da Educação do Brasil. Em 158 cursos (67,8%) foi possível avaliar a documentação em detalhes. Observamos que apenas 12% dos currículos apre-sentavam em seus currículos/disciplinas conteúdo sobre atividade física e/ou exercício físico relacionado à saúde. Essa proporção foi maior nas instituições públicas em comparação às escolas particulares de Medicina (21,5% vs. 5,4%; p = 0,002). O ensino de atividade física relacionada à saúde nos cursos de Medicina no Brasil é escasso. Destacamos a necessidade de ajuste curricular considerando os benefícios conhecidos da atividade física para a saúde pública.

Núcleo de Apoio à Saúde da Família: promoção da saúde, atividade física e doenças crônicas no Brasil - inquérito nacional PMAQ 2013 / Núcleo de Apoyo a la Salud de la Familia: promoción de la salud, actividad física y enfermedades crónicas en Brasil - encuesta nacional PMAQ 2013 / Family Health Support Center: health promotion, physical activity, and chronic diseases in Brazil - national PMAQ survey 2013

Objetivo: descrever o relato de ações de promoção da saúde dirigidas a portadores de doenças crônicas não transmissíveis, o apoio do profissional de educação física (PEF) e a realização da ação de promoção de práticas corporais e atividade física (PCAF) pelas equipes do Núcleo de Apoio à Saúde da Família (NASF), segundo variáveis de contexto dos municípios do Brasil. Métodos: estudo transversal, integrante do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ) 2013/2014, mediante entrevistas a profissionais do NASF. Resultados: a ação mais relatada pelas equipes foi a avaliação e reabilitação de condições psicossociais (90,8%); a ação de promoção de PCAF foi a sexta mais realizada e teve maior prevalência no Sudeste brasileiro (89,6%), em municípios de médio porte (88,7%), com índice de desenvolvimento humano (IDH) médio (86,7%); o PEF apoiou 87% das equipes. Conclusão: revelou-se importante contribuição do NASF para as ações de PCAF.

Objetivo: describir el relato de acciones de promoción de la salud dirigidas a portadores de enfermedades crónicas no transmisibles (ECNT), el apoyo del profesional de educación física (PEF) y la realización de la acción de promoción de prácticas corporales y actividad física (PCAF) por los equipos del Núcleo de Apoyo a la Salud de la Familia (NASF), según variables de contexto de los municipios de Brasil. Métodos: estudio transversal, integrante del Programa Nacional de Mejoría del Acceso y de la Calidad de la Atención Básica (PMAQ) 2013/2014, con entrevistas a profesionales del NASF. Resultados: la acción más relatada por los equipos fue la evaluación y la rehabilitación de condiciones psicosociales (90,8%); la acción de promoción de PCAF fue la sexta más realizada, tuvo mayor prevalencia en el Sudeste brasileño (89,6%), en municipios de mediano porte (88,7%), con índice de desarrollo humano (IDH) medio (86,7%); el PEF apoyó 87% de los equipos. Conclusión: se reveló una importante contribución del NASF a acciones de PCAF.

Objective: to describe reported health promotion actions directed towards chronic non-communicable disease (CNCD) patients, the support of physical education professionals (PEP) and the implementation of actions to promote body practices and physical activity (BPPA) by the Family Health Support Center (FHSC) teams, according to Brazilian municipality context variables. Methods: this was a cross-sectional study, forming part of the 2013/2014 National Primary Health Care Access and Quality Improvement Program (PMAQ), by means of interviews with FHSC professionals. Results: the action most reported by the teams was evaluation and rehabilitation of psychosocial conditions (90.8%); promotion of BPPA was the sixth most performed action, and was more prevalent in the Brazilian Southeast region (89.6%), in medium-sized municipalities (88.7%), with medium human development index (HDI) (86.7%); PEP provided support to 87% of the teams. Conclusion: FHSC were found to make an important contribution to BPPA.

Estrutura para o trabalho e composição de equipes do Núcleo de Apoio à Saúde da Família: pesquisa nacional - Programa de Melhoria do Acesso e da Qualidade (PMAQ), 2013 / Estructura para el trabajo y composición de equipos del Núcleo de Apoyo a la Salud de la Familia, Brasil: encuesta nacional - Programa de Mejora del Acceso y la Calidad (PMAQ), 2013 / Structure for the work and composition of Family Health Support Unit teams: national survey - Program for Improving Primary Health Care Access and Quality (PMAQ), 2013

Objetivo: descrever a estrutura das equipes dos Núcleos de Apoio à Saúde da Família (NASF) quanto a espaços físicos, formação recebida, educação permanente e profissionais que apoiam as equipes de Atenção Básica à Saúde no Brasil, em 2013. Métodos: estudo descritivo, com dados da fase de avaliação externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ). Resultados: as 1.773 equipes de NASF utilizam, principalmente, consultórios compartilhados na unidade básica de saúde (UBS) (85,7%); para 63,4% dos profissionais, foi oferecida formação específica quando iniciaram o trabalho no NASF, e para 67,4%, educação permanente; as equipes receberam o apoio principalmente de fisioterapeutas (87,4%) e profissionais de educação física (87,0%). Conclusão: as equipes de NASF têm estrutura de acordo com o preconizado nas diretrizes; há profissionais do NASF que não receberam formação específica para o trabalho.

Objetivo: describir la estructura de los equipos de Núcleos de Apoyo a la Salud de la Familia (NASF) en relación a espacios físicos, formación recibida, educación permanente y profesionales que apoyan a los equipos de Atención Básica de Salud (ABS) en Brasil, el 2013. Métodos: estudio descriptivo, transversal, con datos de la fase de evaluación externa del Programa de Mejora del Acceso y la Calidad de la Atención Básica (PMAQ). Resultados: los 1.773 equipos de NASF utilizan principalmente consultorios compartidos en la unidad básica de salud (UBS) (85,7%); para el 63,4% de los profesionales se ofreció formación específica cuando iniciaron el trabajo en el NASF, y para el 67,4%, educación permanente; los equipos recibieron el apoyo de fisioterapeutas (87,4%) y de profesionales de Educación Física (87%). Conclusión: los equipos del NASF tienen estructura de acuerdo con lo preconizado en las directrices del NASF; hay profesionales del NASF que no recibieron entrenamiento específico para el trabajo.

Objective: to describe the structure of Family Health Support Unit (FHSU) teams with regard to physical space, training received, continuing education and professionals that support Primary Health Care (PHC) teams in Brazil, in 2013. Methods: this is a descriptive study using data from the external evaluation stage of the Program for Improving Primary Health Care Access and Quality (PMAQ). Results: the 1,773 FHSU teams mainly used shared clinics at primary health care centers (85.7%); 63.4% of professionals were offered specific training when they started work at their FHSU, while 67.4% were offered continuing education; the teams received support mainly from physiotherapists (87.4%) and Physical Education professionals (87,0%). Conclusion: the structure available for FHSU teams is in accordance with the guidelines; some FHSU professionals have not received any specific training for the job.

Falls and self-assessment of eyesight among elderly people: a population-based study in a south Brazilian municipality.

This paper seeks to verify the association between falls and self-assessment of visual acuity in elderly people by means of a cross-sectional population-based study involving 1593 elderly people (aged 60 or over) from the urban zone of the municipality of Bagé-RS. Poisson regression was used for association analysis. Fall prevalence in the last year was 28.0% (95%CI: 25.8; 30.2), with 45.0% of these having suffered two or more falls in the same period. Elderly people self-assessing their eyesight as bad/very poor (10.0%) or regular (33.3%) showed a linear increase in fall occurrence when compared to individuals who considered their eyesight to be good/excellent. Self-assessment of eyesight showed itself to be an important factor associated with the occurrence of falls. This results entails the need to make progress with tracing elderly people with eyesight difficulties and its possible impact on actions to prevent the occurrence of falls.