Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children. (PA approach crosssectional cross sectional study 1200 1 200 1,20 8.1±1.0 8110 8 0 (8.1±1. old municipality (BMI overweight s conducted software 0.847, 0847 0.847 , 847 (0.847) 0.349, 0349 0.349 349 (0.349) 0.564, 0564 0.564 564 (0.564) 0.662 0662 662 (0.662 observed 0.212 0212 212 (-0.212 0.387, 0387 0.387 387 (-0.387) 0.492, 0492 0.492 492 (-0.492) 0.557. 0557 0.557 . 557 (-0.557) Additionally 1.789 1789 789 (1.789 values 2.239 2239 2 239 (2.239 1.230 1230 230 (1.230 lowincome low income 120 20 1,2 8.1±1. 811 (8.1±1 084 0.84 84 (0.847 034 0.34 34 (0.349 056 0.56 56 (0.564 0.66 066 66 (0.66 0.21 021 21 (-0.21 038 0.38 38 (-0.387 049 0.49 49 (-0.492 055 0.55 55 (-0.557 1.78 178 78 (1.78 2.23 223 23 (2.23 1.23 123 (1.23 12 1, 8.1±1 81 (8.1± 08 0.8 (0.84 03 0.3 3 (0.34 05 0.5 5 (0.56 0.6 06 6 (0.6 0.2 02 (-0.2 (-0.38 04 0.4 4 (-0.49 (-0.55 1.7 17 7 (1.7 2.2 22 (2.2 1.2 (1.2 8.1± (8.1 0. (0.8 (0.3 (0.5 (0. (-0. (-0.3 (-0.4 (-0.5 1. (1. 2. (2. 8.1 (8. (0 (-0 (1 (2 8. (8 ( (-

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda. (AF rede Tratase Trata se 1200 1 200 1.20 8,1±1,0 8110 8 0 (8,1±1, anos município (IMC sobrepeso Jasp 0,847, 0847 0,847 , 847 (0,847) 0,349, 0349 0,349 349 (0,349) 0,564 0564 564 (0,564 0,662. 0662 0,662 . 662 (0,662) 0,212, 0212 0,212 212 (-0,212) 0,387, 0387 0,387 387 (-0,387) 0,492 0492 492 (-0,492 0,557. 0557 0,557 557 (-0,557) Adicionalmente 1,789 1789 789 (1,789 intermediação 2,239 2239 2 239 (2,239 1,230. 1230 1,230 230 (1,230) renda 120 20 1.2 8,1±1, 811 (8,1±1 084 0,84 84 (0,847 034 0,34 34 (0,349 0,56 056 56 (0,56 066 0,66 66 (0,662 021 0,21 21 (-0,212 038 0,38 38 (-0,387 0,49 049 49 (-0,49 055 0,55 55 (-0,557 1,78 178 78 (1,78 2,23 223 23 (2,23 123 1,23 (1,230 12 1. 8,1±1 81 (8,1± 08 0,8 (0,84 03 0,3 3 (0,34 0,5 05 5 (0,5 06 0,6 6 (0,66 02 0,2 (-0,21 (-0,38 0,4 04 4 (-0,4 (-0,55 1,7 17 7 (1,7 2,2 22 (2,2 1,2 (1,23 8,1± (8,1 0, (0,8 (0,3 (0, (0,6 (-0,2 (-0,3 (-0, (-0,5 1, (1, 2, (2, (1,2 8,1 (8, (0 (-0 (1 (2 8, (8 ( (-

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda.

Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

ABSTRACT BACKGROUND: Congenital Anomalies of the Upper Limb (CAUL) are a group of structural or functional abnormalities that develop during intrauterine life and can lead to limb dysfunction. OBJECTIVES: To analyze the prevalence of congenital anomalies of the upper limbs in Brazil and assess maternal and neonatal variables. DESIGN AND SETTING: A cross-sectional, descriptive study was conducted on congenital upper limb malformations among live births across Brazil. METHODS: The study spanned from 2010 to 2019. Data were sourced from the Department of Informatics of the Unified Health System (DATASUS) and the Live Birth Information System (SINASC) portal. Analyses focused on the information reported in field 41 of the Live Birth Declaration Form entered into the computerized system. RESULTS: The most common anomaly in Brazil was supernumerary fingers, classified as ICD-Q69.0, affecting 11,708 children, with a prevalence of 4.02 per 10,000 live births. Mothers aged over 40 years had a 36% higher prevalence of having children with CAUL than mothers under 40 years old (OR = 1.36; 95% CI 1.19-1.56). Newborns weighing ≥ 2,499 g were 2.64 times more likely to have CAUL compared to those weighing ≥ 2,500 g (OR = 2.64; 95% CI 2.55-2.73). CONCLUSION: There was an observed increase in the reporting of CAUL cases over the decade studied. This trend serves as an alert for health agencies, as understanding the prevalence of CAUL and its associated factors is crucial for preventive medicine. BACKGROUND (CAUL dysfunction OBJECTIVES variables SETTING crosssectional, crosssectional cross sectional, sectional cross-sectional METHODS 201 2019 DATASUS (DATASUS SINASC (SINASC portal 4 system RESULTS fingers ICDQ69.0, ICDQ690 ICDQ ICD Q69.0, Q69 0 Q ICD-Q69.0 11708 11 708 11,70 402 02 4.0 10000 10 000 10,00 36 OR 1.36 136 1 95 1.191.56. 119156 1.19 1.56 . 19 56 1.19-1.56) 2499 2 499 2,49 264 64 2.6 2500 500 2,50 2.552.73. 255273 2.55 2.73 55 73 2.55-2.73) CONCLUSION studied agencies medicine 20 ICDQ69 ICDQ69.0 Q690 Q69.0 Q6 ICD-Q69. 1170 70 11,7 4. 1000 00 10,0 3 1.3 13 9 191 1.191.56 11915 119 1.1 156 1.5 5 1.19-1.56 249 49 2,4 26 6 2. 250 50 2,5 552 2.552.73 25527 255 2.5 273 2.7 7 2.55-2.73 ICDQ6 ICDQ69. Q69. ICD-Q69 117 11, 100 10, 1. 1.191.5 1191 15 1.19-1.5 24 2, 25 2.552.7 2552 27 2.55-2.7 ICD-Q6 1.191. 1.19-1. 2.552. 2.55-2. ICD-Q 1.191 1.19-1 2.552 2.55-2 1.19- 2.55-

Objective: to analyze the temporal trend and macro-regional distribution of the offer of collective activities of body practices and physical activities (BPPA) and the number of participants in Primary Health Care (PHC), developed by all health professionals and by Physical Education Professionals (PEF). Methods: ecological time series study, using data from the Health Information System for PHC (Sisab) between 2014 and 2022, using Joinpoint regression analysis. Results: at the national level, an increase in the number of collective BPPA and PHC participants developed by all health professionals and by PEF was identified between 2014 and 2019, followed by a reduction in both in 2020. In 2021 and 2022 further increases occurred. Conclusion: even though the Covid-19 pandemic occurred, an exceptional scenario and upward trends were identified both in the offer of collective BPPA and participants.

Objetivo: analisar a tendência temporal e distribuição macrorregional da oferta de atividades coletivas de práticas corporais e atividades físicas (PCAF) e do número de participantes na Atenção Primária (APS), desenvolvidas por todos os profissionais de saúde e por Profissionais de Educação Física (PEF). Métodos: estudo ecológico de série temporal, usando dados do Sistema de Informação em Saúde para a Atenção Básica (Sisab) entre 2014 e 2022, por meio da análise de regressão Joinpoint. Resultados: em âmbito nacional, identificou-se aumento do quantitativo de atividades coletivas de PCAF e de participantes na APS desenvolvidas por todos os profissionais de saúde e por PEF entre 2014 e 2019, seguido de uma redução de ambos em 2020. Em 2021 e 2022 ocorreu novo aumento. Conclusão: ainda que tenha ocorrido a pandemia da Covid-19, um cenário de excepcionalidade, foram identificadas tendências de aumento tanto na oferta de atividades coletivas de PCAF quanto de participantes.

ABSTRACT Objective: Herein, we compared ambulatory blood pressure (ABP) between young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency and a control group. Additionally, we analyzed correlations between the glucocorticoid dose and androgen levels and ABP parameters. Subjects and methods: This case-control study included 18 patients (6 males and 12 females) and 19 controls (8 males and 11 females) matched by age (18-31 years). ABP monitoring was used to estimate blood pressure (BP) over a 24-h period. Results: No difference was noted between patients and controls in terms of systolic BP (males, 115.5 ± 5.6 vs. 117.0 ± 9.3, P = 0.733; and females, 106.4 ± 7.9 vs. 108.4 ± 7.6, P = 0.556, respectively) and diastolic BP during 24 h (males, 62.8 ± 7.5 vs. 66.2 ± 5.6, P = 0.349; and females, 62.7 ± 4.9 vs. 62.3 ± 4.9, P = 0.818, respectively). Systolic and diastolic BP and pulse pressure during daytime and nocturnal periods were similar between patients and controls. Furthermore, no differences were detected in the percentage of load and impaired nocturnal dipping of systolic and diastolic BP between patients and controls during the 24-h period. Additionally, the glucocorticoid dose (varying between r = −0.24 to 0.13, P > 0.05) and androgens levels (varying between r = 0.01 to 0.14, P > 0.05) were not associated with ABP parameters. Conclusion: No signs of an elevated risk for hypertension were observed based on ABP monitoring in young adults with CAH attributed to 21OHase deficiency undergoing glucocorticoid replacement therapy. Objective Herein (ABP (CAH 21hydroxylase hydroxylase 21 OHase (21OHase group Additionally parameters methods casecontrol case 1 6 ( females 8 1831 31 (18-3 years. years . years) (BP 24h period Results males, (males 1155 115 5 115. 56 5. vs 1170 117 0 117. 93 9 3 9.3 0.733 0733 733 1064 106 4 106. 79 7 7. 1084 108 108. 76 7.6 0556 556 0.556 respectively 2 628 62 62. 75 662 66 66. 0.349 0349 349 627 49 4. 623 0818 818 0.818 respectively. Furthermore varying 024 −0.2 013 13 0.13 0.05 005 05 001 01 0.0 014 14 0.14 Conclusion therapy 183 (18- 9. 0.73 073 73 10 055 55 0.55 0.34 034 34 081 81 0.81 02 −0. 0.1 00 0. (18 0.7 07 0.5 0.3 03 08 0.8 −0 (1 −

ABSTRACT Objective: To identify and summarize the possible associations between screen time and low back pain in children and adolescents. Data source: Systematic searches were performed in five electronic databases (Lilacs, Scielo, Scopus, PubMed and Web of Science) on 01/25/2021, complemented by manual searches in reference lists and on Google Scholar, looking for original scientific articles that included Brazilian observational studies; whose samples had children and/or adolescents aged between 6 and 19 years, without specific clinical conditions, and that presented analyses of associations between indicators of screen time and nonspecific low back pain, based on regression models. Data synthesis: Nine cross-sectional studies whose samples had adolescents were included. Of the 18 analyses identified, nine reported risk relationships between the variables of interest. More specifically, risk associations were found in two studies that evaluated adolescents exposed to at least three hours using cell phone or tablet, and watching television per day. Also, instruments, cut-off points adopted, and screen equipment evaluated were diverse. Conclusions: Even though most of the risk associations were borderline from the statistical point of view, we found a higher frequency of risk associations between screen time and non-specific low back pain in adolescents exposed to screen time for at least three hours a day. In addition, further longitudinal studies with samples composed of children should be conducted across the country. Objective source Lilacs, Lilacs (Lilacs Scielo Scopus Science 01252021 01 25 2021 01/25/2021 Scholar andor 1 years conditions models synthesis crosssectional cross sectional identified interest specifically tablet day Also instruments cutoff cut off adopted diverse Conclusions view non addition country 0125202 0 2 202 01/25/202 012520 20 01/25/20 01252 01/25/2 0125 01/25/ 012 01/25 01/2 01/

Resumo Objetivo: Identificar e sumarizar os dados sobre as possíveis associações entre o tempo de tela e a dor lombar em crianças e adolescentes. Fontes de dados: Buscas sistemáticas em cinco bases de dados eletrônicas (Lilacs, Scielo, Scopus, Pubmed e Web of Science), no dia 25/01/2021, complementadas por buscas manuais em listas de referências e no site Google Acadêmico, procurando por artigos científicos originais que comunicaram estudos observacionais brasileiros que envolveram amostras de crianças e/ou adolescentes entre 6 e 19 anos de idade, sem condições clínicas específicas e que apresentassem análises de associações entre indicadores do tempo de tela e dor lombar não específica, baseadas em modelos de regressão. Síntese dos dados: Nove estudos transversais foram incluídos, envolvendo amostras de adolescentes. Das 18 análises identificadas, 9 mostraram relações de risco entre as variáveis de interesse. Mais especificamente, verificaram-se associações de risco em dois estudos que avaliaram adolescentes expostos a, pelo menos, três horas diárias de celular, tablete e televisão. Também se observou diversidade entre instrumentos, pontos de corte adotados e equipamentos de tela avaliados. Conclusões: Mesmo que a maior parte das associações de risco tenha sido limítrofe, do ponto de vista estatístico, a presente síntese apresentou maior frequência de associações de risco entre o tempo de tela e a dor lombar não específica em adolescentes expostos ao tempo de tela por, pelo menos, três horas diárias. Complementarmente, recomenda-se que sejam conduzidos no país estudos longitudinais, com o envolvimento de crianças nas amostras. Objetivo Lilacs, Lilacs (Lilacs Scielo Scopus Science, Science , Science) 25012021 25 01 2021 25/01/2021 Acadêmico eou ou 1 idade regressão incluídos identificadas interesse especificamente verificaramse verificaram menos celular televisão instrumentos avaliados Conclusões limítrofe estatístico Complementarmente recomendase recomenda longitudinais 2501202 2 0 202 25/01/202 250120 20 25/01/20 25012 25/01/2 2501 25/01/ 250 25/01 25/0 25/

ABSTRACT Since the recommendations of moderate-to vigorous physical activity (PA) for health constitute important information to be shared in counseling practice, the present study was aimed to evaluate the level of knowledge of health professionals about the international PA recommendations for adults and elderly and to verify if there are associations between PA motivation with leisure time PA, readiness to change behavior and body mass index (BMI) of these professionals. In 2021, a questionnaire was applied remotely with health professionals from Brazilian health system. The survey had 34 participants, who answered sociodemographic and health questions, knowledge about international PA recommendations for adults and the elderly, PA duration, behavioral stage and motivations for PA practice. Of the five questions that assessed the knowledge of professionals, three had the highest prevalence of wrong answers, and professionals who have a more internal motivation to practice PA showed a significant association with reaching the minimum PA and eutrophic BMI recommendations. Professional qualification is important, together with encouragement to practice PA, through contents that consider internal motivations. moderateto moderate (PA (BMI 2021 system 3 participants duration answers 202 20 2

RESUMO Visto que as recomendações de atividade física (AF) moderadas e vigorosas para a saúde se constituem como uma importante informação a ser compartilhada no aconselhamento sobre AF, o presente estudo teve como objetivos avaliar o nível de conhecimento de profissionais da saúde sobre as recomendações internacionais de AF para adultos e idosos e verificar se existem associações entre a motivação para a prática de AF com o tempo de AF no lazer, o estágio de prontidão à mudança de comportamento e o índice de massa corporal (IMC) destes profissionais. Para isso, em 2021 foi aplicado, de maneira remota, um questionário com profissionais de saúde. A pesquisa contou com 34 participantes, que responderam questões sociodemográficas, de saúde, conhecimento sobre as recomendações internacionais de AF para adultos e idosos, tempo de AF, estágio comportamental e motivações para a prática de AF. Das cinco questões que avaliaram o conhecimento dos profissionais, três tiveram a maior prevalência de respostas erradas e, os profissionais que possuem uma motivação mais interna para a prática de AF apresentaram associação significativa com atingir as recomendações mínimas de AF e IMC eutrófico. É importante a qualificação profissional aliada ao incentivo à prática de AF, por meio de conteúdos que considerem motivações internas. (AF lazer (IMC isso 202 aplicado remota 3 participantes sociodemográficas eutrófico internas 20 2

ABSTRACT BACKGROUND: Common mental disorders (CMDs) have been correlated with consequences in different domains of life. OBJECTIVE: To summarize the prevalence rates of CMDs and factors associated with them among students at Brazilian medical schools. DESIGN AND SETTING: Systematic review and meta-analysis of studies developed in Brazilian medical schools. METHODS: In October 2021, searches were carried out in seven electronic databases, in Google Scholar and in reference lists. Observational studies reporting prevalence rates of CMDs among students at Brazilian medical schools were sought. Variables associated with CMDs arising from multivariate regression models were included in the synthesis. A meta-analysis was developed using a random-effects model and the risk of bias was assessed using an instrument developed from previous references. RESULTS: Fourteen original studies were included. The pooled prevalence rate of CMDs among undergraduate students at Brazilian medical schools was 43.3% (95% confidence interval = 38.9% to 47.6%; I2 = 87%; n = 3,927). Among the nine studies in which multivariate analyses were conducted, five showed risk associations between CMDs and medical school-related dissatisfactions, among which the desire to abandon the medical course can be highlighted (n = 3). In three studies, CMDs were associated with sleep indicators. CONCLUSION: Considering that the prevalence of CMDs among medical students is higher than in the general population, we recommend that Brazilian medical schools should give greater attention to this topic, and should enable expansion of care offerings relating to mental health. SYSTEMATIC REVIEW REGISTRATION: Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020142184).

RESUMO Objetivo: Identificar as estratégias e os efeitos de intervenções conduzidas por agentes comunitários de saúde (ACS) nos níveis de atividade física (AF) em crianças e adolescentes. Fontes de dados: Em agosto de 2020, uma revisão sistemática, delineada de acordo com os itens da lista de verificação PRISMA, foi desenvolvida por meio de buscas em sete bases de dados eletrônicas e em listas de referências. Foram procurados estudos originais, sem restrição quanto ao ano de sua publicação, escritos em espanhol, inglês e português, que desenvolveram intervenções implementadas por ACS envolvendo conteúdos teóricos e/ou práticas de AF com foco em crianças e/ou adolescentes na faixa entre os 3 e os 19 anos de idade. Síntese dos dados: Dos 2.321 estudos inicialmente avaliados, foram incluídos oito, direcionados a amostras com características mais específicas (clínicas, étnicas e/ou socioeconômicas). Em todos os estudos, ACS receberam treinamento prévio para a condução de atividades educativas. Em três ensaios não controlados foram observados resultados positivos envolvendo indicadores de AF moderadas, vigorosas e redução da inatividade física. Complementarmente, dois resultados positivos foram encontrados na redução do comportamento sedentário. Conclusões: Mesmo que a maior parte das intervenções incluídas não tenha apresentado efeitos significativos no aumento dos níveis de AF, a evidência disponível reforça o papel dos ACS como uma importante estratégia de diálogo entre os serviços de saúde e as comunidades mais vulneráveis e sugere maior articulação desses profissionais nas ações desenvolvidas no contexto escolar.

ABSTRACT Objective: To identify the strategies and effects of interventions carried out by community health workers (CHW) on physical activity (PA) levels in children and adolescents. Data source: In August 2020, a systematic review, designed according to the PRISMA checklist items, was conducted by searches in seven electronic databases and in reference lists. Original studies were searched without restriction with regard to year of publication; they were written in Spanish, English or Portuguese and examined interventions implemented by CHW, involving theoretical and/or practical contents of PA, with a focus on children and/or adolescents between three and 19 years of age. Data synthesis: Of the 2,321 studies initially retrieved, eight were included, targeting samples with more specific characteristics (e.g., clinical, ethnic and/or socioeconomic). In all studies, CHW were trained to lead educational activities. In three non-controlled trials, positive results were observed, involving indicators such as moderate and vigorous PA and physical inactivity reduction. Also, two positive results were found in reducing sedentary behavior. Conclusions: Even though most of the interventions included did not have a significant effect on increasing PA levels, the available findings reinforce the role of CHW as an important strategy for dialogue between health services and the most vulnerable communities, and they suggest a greater articulation of these professionals in the actions developed in the school context.

Abstract Aim: The present scoping review aims to provide an overview of barriers to PA reported by pediatric cancer patients undergoing treatment as well as after treatment. This study further aims to describe and discuss the instruments used for assessing barriers in this population. Methods: Article search was performed in common medical databases and yielded five original research articles. Results: The included articles reported barriers to PA that can be grouped into the following categories: individuals, physical, environmental, and treatment. Among the instruments used to assess barriers to PA, it was observed that questionnaires and interviews are commonly adopted. This review underscores a paucity of studies in this area. Conclusion: A comprehensive understanding of barriers to PA in the pediatric cancer population is paramount for the development of tailored strategies and interventions aiming to promote PA in this under-researched group. In addition, future studies must adopt a mixed-methods approach, longitudinal design with specific instruments in the pediatric cancer population.

RESUMO Objetivo. Sintetizar os achados sobre correlatos da atividade física (AF) e do comportamento sedentário (CS) em crianças sul-americanas. Método. Realizou-se uma busca dos artigos no período de 24 de junho até 27 de outubro de 2020, nas bases de dados LILACS, PubMed, SciELO, Scopus e Web of Science. Para ampliar a busca, foram examinadas as referências dos artigos de revisão identificados e realizada uma consulta a um painel de especialistas. Foram incluídos estudos com delineamentos observacional e de intervenção com foco em crianças sul-americanas de zero a 5 anos de idade. Resultados. Dos 3 111 artigos inicialmente identificados, 18 foram elegíveis: 14 com delineamento observacional, 12 realizados no Brasil e 17 conduzidos com pré-escolares (3 a 5 anos de idade). Além do Brasil, os únicos países representados foram o Chile e o Equador. A AF e o CS foram medidos por acelerômetros em sete estudos, porém houve alta variabilidade nos instrumentos e pontos de corte usados. Embora as crianças tenham sido consideradas fisicamente ativas em 12 estudos, seis estudos mostraram que elas despendiam muito tempo em CS. Os domínios de influência mais avaliados foram o individual (14 estudos) e o interpessoal (11 estudos), seguidos pelo ambiental (oito estudos) e o político (um estudo). As intervenções no contexto escolar (quatro estudos) aumentaram os níveis de AF e diminuíram o tempo em CS. Entretanto, as evidências dos estudos transversais e de intervenção apresentaram alto risco de viés. Conclusão. Diante das lacunas identificadas, recomendam-se estudos com delineamentos robustos que incluam mais países sul-americanos, com foco em bebês e crianças com menos de 3 anos de idade e que investiguem correlatos dos domínios ambiental e político.

ABSTRACT Objective. To synthesize the findings on correlates of physical activity (PA) and sedentary behavior (SB) in South American children. Method. A search was carried out from June 24 to October 27, 2020, in the LILACS, PubMed, SciELO, Scopus and Web of Science databases. To broaden the search, the references of identified review articles were examined, and a panel of experts was surveyed. Observational and interventional studies conducted with South-American children from zero to 5 years of age were included. Results. Of 3 111 articles initially identified, 18 were eligible: 14 observational studies, 12 studies conducted in Brazil, and 17 studies investigating preschool children (3 to 5 years of age). In addition to Brazil, only Chile and Ecuador were represented. PA and SB were measured by accelerometers in seven studies; however, high variability was observed in the instruments and cut-off points used. Although children were classified as physically active in 12 studies, six studies showed that they spent considerable time in SB. Most studies assessed the individual (14 studies) and interpersonal (11 studies) domains, followed by the environmental (eight studies) and political (one study) domains. Interventions in the school context (four studies) increased PA levels and reduced the time spent in SB. However, the evidence from cross-sectional and interventional studies presented a high risk of bias. Conclusions. Given the knowledge gap identified in this review, studies with robust designs, covering additional South American countries are warranted, focusing on infants and children under 3 years of age and investigating correlates in the environmental and political domains.

RESUMEN Objetivo. Resumir los hallazgos sobre la correlación entre actividad física (AF) y comportamiento sedentario (CS) en la población infantil en América del Sur. Método. Se realizó una búsqueda de los artículos publicados entre el 24 de junio y el 27 de octubre del 2020 en las bases de datos LILACS, PubMed, SciELO, Scopus y Web of Science. Para ampliar la búsqueda, se examinaron las referencias de los artículos de revisión encontrados y se consultó con un panel de expertos. Se incluyeron estudios observacionales y de intervención centrados en población infantil de 0 a 5 años de edad en América del Sur. Resultados. De los 3 111 artículos encontrados inicialmente, 18 cumplieron con los criterios establecidos: 14 tenían un diseño observacional, 12 se llevaron a cabo en Brasil y 17 se realizaron con niños y niñas en edad preescolar (de 3 a 5 años). Además de Brasil, los únicos países representados fueron Chile y Ecuador. La AF y el CS se midieron con acelerómetros en 7 estudios, pero se observó una alta variabilidad en los instrumentos y los puntos de corte utilizados. Aunque se consideró que niños y niñas eran físicamente activos en 12 estudios, 6 estudios revelaron que pasaban mucho tiempo en CS. Los ámbitos de influencia más evaluados fueron el individual (14 estudios) y el interpersonal (11 estudios), seguidos del ambiental (8 estudios) y el político (1 estudio). Las intervenciones en el contexto escolar (4 estudios) aumentaron los niveles de AF y disminuyeron el tiempo en CS. Sin embargo, la evidencia de los estudios transversales y de intervención presentó un alto riesgo de sesgo. Conclusiones. En vista de las lagunas detectadas, se recomienda que se realicen estudios con diseño robusto que incluyan más países sudamericanos, se centren en bebés y menores de 3 años e investiguen correlaciones en los ámbitos político y ambiental.

Abstract Objective: Summarize the effects of interventions designed to promote physical activity during elementary school recess in children between 5 and 10 years old. Effective school interventions for children can promote physical activity and healthy behaviors. Methods: PubMed, Scopus, Bireme, SciELO, Web of Science, PsychINFO, Proquest, Physical Education Index, Sports Discus, and Eric databases were included in the data search. Original intervention articles on physical activity that used regression methods, published between 2000 and 2019 in English, Portuguese and Spanish were analyzed. Analyses were performed in 2019. Outcomes were organized according to the direction of the association by independent variables. Ten articles were considered eligible for data extraction and evaluation. Results: Several strategies were used including playground markings, demarcation of physical activities zones, group activities, availability of sports equipment and facilities. Most of the studies were conducted in the United States. Recess periods ranged from 20-94 min per day and intervention time ranged from 6 weeks to 2 years. Recess duration and intervention effects were positively associated with physical activity. Gender (girls) and age (oldest) were negatively associated with physical activity during recess. Conclusions: Interventions based on modifications of school environment such as playground markings demarcation of physical activities zones, group activities, availability of sports equipment and facilities are cheap and cost-effective for increasing physical activity in school recess.

Resumo Visto o potencial das abordagens institucionais à promoção da saúde, o presente estudo buscou identificar os países do continente americano que possuem diretrizes nacionais de atividade física (AF) chanceladas por órgãos nacionais de saúde. Em maio de 2019 realizou-se uma revisão de escopo, com buscas em cinco bases de dados eletrônicas, sítios eletrônicos dos órgãos nacionais de saúde e contato com integrantes da Rede de Atividade Física das Américas. Foram encontradas diretrizes nacionais de AF em dez dos 36 países pesquisados (27,8%), publicadas entre 2011 e 2018, com maioria nos países da América do Sul (n=6). Todas as diretrizes apresentaram “abordagens e estratégias para a atenção primária em saúde”, “recomendações de AF para a saúde” e o “envolvimento de distintos domínios da AF”, contudo, poucas diretrizes abordaram o “ambiente construído e infraestrutura” (n=3), assim como “ações de monitoramento e vigilância” (n=5). Pode-se concluir que, ao passo que poucos países do continente americano dispõem de diretrizes para a AF e, que boa parte das disponíveis aborda a AF de maneira limitada, novas diretrizes nacionais, fundamentadas na complexidade dos determinantes, monitoramento e consequências da AF são necessárias para a orientação e incentivo de políticas de promoção da AF no contexto populacional.

Abstract Given the potential of institutional approaches to health promotion, this study sought to identify the countries on the American continent which have national physical activity (PA) guidelines approved by their national health agencies. A scoping review was conducted in May 2019, with a search conducted in five electronic databases, national health agency websites and contacts with members of the Physical Activity Network of the Americas. In all, national PA guidelines were found in ten of the 36 countries surveyed (27.8%), published between 2011 and 2018, the majority being in South American countries (n = 6). All guidelines presented “approaches and strategies for primary health care,” “PA recommendations for health,” and the “involvement of different PA domains,” however, few guidelines addressed “constructed environment and infrastructure” (n = 3), as well as “monitoring and surveillance actions” (n = 5). The conclusion can be drawn that, although few countries on the American continent have guidelines for PA and that the majority of those available address PA in a limited way, new national guidelines, based on the complexity of the determinants, monitoring and consequences of PA are needed to guide and foster policies to promote PA within the population.

ABSTRACT BACKGROUND: Coronavirus disease-19 (COVID-19) has imposed a new reality that presents several challenges for healthcare professionals. The main challenge has been the lack of proper training in relation to an unknown disease. OBJECTIVE: To investigate healthcare professionals’ acquisition of knowledge of a new airway management protocol for COVID-19 through their participation in simulation training. DESIGN AND SETTING: Pre and post-test study with purpose sampling, carried out in a tertiary-level hospital in the city of Campinas, state of São Paulo, Brazil. METHODS: This was a cross-sectional pre and post-test intervention among healthcare professionals working in the intensive care unit and emergency department of a large hospital. The training was carried out using an in situ simulation scenario and the participants answered pre and post-tests consisting of a 20-item questionnaire about the new protocol. RESULTS: The paired-sample t test demonstrated that there was a significant increase in test score (t = −19.06; P < 0.001), from before the training (M = 8.62; standard deviation, SD = 3.53) to after the simulation training (M = 17.02; SD = 1.76). CONCLUSIONS: The simulated training had a positive impact on the healthcare professionals’ acquisition of the COVID-19 protocol. We also demonstrated that in situ simulation training was an efficient tool for implementing new protocols, thus bringing benefits to healthcare systems, professionals and patients.