ABSTRACT BACKGROUND: Compared to young individuals, older adults participate more in sedentary behavior (SB) and less in physical activity (PA). These behaviors are associated with numerous adverse health factors. OBJECTIVE: The purpose of the study was to examine the hypothetical effects of substituting time spent sleeping, performing SB, and performing moderate-to-vigorous physical activity (MVPA) on depressive symptomatology in older adults. DESIGN AND SETTING: An analytical cross-sectional study employing exploratory survey methods was conducted in the city of Alcobaça in the state of Bahia, Brazil METHODS: The study included 473 older adults who answered a structured questionnaire during an interview. Exposure time to SB and PA level were assessed using the International Physical Activity Questionnaire, and depressive symptoms were analyzed using the short version of the Geriatric Depression Scale. An isotemporal replacement model was used to evaluate the effects of different SB sessions on depressive symptomatology. RESULTS: An increase in the risk of depressive symptoms was observed when MVPA and sleep time were substituted for the same SB time at all times tested, with maximum values of 40% and 20%, respectively. Opposite substitution of MVPA and sleep time increments reduced the risk of depressive symptomatology by 28% and 17%, respectively. CONCLUSIONS: The results of the present study indicate that replacing SB with the same amount of sleep or MVPA may reduce depressive symptoms. The longer the reallocation time, the greater are the benefits. BACKGROUND individuals (SB PA. . (PA) factors OBJECTIVE sleeping moderatetovigorous moderate vigorous (MVPA SETTING crosssectional cross sectional Bahia METHODS 47 interview Questionnaire Scale RESULTS tested 40 20 20% respectively 28 17 17% CONCLUSIONS benefits (PA 4 2 1

ABSTRACT Background: Blood transfusion is an effective therapeutic practice. However, even adopting all procedures for transfusion safety, there are risks, one of which is immediate adverse reactions. The aim of this study was, by active search, to evaluate the occurrence of immediate adverse reactions estimating the occurrence rate within the first 24 h. Methods: An exploratory, descriptive, prospective study with quantitative analysis was carried out of patients undergoing surgery who received blood component transfusions during hospitalization from October 2018 to August 2019. Data on blood component request forms were collected from the transfusion agency by reviewing medical records and interviewing the patient or family members. Descriptive statistics and the chi-square test were used to analyze the association of demographic variables with the presence or absence of transfusion reactions. Results: A total of 1042 blood component units were transfused in 393 transfusions performed on 184 patients. The main transfused blood component was packed red blood cells. Seventeen reactions were identified in the medical records, using the active search method, none of which had been reported. The transfusion reaction rate was 16.3 occurrences per 1000 transfused units, while the notification rate for the 9389 blood component units transfused by the transfusion agency in the study period was 3.83/1000. There was no statistically significant association between the occurrences or not of transfusion reactions and demographic variables. Conclusion: Through the active search method, it was possible to observe the underreporting of adverse reactions, showing inadequate compliance with current legislation, which is essential to minimize errors and increase transfusion safety. Background practice However safety risks 2 h Methods exploratory descriptive 201 2019 members chisquare chi square Results 104 39 18 cells method reported 163 16 3 16. 100 938 3831000 83 3.83/1000 Conclusion legislation 20 10 1 93 383100 8 3.83/100 9 38310 3.83/10 3831 3.83/1 383 3.83/ 38 3.83 3.8 3.

ABSTRACT BACKGROUND: Frailty syndrome is associated with various physical, cognitive, social, economic, and environmental factors. Although frailty syndrome occurs progressively with age, prevention and treatment are possible. Reducing or eliminating risks and increasing protective factors may be potential strategies for reducing the prevalence of injuries related to frailty. One of the most effective actions is to decrease the time spent in sedentary behavior (SB) by increasing regular physical activity (PA). OBJECTIVE: To examine the hypothetical effect of substitution of the time spent in sleep or SB with an equivalent time spent performing moderate or vigorous PA on frailty syndrome in the older population. DESIGN AND SETTING: An analytical cross-sectional study conducted using exploratory methods of survey, carried out in Alcobaça city, Bahia, Brazil. METHODS: A total of 456 older adults of both sexes, aged ≥ 60 years, participated in this study. Frailty syndrome was identified according to the criteria of the Study of Osteoporotic Fractures. PA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. The effects of time substitution on these behaviors were verified using Poisson regression. RESULTS: The replacement of 60 min/day of SB (prevalence ratio, PR = 0.52; 95% confidence interval, CI: 0.28–0.96) or sleep (PR = 0.52; 95% CI: 0.27–0.98) with 60 min/day of moderate PA (MPA) was associated with a 48% reduction in the prevalence of frailty syndrome. CONCLUSIONS: Replacing the time spent sitting or sleeping with the same amount of MPA time may reduce frailty; the longer the duration of time spent in the substitution of sleep or SB with MPA, the greater the benefits.

ABSTRACT BACKGROUND: Dynapenia is characterized by mobility limitations in the older population when combined with aggravating behavioral factors that can increase the risk of morbidity and mortality. OBJECTIVE: To investigate the hypothetical effects of reallocation of time spent on sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and sleep on dynapenia in older adults. DESIGN AND SETTING: A prospective cohort study using exploratory surveys in Alcobaça City, Bahia State, Brazil. METHODS: In total, 176 older adults (≥ 60 years) of both sexes participated in this study. Dynapenia was assessed using the handgrip strength test with cutoff points of < 27 kg for men and < 16 kg for women. MVPA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. RESULTS: Effects on reallocation were found for the shortest times, such as 10 minutes (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.85–0.99); substituting MVPA with SB increased the chances of dynapenia by 58.0% (95% CI: 1.01–2.49). Analyzing the substitution of 60 minutes/day of SB with 60 minutes/day of MVPA revealed a protective effect, with a lower OR for dynapenia of 37.0% (OR 0.63; 95% CI: 0.40–0.99). The reallocation of sleep time did not significantly reduce dynapenia. CONCLUSIONS: Substituting the time spent sitting with the same amount of time spent on MVPA can reduce dynapenia, and a longer reallocation time confers greater health benefits in older adults. BACKGROUND mortality OBJECTIVE SB, , (SB) moderatetovigorous moderate to vigorous MVPA, (MVPA) SETTING City State Brazil METHODS total 17 ≥ ( 6 years 2 1 women Questionnaire Index RESULTS times odds 0.92 092 0 92 95 CI (CI) 0.85–0.99 085099 85 99 0.85–0.99) 580 58 58.0 (95 1.01–2.49. 101249 1.01–2.49 . 01 49 1.01–2.49) minutesday day effect 370 37 37.0 0.63 063 63 0.40–0.99. 040099 0.40–0.99 40 0.40–0.99) CONCLUSIONS (SB (MVPA 0.9 09 9 (CI 0.85–0.9 08509 8 5 58. (9 10124 1.01–2.4 4 3 37. 0.6 06 04009 0.40–0.9 0. 0.85–0. 0850 1012 1.01–2. 0400 0.40–0. 0.85–0 085 101 1.01–2 040 0.40–0 0.85– 08 1.01– 04 0.40– 0.85 1.01 0.40 0.8 1.0 0.4 1.

RESUMEN Objetivo: comparar la efectividad de diferentes métodos diagnósticos para estimar la pérdida de volumen sanguíneo posparto. Métodos: revisión sistemática de efectividad según PRISMA y Protocolo JBI. Búsquedas en bases de datos: PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science y CINAHL, con el descriptor “Postpartum Hemorrhage” asociado a la palabra clave “Quantification of Blood Loss”. Los datos extraídos tabulados fueron presentados en metasíntesis y metanálisis se aplicaron a los datos cuantitativos. Para evaluar el riesgo de sesgo, se aplicaron las herramientas de evaluación de JBI. Resultados: se incluyeron 14 estudios, publicados entre 2006 y 2021. La cuantificación de pérdida por cualquier método fue superior a la estimación visual y es muy recomendable, sin embargo, la alta heterogeneidad de los estudios no permitió estimar esta asociación. Conclusión: la alta heterogeneidad de los estudios, con probable margen de error dado el descontrol de los factores, indica la necesidad de más estudios, sin embargo la cuantificación demostró ser efectiva en relación a la estimación visual. Registro PRÓSPERO CRD 42021234486. Objetivo posparto Métodos JBI PubMedMEDLINE PubMed MEDLINE PubMed/MEDLINE LILACS Scopus Embase CINAHL Postpartum Hemorrhage Quantification Loss. Loss . Loss” cuantitativos sesgo Resultados 1 200 2021 recomendable asociación Conclusión factores 42021234486 20 202 4202123448 2 420212344 42021234 4202123 420212 42021 4202 420 42 4

ABSTRACT Objective: to compare the effectiveness of different diagnostic methods to estimate postpartum blood volume loss. Methods: a systematic review of effectiveness according to PRISMA and JBI Protocol. Searches in PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science and CINAHL, with descriptor “Postpartum Hemorrhage” associated with keyword “Quantification of Blood Loss”. Tabulated extracted data, presented in metasynthesis and meta-analysis was applied to quantitative data. To assess risk of bias, JBI Appraisal Tools were applied. Results: fourteen studies were included, published between 2006 and 2021. Quantification of loss by any method was superior to visual estimation and is highly recommended, however the studies’ high heterogeneity did not allow estimating this association. Conclusion: the studies’ high heterogeneity, with a probable margin of error given the uncontrolled factors, indicates the need for further studies, however quantification proved to be effective in relation to visual estimate. PROSPERO registration CRD 42021234486. Objective Methods Protocol PubMedMEDLINE PubMed MEDLINE PubMed/MEDLINE LILACS Scopus Embase CINAHL Postpartum Hemorrhage Loss. Loss . Loss” data metaanalysis meta analysis bias Results included 200 2021 recommended association Conclusion factors 42021234486 20 202 4202123448 2 420212344 42021234 4202123 420212 42021 4202 420 42 4

RESUMO Objetivo: comparar a efetividade de diferentes métodos diagnósticos para estimar a perda volêmica sanguínea pós-parto. Métodos: revisão sistemática de efetividade, de acordo com protocolo PRISMA e JBI. Buscas nas bases PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science e CINAHL, com o descritor “Postpartum Hemorrhage” associado à palavra-chave “Quantification of Blood Loss”. Dados extraídos tabulados, apresentados em metassíntese, e aplicou-se metanálise para dados quantitativos. Para avaliar o risco de viés, aplicou-se o JBI Appraisal Tools. Resultados: incluídos 14 estudos, publicados entre 2006 e 2021. A quantificação da perda por qualquer método apresentou superioridade em relação à estimativa visual, sendo altamente recomendada, porém a alta heterogeneidade dos estudos não permitiu estimar essa associação. Conclusão: a alta heterogeneidade dos estudos, com provável margem de erro dado aos fatores não controlados, indica a necessidade de realização de novos estudos, contudo a quantificação se mostrou efetiva em relação à estimativa visual. Registro PROSPERO CRD 42021234486. Objetivo pósparto. pósparto pós parto. parto pós-parto Métodos PubMedMEDLINE PubMed MEDLINE PubMed/MEDLINE LILACS Scopus Embase CINAHL Postpartum Hemorrhage palavrachave palavra chave Quantification Loss. Loss . Loss” tabulados metassíntese aplicouse aplicou quantitativos viés Tools Resultados 1 200 2021 visual recomendada associação Conclusão controlados 42021234486 20 202 4202123448 2 420212344 42021234 4202123 420212 42021 4202 420 42 4

SUMMARY OBJECTIVE: This study aimed to evaluate the safety of the transfusion process in a public teaching hospital and to outline the profile of the hemotherapy care provided. METHODS: This was an exploratory, descriptive, and prospective study with a quantitative approach and grounded in field research. Data were obtained from medical and nursing records and active search. RESULTS: Concentrated red blood cells were the most transfused blood component. Inadequate indications of blood components were detected in 15% of Concentrated red blood cells transfusions, 20% of fresh plasma, 29.2% of platelet concentrates, and 36.4% of cryoprecipitates. Filling out the blood component request forms, the nursing checklist and the entry book were inadequate in 88.3, 92.8, and 69.5% of the procedures, respectively. CONCLUSIONS: Faults were identified throughout the transfusion process, revealing inadequate compliance with current standards and legislation, essential in minimizing the occurrence of errors and maximizing the safety of transfusion. Studies of this nature reinforce the need for continued research in this field.

ABSTRACT BACKGROUND: Dynapenia is characterized by mobility limitations in the older population when combined with aggravating behavioral factors that can increase the risk of morbidity and mortality. OBJECTIVE: To investigate the hypothetical effects of reallocation of time spent on sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and sleep on dynapenia in older adults. DESIGN AND SETTING: A prospective cohort study using exploratory surveys in Alcobaça City, Bahia State, Brazil. METHODS: In total, 176 older adults (≥ 60 years) of both sexes participated in this study. Dynapenia was assessed using the handgrip strength test with cutoff points of < 27 kg for men and < 16 kg for women. MVPA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. RESULTS: Effects on reallocation were found for the shortest times, such as 10 minutes (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.85–0.99); substituting MVPA with SB increased the chances of dynapenia by 58.0% (95% CI: 1.01–2.49). Analyzing the substitution of 60 minutes/day of SB with 60 minutes/day of MVPA revealed a protective effect, with a lower OR for dynapenia of 37.0% (OR 0.63; 95% CI: 0.40–0.99). The reallocation of sleep time did not significantly reduce dynapenia. CONCLUSIONS: Substituting the time spent sitting with the same amount of time spent on MVPA can reduce dynapenia, and a longer reallocation time confers greater health benefits in older adults.

Objetivo: analisar a incapacidade funcional e seus fatores associados entre idosos na comunidade. Método: estudo transversal, com 1.635 idosos distribuídos nas faixas etárias: 60 a 69, 70 a 79 e 80 ou mais, residentes em uma macrorregião de saúde do Estado de Minas Gerais. Procedeu-se à análise descritiva e de trajetórias (p<0,05). Os parâmetros foram estimados pelo método da Máxima Verossimilhança. Resultados: o maior percentual era do sexo feminino, com renda mensal de 1 salário mínimo e morava acompanhado. Nas faixas etárias de 60 a 69 e 70 a 79 anos predominaram os idosos com companheiro, e entre aqueles com 80 anos ou mais os viúvos. Nos três grupos, a incapacidade funcional se deu de forma hierárquica. A menor escolaridade, a fragilidade e a sintomatologia depressiva foram fatores associados diretamente à incapacidade funcional nas atividades avançadas; a fragilidade e o comportamento sedentário associaram-se diretamente à incapacidade funcional nas atividades instrumentais. Nos idosos com idade entre 60 e 69 anos e 70 a 79 anos, o comportamento sedentário associou-se à maior dependência nas atividades básicas. Conclusão: a compreensão ampliada dos fatores atuantes na incapacidade funcional dos idosos, segundo faixa etária, auxilia o profissional de saúde no desenvolvimento de medidas preventivas desse agravo.

Objective: to analyze functional disability and its associated factors among community-dwelling older adults. Method: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. Results: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. Conclusion: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.

Objetivo: analizar la incapacidad funcional y sus factores asociados entre adultos mayores de la comunidad. Método: estudio transversal, con 1.635 adultos mayores distribuidos en rangos etarios: 60 a 69, 70 a 79 y 80 o más, residentes en una macrorregión de salud del Estado de Minas Gerais. Se realizó análisis descriptivo y de trayectoria (p<0,05). Los parámetros se estimaron mediante el método de máxima verosimilitud. Resultados: el mayor porcentaje fue de sexo femenino, con un ingreso mensual de 1 salario mínimo y vivía acompañado. En los rangos etarios de 60 a 69 y de 70 a 79 años predominaron los adultos mayores con pareja, y entre los de 80 años o más, los viudos. En los tres grupos, la incapacidad funcional se presentó de forma jerárquica. Menor educación, fragilidad y síntomas de depresión fueron factores directamente asociados con la incapacidad funcional en actividades avanzadas; la fragilidad y el sedentarismo se asociaron directamente con la incapacidad funcional en las actividades instrumentales. En los adultos mayores de 60 y 69 años y de 70 a 79 años, el sedentarismo se asoció con una mayor dependencia de las actividades básicas. Conclusión: una mayor comprensión de los factores que influyen en la incapacidad funcional del adulto mayor, según el rango etario, ayuda a los profesionales de la salud en el desarrollo de medidas preventivas de esta enfermedad.

RESUMO Objetivo: identificar a associação das anomalias congênitas em nascidos vivos com o perfil obstétrico-neonatal e sociodemográfico. Método: estudo ecológico, realizado em 2019, com 251.444 nascidos vivos, identificados por meio do banco de dados do Sistema de Informações de Nascidos Vivos da Secretaria de Saúde de Minas Gerais. Para análise, adotaram-se a estatística descritiva e a regressão logística binária. Resultados: foram encontrados 1.865 casos de anomalias (0,7%), com predominância de deformidade do sistema osteomuscular em 789 (42,3%) nascidos vivos. As variáveis que apresentaram associação significativa com a anomalia congênita foram mães solteiras, idade ≥35 anos, pré-natal realizado de forma inadequada, iniciado no terceiro trimestre de gestação, gestação dupla ou mais, nascimentos pré-termo, parto cesárea, apresentação fetal pélvica, assistência exclusiva do profissional médico durante o parto, recém-nascido com Apgar de alto risco no quinto minuto, baixo peso ao nascer e sexo masculino. Conclusão: em 2019, as malformações congênitas no estado de Minas Gerais associaram-se às mulheres solteiras, com idade ≥35 anos, que realizaram pré-natal inadequado e tardio, com gestações duplas ou mais. Em relação aos recém-nascidos, as malformações foram associadas com alto risco para sequelas tardias, peso entre ≤1.000g e <2.500g e ser do sexo masculino.

ABSTRACT Objective: to identify the association of congenital anomalies in live births with the obstetric-neonatal and sociodemographic profile. Methods: an ecological study, conducted in 2019, with 251,444 live births, identified through the database of the Live Birth Information System of the Minas Gerais Health Secretariat. Descriptive statistics and binary logistic regression were adopted for the analysis. Results: 1,865 cases of anomalies (0.7%) were found, with predominance of deformity of the musculoskeletal system in 789 (42.3%) live births. The variables that presented a significant association with congenital anomalies were single mothers, age ≥35 years old, inadequately performed prenatal care initiated in the third trimester of pregnancy, double (or more) pregnancy, preterm births, cesarean delivery, fetal breech presentation, exclusive assistance by the medical professional during delivery, newborn with high-risk 5-minute Apgar score, low birth weight, and male gender. Conclusion: in 2019, the congenital malformations in the state of Minas Gerais were associated with single women, aged ≥35 years old, who underwent inadequate and late prenatal care, and with double or more pregnancies. In relation to the newborns, the malformations were associated with a high risk for late sequelae, weight between ≤1,000 g and <2.500 g, and male gender.

RESUMEN Objetivo: identificar la asociación entre las anomalías congénitas en nacidos vivos y el perfil obstétrico-neonatal y sociodemográfico. Métodos: estudio ecológico realizado en el año 2019 con 251.444 nacidos vivos, identificados por medio de la base de datos del Sistema de Información sobre Nacidos Vivos de la Secretaría de Salud de Minas Gerais. Para el análisis, se adoptaron estadística descriptiva y regresión logística binaria. Resultados: se encontraron 1.865 casos de anomalías (0,7%), con predominio de deformidad del sistema osteomuscular en 789 (42,3%) nacidos vivos. Las variables que presentaron una asociación significativa con las anomalía congénitas fueron las siguientes: madres solteras, edad ≥35 años, cursar atención pre-natal inadecuada e iniciada en el tercer trimestre de embarazo, embarazo de gemelos o más bebés, nacimientos prematuros, parto por cesárea, presentación fetal pelviana, asistencia exclusiva de un médico durante el parto, recién nacido con Apgar de alto riesgo al quinto minuto, bajo peso al nascer y sexo masculino. Conclusión: en el año 2019, las malformaciones congénitas en el estado de Minas Gerais estuvieron asociadas a mujeres solteras, con edad ≥35 años, que cursaron atención pre-natal inadecuada y tardía, con embarazos de gemelos o más bebés. En relación con los recién nacidos, las malformaciones estuvieron asociadas con alto riesgo de secuelas tardías, peso entre ≤1.000 g y <2.500 g y ser del sexo masculino.

RESUMO Objetivo Estimar a prevalência de sintomatologia depressiva em idosos brasileiros residentes na comunidade. Métodos Foi realizada uma revisão sistemática nas bases de dados Medline, SciELO, Web of Science, Scopus e CINAHL, sendo selecionados estudos com idosos brasileiros que identificaram a prevalência de sintomatologia depressiva. De forma independente, dois pesquisadores selecionaram os estudos, extraíram os dados e avaliaram a qualidade metodológica. A metanálise foi realizada para estimar a prevalência de sintomatologia depressiva usando um modelo de efeito aleatório. Resultados Foram identificados 176 artigos e 33 foram incluídos na revisão, que investigaram 34 prevalências, com um total de 39.431 idosos. A distribuição geográfica dos estudos indicou pesquisas em todas as regiões do Brasil. A versão curta da Escala de Depressão Geriátrica foi a mais utilizada. A prevalência estimada de sintomatologia depressiva foi de 21,0% (IC de 95%: 18,0-25,0; I2 = 98,3%). As análises de subgrupos revelaram elevada heterogeneidade em todas as categorias analisadas. A metarregressão não identificou as causas da heterogeneidade. Conclusão Apesar da heterogeneidade entre os estudos analisados, os resultados indicam a necessidade de estratégias de intervenção para reduzir a prevalência de sintomatologia depressiva.

ABSTRACT Objective To estimate the prevalence of depressive symptoms in Brazilian elderly people living in the community. Methods We searched the electronic databases Medline (PubMed), SciELO, Web of Science, Scopus and CINAHL, and also selected studies with Brazilian elderly people that identified the prevalence of depressive symptoms. Independently, two researchers selected the studies, extracted the data and assessed the methodological quality. The meta-analysis was performed to estimate the prevalence of depressive symptoms using a random effect model. Results We identified 176 articles and 33 were included in the review, which investigated 34 prevalences, with a total of 39,431 elderly people. The geographical distribution of the studies indicated researches in all regions of Brazil. The short version of the Geriatric Depression Scale was the most used. The estimated prevalence of depressive symptoms for Brazilian community-dwelling older adults was 21.0% (95% CI: 18.0-25.0, I2 = 98.3%). Subgroup analyzes revealed high heterogeneity in all categories analyzed. Meta-regression did not identify the causes of heterogeneity. Conclusion Despite the heterogeneity between the studies analyzed, the results indicate the need for intervention strategies to reduce the prevalence of depressive symptoms.

Resumo O estilo de vida moderno está associado a maior exposição ao comportamento sedentário (CS), sobretudo em idosos, entretanto, há uma carência de questionários validados para medida do CS em idosos brasileiros. Objetivou-se adaptar transculturalmente e validar a versão brasileira do questionário “Measure of Older Adults Sedentary Time” (MOST). Adotou-se para adaptação e validação os critérios de validade de conteúdo, clareza e concorrente. Responderam ao MOST adaptado e utilizaram acelerômetro ActiGraph wGT3X-BT por sete dias, 57 idosos (68,7 ± 3,5 anos). Após esse período, o MOST adaptado foi reaplicado e o acelerômetro recolhido. Realizou-se o somatório dos tempos das questões do MOST, download dos dados do acelerômetro em counts/min e reintegração dos dados brutos para counts em epochs de 60 segundos no software ActiLife 6.0. Foi utilizado o ponto de corte <100 counts/min. A relação entre CS através do MOST e acelerômetro foi verificada pela correlação de Pearson, reprodutibilidade pelo coeficiente de correlação intraclasse (CCI), consistência interna pelo alpha de Cronbach (α) e concordância pelo Bland-Altman. Adotou-se p ≤ 0,05 para significância estatística. O índice de validade de conteúdo foi de 100% e clareza 98%. O CCI foi de 0,72 (IC95%: 0,56-0,82) para o tempo total em CS pelo MOST. A correlação entre o CS do MOST e do acelerômetro foi de 0,37 (IC95%:0,13-0,58). Houve tendência de subestimação do CS pelo MOST adaptado comparado ao acelerômetro (viés de medida: 732,8 min/sem [2087,6; -3553,2 min/sem]). O questionário MOST adaptado apresenta parâmetros psicométricos adequados para avaliação do CS em idosos brasileiros.

Abstract Modern lifestyle is associated with prolonged exposure to sedentary behavior (SB), especially in older adults; however, there is a lack of validated questionnaires to measure SB in Brazilian older adults. The aim of this study was to adapt and validate the Brazilian version of the "Measure of Older Adults Sedentary Time" (MOST) questionnaire in Brazilian older adults. Content validity, clarity and concurrent validity of the adapted MOST were examined. Fifty-seven participants (68.7 ± 3.47 years) answered the adapted version of the MOST questionnaire and wore an ActiGraph wGT3X-BT accelerometer for seven days. After this period, participants answered the adapted MOST again and the accelerometer was collected. MOST answers were summed over for calculating self-reported time spent in SB. A cutoff point of < 100 counts/min was applied to accelerometer data for estimating time spent in SB. The relationship between SB estimates from MOST and accelerometer was verified by Pearson correlation, reproducibility was verified by intra-class correlation coefficient (ICC), internal consistency by Cronbach's alpha (α) and concordance by Bland-Altman. Significance was set at P <0.05. Content validity index and clarity index were 100% and 98%, respectively. ICC was 0.72 (95% CI: 0.56-0.82) for total time in SB assessed with the MOST questionnaire. The correlation between SB estimates from MOST and accelerometer data was 0.37 (95% CI: 0.13-0.58). The adapted MOST systematically underestimated SB compared to accelerometer (measurement bias: -732.8 min/week [2087.6; -3553.2 min/wk]). The adapted MOST questionnaire presents adequate validity for assessing SB in the Brazilian older adults.

ABSTRACT Objective to identify the sociodemographic and health profile of older adults in municipalities of the Uberaba Health Region in Minas Gerais, Brazil. Method in this cross-sectional, population-based study, the Mini-Mental State Examination, a demographic and health profile instrument, the Mini Nutritional Assessment, WHOQOL-BREF and WHOQOL-OLD were applied to 3430 older adults in 24 cities, between 2012 and 2013. Data were analyzed using SPSS version 20.0. Results female (61.5%), 60 to 69 years old (52.6%), no schooling or incomplete basic schooling (83.5%), income of one minimum wage or less (39.7%), pensioners (80.7%), mean 3.17 illnesses (SD = 1.92), use of 2.47 medicines (DP = 1.37), at risk for malnutrition (29.1%), overweight (62.9%), alcohol use (15.7%), smoking (15%), sedentary (43.1%), and with lowest quality of life scores in the environment domain (62.0%; DP = 13.2) and autonomy facet (66.8%; DP = 16.4). Conclusion the study population was characteristically female, low-income, overweight, sedentary, had three diseases, and lowest quality of life scores in the environment domain and autonomy facet.

RESUMEN Objetivo identificar el perfil sociodemográfico y de salud de ancianos de las ciudades en una Regional de Salud de Minas Gerais, Brasil. Método estudio transversal de base poblacional, realizado en 24 ciudades junto a 3430 ancianos, entre 2012 y 2013. Se aplicó: mini-examen del estado mental, instrumento del perfil del sociodemográfico, mini-evaluación nutricional, WHOQOL-BREF y WHOQOL-OLD. Para el análisis se utilizó SPSS versión 20.0. Resultados sexo femenino (61,5%), 60 a 69 años (52,6%), sin escolarización/analfabeto o secundario incompleto (83,5%), recibiendo hasta un salario mínimo (39,7%), jubilados (80,7%), promedio de 3,17 (dp=1,92) enfermedades por anciano, uso de 2,47 remedios (dp=1,37) en promedio, riesgo para la desnutrición (29,1%), exceso de peso (62,9%), alcoholismo (15,7%), tabaquismo (15%), sedentarismo (43,1%), calidad de la vida con menores puntuaciones en el dominio medio ambiente (62,0/dp=13,2) y, en el área autonomía (66,8/dp=16,4). Conclusión sexo femenino, bajos ingresos, promedio de tres enfermedades por persona, exceso de peso, sedentarismo y calidad de la vida, con menores puntuaciones en el dominio medio ambiente y el área autonomía, caracterizan la población encuestada.

RESUMO Objetivo identificar o perfil sociodemográfico e de saúde de idosos dos municípios numa regional de Minas Gerais. Método estudo transversal de base populacional, realizado em 24 cidades com 3430 idosos. Aplicou-se: Mini exame do Estado Mental, instrumento de perfil sociodemográfico, Mini avaliação Nutricional, WHOQOL-BREF e WHOQOL-OLD. Para a análise se usou SPSS versão 20.0. Resultados sexo feminino (61,5%), 60 a 69 anos (52,6%), sem escolarização/analfabeto ou fundamental incompleto (83,5%), recebendo até um salário mínimo (39,7%), aposentados (80,7%) média de 3,17 (dp=1,92) doenças por idoso, uso em média de 2,47 medicamentos (dp=1,37), risco para desnutrição (29,1%), excesso de peso (62,9%), etilismo (15,7%), tabagismo (15%), sedentarismo (43,1%), qualidade de vida com menores escores no domínio meio ambiente (62,0/dp=13,2) e, na faceta autonomia (66,8/dp=16,4). Conclusão sexo feminino, baixa renda, média de três doenças por pessoa, excesso de peso, sedentarismo e qualidade de vida com menores escores no domínio meio ambiente e faceta autonomia caracterizam a população pesquisada.

O objetivo desse estudo foi analisar a produção de artigos sobre comportamentos sedentários em idosos. Trata-se de uma revisão sistemática a partir da base de dados Pubmed. Os descritores utilizados foram “sedentary behavior” e “sitting time” combinados com elderly, older e aging. Foram incluídos artigos originais completos disponíveis até dezembro de 2013, que apresentassem medida do comportamento sedentário. Considerou-se o tipo de inquérito e delineamento, local da coleta dos dados, instrumentos, definição operacional e ponto de corte para comportamento sedentário. Foram encontrados 559 artigos, e desses 130 foram excluídos por duplicação, resultando em 429, desses 39 atenderam os critérios de inclusão estabelecidos. Os artigos foram publicados entre 2003 a 2013. Acelerômetro e questionário foram os instrumentos mais pronunciados para medida do comportamento sedentário nos artigos analisados. Foram identificadas lacunas na produção científica em relação aos pontos de corte para definir a quantidade de tempo sentado que representa risco à saúde das pessoas idosas, definição operacional universal, bem como falta de padronização dos instrumentos. Sugerem-se mais estudos relacionados com essa temática a fim de reduzir as lacunas existentes.

The aim of this study was to analyze the production of articles on sedentary behaviors in the elderly. This is a systematic review from the Pubmed database. The descriptors used were “sedentary behavior” and “sitting time” combined with elderly, older and aging. We included original articles available until December 2013, to submit measure of sedentary behavior. We considered the type of survey and design, instruments, operational definition and cutoff for sedentary behavior. The initial electronic searches resulted in 559 manuscripts, and of these 130 were excluded for duplication, resulting in 429 manuscripts. The process of analysis of the studies involved reading titles, abstracts and full texts. After all these phases, 39 manuscripts met the inclusion criteria of the review. The articles were published between 2003 and 2013. Accelerometer and questionnaire were instruments more pronounced for the measurement of sedentary behavior in the analyzed articles. We identified gaps in scientific production in relation to the cutoff points to define the amount of time sitting that poses a risk to the health of the elderly, operational definition universal, as well as lack of standardization of instruments. We suggest further studies related to this theme in order to reduce the gaps.

Resumo Em meados do século passado, transformações na economia e sociedade brasileira somaram-se para desencadear uma rápida transição demográfica, que se caracterizou pelo aumento de idosos. Assim, presenciou-se um envelhecimento populacional, que foi acompanhado pelo aumento da incidência de doenças crônicas não transmissíveis. Alguns fatores de risco estão bem estabelecidos para o desenvolvimento das doenças crônicas não transmissíveis, como excesso de peso, consumo de tabaco e álcool, alimentação inadequada e inatividade física. Adicionalmente, o comportamento sedentário mostrou-se relacionado a importantes efeitos deletérios à saúde, como, por exemplo, diabetes mellitus tipo 2, obesidade e mortalidade.O estudo teve como objetivo investigar a associação entre tempo sentado e diabetes mellitus em idosos. Estudo transversal, realizado em 24 municípios integrantes da Superintendência Regional de Saúde de Uberaba, MG. Os indivíduos selecionados responderam um questionário estruturado e foram submetidos à avaliação antropométrica. Foram analisados 3.265 idosos. A prevalência de diabetes mellitus foi de 20,0% e a mediana de tempo sentado de 240,00 (P25º=137,14 e P75º=330,00) minutos/dia. A análise de regressão logística ajustada demonstrou que o tempo sentado superior a 330,00 minutos/dia associou-se positivamente com a diabetes mellitus (OR=1,329; IC95%: 1,040-1,700). Pode-se concluir que os idosos que ficam sentados por longos períodos diariamente apresentam maior chance de ter diabetes mellitus quando comparados com aqueles que ficam sentados por menor tempo.

Abstract By the middle of the last century, changes in the Brazilian economy and society triggered a rapid demographic transition characterized by an increased number of older adults in the population. Thus, Brazil has witnessed population aging, which was accompanied by an increased incidence of non-communicable chronic diseases. Some risk factors for the development of the chronic non-communicable diseases have been well established, such as overweight, tobacco and alcohol consumption, inadequate nutrition, and physical inactivity. Additionally, sedentary behavior has been related to significant deleterious effects on health, such as diabetes mellitus type 2, obesity and mortality. The objective of this study was to investigate the association between sitting time and diabetes mellitus in older adults. A cross-sectional study was conducted in 24 municipalities in the Regional Health Superintendence of Uberaba, MG. Selected subjects answered a structured questionnaire and underwent anthropometric assessment. A total of 3,265 elderly subjects, with a median time spent sitting of 240.00 (P25th=137.14 and P75th=330.00) minutes/day and a 20.0% prevalence of diabetes mellitus were detected. Adjusted logistic regression analysis showed that a sitting time of more than 330.00 minutes/day was positively associated with diabetes mellitus (OR=1.351, 95%CI: 1.057-1.729). It was concluded that older adults who daily sit for long periods of time have higher chances of having diabetes compared to those who sit for less time.

O presente estudo de revisão narrativa teve como objetivos: a) rever os termos operacionais utilizados para a caracterização do comportamento sedentário; b) descrever as implicações para a saúde; e c) os principais métodos de avaliação do comportamento sedentário. Comportamento sedentário é o termo direcionado para as atividades que são realizadas na posição deitada ou sentada e que não aumentam o dispêndio energético acima dos níveis de repouso, <= 1.5 equivalentes metabólicos (METs). Ao analisar as implicações fisiológicas destes comportamentos para a saúde das pessoas é possível destacar a redução e/ou a cessação da contratilidade muscular como desencadeador do processo de diminuição da utilização da glicose pelos músculos, do aumento da insulina e do favorecimento da produção de lipídios que serão preferencialmente armazenados no tecido adiposo da região central do corpo, o qual por sua vez produz moléculas inflamatórias precursoras das doenças crónicas não transmissíveis. A inatividade física e a exposição prolongada a comportamentos sedentários devem ser avaliadas distintamente, respeitando as bases teóricas de cada constructo. O efeito prolongado da exposição aos comportamentos sedentários e da inatividade física ao longo do curso da vida favorece a potencialização dos efeitos nocivos de tais comportamentos na velhice e a mortalidade precoce.

This present study aimed to: a) review the operational terms of sedentary behaviour characterization, b) describe the health implications, and c) sedentary behaviour main evaluation methods. Sedentary behaviour is the word targeting activities that are performed in lying or sitting position and that do not increase energy expenditure above resting levels, <= 1.5 metabolic equivalent units (METs). Through the analysis of the physiological implications of such behaviour to people's health it is possible to highlight the reduction and / or cessation of muscle contractility as a beginner of the reducing process of the use of glucose by muscles, increasing insulin and facilitating the production of lipids that are preferentially stored in the central body adipose tissue, which in turn produces inflammatory molecules which are the precursors of non-transmissible chronic diseases. Physical inactivity and prolonged exposure to sedentary behaviours should be evaluated distinctly, considering the theoretical bases of each construct. The prolonged effect of sedentary behaviours and physical inactivity throughout lifespan enables the possibility of the harmful effects of such behaviours in old age and premature mortality.