Resumo O uso de preservativos pode ser influenciado por aspectos psicológicos e socioculturais, que podem ser modulados por atitudes individuais. O objetivo foi propor uma versão em português brasileiro da Short-Form Condom Attitude Scale (Short-Form CAS), descrevendo os procedimentos de tradução, adaptação transcultural e avaliação das propriedades psicométricas em uma amostra de universitários. Trata-se de estudo transversal com estudantes matriculados na Universidade de São Paulo (USP), Campus Ribeirão Preto (n = 491; 61,2% feminino; média de idade: 22 anos; desvio-padrão: quatro anos). Foi realizada análise fatorial confirmatória. O modelo unifatorial com sete itens apresentou boa validade fatorial e confiabilidade, sugerindo ser a melhor solução fatorial para a Short-Form CAS. Há poucos estudos sobre os fatores comportamentais associados ao uso de preservativos em populações-chave, o que pode ser influenciado pela falta de instrumentos. A principal contribuição deste estudo foi propor uma versão simples e adaptada transculturalmente da Short-Form CAS com algumas propriedades psicométricas verificadas. Uma vez que o uso de preservativos é um componente do comportamento sexual de risco, a escala se apresenta como uma nova opção para futuros estudos na população brasileira.

Abstract The condom use can be influenced by psychological and sociocultural aspects, which can be modulated by individual’s attitudes. The aim was to propose a Brazilian Portuguese version of the Short-Form Condom Attitude Scale (Short-Form CAS), describing all procedures of translation, transcultural adaptation, and psychometric properties evaluation when applied to undergraduate students. A cross sectional study was conducted among students enrolled at University of São Paulo (USP), Campus Ribeirão Preto (n = 491; 61.2% female; average age: 22 years; standard deviation: four years). Confirmatory factor analysis was performed. A one-factor model with seven items exhibited good factorial validity and reliability, suggesting to be a better factorial solution of the Short-Form CAS in the sample. Few studies have been carried out on the behavioral factors associated with condom use in key populations, which can be exacerbated by a lack of appropriate scales. Therefore, the main contribution of the present study was to propose a simplified and transculturally adapted version of the Short-form CAS with some psychometric properties verified. Since the use of condoms is a component of the study of sexual risk behavior, this scale might be an option to be applied in various Brazilian population segments for this purpose.

ABSTRACT Many countries have modified their policies on banning or deferring blood donation by men who have sex with men (MSM) in light of ethical concerns and new evidence about transfusion risks. In Brazil, MSM were not eligible to donate blood unless they had been celibate for the previous 12 months. However, in May 2020, the Brazilian Federal Supreme Court overturned this restriction. Many authors have attempted to stress possible risks of transfusion-transmitted infection under various scenarios of changes in bans or restrictions on donations by MSM using mathematical models, but we consider that it is a difficult task due to the wide variety of sexual behaviors, attitudes, and practices. Among these factors, we highlight sex under the influence of illicit drugs, and the fact that people with an undetectable human immunodeficiency virus viral load have the potential to transmit should their blood be transfused. Despite these possible risks, we believe that some MSM can donate blood regardless of the time elapsed since their last sexual contact, especially because blood donations by MSM were occurring even when there were time-based deferral rules. Blood banks should always seek to use screening algorithms to identify high-risk sexual behaviors using gender-neutral criteria, and education about transfusion risks should be offered to healthcare workers and MSM. (MSM Brazil 1 months However 2020 restriction transfusiontransmitted transmitted models attitudes practices factors drugs transfused contact timebased based rules highrisk high risk genderneutral gender neutral criteria 202 20 2

Resumo No Brasil, o advento dos centros de testagem e aconselhamento (CTA) trouxe muitos benefícios na luta contra a Aids. Um estudo transversal do tipo web survey foi realizado para investigar o conhecimento e as percepções dos indivíduos LGBT+ brasileiros sobre a existência dos CTAs e suas associações com comportamentos de risco e outras variáveis de interesse. O questionário incluiu questões sociodemográficas e comportamentais, conhecimento sobre o CTA, acesso e uso, crenças sobre a infecção pelo HIV, resultados de testes e percepção de risco. O escore de comportamento de risco (RBS) também foi utilizado. Participaram 1.630 voluntários (56,8% homens). Destes, 96,1% se autodeclararam homens que fazem sexo com homens (HSH). Quase 50% dos participantes não conhecem os CTAs, sendo este conhecimento maior entre os HSHs. Uma baixa frequência de participantes tem percepção clara dos riscos a que estão expostos, e os HSHs com maior pontuação no RBS estão cientes da existência dos CTAs, que são fundamentais na implementação de políticas de combate e prevenção ao HIV e outras doenças sexualmente transmissíveis. Nossos resultados contribuem para a melhor compreensão da sua influência na frequência de testagem, na vigilância do status sorológico e no aconselhamento em populações-chave. Brasil CTA (CTA Aids LGBT interesse comportamentais uso (RBS utilizado 1630 1 630 1.63 56,8% 568 56 8 (56,8 homens. . homens) Destes 961 96 96,1 HSH. HSH (HSH) 50 expostos transmissíveis populaçõeschave. populaçõeschave populações chave. chave populações-chave 163 63 1.6 56,8 5 (56, 9 96, (HSH 16 6 1. 56, (56 (5 (

Abstract In Brazil, the advent of voluntary and counseling testing (VCT) has provided many benefits in the fight against AIDS. A sectional open web survey was conducted to investigate the Brazilian LGBT+ individuals’ knowledge and perceptions of the existence of VCT centers and their associations with risk behavior and other variables of interest. The study instrument included questions on sociodemographic and behavioral variables, knowledge on VCT, access to and use of it, beliefs about HIV infection, test results, and risk perception. The Risk Behavior Score for HIV infection (RBS) was also used. A total of 1,630 volunteers participated in the survey, of whom 56.8% were men. Of these, 96.1% declared themselves as (MSM). Almost 50% of the participants had never heard about the existence of VCT, which was a higher knowledge score among MSM. A low frequency of participants had a clear perception of the risks to which they are exposed, whereas those with higher RBS were aware of the existence of VCT. As VCT is critical for the implementation of policies to combat and prevent HIV and other sexually transmitted diseases, our results can contribute to a better understanding of the influence of VCT on the frequency of testing, serological surveillance, and routine counseling for key populations. Brazil (VCT AIDS LGBT individuals interest it (RBS used 1630 1 630 1,63 568 56 8 56.8 men these 961 96 96.1 MSM . (MSM) 50 exposed diseases surveillance populations 163 63 1,6 5 56. 9 96. (MSM 16 6 1,

Abstract In Brazil, the advent of voluntary and counseling testing (VCT) has provided many benefits in the fight against AIDS. A sectional open web survey was conducted to investigate the Brazilian LGBT+ individuals’ knowledge and perceptions of the existence of VCT centers and their associations with risk behavior and other variables of interest. The study instrument included questions on sociodemographic and behavioral variables, knowledge on VCT, access to and use of it, beliefs about HIV infection, test results, and risk perception. The Risk Behavior Score for HIV infection (RBS) was also used. A total of 1,630 volunteers participated in the survey, of whom 56.8% were men. Of these, 96.1% declared themselves as (MSM). Almost 50% of the participants had never heard about the existence of VCT, which was a higher knowledge score among MSM. A low frequency of participants had a clear perception of the risks to which they are exposed, whereas those with higher RBS were aware of the existence of VCT. As VCT is critical for the implementation of policies to combat and prevent HIV and other sexually transmitted diseases, our results can contribute to a better understanding of the influence of VCT on the frequency of testing, serological surveillance, and routine counseling for key populations.

Resumo No Brasil, o advento dos centros de testagem e aconselhamento (CTA) trouxe muitos benefícios na luta contra a Aids. Um estudo transversal do tipo web survey foi realizado para investigar o conhecimento e as percepções dos indivíduos LGBT+ brasileiros sobre a existência dos CTAs e suas associações com comportamentos de risco e outras variáveis de interesse. O questionário incluiu questões sociodemográficas e comportamentais, conhecimento sobre o CTA, acesso e uso, crenças sobre a infecção pelo HIV, resultados de testes e percepção de risco. O escore de comportamento de risco (RBS) também foi utilizado. Participaram 1.630 voluntários (56,8% homens). Destes, 96,1% se autodeclararam homens que fazem sexo com homens (HSH). Quase 50% dos participantes não conhecem os CTAs, sendo este conhecimento maior entre os HSHs. Uma baixa frequência de participantes tem percepção clara dos riscos a que estão expostos, e os HSHs com maior pontuação no RBS estão cientes da existência dos CTAs, que são fundamentais na implementação de políticas de combate e prevenção ao HIV e outras doenças sexualmente transmissíveis. Nossos resultados contribuem para a melhor compreensão da sua influência na frequência de testagem, na vigilância do status sorológico e no aconselhamento em populações-chave.

Abstract Objectives To propose a Portuguese version of the Objective and Subjective Knowledge and HIV Testing Scale (OSK-HIV-TS), assess its content validity, and perform item analysis after administration to a sample of undergraduate students. Methods Three translators translated the OSK-HIV-TS into Portuguese. Judges evaluated each item of a consensus version of the translated instrument for semantic, idiomatic, cultural, and conceptual equivalence. A consensus committee reviewed a back-translation against the original version of the OSK-HIV-TS. Content validity was calculated with the content validity index (CVI) and item analysis was conducted using Classical Test Theory (CTT). Results The translated scale achieved semantic, idiomatic, conceptual, and cultural equivalence to the original version. A total of 491 undergraduate students participated and the distribution of students’ responses to the OSK-HIV-TS revealed a high proportion of correct answers. All items were classified as easy or very easy and only item 16 was classified having strong discrimination power according to the discrimination index. Conclusion The OSK-HIV-TS is a novel instrument in the Brazilian literature for assessing human immunodeficiency virus (HIV) knowledge and should inspire more research into HIV/acquired immunodeficiency syndrome (AIDS) behavior and associated factors, which, despite being essential and necessary, is still lacking in the Brazilian literature. OSKHIVTS, OSKHIVTS OSK TS , (OSK-HIV-TS) semantic idiomatic backtranslation back translation OSKHIVTS. TS. CVI (CVI CTT. CTT . (CTT) 49 answers 1 (HIV HIVacquired acquired AIDS (AIDS factors which necessary (OSK-HIV-TS (CTT 4

Resumo Introdução As fraturas de fêmur são uma das causas principais de morbidade e mortalidade, principalmente entre as pessoas idosas. Objetivo Examinar o efeito da sazonalidade nas hospitalizações devido à fratura do fêmur entre residentes do estado do Rio Grande do Sul, sul do Brasil, de 2008 a 2019. Métodos Trata-se de um estudo ecológico baseado em dados secundários do Sistema de Informação Hospitalar do SUS (SIH/SUS). Um total de 74.374 relatórios de internações hospitalares foi considerado. O modelo aditivo generalizado (GAM) foi usado para avaliar a sazonalidade da série temporal, com estratificação por sexo e grupos etários e considerando a média mensal de eventos de fraturas do fêmur por dia como uma variável dependente. Resultados Descreveu-se uma incidência consideravelmente maior de fraturas do fêmur em mulheres com 70 anos de idade ou mais. Entre as pessoas com menos de 50 anos de idade, não há um efeito sazonal aparente. Homens com idade de 70 anos ou mais e mulheres com 50 anos ou mais têm maior frequência de hospitalizações devido a fraturas do fêmur nos meses mais frios. Conclusão Entre as pessoas mais idosas, as fraturas do fêmur ocorreram mais frequentemente durante o inverno em comparação ao verão. Isto reafirma os resultados de outros estudos, embora as razões para esta variação sazonal sejam incertas. O conhecimento destas variações sazonais pode ajudar no planejamento da assistência médica no sistema público de saúde.

Abstract Introduction Femoral fractures are a major cause of morbidity and mortality, mainly among older people. Objective To examine the effect of seasonality on hospitalizations due to femur fracture among people residing in the Rio Grande do Sul state, southern Brazil, from 2008 to 2019. Methods Ecological study based on secondary data from the SUS Hospital Information System (SIH/SUS). A total of 74,374 reports of hospital admissions was considered. The generalized additive model (GAM) approach was employed to assess the seasonality of the time series, with stratification by sex and age groups and considering the monthly average number of events of femoral fractures per day as a dependent variable. Results A considerably higher incidence of femoral fractures in women aged 70 years or more was described. Among people aged less than 50 years, there is not an apparent seasonal effect. Men aged 70 years or older and women aged 50 years or older have a higher frequency of hospitalizations due to femur fractures in the colder months. Conclusion Among older people, more femoral fractures occurred during the winter compared to summer. This supports findings from other studies, although reasons for this seasonal variation are uncertain. The knowledge of these seasonal variations can help to plan the health care in the public health system.

Abstract Introduction Studies based on knowledge, attitude, and practice (KAP) theory are conducted to identify ways to improve strategies aimed at preventing and combatting certain conditions or diseases, to understand the way how behavioral changes are assimilated by the populations, and to reorient interventions. In view of the coronavirus disease 2019 (COVID-19) pandemic, studies based on KAP theory have been useful to better understand certain behaviors, such as adherence to prevention measures and control of the spread of the virus. Objective To describe the process of cross-cultural adaptation of two complementary instruments for assessing KAP regarding the COVID-19 pandemic in the Brazilian population. Methods Two independent translators proposed a first Brazilian Portuguese version of the scales. The cultural adaptation and pre-test of the Brazilian Portuguese versions occurred at different stages, using a panel of specialists and a subsample of the target population, respectively. Results The pre-test of the adapted instruments involved 30 Brazilian adults (mean age = 41.8 years; standard deviation = 4.24) and was carried out to assess instrument understanding and applicability. The participants informed they did not have difficulties to self-complete the instruments and reported a high level of clarity and understanding. Conclusion Both instruments can bring an opportunity to study behavioral constructs about COVID-19 in the Brazilian population, aiming to articulate strategies that enable the fulfillment of effective preventive measures.

ABSTRACT Background: The level of satisfaction of donors with the blood donation system is an important factor which influences their intent to return for future donation. A 25-item questionnaire on the satisfaction of blood donors has been recently proposed to assess the donor satisfaction with the service provided by a blood bank. The objective of this study was to present a proposal for application and interpretation of a BDSQ considering a sample of blood donors of a Brazilian blood bank. Methods: A sample of 1019 blood donors at the Regional Hemotherapy Center of Franca, Brazil, answered the BDSQ. A top-box analysis was used to assess the associations between the variables characterizing the profiles of blood donors and their overall satisfaction with the service provided by the blood bank. We proposed the use of a performance-importance plot (PIP) for the interpretation of the 25 items of the BDSQ. Results: Older donors are more likely to report lower overall satisfaction with the service provided by the blood bank. PIP allows us to classify the items of BDSQ into longand short-term improvement opportunities as well as into motivational and hygiene factors. Motivational factors (i.e. attributes that promote overall satisfaction when present) tend to be associated with the treatment offered by the blood bank staff. Donors seem to give more importance to the interpersonal aspects than to the physical structure of the service and other aspects of convenience. Conclusions: Top-box analysis and PIP proved to be efficient strategies to interpret the results of the BDSQ.

Abstract Introduction The university period is often characterized as a critical period of vulnerability for smoking habit initiation. Objective The purpose of this cross-sectional study was to assess the relationship between religiosity and smoking among undergraduate students on health sciences courses. Methods A total of 336 students on four health sciences courses (occupational therapy, speech therapy, nutrition, and physiotherapy) completed a cigarette smoking questionnaire along with the Duke University Religion Index. Results Smoking prevalence was 8.3% among females and 12.7% among males. Prevalence among students who do not have a religion, but do believe in God, was higher than among those who do have a religion (16.3 and 6.3%, respectively). Organizational religious activity has a significant effect on smoking status. Conclusion The students have health habits that are not only motivated by the technical knowledge acquired on their undergraduate courses, since there was a possible influence of social norms stimulated by religious institutions on their attitudes, knowledge and practices in health.

RESUMO Objetivo Este estudo metodológico objetivou realizar a adaptação cultural do Questionário de Alimentação Infantil para uso no Brasil. Methods Os dados foram coletados em município do nordeste paulista, entre março e setembro de 2018. Sete juízes avaliaram a padronização idiomática, e 85 pais de crianças em idade pré-escolar realizaram a adaptação cultural. Results Entre os juízes, obteve-se concordância acima de 80% para 54 das 55 afirmações do questionário. Para os pais, o questionário é muito bom; não há dificuldade em utilizá-lo; a maioria compreendeu as frases afirmativas; e todos o julgaram de grande importância para o conhecimento da alimentação saudável da criança. A consistência interna foi estimada considerando o coeficiente Kuder-Richardson para variáveis dicotômicas; buscou-se também a correlação de cada item com o total. Obtiveram-se valores entre 0,72 e 0,76, ou seja, boa consistência, o que confirma a fidedignidade da versão brasileira do questionário. Conclusions O Questionário de Alimentação Infantil foi adaptado culturalmente com pais. Estudos futuros devem ser conduzidos em outras realidades brasileiras para permitir a ampla utilização do questionário. Ele contribui para fomentar a implementação de melhores práticas na alimentação infantil que favoreçam crescimento e desenvolvimento saudáveis, assim como para estimular hábitos saudáveis nas famílias brasileiras e a redução dos quadros de sobrepeso e obesidade infantil no país.

ABSTRACT Objective A methodological study aimed at performing the cultural adaptation of the Child Feeding Questionnaire for its use in Brazil. Methods We collected data in a city in the northeastern region of the state of São Paulo, between March and September 2018; seven judges assessed its language standardization, and 85 parents of preschool children performed the cultural adaptation. Results The judges’ agreement level was above 80% for 54 of the 55 statements in the questionnaire. For the parents, the questionnaire is very good, they had no difficulties in using it; most of them understood the affirmative sentences and all parents considered the questionnaire important for the knowledge of child´s healthy eating. We estimated the internal consistency by considering the Kuder-Richardson coefficient for dichotomous variables, and the correlation of each item with the total score was also sought. The results showed values between 0.72 and 0.76, indicating a good consistency, which confirms the reliability of the Brazilian version of the questionnaire. Conclusions The Child Feeding Questionnaire was culturally adapted, aided by the parents. Future studies must be conducted in other Brazilian realities to allow the questionnaire to be widely used. It contributes to promoting the implementation of better practices in child feeding that favor healthy growth and development, as well as to encourage healthy habits in Brazilian families, and to reduce overweight and childhood obesity in the country.

ABSTRACT Objective: To develop a self-reporting questionnaire, namely the Blood Donor Satisfaction Questionnaire (BDSQ) in Brazilian Portuguese, to assess the blood donor satisfaction with the service provided by a blood bank. Method: This study was carried out in three stages: 1) a preliminary version of the instrument was proposed, based on a revision of a previous questionnaire and consideration of the focus groups blood donor perceptions; 2) a content validation to assess the relevance of the items, clarity, domain structure and comprehensiveness of the satisfaction measurement, and; 3) a pre-test of the instrument using a sample of blood donors. All the stages of the research were performed at the Regional Hemotherapy Center in Franca, São Paulo, Brazil. Results: The 25-item BDSQ being proposed has an additional question on overall satisfaction. Responses to items are presented on a five-point scale, including a neutral answer. The BDSQ has three domains: accessibility and convenience, technical aspects, and interpersonal aspects. Conclusion: The application of the BDSQ has shown that it can be a useful tool in generating information for managers on specific aspects of blood bank services which need to be improved, monitored or maintained, aiming to provide a service which meets the blood donor expectations and makes him or her feel satisfied with the care received.

Resumo Inatividade física e sedentarismo são associados com baixa saúde física e mental. O objetivo deste artigo é avaliar as mudanças nos hábitos dos participantes brasileiros praticantes de atividades físicas em relação às suas práticas, devido às medidas de distanciamento social durante a epidemia COVID-19 em 2020. O objetivo secundário foi descrever seus níveis de ansiedade e depressão. O questionário utilizado nesta pesquisa on-line incluiu informações demográficas, questões sobre a autopercepção do impacto do COVID-19 nas rotinas da vida e a Escala de Depressão de Ansiedade Hospitalar de 14 itens. Um total de 1.613 adultos completou o questionário entre 11 e 15 de maio de 2020. Destes, 79,4% relataram que as medidas para conter a epidemia tiveram algum impacto em suas atividades físicas e muitos tiveram que interromper ou diminuir a frequência de suas práticas. Os participantes que sentiram um maior impacto da quarentena em suas atividades físicas tendem a ter maior prevalência de sintomas de ansiedade e depressão. Os indivíduos que praticavam atividades físicas relataram que o distanciamento social teve alta influência em suas práticas. Além disso, as mudanças destes hábitos são associadas com altos níveis de precária saúde mental.

Abstract Physical inactivity and sedentary behavior are associated with poor physical and mental health. The article aims to assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020. The secondary objective was to describe their levels of anxiety and depression. The questionnaire used in this online survey included demographic information, questions about self-perceptions of the impact of the COVID-19 in the life routines and the 14-item Hospital Anxiety Depression Scale. A total of 1,613 adults completed the questionnaire between May 11 and 15, 2020. Of those, 79.4% reported that the measures to contain the epidemic had any impact on their physical activities, and many had to interrupt or decrease the frequency of their practices. Participants who felt a higher impact of quarantine on their physical activities tend to have higher prevalence of anxiety and depression symptoms. Individuals who practiced physical activities reported that social distance had a high influence on their practices. Furthermore, changes in these habits are associated with high levels of poor mental health.

Abstract INTRODUCTION: Acquired immunodeficiency syndrome (AIDS) remains a major public health issue in Brazil. This ecological study aimed to evaluate the spatiotemporal distribution of notified new AIDS cases in Brazil between 2012 and 2016. METHODS: A Bayesian spatiotemporal model based on the Poisson distribution was used to obtain smoothed incidence estimates of AIDS in each of the 133 Brazilian intermediate regions. RESULTS: Spatial distribution of new AIDS cases is highly heterogeneous. Regions with higher gross domestic product per capita tend to have higher incidence rates of AIDS. CONCLUSIONS: Strategies to prevent and control AIDS should consider regional differences.

Resumo Inatividade física e sedentarismo são associados com baixa saúde física e mental. O objetivo deste artigo é avaliar as mudanças nos hábitos dos participantes brasileiros praticantes de atividades físicas em relação às suas práticas, devido às medidas de distanciamento social durante a epidemia COVID-19 em 2020. O objetivo secundário foi descrever seus níveis de ansiedade e depressão. O questionário utilizado nesta pesquisa on-line incluiu informações demográficas, questões sobre a autopercepção do impacto do COVID-19 nas rotinas da vida e a Escala de Depressão de Ansiedade Hospitalar de 14 itens. Um total de 1.613 adultos completou o questionário entre 11 e 15 de maio de 2020. Destes, 79,4% relataram que as medidas para conter a epidemia tiveram algum impacto em suas atividades físicas e muitos tiveram que interromper ou diminuir a frequência de suas práticas. Os participantes que sentiram um maior impacto da quarentena em suas atividades físicas tendem a ter maior prevalência de sintomas de ansiedade e depressão. Os indivíduos que praticavam atividades físicas relataram que o distanciamento social teve alta influência em suas práticas. Além disso, as mudanças destes hábitos são associadas com altos níveis de precária saúde mental.

Abstract Physical inactivity and sedentary behavior are associated with poor physical and mental health. The article aims to assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020. The secondary objective was to describe their levels of anxiety and depression. The questionnaire used in this online survey included demographic information, questions about self-perceptions of the impact of the COVID-19 in the life routines and the 14-item Hospital Anxiety Depression Scale. A total of 1,613 adults completed the questionnaire between May 11 and 15, 2020. Of those, 79.4% reported that the measures to contain the epidemic had any impact on their physical activities, and many had to interrupt or decrease the frequency of their practices. Participants who felt a higher impact of quarantine on their physical activities tend to have higher prevalence of anxiety and depression symptoms. Individuals who practiced physical activities reported that social distance had a high influence on their practices. Furthermore, changes in these habits are associated with high levels of poor mental health.