Resumo Fundamento A íntima relação entre a regulação do sono e os eventos cardiovasculares é um dos principais focos de investigação na medicina contemporânea. Hábitos e características do sono interferem na ritmicidade cardíaca e também na expectativa de vida, principalmente em idosos. Objetivo Estimar o risco de óbito e de eventos cardiovasculares em idosos comunitários que apresentam queixa de insônia e sonolência excessiva diurna ao longo de oito anos de seguimento. Método Foi desenhada uma coorte prospectiva com 160 idosos, a primeira onda em 2009 e a segunda em 2017. Os grupos de seguimento foram determinados pela exposição ou não às queixas de insônia primária e a sonolência excessiva diurna, com ou sem ronco. As covariáveis sexo, estado conjugal, depressão, hipertensão e diabetes foram controladas. O desfecho primário foi o óbito e o secundário, os eventos cardiocerebrovasculares (ECV). As probabilidades dos desfechos foram estimadas pelo risco relativo (RR), através da regressão de Poisson, adotando-se α ≤ 0,05. Resultados Registraram-se 40 mortes no período (25,97%:19,04-32,89) e 48 ECVs (30,76%:23,52-38,01). Os homens apresentaram maior risco (RR = 1,88;1,01-3,50) de óbito. A depressão (RR = 2,04;1,06-3,89), a gravidade da insônia (RR = 2,39;1,52-4,56) e a latência do sono entre 16-30 minutos (RR = 3,54;1,26-9,94) e 31-60 minutos (RR = 2,23;1,12-4,47) aumentaram independentemente o risco de óbito em idosos comunitários. Os ECVs foram preditos apenas por idosos hipertensos e/ou diabéticos (RR = 8,30; 1,98-34,82). Conclusão A mortalidade em idosos é influenciada pelo estado emocional e pela dificuldade de dormir, diferentemente dos ECVs, condicionados apenas pelas condições pressóricas arteriais e metabólicas.

Abstract Background The close relationship between sleep regulation and cardiovascular events is one of the main focuses of research in contemporary medicine. Sleep habits and characteristics interfere with the cardiac rhythm and also with life expectancy, especially in the elderly. Objective To estimate the risk of death and cardiovascular events in community-dwelling elderly individuals complaining of insomnia and excessive daytime sleepiness over eight years of follow-up. Method A prospective cohort was designed with 160 elderly, with the first wave occurring in 2009 and the second in 2017. Follow-up groups were determined by exposure or not to complaints of primary insomnia and excessive daytime sleepiness with or without snoring. The covariates gender, marital status, depression, hypertension and diabetes were controlled. The primary outcome was death and the secondary outcome was cardio-cerebrovascular events (CCV). Outcome risks were estimated by relative risk (RR) through Poisson regression, adopting α≤0.05. Results There were 40 (25.97%: 19.04-32.89) deaths over the period and 48 (30.76%: 23.52-38.01) CCV. Men had a higher risk (RR = 1.88; 1.01-3.50) of death. Depression (RR = 2.04; 1.06-3.89), insomnia severity (RR = 2.39; 1.52-4.56) and sleep latency between 16-30 minutes (RR = 3, 54; 1.26-9.94) and 31-60 minutes (RR = 2.23; 1.12-4.47) increased the risk of death independently in community-dwelling elderly. CCV were predicted only in the hypertensive and / or diabetic elderly (RR = 8.30; 1.98-34.82). Conclusion Mortality in the elderly is influenced by the emotional state and difficulty in falling asleep, unlike CCVs, which are conditioned only by arterial and metabolic blood pressure conditions.

ABSTRACT Objective: To investigate the effectiveness of a home-based therapeutic exercise program on lower back pain and functionality of SCD patients. Setting: A Hematology and Transfusion Medicine Center, University of Campinas (HEMOCENTRO-UNICAMP). Methods: This was a prospective study, with a three-month follow-up of SCD patients with lower back pain. The lumbar spine functionality was evaluated by questionnaires, trunk flexion and extension analyses by fiber-optic-electrogoniometry and measurements of muscle strength of trunk flexor and extensors. The Intervention Group (IG) comprised 18 volunteers, median age 44y (28–58) and the control group (CG) comprised 15 volunteers, median age 42y (19–58), who did not perform exercises. The protocol consisted of daily home-based exercises with two evaluations: at the beginning and end of a three-month program. In order to compare the groups at baseline, the Fishers´ exact test and Mann–Whitney test were used for categorical and numeric variables, respectively. The Wilcoxon test was used for related samples comparing numeric measures of each group over time with a 5% (p < 0.05) significance level. Results: After the intervention, patients demonstrated a significant improvement, according to the Visual-Analog-Scale (VAS; p = 0.01), Rolland Morris Disability questionnaire (RMDQ; p < 0.01) and trunk flexion and extension muscle strength (p < 0.01). No significant differences were found for the Start-Back-Screening-Tool-Brazil (SBST) and in measures of trunk flexion and extension range-of-motion (RoM). Conclusion: Results suggest that daily home-based exercises for a three-month period ameliorate pain and improve disability related to lower back pain and muscle strength.

ABSTRACT Background: The Children's Hospital Oakland Hip Evaluation Scale is a disease-specific tool for the clinical and functional assessment of the hip in sickle cell disease. Objectives: To translate the tool into Brazilian Portuguese and evaluate the interobserver and test–retest reliability. Methods: Eighteen patients diagnosed with sickle cell disease and a mean age of 49 ± 11.9 years participated in the study. The scale was applied by two evaluators who did not speak to each other regarding their understanding of the tool and who had no prior training. Interobserver and test–retest reliability of individual items and of the total score were evaluated using the intraclass correlation coefficient and the Bland–Altman method. Results: When the overall score for each hip was considered, the test–retest intraclass correlation coefficient score for the right hip was 0.95 (0.89–0.98) and for the left hip it was 0.96 (0.91–0.98). Considering all assignments (total score), the score was 0.96 (0.90–0.98). The test–retest intraclass correlation coefficient varied from 0.76 to 1 for 18 of the 27 items (excellent) and from 0.53 to 0.75 for nine items (moderate). When the overall score for each hip was considered, the interobserver intraclass correlation coefficient for both hips was 0.94 (0.86–0.98). Considering all assignments, the total score was 0.94 (0.86–0.98). The interobserver intraclass correlation coefficient varied from 0.48 to 0.75 for 18 out of 27 items (moderate) and varied from 0.77 to 1 for the remaining nine items (excellent). Conclusion: The results demonstrate that the Brazilian version of the Children's Hospital Oakland Hip Evaluation Scale presented adequate interobserver and test–retest reliability and that the version can be used to evaluate clinical function in sickle cell disease patients, producing consistent, standardized and reproducible results.

Resumo Com base na perspectiva teórica do priming de marca, neste estudo, se propõe que marcas associadas à personalidade de audácia podem influenciar os consumidores a tomarem decisões mais arriscadas em situações subsequentes. Dois experimentos, realizados no contexto de marcas esportivas, mostram que os indivíduos expostos a marcas com alta (vs. baixa) audácia demonstraram maior propensão ao risco em decisões financeiras. Esses estudos também mostram que esse efeito é moderado pela experiência do indivíduo com o mercado financeiro. Essa moderação sugere que houve a ativação de uma meta por meio do priming da marca e que não houve apenas uma ativação semântica. Essa pesquisa apresenta alguns caminhos sobre como os consumidores lidam com o priming de marca e seus efeitos sobre as escolhas. Sob a ótica gerencial, os resultados podem ajudar os gestores a entender os efeitos prováveis do priming de marca sobre o comportamento e assim prever a probabilidade de maior aversão ou propensão ao risco.

Abstract Taking the perspective of brand priming theory, this study proposes that brands associated with an audacious personality trait may influence consumers to be take more risks in making subsequent decisions. Two experiments, run in sport brands contexts, showed that individuals exposed to brands with high (vs. low) audacity traits demonstrated a higher rate of risk taking in financial decisions. The studies also showed that this effect is moderated by individuals’ experience with the financial market. This moderation suggests that there was an activation of a goal not just semantic activation, but through the brand priming. This research provides insights into how today's consumers deal with brand priming effects in risky choice settings. From a managerial perspective, it can help managers to understand the likely effects of brand priming on behavior and better predict the probability of risk aversion or risk seeking outcomes.

Resumen Con base en la perspectiva teórica del priming de marca, en este estudio se sugiere que las marcas asociadas con la personalidad osada o audaz pueden influir en la conducta del consumidor y llevarlo a tomar decisiones más arriesgadas en situaciones posteriores. Dos experimentos, llevados a cabo en el contexto de marcas deportivas, muestran que los individuos expuestos a marcas con alta (vs. baja) osadía demostraron mayor propensión al riesgo en las decisiones financieras. Los estudios también muestran que tal efecto es moderado por la experiencia del individuo con el mercado financiero. Esa moderación sugiere que hubo la activación de una meta por medio del priming de la marca y no solo una activación semántica. Este estudio indica algunos caminos para entender cómo los consumidores se relacionan con el priming de marca y su efecto en las elecciones. Desde la perspectiva de la gestión, los resultados pueden ayudar a los gerentes en la comprensión de los efectos probables del priming de marca en el comportamiento y, así, podrán predecir la probabilidad de una mayor aversión o propensión al riesgo.

OBJETIVO: Verificar a relação entre o índice de massa corpórea, a autoestima e a autoimagem corporal de idosas participantes de grupos da terceira idade. MÉTODOS: Estudo transversal por amostragem casual e assistemática. Participaram do estudo 50 idosas residentes no município de João Pessoa-PB. As variáveis pesquisadas foram: sexo, idade, estado civil, renda, escolaridade e índice de massa corpórea. A análise da percepção da imagem corporal foi realizada utilizando-se a escala de nove silhuetas (Sorensen & Stunkard). Para avaliar a autoestima, utilizou-se a Escala de Autoestima de Rosenberg. RESULTADOS: Não se observou significância estatística entre as variáveis estudadas. A média de idade das idosas foi 72,12 (6,14). O índice de massa corpórea apresentou média de 26,91 Kg/m², sendo verificado excesso de peso em 51,02%; a maior parte das idosas (90,60%) apresentou autoestima satisfatória, embora mais da metade (79,31%) delas se encontrasse acima do peso ideal; 87,50% estavam insatisfeitas com seu próprio corpo devido ao excesso de peso. CONCLUSÃO: Embora os dados não tenham mostrado significância estatística entre as variáveis, os resultados sugerem que, apesar de a maioria das idosas estar com excesso de peso, a autoestima apresentou nível satisfatório, enquanto a percepção da autoimagem corporal foi insatisfatória.

OBJECTIVE: To investigate the relationship between body mass index, self-esteem and body self-image of elderly participants in groups of seniors. METHODS: Cross-sectional study by casual and unsystematic sampling. Participated in the study 50 elderly residents in the city of João Pessoa-PB. The variables investigated were: sex, age, marital status, income, education and body mass index. The analysis of body image perception was performed using the Nine-figure Outline Scale ( Sorensen & Stunkard). RESULTS: There was no statistical significance between variables. The mean age was 72.12 (6.14). The body mass index had an average of 26.91 kg/m², with overweight observed in 51.02% of this population; most women (90.60%) showed good self-esteem, although half (79.31%) of these were above ideal weight; 87.50% were dissatisfied with their own bodies due to excess weight. CONCLUSION: Although the data did not show statistical significance between the variables, the results suggest that, although most elderly women were overweight, self-esteem showed satisfactory level while the perception of body self-image was unsatisfactory.

Objective: To compare the effect of aquatic and land-based physiotherapy in reducing musculoskeletal hip and lower back pain and increasing overall physical capabilities of sickle cell disease patients. Methods: Informed written consent was obtained from all volunteers who were submitted to evaluations using different functional scales: Lequesne's Algofunctional Questionnaire and Oswestry Disability Index, trunk and hip range of motion, goniometry, trunk and hip muscle strength assessment using load cell, and surface electromyography of the iliocostalis, long dorsal (longissimus), gluteus maximus, gluteus medius and tensor fasciae latae muscles. Ten patients were randomized into two groups: aquatic physiotherapy with a mean age of 42 years (range: 25-67) and conventional physiotherapy with a mean age of 49 years (range: 43-59). Both groups were submitted to a twelve-week program of two sessions weekly. Results: After the intervention, significant improvements were observed regarding the Lequesne index (p-value = 0.0217), Oswestry Disability Index (p-value = 0.0112), range of motion of trunk extension (p-value = 0.0320), trunk flexion muscle strength (p-value = 0.0459), hip extension and abduction muscle strength (p-value = 0.0062 and p-value = 0.0257, respec- tively). Range of motion of trunk and hip flexion, extension, adduction and abduction, trunk extensor muscle strength and all surface electromyography variables showed no significant statistical difference. Conclusion: Physical therapy is efficient to treat musculoskeletal dysfunctions in sickle cell disease patients, irrespective of the technique; however, aquatic therapy showed a trend toward improvement in muscle strength. Further studies with a larger patient sample and longer periods of therapy are necessary to confirm these results.

O hábito de fumar pode reduzir a capacidade aeróbica, aumentar a resistência ao fluxo aéreo e afetar a função dos músculos respiratórios. O objetivo deste estudo foi comparar os efeitos do Treinamento Muscular Inspiratório (TMI) entre dois grupos: tabagistas e não tabagistas. Participaram 44 voluntários universitários, divididos em dois grupos: tabagistas (GT), composto por 20 indivíduos (25,60±7,01 anos) e não tabagistas, constituindo o Grupo Controle (GC), composto por 24 voluntários (24,08±7,52 anos). Ambos os grupos foram submetidos ao TMI, por meio do uso do manovacuômetro aneroide, com duração de 6 semanas, sendo 3 sessões semanais, totalizando 18 sessões. Os resultados mostraram diferença estatisticamente significativa (p<0,05) pós-TMI no GC para as variáveis: Pressão Inspiratória Máxima (PImáx), Pico de Fluxo Expiratório (PFE), Pressão Arterial Média ao repouso (PAM pré-TC6) e Teste de Caminhada de Seis Minutos (TC6). No GT, houve diferença estatisticamente significativa pós-TMI para as variáveis: PImáx, PFE, TC6 e saturação periférica de oxigênio após o TC6 (SpO2 pós-imediata). A comparação das médias das variáveis entre GT e GC mostrou diferença estatisticamente significativa no pós-TMI para as variáveis PImáx e PFE. A variável TC6 não apresentou diferença estatisticamente significativa. Conclui-se que o TMI proporcionou um aumento significativo da força muscular inspiratória, melhora da função pulmonar e melhora do desempenho físico nos indivíduos estudados.

Cigarette smoking may reduce the aerobic capacity, increase resistance to air flow and affect the function of the respiratory muscles. The aim of this study was to compare the effects of Inspiratory Muscle Training (IMT) between two groups: smokers and nonsmokers. Participated 44 college volunteers, divided into two groups: smokers (SG), composed of 20 individuals (25,60±7,01 years) and nonsmokers, constituting the Control Group (CG), composed of 24 volunteers (24,08±7,52 years). Both groups were submitted to TMI, through the use of the aneroid manometer, with duration of 6 weeks, being 3 sessions per week, totaling 18 sessions. The results showed differences statistically significant (p<0.05) post TMI in CG for the variables: Maximal Inspiratory Pressure (MIP), Peak Expiratory Flow (PEF), average arterial pressure in rest (PAM pre-6MWT) and six minute walk test (6MWT). In SG, there was statistically significant difference post TMI for the variables: MIP, PEF, 6MWT and peripheral oxygen saturation after 6MWT (post-immediate SpO2). The comparison of averages of the variables between SG and CG show statistically significant difference post TMI for the variables MIP and PEF. The variable 6MWT not presented statistically significant difference. We conclude that the IMT resulted in a significant increase in inspiratory muscle strength, improve lung function and improve physical performance in subjects studied.