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INTRODUCTION: The growing older population increases proportionately the demand for hospital care due to the increase in health problems. OBJECTIVE: To estimate the prevalence and incidence of hospitalizations, and to investigate associated factors in older adults from the Zona da Mata of Minas Gerais, Brazil, between 2016-2018. Secondly, to provide a more comprehensive epidemiological overview of hospitalizations, the following were estimated: monthly hospitalization rate; hospital mortality rate; frequency of hospitalizations according to diagnosis, hospitalizations for conditions sensitive to primary care and in-hospital death; and hospital costs. METHODS: This is an ecological and descriptive-analytic study. Data were obtained from the Brazilian Hospital Information System (SIH/SUS). RESULTS: The prevalence of hospitalizations was 35.1% (31.2% in women and 39.7% in men). The monthly rate of hospitalizations was higher in older men when compared with older women (Rate-Ratio=1.35 [95% CI=1.27-1.43]) and adult men between 40­59 years (Rate Ratio=2.42 [95% CI=2.26-2.58]). The cumulative incidence of hospitalization was 144/1,000 older persons (125/1,000 women and 169/1,000 men). Factors significantly associated with hospitalizations were: male sex (PR=1.52 [95% CI=1.11-2.08]); hospitalization in surgical bed (PR=1.93 [95% CI=1.05-3.56]); absence of death (PR=1.94 [95% CI=1.03-3.65]); and hospital stay ≥15 days (PR=0.71 [95% CI=0.54 0.95]). The cost of hospitalizations was R$ 220,8 million (mean of R$ 201,700/day). CONCLUSÃO: The findings strengthen the need for preventive healthcare for the older population living in the Zona da Mata of Minas Gerais and alert managers to the substantial socioeconomic impact of hospitalizations.

INTRODUÇÃO: O crescente aumento da população idosa faz aumentar proporcionalmente a demanda por cuidados hospitalares devido ao aumento dos problemas de saúde. OBJETIVO: Estimar a prevalência e incidência de hospitalizações, e investigar fatores associados, em idosos da Zona da Mata Mineira, Brasil, entre 2016-2018. Secundariamente, com intuito de fornecer um panorama epidemiológico mais abrangente acerca das hospitalizações, foram estimadas: taxa mensal de hospitalização; taxa de mortalidade hospitalar; frequência de hospitalizações conforme o diagnóstico, internações por condições sensíveis à atenção primária (ICSAP) e óbito hospitalar; e custos hospitalares. MÉTODO: Trata-se de um estudo ecológico e descritivo-analítico. Os dados foram obtidos do Sistema de Informação Hospitalar brasileiro (SIH/SUS). RESULTADOS: A prevalência de hospitalizações em idosos foi de 35,1% (31,2% em mulheres e 39,7% em homens). A taxa mensal de hospitalização foi maior em homens idosos quando comparados com mulheres idosas (Razão-de-Taxas=1,35 [IC 95%=1,27-1,43]) e homens adultos entre 40­59 anos (Razão-de-Taxas=2,42 [IC 95%=2,26-2,58]). A incidência acumulada de hospitalização foi de 144/1.000 idosos (125/1.000 mulheres e 169/1.000 homens). Os fatores significativamente associados com as hospitalizações foram: sexo masculino (RP=1,52 [IC 95%=1,11­2,08]), internação em leito cirúrgico (RP=1,93 [IC 95%=1,05­3,56]), ausência de óbito (RP=1,94 [IC 95%=1,03-3,65]) e permanência hospitalizado ≥15 dias (RP=0,71 [IC 95%=0,54-0,95]). O custo das hospitalizações foi de R$ 220,8 milhões (média de R$ 201,7 mil/dia). CONCLUSÃO: Os resultados reforçam a necessidade de cuidados preventivos à saúde da população idosa da Zona da Mata Mineira e alertam gestores para o substancial impacto socioeconômico gerado pelas hospitalizações.

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Chagas cardiomyopathy (ChC) presents many biopsychosocial complexities, highlighting the need to have patient self-report questions. This study demonstrates the scope of the use of patient-reported outcome measures (PROMs) in patients with ChC and highlights the main research gaps. This is a scoping review and the search strategy was performed in the Online Medical Literature Analysis and Retrieval System (MEDLINE), Excerpta Medica database (EMBASE), Accumulated Index of Nursing and Allied Health Literature (CINAHL), Cochrane Central, Latin American Literature and Caribbean in Health Sciences (LILACS) and Diagnostic Test Accuracy (DITA). The search identified 4484 studies and 20 studies met the inclusion criteria. The Short-Form of 36 items (SF-36) had potential prognostic value and the ability to identify systolic dysfunction. The Human Activity Profile was able to screen for functional impairment, and the New York Heart Association showed potential prognostic value. The SF-36 and Minnesota Living with Heart Failure Questionnaire were responsive to interventions. The pharmaceutical care affected adherence to treatment as assessed by the Morisky score and also for SF-36. Despite the increased use of PROMs, there are still a large number of gaps in the literature, and further studies using PROMs are needed.

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Abstract Introduction Community health workers, like the physiotherapist, perform essential functions in primary health care, being an important element in the transformation of public policies. There are no reported studies investigating the knowledge of community health workers about health conditions amenable to physiotherapy intervention in primary health care. Objective To construct a questionnaire to investigate the perception of community health workers about health conditions that could be remedied by physiotherapy intervention in primary health care. Methods This was a methodological study in which it was initially an analysis matrix with the aim of encompassing the ideas contemplated in the questionnaire. To construct the instrument, a literature review was carried out, and health conditions treatable with physiotherapy in primary health care were chosen. To validate the content and appearance of the items, twelve physiotherapists specialized in primary health care judged the suitability of the items contained. The content validity index was used to determine the degree of agreement during the response analysis process. Subsequently, a semantic analysis was carried out through the understanding of the items by 15 community health workers. In the validation stage, two rounds of evaluation were carried out. Adjustments were made to 17 questions. Results The study investigated a questionnaire with 20 questions containing hypothetical situations of home visits, in which the resident's situation could or could not constitute a health risk amenable to physiotherapeutic intervention. Conclusion The community health workers perception instrument on health conditions amenable to physiotherapy intervention in primary health care proved to be valid for use in this context. The use of the instrument may contribute to the development of community health worker training programs, with the aim of facilitating team communication.

Resumo Introdução O Agente Comunitário de Saúde (ACS), assim como o fisioterapeuta, desencadeia funções fundamentais na Atenção Primária à Saúde (APS), sendo ele-mento importante na transformação de políticas públicas. Inexistem estudos que investiguem o conhecimento dos ACS sobre as condições de saúde sensíveis à inter-venção da fisioterapia na APS. Objetivo Construir um questionário de investigação da percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS. Métodos Trata-se de um estudo metodológico no qual, inicialmente, construiu-se uma matriz de análise com o intuito de englobar as ideias contempladas no questionário. Para a construção do instrumento, realizou-se uma revisão da literatura, sendo eleitas condições de saúde sensíveis à intervenção da fisioterapia na APS. Para a validação de conteúdo e aparente dos itens, 12 fisioterapeutas especialistas em APS julgaram a adequação dos itens contidos. Utilizou-se o índice de validade de conteúdo para verificar o grau de concordância durante o processo de análise das respos-tas. Posteriormente, realizou-se análise semântica por meio da compreensão dos itens por 15 ACS. Na etapa de validação, foram realizadas duas rodadas de avaliação. Foram feitos ajustes em 17 questões. Resultados O estudo resultou em um questionário com 20 questões contendo situações hipotéticas de visitas domiciliares, cuja situação do morador poderia ou não configurar um risco à saúde sensível à intervenção fisioterapêutica. Conclusão O instrumento de percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS mostrou-se válido para ser utilizado no contexto da APS. A utilização do instrumento poderá contribuir na elaboração de programas de capacitação dos ACS, com o intuito de facilitar a comunicação da equipe.

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Knee instability in patients with knee osteoarthritis (KOA) is associated with fear of falling (FoF). This study aimed to investigate the prevalence and the factors associated with FoF in older women with KOA. A cross-sectional study was conducted with 93 older women with KOA. Sociodemographic variables, medical conditions, handgrip strength, and anthropometric and body composition measurements were assessed. The Short Physical Performance Battery was used to measure functional performance. The Western Ontario and McMaster Universities Osteoarthritis Index was applied to assess pain, stiffness, and disability. FoF was assessed by the Falls Efficacy Scale-International. The prevalence of FoF was high (88.2 %). Disability, history of falls, handgrip strength, obesity, number of medications, and pain were independently associated with FoF. Our findings suggest that health professionals should investigate FoF when evaluating older women with KOA and address these risk factors when developing strategies to prevent or minimize FoF in this population.

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OBJECTIVES: To investigate home-based gait speed performance for men and women stratified by age group and its associations with sociodemographic and anthropometric variables. METHODS: Data from the 2nd wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021) were used. Gait speed was tested twice at home over 3.0 meters at usual pace. Associations of sociodemographic and anthropometric variables with gait speed were evaluated using gamma regression. RESULTS: Median gait speed value reduced with increasing age in both sexes [men: 0.70 m/s (50-59 years) to 0.53 m/s (≥80 years); women: 0.68 m/s (50-59 years) to 0.48 m/s (≥80 years)] and was significantly lower in women than men in the age groups of 60-69 and 70-79 years. Age group and education among men and age group, education, and waist circumference among women were significantly associated with gait speed. CONCLUSIONS: Our findings may be helpful as reference values to identify mobility limitation among older Brazilians.

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This systematic review aimed to discuss the main findings regarding the reliability and validity of health-related quality of life questionnaires for chronic venous insufficiency. Searches were performed on the MEDLINE, CINAHL, Web of Science, LILACS, and Scopus databases. The search terms used were related to "venous insufficiency", and "quality of life". The CIVIQ-20 and CIVIQ-14 instruments had adequate internal consistency and both were able to discriminate disease severity. The VEINES-QoL showed adequate internal consistency but was not able to discriminate disease severity. Most studies did not demonstrate a correlation between VEINES-QoL and the mental component of the SF-36. The AVVQ had inadequate reliability but its validity was also doubtful when compared to the SF-36. The VARIShort demonstrated good internal consistency, reproducibility, and validity, but only the original study was included. For venous leg ulcers, the CCVUQ showed adequate reliability and validity when compared to VLU-QoL.

Esta revisão sistemática objetivou discutir os principais achados sobre a confiabilidade e validade dos questionários de qualidade de vida relacionada à saúde na insuficiência venosa crônica. A busca foi realizada nas bases de dados MEDLINE, CINAHL, Web of Science, LILACS e Scopus. Os termos de busca foram relacionados a "insuficiência venosa" e "qualidade de vida". O Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ)-20 e o CIVIQ-14 apresentaram consistência interna adequada e foram capazes de discriminar a gravidade da doença. O Venous Insufficiency Epidemiological and Economic Study ­ Quality of Life (VEINES-QoL) apresentou consistência interna adequada, mas não foi capaz de discriminar a gravidade da doença. A maioria dos estudos não demonstrou associação do VEINES-QoL com o componente mental do Short Form Health Survey (SF-36). O Aberdeen Varicose Vein Questionnaire (AVVQ) apresentou confiabilidade inadequada e validade duvidosa quando comparado ao SF-36. O VARIShort demonstrou consistência interna, reprodutibilidade e validade boas, mas apenas o estudo original foi incluído. Na úlcera venosa, o Charing Cross Venous Ulcer Questionnaire (CCVUQ) apresentou confiabilidade e validade adequadas quando comparado ao Venous Leg Ulcer Quality of Life (VLU-QoL).

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This time-series study examined a 10-year historical series of the physical activity prevalence for leisure and transportation in the Brazilian adult population. Information from 512,969 adults interviewed from the Vigitel between 2010 and 2019 was analyzed. Individuals who reported practicing at least 150 minutes/week of moderate-intensity physical activity or at least 75 minutes/week of vigorous-intensity physical activity were considered active during leisure time. Individuals who reported walking or cycling to/from work, course, or school at least 30 minutes/day, equivalent to at least 150 minutes/week of moderate-intensity physical activity, were considered active during transportation. The prevalence of physical activity for leisure and transportation was calculated annually and stratified by sex, age group, schooling, and race/skin color. The segmented regression model was applied to analyze the time series. Annual percent change and average annual percent change were calculated. Over time, the prevalence of physical activity for leisure increased, and the prevalence of physical activity for transportation decreased. The highest prevalence of physical activity for leisure was observed among males, young individuals, and those with high education. Older adults, those with high education, and white people presented the lowest prevalence of active transport. Policymakers should propose strategies that encourage and facilitate physical activity for leisure in women, individuals aged ≥ 35 years, and those with less education (< 12 years), and physical activity for transportation among older adults (≥ 60 years), those with high education (≥ 12 years), and white people.

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Objetivo: Avaliar os fatores de risco para fratura por fragilidade (FF) em pacientes internados em um hospital terciário de ensino, no município de Diamantina, Minas Gerais. Métodos: Dados sociodemográficos, de saúde, estilo de vida (tabagismo, consumo de álcool, exposição ao sol, nível de atividade física, hábitos alimentares), mobilidade e nível de dependência foram coletados dos prontuários de pacientes com 50 anos ou mais, internados com FF, no período de abril a setembro de 2020. Resultados: Um total de 52 pacientes foram internados com diagnóstico de FF, sendo 60% com diagnóstico de fratura proximal de fêmur. Somente 17,3% dos pacientes possuíam diagnóstico prévio de osteoporose. Os fatores de risco mais frequentes para FF foram sexo feminino, déficit cognitivo, sarcopenia, dinapenia, histórico familiar de osteoporose ou fratura por queda, baixa exposição ao sol, consumo insuficiente de leite e derivados, inatividade física e dependência nas atividades básicas e instrumentais de vida diária. Quando comparados os grupos com fratura proximal de fêmur e outras fraturas, o grupo com fratura proximal de fêmur apresentou maior frequência de indivíduos com idade avançada (≥ 80 anos), déficit cognitivo, baixo peso, sarcopenia, tabagismo, inatividade física e limitação na mobilidade, ao passo que o grupo com outras fraturas apresentou maior frequência de histórico familiar de osteoporose ou fratura por queda. Conclusão: Os resultados demonstraram um subdiagnóstico da osteoporose na população estudada. Muitos fatores de risco modificáveis para osteoporose e quedas foram identificados. Intervenções direcionadas para estes fatores de risco devem ser consideradas de forma a prevenir as FF.

Objective: To evaluate the risk factors for fragility fractures (FF) in patients admitted to a tertiary teaching hospital in the municipality of Diamantina, Minas Gerais. Methods: Sociodemographic, health, lifestyle (smoking, alcohol consumption, sun exposure, physical activity level, eating habits), mobility, and dependence level data were collected from the medical records of patients aged 50 years or older, hospitalized with FF, from April to September 2020. Results: A total of 52 patients were hospitalized with FF, 60% had a diagnosis of proximal femur fracture. Only 17.3% of the patients had a previous diagnosis of osteoporosis. The most prevalent risk factors for FF were female gender, cognitive deficit, sarcopenia, dynapenia, family history of osteoporosis or fracture due to fall, low sun exposure, insufficient consumption of milk and dairy products, physical inactivity, and dependence on basic and instrumental activities of daily living. When comparing the groups with proximal femoral fractures and other fractures, the group with proximal femoral fractures showed a higher frequency of individuals with advanced age (≥ 80 years), cognitive deficit, low weight, sarcopenia, smoking, physical inactivity, and mobility limitation, whereas the group with other fractures presented a higher frequency of family history of osteoporosis or fracture due to fall. Conclusion: The results demonstrated an underdiagnosis of osteoporosis in the studied population. Many modifiable risk factors for osteoporosis and falls have been identified. Interventions toward these risk factors should be considered in order to prevent FF.

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A cross-sectional study was conducted to compare the habitual physical activity level, measured by accelerometry, gait performance, assessed by the GAITRite® system, handgrip strength, and static balance between older Brazilian women who participate (n = 50; 70.7 ± 5.5 years) and do not participate (n = 50; 70.1 ± 5.6 years) in a regular physical exercise program, and to investigate whether participation in a regular exercise program ensures compliance with physical activity recommendations. Older women who participated in a regular physical exercise program had significantly shorter sedentary activity time (effect size [ES] = 0.54), longer moderate activity time (ES = 0.85), and higher energy expenditure (ES = 0.64), number of steps (ES = 0.82), gait speed (ES = 0.49), and step length (ES = 0.45). However, regular participation in an exercise program did not guarantee compliance with physical activity recommendations. Behavioral changes to increase physical activity levels among older women who do and do not participate in a regular exercise program are necessary.

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This time-series study examined a 10-year historical series of the physical activity prevalence for leisure and transportation in the Brazilian adult population. Information from 512,969 adults interviewed from the Vigitel between 2010 and 2019 was analyzed. Individuals who reported practicing at least 150 minutes/week of moderate-intensity physical activity or at least 75 minutes/week of vigorous-intensity physical activity were considered active during leisure time. Individuals who reported walking or cycling to/from work, course, or school at least 30 minutes/day, equivalent to at least 150 minutes/week of moderate-intensity physical activity, were considered active during transportation. The prevalence of physical activity for leisure and transportation was calculated annually and stratified by sex, age group, schooling, and race/skin color. The segmented regression model was applied to analyze the time series. Annual percent change and average annual percent change were calculated. Over time, the prevalence of physical activity for leisure increased, and the prevalence of physical activity for transportation decreased. The highest prevalence of physical activity for leisure was observed among males, young individuals, and those with high education. Older adults, those with high education, and white people presented the lowest prevalence of active transport. Policymakers should propose strategies that encourage and facilitate physical activity for leisure in women, individuals aged ≥ 35 years, and those with less education (< 12 years), and physical activity for transportation among older adults (≥ 60 years), those with high education (≥ 12 years), and white people.

Este estudo de série temporal analisou a prevalência de atividade física para lazer e transporte na população adulta brasileira em uma série histórica de uma década. Foram analisadas informações de 512.969 adultos entrevistados pelo Vigitel entre 2010 e 2019. Os indivíduos que relataram praticar pelo menos 150 minutos/semana de atividade física moderada ou pelo menos 75 minutos/semana de atividade física vigorosa foram considerados ativos durante seu lazer. Os indivíduos que relataram caminhar ou andar de bicicleta para/do trabalho, curso ou escola por pelo menos 30 minutos/dia (equivalente a pelo menos 150 minutos/semana de atividade física moderada) foram considerados ativos durante seu transporte. A prevalência de atividade física para lazer e transporte foi calculada anualmente e estratificada por sexo, faixa etária, escolaridade e cor da pele/raça. Modelo de regressão segmentada foi aplicado para analisar a série temporal. Foram calculadas as mudanças percentuais anuais e as mudanças médias anuais. Com o tempo, a prevalência de atividade física para o lazer aumentou e a prevalência de atividade física para o transporte diminuiu. A maior prevalência de atividade física para lazer foi observada entre homens, jovens e pessoas com Ensino Médio completo. Idosos, pessoas com Ensino Médio e brancos apresentaram a menor prevalência de transporte ativo. Formuladores de políticas devem propor estratégias que incentivem e facilitem a atividade física para o lazer em mulheres, indivíduos com idade ≥ 35 anos e pessoas com baixa escolaridade (< 12 anos), e atividade física para transporte entre idosos (≥ 60 anos), aqueles com Ensino Médio completo (≥ 12 anos) e pessoas brancas.

Este estudio de serie temporal analizó la prevalencia de la actividad física para el ocio y el transporte en la población adulta brasileña en una serie histórica de una década. Se analizaron las informaciones de 512.969 adultos, entrevistados por Vigitel entre 2010 y 2019. Las personas que informaron practicar al menos 150 minutos/semana de actividad física moderada o al menos 75 minutos/semana de actividad física vigorosa se consideraron activas durante su tiempo libre. Las personas que informaron caminar o andar en bicicleta al/desde el trabajo, curso o escuela por al menos 30 minutos/día (equivalente al menos a 150 minutos/semana de actividad física moderada) se consideraron activas durante su transporte. La prevalencia de la actividad física para el ocio y el transporte se calculó anualmente y se estratificó por sexo, grupo de edad, escolaridad y color de piel/raza. Se aplicó un modelo de regresión segmentada para analizar la serie temporal. Se calcularon las variaciones porcentuales anuales y las variaciones porcentuales medias anuales. Con el paso del tiempo, la prevalencia de la actividad física para el ocio tuvo un aumento y una reducción para el transporte. La mayor prevalencia de actividad física para el ocio se observó entre hombres, jóvenes y personas con educación secundaria. Los ancianos, las personas con educación secundaria y los blancos tuvieron una prevalencia más baja en el transporte activo. Los formuladores de políticas deben proponer estrategias de fomento a la actividad física para el ocio en mujeres, personas ≥ 35 años y personas con baja escolaridad (< 12 años), y la actividad física para el transporte entre los ancianos (≥ 60 años), aquellos con educación secundaria (≥ 12 años) y personas blancas.