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Participation is defined as frequency (measured by attendance and/or variety or diversity of activities) and involvement (participation experience including engagement, motivation, persistence, social connection and affection) in all life situations, and is seen as an essential condition for the development of the child. Children with myelomeningocele have several functional limitations that can lead to restriction of participation. Improving these children's participation requires knowledge about what factors may influence a child's ability to participate in activities of their choice. To verify whether factors such as age, mobility performance, access to assistive technology equipment and the presence of environmental facilitators are associated with the frequency and involvement of young children with myelomeningocele participation at home, daycare/preschool and in the community. A cross-sectional observational study was carried out with children diagnosed with myelomeningocele, between 6 months and 5 years of age. The dependent variables were Frequency and involvement in participation at home, day care/preschool and in the community, as measured by The Young Children's Participation Environment Measure - YC-PEM. The independent variables were age and access to assistive technology equipment collected through interviews with parents and caregivers, mobility performance measured by the questionnaire: Pediatric Assessment of Disability Inventory – Computerized Adaptive Testing (PEDICAT), and environmental facilitators measured by YC-PEM. Data were analyzed using SPSS version 22.0. To verify the associations between age, mobility performance, access to assistive technology equipment and the presence of environmental facilitators with the frequency and involvement of participation, Spearman's correlation was performed, with a significance level of 5%. Sixty-five children and their families (mean age 27.91 (±17.36) months) participated in the study. The presence of environmental facilitators at home increased the child's involvement at home (r=0.30, p=0.01). In the daycare/preschool setting, a significant positive association was found between age (r=0.50, p<0.0001; r=0.55, p<0.0001), mobility performance (r= 0.35, p=0.003; r=0.37, p=0.002) and the presence of environmental facilitators in daycare/preschool (r=0.95, p<0.0001; r=0.98, p <0.0001), with frequency and involvement, respectively. However, there was a negative association between having access to assistive technology equipment and attendance (r=-0.32, p=0.008) and participation involvement (r=-0.36, p=0.03) in daycare/preschool. In relation to the community environment, factors such as age (r=0.40, p=0.001), mobility performance (r=0.26, p=0.03), and the presence of environmental facilitators (r=0, 35, p=0.003) correlated positively with community engagement. Preliminary results indicated that the presence of environmental facilitators increases the participation involvement of children with myelomeningocele in all environments. Older and more mobile children are more involved in daycare/preschool and in the community. However, having access to assistive technology equipment that facilitates mobility worsens the frequency and involvement of participation in the daycare/preschool environment. These findings highlight the role of the environment for the participation of children with myelomeningocele in different contexts, pointing to the need for more facilitators and environmental changes. [ABSTRACT FROM AUTHOR]

The International Classification of Functioning, Disability and Health (ICF) is part of the Family of International Classifications of the World Health Organization (WHO) and acts as a tool for describing and organizing information about the functioning and disability of people with and without disabilities, providing a language standard. Marajó is a region with infrastructure peculiarities and disabled people who face very specific and little-known challenges there. Classify the mobility of people with physical disabilities in the Marajó archipelago according to the ICF. Cross-sectional study, with a quantitative approach, referring to the activity profile of physical PCD residents in the municipalities of Marajó. The subjects were selected by convenience through the dissemination of the action in Basic Health Units visited by the group of the "Abrace o Marajó'' Project between August 2021 and January 2022. The participants underwent a structured interview where they answered an adapted checklist, based on the ICF biopsychosocial model, which provides a standardized language. The ICF data used are related to the "activity and participation" domains, with a focus on mobility. The study included 51 physically disabled persons, with a predominance of age between 40 and 59 years (39.22%), men (54.90%), browns/mulattoes (62.75%). Most respondents had mobility problems, with 88.24% having difficulty walking (d450), 84.31% having difficulty lifting and carrying objects (d430), 78.43% having difficulty using transportation (d470), 64.71% using some locomotion device (d465), and 41.18% with impaired fine use of the hands (d440). These data suggest that the mobility deficit combined with the lack of accessibility may be one of the factors that most interfere with the lives of these participants, as it limits and/or restricts their participation in daily activities. Disabled persons residing in Marajó have several limitations and/or restrictions on participation in day-to-day activities related to lack of mobility, the main limitations are those with the highest percentages, that is, walking, lifting, and carrying objects, and using means of transport. In this regard, it is vital to adopt public policies aimed at improving the infrastructure of streets and sidewalks in order to facilitate access for this population, thus promoting an increase in the level of activity and participation. This study can contribute to the visibility of the needs of disabled persons who live in Marajó and the implementation of public policies to assist this population, as well as to understand their main difficulties and what accessibility measures can bring more autonomy. [ABSTRACT FROM AUTHOR]

The prevalence of obesity has increased substantially in the last decades in the elderly population and, consequently, it has been considered one of the main risk factors for non-communicable diseases in the world. Compared to general obesity, central obesity, which is characterized by excessive accumulation of fat in the abdominal region, has shown a greater association with diabetes and all-cause mortality, in addition to being considered a risk factor for disability in the elderly, regardless of BMI. Some studies suggest that the relationship between central obesity and disability differs according to gender, however, the results are still conflicting. To investigate the association between central obesity and mobility limitation in elderly Brazilians and to assess whether this association was modified by gender. This is a cross-sectional, analytical, and quantitative study that used data from the PNS. This is a household-based survey proposed by the Ministry of Health in partnership with the Brazilian Institute of Geography and Statistics (IBGE). For the present study, those aged 60 years or older were considered (n=11,177). Central obesity was defined when waist circumference (WC) was greater than 84 cm in women and 88 cm in men. Participants reported the degree of difficulty to move, being classified as no difficulty versus some difficulty. Binary logistic regression was used to investigate the association between central obesity and mobility limitation adjusted for sex, age, exercise, chronic diseases, self-reported health, and literacy. P<0.05 and a 95% confidence interval were considered. Women were the majority, representing 55.7% of the sample and the mean age was 66.9 ± 8.07 years. Central obesity was identified in 76.7% of the participants, being more prevalent among older women (60.4%) and 25.9% reported some difficulty with mobility, with a higher prevalence of females (64.8%). Elderly people with central obesity were 1.2 times more likely to have some difficulty with mobility (OR=1.21; 95%CI: 1.08-1.36) compared to elderly people who did not have any difficulty, even after adjusting the covariates. In the analysis stratified by gender, the association between central obesity and mobility limitation was significant among women (OR=1.48; 95%CI: 1.27-1.7; however, it, lost significance among men (OR =0.93;95%CI: 0.78-1.10). The results suggest that elderly women with central obesity are more likely to have some difficulty with mobility compared to men. The high prevalence of central obesity in the Brazilian elderly population, especially in the female public, represents a serious public health problem. Our findings identified a subgroup of the elderly population that is more vulnerable to limited mobility associated with abdominal obesity. Therefore, implementing health actions to prevent or reduce abdominal obesity should be strongly encouraged among elderly women. [ABSTRACT FROM AUTHOR]

• The chair stand test was a better predictor of mortality than gait speed. • Those with poorer mobility are at increased risk of dying from cardiovascular causes. • Cognitive impairment increased the risk of dying among those with worse mobility. • Multimorbidity also increased the risk of dying among those with worse mobility. • Worst performance in the tests was marginally associated with mortality by neoplasms. A better understanding of performance in functional mobility tasks related to the mortality patterns for the different causes of death for the Brazilian older population is still a challenge. To analyze if gait speed and chair stand test performance are associated with mortality in older adults, and if the overall mobility status changes the effect of other mortality risk factors. The data were from SABE (Health, Well-being and Aging Study), a multiple-cohort study conducted in São Paulo, Brazil, with a representative sample of people aged 60 and more. Cox regression models were used to analyze 10-year all-cause and cause-specific mortality with consideration for gait speed and the chair stand test. Of the 1411 participants, 26% died during the follow-up. The performance in the chair stand test had a more consistent association with mortality (hazard ratio (HR)=1.03, 95%CI: 1.00, 1.05) than gait speed. Being unable to perform the test also increased the risk to die by all-cause (HR=1.71, 95%CI: 1.21, 2.42) and by diseases of the circulatory system (HR=2.14, 95%CI: 1.25, 3.65). The stratified analysis of mobility performance changed the effects of some of the mortality risk factors, such as cognitive impairment and multimorbidity. The chair stand test could be a better choice than 3-meters walking test as a mortality predictor. In addition, the impact of cognitive decline and multimorbidity were greater among those with reduced mobility, supporting the development of preventive interventions and public policies targeted at more vulnerable groups of older adults. [ABSTRACT FROM AUTHOR]