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The Brazilian government has adopted measures that aim to influence students' spatial mobility. The extent and success of such measures require detailed knowledge of the mobility determinants. Gravity models are the appropriate tool for analyzing the flows of college students from their place of origin to their destination. To analyze the determinants of student flows, we estimate a negative binomial regression model with Brazilian data. The results show the deterrence effect of distance on mobility, as the total costs of entering a university increase with the distance between the place of origin and the destination institution. Places with lower living costs and smaller university centers (campuses) are attraction factors to students, as are the possibility of having non-reimbursable financing and a larger number of study programs.

Aim(s): To demonstrate how interoperable nursing care data can be used by nurses to create a more holistic understanding of the healthcare needs of multiple traumas patients with Impaired Physical Mobility. By proposing and validating linkages for the nursing diagnosis of Impaired Physical Mobility in multiple trauma patients by mapping to the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) equivalent terms using free‐text nursing documentation. Design: A descriptive cross‐sectional design, combining quantitative analysis of interoperable data sets and the Kappa's coefficient score with qualitative insights from cross‐mapping methodology and nursing professionals' consensus. Methods: Cross‐mapping methodology was conducted in a Brazilian Level 1 Trauma Center using de‐identified records of adult patients with a confirmed medical diagnosis of multiple traumas and Impaired Physical Mobility (a nursing diagnosis). The hospital nursing free‐text records were mapped to NANDA‐I, NIC, NOC and NNN linkages were identified. The data records were retrieved for admissions from September to October 2020 and involved medical and nursing records. Three expert nurses evaluated the cross‐mapping and linkage results using a 4‐point Likert‐type scale and Kappa's coefficient. Results: The de‐identified records of 44 patients were evaluated and then were mapped to three NOCs related to nurses care planning: (0001) Endurance; (0204) Immobility Consequences: Physiological, and (0208) Mobility and 13 interventions and 32 interrelated activities: (6486) Environmental Management: Safety; (0840) Positioning; (3200) Aspiration Precautions; (1400) Pain Management; (0940) Traction/Immobilization Care; (3540) Pressure Ulcer Prevention; (3584) Skincare: Topical Treatment; (1100) Nutrition Management; (3660) Wound Care; (1804) Self‐Care Assistance: Toileting; (1801) Self‐Care Assistance: Bathing/Hygiene; (4130) Fluid Monitoring; and (4200) Intravenous Therapy. The final version of the constructed NNN Linkages identified 37 NOCs and 41 NICs. Conclusion: These valid NNN linkages for patients with multiple traumas can serve as a valuable resource that enables nurses, who face multiple time constraints, to make informed decisions efficiently. This approach of using evidence‐based linkages like the one developed in this research holds high potential for improving patient's safety and outcomes. No Patient or Public Contribution: In this study, there was no direct involvement of patients, service users, caregivers or public members in the design, conduct, analysis and interpretation of data or preparation of the manuscript. The study focused solely on analysing existing de‐identified medical and nursing records to propose and validate linkages for nursing diagnoses. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of diadynamic currents administered prior to exercises on pain and disability in patients with osteoarthritis of the knee. Design: A randomized-controlled trial. Setting: Special Rehabilitation Services in Taboão da Serra. Participants: Patients with bilateral knee osteoarthritis. Intervention: Participants were randomly allocated to Group I (diadynamic currents and exercises; n = 30, 60 knees) or Group II (exercises alone; n = 30, 60 knees) and were treated three times a week for 8 weeks. Main outcome measures: The primary outcome measures were change in knee pain evaluated by visual analog scale and disability Index Score (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscle strength (dynamometer), a composite score for pain and disability (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and a drug diary to measure consumption of rescue pain medication (paracetamol). All measurements were collected at baseline, 8 weeks, and 6 months from baseline (follow-up). Results: There were 60 participants with a mean (SD) age of 63.40 (8.20) years. Between-group differences in the follow-up (8 weeks and 6 months) were observed for pain at rest, pain during activities of daily living and disability. There was improvement in Group I that was maintained for the three variables 6 months after treatment. Mean difference for pain at rest was −3.08 points (95% confidence interval −4.13; −2.02), p < 0.01 with an effect size of 1.4; mean difference for pain during activities of daily living was −2.40 points (95% confidence interval −3.34; −1.45), p < 0.01 with an effect size of 1.24; and mean difference for disability was −4.08 points (95% confidence interval −5.89; −2.26), p < 0.01 with an effect size of 1.04. Conclusion: Patients with symptomatic knee osteoarthritis receiving 8 weeks of treatment with diadynamic currents as an adjunct to a program of exercises had significantly greater improvements in pain and disability than those receiving exercises alone. Beneficial effects were sustained for 6 months. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nImplications for RehabilitationTo develop and assess the Bed Bridge Test’s (BBT) feasibility, safety, and clinimetric properties and evaluate functional capacity in hospitalised patients.This feasibility and measurement study examined four BBT versions, including the timed-limited at 30 and 60 s and repetition-limited at 5 and 10 times, in hospitalised patients in a university hospital in Brazil. Ninety-two functionally stable patients with respiratory, gastrointestinal, or post-surgical conditions participated. Participants completed the BBT versions in a random order. BBT concurrent criterion validity was evaluated using the Short Physical Performance Battery (SPPB), Sit-to-Stand (STS) test, and Functional Status Score (FSS).The participants were 51 ± 17 years old, 60% female, and 66% with clinical conditions. All participants completed the BBT versions without adverse events. Test–retest reliability was good–excellent (intraclass correlation coefficient >0.87) for all BBT versions, with acceptable agreement parameters and minimal detectable changes. The time-limited versions of the BBT might be affected by a ceiling effect. Floor effects were minimal for all BBT versions. BBT showed moderate associations with SPPB and STS and weak associations with FSS.The BBT is feasible and has promising measurement properties.The Bed Bridge Test (BBT) offers a valuable solution for healthcare professionals by addressing the limitations of existing functional tests, providing a straightforward assessment of functional capacity for both the patient and the assessor.The BBT has demonstrated excellent feasibility and safety, as all eligible participants completed its various versions without adverse events, indicating its potential utility across diverse patient populations.The BBT exhibits good to excellent reliability, indicating its reproducibility in clinical settings.The BBT has validated its effectiveness by exhibiting robust correlations with established functional tests such as the Short Physical Performance Battery (SPPB) and Sit-to-Stand (STS) test.The Bed Bridge Test (BBT) offers a valuable solution for healthcare professionals by addressing the limitations of existing functional tests, providing a straightforward assessment of functional capacity for both the patient and the assessor.The BBT has demonstrated excellent feasibility and safety, as all eligible participants completed its various versions without adverse events, indicating its potential utility across diverse patient populations.The BBT exhibits good to excellent reliability, indicating its reproducibility in clinical settings.The BBT has validated its effectiveness by exhibiting robust correlations with established functional tests such as the Short Physical Performance Battery (SPPB) and Sit-to-Stand (STS) test. [ABSTRACT FROM AUTHOR]

different populations have different averages of life-space assessment scores and defining cutoff values of clinical significance by each population should take into consideration. Different cutoffs to define restricted life space have been reported. The most common is a score of 60 points. There are other cutoffs derived from receiver operating characteristic (ROC) analysis and used to classify older adults according to their ability in activities of daily living (ADLs) (52.3 points) or instrumental activities of daily living (IADLs) (56 points); other cutoffs are specialized for people with cognitive impairment (26.75 points) or people with spinal cord injury who need mobility aids (78.5 points). The aims were to identify cutoff points of Life Space Assessment (LSA) in older adults in different sites and to determine the relationship of the cutoff scores with mobility disability and depression. The study population was composed of community-dwelling adults aged 65–74 years who were not institutionalized. An ROC analysis was constructed, and the area under the curve (AUC) was calculated to identify the optimal cutoff that discriminates life-space restriction for each city. Logistic regressions were executed by site to comprehend the association among restricted LSA and mobility disability and depression. In total, 1890 participants were included in the analyses (52.38% women, 37.19% mobility disability and 21.32% had depression). Canada cities had the highest cutoff, while Tirana and Natal had the lowest cutoff (< 50). Kingston was the site with the highest association between life-space restriction and mobility disability (OR 5.4, 95% CI 2.9–10). Saint-Hyacinthe, Tirana, and Manizales had significant associations between depression and restricted life space (OR 3.25, 95% CI 1.53–6.89, OR 3.14, 95% CI 1.88–5.24, and OR 3.99, 95% CI 2.28–6.98, respectively). Different cutoffs to define restricted life-space have been identified in elderly people at different sites. The analysis of the relationship between the restricted life space and personal characteristics like depression and mobility disability supported these findings. The groupings produced by the cutoff points for each site showed notable variations. These findings emphasize the importance of population-based cutoffs to improve the general applicability of LSM criteria and take into consideration the importance of site-specific approaches. [ABSTRACT FROM AUTHOR]

To understand and discuss the perceptions about fear of falling (FOF) in older adults without a history of falls. A qualitative study with a convenience sample consisting of 51 older adults. Data collection was out through semi-structured interviews during the Covid-19 pandemic. Data were analyzed using thematic analysis. Three themes were grouped: FOF and its repercussions; Reactions to FOF in the daily life of the pandemic; and No fear, but aware of aging. The older adults reported a fear of dependence, difficulties and cautious behaviors in activities of daily living and mobility in the community. Understanding FOF can contribute for your approach and building multidisciplinary and intersectoral strategies aimed at maintaining independence and strengthening the identity of older adults without a history of falls in the community. [ABSTRACT FROM AUTHOR]

Objective: To analyze the factors associated with low functional mobility in older adults residing in Alcobaça, BA. Methods: This is an epidemiological survey with a cross‐sectional design, conducted in 2015 with 473 older adults (62.4% women; mean age 70.2 ± 8.2 years) from Alcobaça, BA. The interview script addressed sociodemographic characteristics, health, and behavioral aspects. Functional mobility was assessed using the Short Physical Performance Battery (≤6 points). Inferential analyses were conducted using the Mann–Whitney U test and Poisson regression (with robust variance and estimation of prevalence ratios and their respective 95.0% confidence intervals). Results: The prevalence of low functional mobility was 9.6%, with associated factors including the use of alcoholic beverages (PR = 1.7, 95% CI: 1.01–1.13) and the number of repetitions in elbow flexion (PR = 1.01, 95% CI: 1.01–1.05). Additionally, older adults with low mobility had lower height, thigh circumference, and lower performance in handgrip strength tests, elbow flexion, and flexibility. They also spent more time in sedentary behavior and less time in physical activity compared to older adults with preserved mobility (p < 0.05). Conclusion: Older adults with low mobility exhibit poorer values in anthropometric parameters, lower performance in motor tests, spend less time engaged in physical activities, and more time in sedentary behavior. [ABSTRACT FROM AUTHOR]

Background. Prolonged joint immobilization causes muscle hypotrophy and joint stiffness, which worsen as the immobilization time increases. Muscle remobilization is essential to restore muscle mass and activity as soon as possible. There are various treatments for muscle remobilization, but therapeutic ultrasound has proved to be a promising technique, with thermal and athermic actions, generating possibilities for increasing tissue extensibility and cell metabolism, helping with the anabolic effects of static stretching. Objective. To evaluate the histopathological changes in the tibialis anterior muscle of Wistar rats after remobilization using therapeutic ultrasound, using the histopathological index. Methods. 21 male Wistar rats were used, divided into 3 groups (n = 7): immobilization group, immobilization and free remobilization group, immobilization and remobilization with ultrasound group. Immobilization was carried out with the knee flexed at 120° and total ankle plantiflexion for three weeks. Ultrasound was used at a frequency of 1.0 MHz with an intensity of 0.5 w/cm², lasting 2 minutes on the knee and a further 2 minutes on the ankle. Analyses were carried out using the histopathological index to measure the level of alterations and lesions in the muscle tissue, classifying them as severe, moderate or mild. Conclusions. It was concluded that the anabolic stimulus of ultrasound was favorable to the trophic recovery of muscle tissue. [ABSTRACT FROM AUTHOR]

Background: There are few studies that assess the relationship between nutritional status and quality of life in individuals with Parkinson's disease, despite the well-established negative impact of sarcopenia and dynapenia on functional capacity and quality of life. These conditions impair protein-muscular status and are prevalent in individuals with Parkinson's disease. This study aimed to examine the relationship between nutritional status, including body composition, functional capacity, and diagnosis of sarcopenia and dynapenia, and quality-of-life perception in individuals with Parkinson's disease. Methods: This is a cross-sectional study conducted in two Parkinson's disease centers in the northeast of Brazil. The researchers assessed muscle strength, muscle mass, and physical performance to diagnose dynapenia, sarcopenia and functional capacity. Quality of life was estimated using the Parkinson's disease Quality of Life Questionnaire. Results: We found positive correlations between quality of life and variables such as severity and duration of the disease, as well as positive screening for sarcopenia (p<0.001). Negative correlations were observed between quality of life and muscle strength and functional capacity. The study also found that individuals with sarcopenia and dynapenia had significantly worse quality-of-life scores compared to those who did not have these nutritional outcomes (p <0.05; p <0.001). Conclusions: The presence of sarcopenia, dynapenia, low gait speed, disease duration, and severity had an impact on higher scores in the Parkinson's Disease Quality of Life Questionnaire, indicating a worsening perception of quality of life. [ABSTRACT FROM AUTHOR]

Stroke is the leading cause of disability worldwide. Assessing stroke's impact on patients' daily activities and social participation can provide important complementary information to their rehabilitation process. However, no previous study had been conducted on the psychometric properties of the Brazilian version of the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) in the stroke population. This study aimed to examine the internal consistency, test-retest and inter-rater reliability, convergent validity and floor/ceiling effect of the Brazilian version of the WHODAS 2.0 in individuals after chronic stroke. Two examiners interviewed 53 chronic stroke individuals who responded to the Brazilian 36-item version of the WHODAS 2.0 three times to analyze test-retest and inter-rater reliabilities. Floor/ceiling effects were calculated as relative frequencies of the lowest or the highest possible WHODAS 2.0 scores. Participants also responded to the Stroke Impact Scale 3.0 (SIS 3.0) and the Functional Independence Measure (FIM) to analyze convergent validity. The internal consistency analyses for domains of WHODAS showed a strong correlation among the items of each domain (0.76–0.91) except for the "getting along" domain, which presented a moderate correlation (ρ = 0,62). Total scores of WHODAS 2.0 showed satisfactory internal consistency (α = 0.93), good inter-rater reliability (ICC = 0.85), excellent test-retest reliability (ICC = 0.92) and no significant floor/ceiling effect. Convergent validity indicated moderate to strong correlations (ρ=-0.51 to ρ=-0.88; p < 0.001), with the highest values associated with the correlation with the SIS scale. The Brazilian version of the WHODAS 2.0 instrument presented evidence of reliability and validity for chronic post-stroke individuals. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to investigate whether peripheral and inspiratory muscle strength and architecture, functional capacity, functional mobility, fatigue, and health-related quality of life are predictors of the Post–COVID-19 Functional Status Scale score in patients with post–COVID-19 syndrome who were hospitalized. Design: A cross-sectional study included 69 patients (53.3 ± 13.2 yrs, 36 men) with post–COVID-19 syndrome. The following outcomes were assessed: peripheral (dynamometry) and inspiratory (manovacuometry) muscle strength, muscle architecture (ultrasound), functional capacity (six-minute walk test), functional mobility (Timed Up and Go), fatigue (Functional Assessment of Chronic Illness Therapy), health-related quality of life (36-item Short-Form Health Survey), and functional status (Post–COVID-19 Functional Status scale). Results: Functional mobility (β = 0.573, P < 0.001), vastus intermedius echogenicity (β = −0.491, P = 0.001), length of stay (β = 0.349, P = 0.007), and female sex (β = 0.415, P = 0.003) influenced the Post– COVID-19 Functional Status Scale. Conclusions: Functional mobility, muscle quality of the vastus intermedius, length of stay, and female sex influence the Post–COVID-19 Functional Status Scale score in this population. It is noteworthy that functional mobility is an independent predictor of Post–COVID-19 Functional Status Scale. [ABSTRACT FROM AUTHOR]

Our goal was to explore older adults' views on walkability on sidewalks. An online survey was conducted based on the Active Design framework and participants and experts committee analyzed 22 photographs about the quality of sidewalks for walking. The top barriers reported by older adults were poor sidewalk condition and lack of accessibility. Safety and good accessibility were identified as facilitators for a positive walking experience. There was disagreement in seven pictures, reflecting that they might not perceive bad walking experiences. Understating how older adults perceive attributes for walking may help shape actions for aging-friendly cities. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to evaluate the impact of intensive care unit (ICU)-acquired weakness (ICUAW) on the functional independence of patients hospitalized for coronavirus disease 2019 (COVID-19) over 6 months after ICU discharge. Methods This was a prospective cohort study that included patients who were admitted to the ICU because of COVID-19 and who were monitored for 6 months after discharge from the ICU via telephone. Patients were evaluated at 3 times (30 days, 3 months, and 6 months after discharge from the ICU) for functional independence for personal care and mobility activities (Barthel Scale), independence for self-care (Katz Index), impact of COVID-19 on functional status (post–COVID-19 Functional Status Scale [PCFS]), and mobility level (ICU Mobility Scale). The existence of some degree of dependence was considered when the Barthel Scale score was <100 points, the Katz Index was ≥1, and the PCFS score was ≥1. A PCFS score of ≥3 indicated moderate or severe dependence. Patients with a Medical Research Council score of <48 at discharge from the ICU were diagnosed with ICUAW. Results Sixty-eight patients were included, with a mean age of 51 (SD = 13) years. The ICUAW rate at ICU discharge was 35%. In the evaluation with the PCFS, the values for the presence of any functional limitation at 30 days, 3 months, and 6 months after ICU discharge were 89.7%, 57.4%, and 38.2%, respectively. The rate of persistence of functional limitations after 6 months was higher in patients with ICUAW than in those without ICUAW (66.7% vs 22.8%; P  = .000); the same was true for moderate or severe limitations (20.8% vs 4.5%; P  = .035). Likewise, functional independence for personal care, mobility, and self-care activities was poorer in patients with ICUAW. Conclusions In patients surviving an ICU stay due to COVID-19, decreased functional independence persists even 6 months after discharge, and patients with ICUAW have worse outcomes. Impact Patients who survive ICU stays due to COVID-19 continue to have greater functional dependence even 6 months after ICU discharge. [ABSTRACT FROM AUTHOR]

Background: There are several markers for the suspicion, identification, and confirmation of sarcopenia. Objectives: To analyse the importance of several markers for assessing sarcopenia by classifying phenotypes based on five domains: symptomatology, muscle function, muscle mass, physical performance, and physical function. Methods: A cross-sectional study analysing 312 older adults (72.6±7.8 yrs) was conducted in Novo Aripuanã, Amazonas, Brazil. Symptoms of sarcopenia were determined with the SARC-Calf; muscle function was assessed using the 30-Chair Stand test (CST), 30-CST power, and handgrip strength (HGS) with and without normalisation for body mass/height; the skeletal muscle mass index (SMMI) was estimated from anthropometry; physical performance was determined through the 4-m gait speed (GS) and 6-min walking test (6MWT); and physical function was determined with the Composite Physical Function Scale (CPF). Results: Cluster analysis revealed two phenotypes (at risk vs not at risk for sarcopenia) and the contribution of each marker (ranged from 0 to 1). In men, the contribution of each marker was: 1 for SARC-Calf, 0.18 for SMMI, 0.09 for 30-CST power and 0.06 for HGS; in women: 1 for SARC-Calf, 0.25 for 30-CST power, 0.22 for SMMI, 0.06 for GS, 0.04 for HGS, and 0.03 for CPF. Considering the cutoff values proposed by Rikli and Jones (2013) for physical function and Cruz-Jentoft et al. (2019) for the other domains, the risk profile for sarcopenia was characterized by: high SARC-Calf in both sexes (men:51.8 vs 3.6%, p<0.001; women:71.2 vs 1.1%, p<0.001), low SMMI (men:73.2 vs 44.6%, p<0.002; women:44.1 vs 23.6%, p = 0.002); in women, low GS (38.7 vs 12.4%, p<0.001) and low CPF (29.7 vs 15.7%, p = 0.020), and no differences in HGS between groups in both sexes. Conclusions: SARC-Calf, SMMI, and 30-CST were more relevant markers for sarcopenia risk in older adults of both sexes, GS and CPF played also an important role in women. [ABSTRACT FROM AUTHOR]

Objective: Currently, little is known about the long-term outcomes of COVID-19 in the pediatric population. The aim of this study was to investigate the long-term clinical outcomes of pediatric patients hospitalized with COVID-19. Methods: This was a prospective cohort study involving unvaccinated children and adolescents admitted to a tertiary hospital in southern Brazil with a COVID-19 diagnosis. Data were collected from electronic medical records for one year after the diagnosis. Results: A total of 66 children were included: the median age was 2.9 years; 63.6% were male; and 48.5% were under 2 years of age. Over 70% had at least one comorbidity prior to the COVID-19 diagnosis. During the one-year follow-up period, 59.1% of the children revisited the emergency department, 50% required readmission, and 15.2% died. Younger children with longer hospital stays were found to be at greater risk of readmission. Having cancer and impaired functionality were found to increase the risk of death within one year. Conclusions: Our findings indicate that most children hospitalized with COVID-19 have comorbidities. Younger age at admission and a longer hospital stay seem to be risk factors for readmission. In addition, the presence of cancer and impaired functionality are apparently associated with the poor outcome of death within the first year after the diagnosis of COVID-19. [ABSTRACT FROM AUTHOR]

Background and Purpose: Physical functioning refers to the ability to independently perform activities that require physical ability, and may be an important tool for predicting a higher risk of hospitalization. The objective of this study was to verify whether aspects of physical functioning are independently associated with the risk for new hospitalization in older adults seen in primary health care. Methods: This prospective cohort study consisted of 473 older adults 60 years and older who had not been hospitalized in the prior year. Hospitalization records were obtained with authorization from the hospital admission. Depending on physical functioning, the probability of a new hospital admission within the next 5 years was determined based on survival analysis and the Kaplan-Meier curve. Physical functioning was evaluated using 5 easy-to-administer tests: handgrip strength using a Jamar dynamometer, functional performance using the Short Physical Performance Battery, balance using the step test, mobility using the Timed Up and Go (TUG) test, and gait speed using the 4-m walk test. The association between poor physical functioning and new hospitalization was verified using a Cox regression model, adjusted for sex, age, number of comorbidities, number of medications, and BMI. Models were implemented separately for each physical functioning test. Results: In the sample, 32% had been hospitalized at least once in 5 years. The Kaplan-Meier curve showed a decrease in the probability of nonhospitalization within the next 5 years. Cox regression analysis showed an association between hospitalization within the next 5 years and mobility on the TUG test of more than 12.4 seconds in the crude (hazard ratio [HR] = 1.33, 95% CI = 1.10-1.60) and adjusted models (HR = 1.26, 95% CI = 1.02-1.56), and balance using the step test of more than 7.5 seconds in the crude (HR = 1.27, 95% CI = 1.03-1.56) model. Conclusions: Physical functioning tests demonstrated that poor physical performance predicts new hospitalization, and reinforced the importance of their application in physical therapy practice in primary health care settings. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to propose a link between Functional Independence Measure (FIM) levels and International Classification of Functioning, Disability and Health (ICF) qualifiers for use in low- or middle-income countries such as Brazil. Method: A multidisciplinary committee was formed to discuss the need for standardisation of the classification so that different professionals could accurately record the functioning and for the standardisation to be meaningful for the individual and his /her support group, allowing observation and participation in the rehabilitation process. The proposed steps to adapt linking ICF qualifiers with FIM scores and functional levels were: 1. Inversion, 2. Parity, 3.Transposition, and 4. Adaptation. Results: FIM's seven levels of functioning have been linked to the five ICF qualifiers. FIM levels "7 (independent)" and "6 (modified independence)" have been linked to qualifiers "0 (no problem)" and "1 (mild problem)", respectively. FIM levels "4" and "5" have been grouped and linked to ICF qualifier "2 (moderate)". FIM levels "3" and "2" have been related to qualifier "3 (severe)". FIM level "1" which indicates complete dependence has been linked to qualifier "4 (complete)". Conclusion: This methodology allows for the creation of a link between the FIM and ICF, preserving clinically important information and having a description and clear relationship. It is thus able to facilitate clinical use of the ICF. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Engenharia Agricola e Ambiental - Agriambi is the property of Revista Brasileira de Engenharia Agricola e Ambiental and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To investigate the feasibility, safety, and effects of dual task (DT) in a mixed physical exercise protocol on mobility under DT in stroke survivors. Twenty-six chronic mild-impaired stroke survivors (age 51.57 ± 12.55; men= 13, women= 13) were randomly assigned into Experimental Group participating in a 15-week mixed (aerobic and resistance exercises performing a cognitive DT condition simultaneously) physical exercise protocol (30 sessions, 2x/week, duration of 60–90 min), and Control Group engaged in the same protocol without DT. Feasibility and outcome measures were assessed before and after the intervention and in a 5-week follow-up. DT physical exercise protocol was viable and safe. This protocol also improved mobility and gait when performed under DT, which was not found in the control group. DT does not influence aerobic resistance, strength, and balance responsiveness. It does not present any improvement in cognition, self-efficacy for falls, and quality of life. The results indicate that mixed physical exercise under DT is feasible and safe for mild-impaired stroke survivors. Stroke survivors demonstrate more significant improvement in the mobility performance under DT when submitted to a DT mixed physical exercise protocol than the standard physical exercise intervention. Brazilian clinical trials registry (RBR-4mvzz6); WHO trial record (U1111-1198-7173) DT training can be prescribed by using clear and precise parameters for stroke survivors. Physical Exercise without DT requirements did not improve mobility performing and cognitive tasks simultaneously in stroke survivors. Clinicians are encouraged to incorporate DT requirements into the exercise routines to enhance mobility under DT to mild-moderate stroke survivors. [ABSTRACT FROM AUTHOR]

The scientific literature mentions the existence of factors associated with fear of falling in older adults. However, the direct and indirect paths of its predictors have not yet been fully explored. This study aimed to analyze the socioeconomic, clinical, and health factors directly and indirectly associated with fear of falling in community-dwelling older adults. This is a cross-sectional study conducted in older adults (n = 410 – 70.11 ± 7.22 years). Clinical and health-condition data were collected, as were data on fear of falling using the Falls Efficacy Scale International—Brazil (FES-I Brazil). It was found that being female and having a higher number of self-reported morbidities, worse physical performance, and a higher number of depressive symptoms were directly associated with greater fear of falling. Regarding indirect associations, physical inactivity, mediated by a greater number of morbidities, worse physical performance, and a greater number of depressive symptoms, was associated with greater fear of falling. In addition, worse self-rated health, mediated by a greater number of depressive symptoms, as well as older age, mediated by worse physical performance, were associated with the outcome. This study provides information on the predictors directly and indirectly associated with fear of falling, expanding current understanding of this relationship. [ABSTRACT FROM AUTHOR]

Objective: the purpose of this pre-feasibility study was to examine perceptions and experiences of a Sit-to-stand activity with urban Brazilian community-dwelling older people in their homes. Method: the exploration method was focused ethnography. Purposive sampling was used to recruit 20 older people. Five means of data generation were used, namely: socio-demographic surveys, participant observations, informal interviews, formal semi-structured interviews, and field notes. Data analysis was qualitative content analysis. Results: the experience of mobility-challenged older people with the Sit-to-stand activity was dependent on their mobility expectations involving many factors that worked together to influence their beliefs and attitudes towards the activity, preferences, behaviors, and cultural perceptions. The participants of this study seemed to find the activity enjoyable; however, the most noticeable shortcomings for their engagement in the Sit-to-stand activity emerged as gaps in their personal and intrapersonal needs. Conclusion: the recommendations generated from the study findings call for the design of implementation strategies for the Sit-to-stand intervention that are tailored to this particular population's needs. [ABSTRACT FROM AUTHOR]

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Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Brazilian Journal of Kineanthropometry & Human Performance is the property of Brazilian Journal of Kineanthropometry & Human Performance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To identify the most frequent determinants of contact limitation on older adults' mobility addressed by the recommendations to mitigate mobility limitation during the COVID‐19 pandemic and identify the recommendations characteristics and means of dissemination that might guide coping actions. Background: Measures for physical contact restriction were implemented to prevent COVID‐19 spread. These measures directly impacted older people, reducing their mobility, especially outside home environment. Health systems worldwide need to be prepared to implement strategies to mitigate negative effects of reduced mobility in this population. Design: Scoping review using Arksey and O′Malley's methodological framework. Method: Therefore, a scoping review was conducted in LILACS, CINAHL, MEDLINE, WEB OF SCIENCE and SCOPUS databases. Documents and reports with recommendations from government agencies were also consulted. Results were presented in a narrative synthesis based on a conceptual model of mobility proposed by Webber (The Gerontologist, 2010, 50, 443) regarding the most frequently addressed determinants, characteristics of the proposed interventions, and means of dissemination for the older person population. Findings Twenty‐eight studies were selected for the final sample. According to Webber's model, most articles (n = 14) presented the impacts on mobility from the perspective of physical determinants, relating this aspect to biological losses in the musculoskeletal system, and a minority assessed mobility in vital spaces, encompassing environmental (n = 3) and financial (n = 1) determinants. Also, the most frequent recommendation was that physical activity promotes maintenance of mobility and prevents the occurrence of adverse results, such as falls, fractures and functional decline. As to dissemination, digital technologies were recognised as a strategy to motivate, instruct and monitor exercise practice to increase mobility in older adults. Conclusion: The main conditions related to the decline in mobility of older adults during COVID‐19 pandemic were physical inactivity and sedentary lifestyle. The practice of physical activity is widespread and needs to be adapted according to individual needs. Finally, digital technologies are essential tools in this period, but other alternatives should also be considered for low‐income seniors. Implications for practice: It is hoped that the gaps identified through this scoping review can help enhance the discussion on the broader assessment of mobility in older adults and the design of interventions when contact restriction is a reality. [ABSTRACT FROM AUTHOR]

COPD fits the profile of disabling health conditions. This study aims to validate the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with COPD. 100 participants with COPD responded to the Brazilian 36-item version of the WHODAS 2.0, as well as the Saint George's Respiratory Questionnaire (SGRQ), and the COPD Assessment Test (CAT). Spirometric data was extracted from medical records. The internal consistency analysis showed coefficients for all WHODAS 2.0 domains with a strong correlation (0.70–0.85) except for Life activities, which had a moderate correlation (coefficient = 0.60). In the construct analysis, the coefficients for the WHODAS and SGRQ domains presented a consistent correlation among them, varying from 0.40 to 0.69. No correlation was evidenced among the WHODAS domains and the spirometric data, highlighting that linear measures fail when associated with the functioning of an individual with COPD. Discriminative analysis revealed a capacity for the WHODAS 2.0 to distinguish among COPD different levels of clinical impact obtained from CAT excluding the Getting along domain. The WHODAS 2.0 shows as a valid instrument that can sensibly assess functioning differences related to the clinical impact classification level in subjects with COPD. WHODAS 2.0 is a valid tool to assess functioning in subjects with COPD. WHODAS 2.0 is sensitive to functioning differences related to classification level and to clinical impact in individuals with COPD. As a Patient-Reported Outcome Measure (PROM), WHODAS 2.0 offers the opportunity to develop clinical patient-centered interventions, improving the health care. As a low-cost, easy-to-use tool, WHODAS can be a useful resource in the process of clinical assessment of patient functioning. [ABSTRACT FROM AUTHOR]

Background: Mobility challenges may indicate functional decline and are a relevant problem faced by older people. An individual's perception of mobility is affected and moderated by several factors and varies significantly from one community to another. Providing an improved understanding of how older people perceive and experience mobility is a step towards better preparing nurses for roles they are increasingly expected to play. Purpose: The purpose of the study was to investigate perceptions and experiences of mobility in a group of Brazilian community‐dwelling older people living with mobility challenges. Method: Data were generated between June and October 2018 through in‐depth interviews, socio‐demographic surveys and field notes. Purposive sampling strategies were used to recruit 23 Brazilian older people to participate in this focused ethnographic study. Data were analysed using qualitative content analysis. Findings: Perceptions of Brazilian community‐dwelling older people living with mobility challenges were culturally learned and influenced by the social, physical and health environments. Participants' previous experiences with mobility had significant implications on values they attributed to mobility challenges. In addition, older people's experiences with mobility challenges were an integral part of sense of self and strongly related to contextual factors. Conclusions: This study contributes new information to the field of inquiry on mobility of older people as it focuses on the perceptions of a specific age group and culture and attends to the interrelationships between health conditions and contextual factors affecting the mobility of older people. Implications for practice: This study's particular contributions to the nursing discipline are related to improving care by revealing the significance of the context of mobility in which nursing actions are applied. [ABSTRACT FROM AUTHOR]

Background: Patients undergoing cardiac surgery can experience functional impairment. Objective: Assess the influence of Perme Score on the intensive care unit (ICU) length of stay in patients after cardiac surgery. As a secondary objective, investigate if preoperative variables can predict the patient's mobility status after surgery. Methods: A prospective observational study was conducted in ICU in a university hospital. The mobility status (Perme Score) was collected from the first postoperative day until ICU discharge. The preoperative assessment of respiratory muscle strength, pulmonary function, and handgrip strength were collected. Results: A total of 44 patients, mean age of 62.3 years, 28 men were included in the study. A high Perme Score on the second postoperative day among patients who underwent Coronary artery bypass grafting and the third postoperative day on three types of intervention (Coronary artery bypass grafting, valve replacement, or both simultaneously) was associated with shorter ICU length of stay). The preoperative pulmonary function was one of the main independent predictors of mobility status on the first three days of ICU stay, in addition to left ventricular ejection fraction and cardiopulmonary bypass time on the first day, age, and left ventricular ejection fraction on the second day and maximum expiratory pressure on third day. Conclusion: An increase in mobility status (Perme Score), mainly on the third postoperative day, reduced the ICU stay, mainly influenced by preoperative pulmonary function. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the impact of the additional use of early neuromuscular electrical stimulation (NMES) on an early mobilization (EM) protocol.Design: Randomized controlled trial.Setting: ICU of the Clinical Hospital of Ribeirão Preto, University of São Paulo, Brazil.Patients: One hundred and thirty-nine consecutive mechanically ventilated patients were included in the first 48 hours of ICU admission.Interventions: The patients were divided into two groups: EM and EM+NMES. Both groups received EM daily. In the EM+NMES group, patients additionally received NMES 5 days a week, for 60 minutes, starting in the first 48 hours of ICU admission until ICU discharge.Measurements and Main Results: Functional status, muscle strength, ICU and hospital length of stay (LOS), frequency of delirium, days on mechanical ventilation, mortality, and quality of life were assessed. Patients in the EM+NMES group presented a significant higher score of functional status measured by the Functional Status Score for the ICU scale when compared with the EM group in the first day awake: 22 (15-26) versus 12 (8-22) (p = 0.019); at ICU discharge: 28 (21-33) versus 18 (11-26) (p = 0.004); and hospital discharge: 33 (27-35) versus 25 (17-33) (p = 0.014), respectively. They also had better functional status measured by the Physical Function Test in the ICU scale, took less days to stand up during the ICU stay, and had a significant shorter hospital LOS, lower frequency of ICU-acquired weakness, and better global muscle strength.Conclusions: The additional application of early NMES promoted better functional status outcomes on the first day awake and at ICU and hospital discharge. The patients in the EM+NMES group also took fewer days to stand up and had shorter hospital LOS, lower frequency of ICU-acquired weakness, and better muscle strength. Future studies are still necessary to clarify the effects of therapies associated with EM, especially to assess long-term outcomes. [ABSTRACT FROM AUTHOR]

Background and Purpose: Mobility is a basic human need, and its limitation compromises health status, especially in older adults from developing countries and residing in nursing homes. This study aims to determine the prevalence and factors associated with mobility limitation in older adults residing in nursing homes. Methods: A cross-sectional study was conducted with 305 older adults (≥60 years) residing in 10 nursing homes in Northeast Brazil. Mobility limitation was evaluated using the "walking" item of the Barthel index. Sociodemographic/economic data concerning the participants and institutions, as well as conditions that could influence the mobility state of the older adults, were collected. The χ2 test and multiple logistic regression were performed using a significance level of 5%. Results and Discussion: The prevalence of mobility limitation was 65.6% (95% confidence interval [CI], 59.6-70.4). Walking dependence was identified in 39.7% of the sample (26.9% wheelchair users and 12.8% bedridden), while 25.9% walked with assistance (16.7% with maximal assistance and 9.2% with minimal assistance). Mobility limitation was significantly associated with malnutrition/risk of malnutrition (1.86, 95% CI, 1.54-2.26, P <.001) and age ≥81 years (1.35, 95% CI, 1.12-1.63, P =.002). Conclusion: Mobility limitation has a high prevalence among older adults residing in nursing homes in Brazil, and is associated with advanced age and poor nutritional status. Health professionals should advocate for the maintenance of mobility and adequate nutritional support. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Background: Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia.Methods: The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015-2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,023 who had complete data and did not have anemia in 2010. In the follow-up, there were 567 without anemia.Results: In analyses adjusted for age, education, comorbidities, body mass index, and physical inactivity, we found a differential association between hemoglobin concentration and SBBP by sex, with a positive interaction (β Hb*female= 0.20, 95% CI 0.04,0.37). At lower levels of hemoglobin, women have lower levels of SPPB than men, but at higher levels of hemoglobin concentration, there are no sex differences in physical performance. In addition, higher age was negatively associated with SPPB levels and cardiometabolic diseases, other diseases, and physical inactivity. Education was positively associated with physical performance.Conclusion: Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older adults without anemia in Brazil. However, there were sex differences in this association. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia, and highlights sex differences. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The purpose of this study was to analyze the prognostic capacity of the clinical indicators of a delayed surgical recovery nursing diagnosis throughout the hospital stay of patients having cardiac surgery. Design: A prospective cohort design was adopted. A sample of inpatients undergoing elective cardiac surgery was followed during the immediate preoperative period and hospitalization. This research was conducted in the southeast region of Brazil at a national reference institution that treats highly complex diseases and performs cardiac surgeries. Data were collected from July 2017 to July 2018. Methods: At the end of 1 year of data collection, 181 patients were followed in this study. The Kaplan‐Meier method was used to calculate the survival time related to delayed surgical recovery. In addition, an extended Cox model of time‐dependent covariates was adjusted to identify the clinical signs that influenced the change in the nursing diagnosis status. Results: A delayed surgical recovery nursing diagnosis was present in 23.2% of the sample studied. With an expected length of stay of 8 to 10 days, most new cases of delayed surgical recovery were observed on the 10th postoperative day, and the survival rate after this day was decreased until the 29th postoperative day, when the nursing diagnosis no longer appeared. Interrupted healing of the surgical area, loss of appetite, and atrial flutter were indicators related to an increased risk for delayed surgical recovery. Conclusions: Timely recognition of selected clinical indicators demonstrates a promising prognostic capacity for delayed surgical recovery. Clinical Relevance: Accurate identification of prognostic factors allows nurses to identify early signs of postoperative complications. Consequently, the professional can develop an individualized plan of care, aiming at the satisfactory clinical recovery of the patient. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has led to abrupt restrictions of lile-space mobility. The impact of shelter-in-place orders on older adults' health and well-being is still unclear. Objective: To investigate the relationship between life-space mobility and quality of life (QoL) in older adults with and without frailty during the COVID-19 pandemic. Design: Multicenter prospective cohort study based on structured telephone interviews. Setting: Four geriatric outpatient clinics in the metropolitan area of Sao Paulo, Brazil. Participants: 557 community-dwelling adults aged 60 years and older. Measurements: The Life-Space Assessment was used to measure community mobility before and during the COVID-19 pandemic, and a previously validated decrease of ≥ 5 points defined restricted life-space mobility. Frailty was assessed through the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale. The impact of shelter-in-place orders on QoL was evaluated with the question «How is the COVID-19 pandemic affecting your QoL?», to which participants could respond «not at all», «to some extent», or «to a great extent». We used ordinal logistic regressions to investigate the relationship between restricted life-space mobility and impact on QoL, adjusting our analyses for demographics, frailty, comorbidities, cognition, functionality, loneliness, depression, and anxiety. We explored whether frailty modified the association between life-space mobility and impact on QoL. Results: Participants were on average 80±8 years old, 65% were women, and 33% were frail. The COVID-19 quarantine led to a restriction of community mobility in 79% of participants and affected the QoL for 77% of participants. We found that restricted life-space mobility was associated with impact on QoL in older adults during the pandemic, although frailty modified the magnitude of the association (P-value for interaction=0.03). Frail participants who experienced restricted life-space mobility had twice the odds of reporting an impact on QoL when compared with non-frail individuals, with respective adjusted odds ratios of 4.20 (95% CI=2.36–7.50) and 2.18 (95% CI=1.33–3.58). Conclusion: Older adults experienced substantial decreases in life-space mobility during the COVID-19 pandemic, and this unexpected change impacted their QoL. Providers should be particularly watchful for the consequences of abrupt life-space restrictions on frail individuals. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Kineanthropometry & Human Performance is the property of Brazilian Journal of Kineanthropometry & Human Performance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Obesity in Brazil is increasing with 54% of the Brazilian population being overweight, of which 20% is obese. Obesity is a risk factor for non-communicable diseases such as cardiovascular disease: the leading cause of mortality in Brazil. This study aims to identify the barriers and facilitators to weight loss as perceived by patients with a view to reducing the burden of obesity-related diseases on patients and healthcare services. Methods: Fifteen qualitative, semi-structured, in-depth interviews were conducted in the preventive medicine department in a private health clinic in Bauru, Southeast Brazil. Inductive thematic analysis was conducted. Results: The barriers and facilitators were classified into three themes: lifestyle, motivation and education. Barriers include cost of a healthy lifestyle, time management, personal safety, mobility, junk food advertising, sustaining weight loss, mental health, lack of support and health education. Facilitators include change in eating habits, sleep quality, cooperative food networks, access to the multidisciplinary team and expert patients as health educators. Conclusion: Expert patients should be utilized as an education method, as they increase motivation, promote the facilitators and provide realistic expectations of the weight loss process. Barriers such as junk food advertising and accessibility to treatment need to be addressed. Abbreviations: BMI: Body Mass Index; NCD: Non-Communicable Disease; SUS: Sistema Único de Saúde; WHO: World Health Organization [ABSTRACT FROM AUTHOR]

• Elevated Allostatic Load Index determines worse physical performance states in older adults. • Distributions of Allostatic Load Averages do not differ significantly among the cities evaluated. • Total and Indirect Mediation Effects between Allostatic Load and the variables of age, socioeconomic and chronic conditions on physical performance scores were evidenced. This study aimed to evaluate the association between Allostatic Load (AL) and physical performance scores in older adults from four cities in North and South America. In this cross-sectional study, data from 1101 volunteers from three countries (Canada, Brazil, and Colombia) from the International Mobility in Aging Study (IMIAS) were used to evaluate the association between AL index and Short Physical Performance Battery (SPPB) scores. Three multiple linear regression models adjusted by age, Socioeconomic Status (SES), chronic conditions, depression symptoms, and Leganés Cognitive Test (LCT) were developed to estimate the independent association between SPPB and AL. Mediation analysis with 2012 LA data and covariates was performed to access the total, direct, and indirect effects of mediation on SPPB scores from 2016. AL and SPPB were inversely associated, with older adults with high allostatic load scoring lower on SPPB (β: -0.234, Std: 0.033, p-value: <0.001). Indirect effects were evidenced between age, SES and chronic conditions with AL and SPPB scores. Chronic conditions also had a total effect on SPPB scores and were also mediated by AL. However, indirect effects of depressive symptoms and LCT on SPPB scores mediated by AL were not observed. Findings from this study support that increased AL index determines worse physical performance states after full adjustments. AL has a mediator role between the number of chronic diseases, depressive symptoms, cognitive status and physical performance. Socioeconomic status also influenced physical scores mediated by the AL index. [ABSTRACT FROM AUTHOR]

Objective To evaluate the adequacy of the activities in the nursing intervention Exercise Therapy: Ambulation for medical-surgical patients with impaired physical mobility. Methods A methodological study with 60 medical-surgical nurses in a large hospital in São Paulo, SP, Brazil. Nurses judged the appropriateness of the 20 activities that comprise the intervention, classified as major or minor. Results Eight activities were classified as major and 12 as minor for the care of medical-surgical patients with impaired physical mobility. Conclusion and Implications for Practice The activities of the intervention Exercise Therapy: Ambulation were considered adequate for medical-surgical patients with impaired physical mobility. These results contribute to future content validation studies and teaching of undergraduate students. [ABSTRACT FROM AUTHOR]

• The trajectory of mobility of institutionalized Brazilian older adults is dynamic. • Age > 83 years and hospitalization are risk factors for mobility decline. • Chances of recovering gait performance are reduced in older adults aged > 83 years. • Maintenance of independent mobility is challenging for institutionalized older adults. • Multi-professional strategies must be applied to prevent incapacities. To analyze the trajectory of changes in mobility during walking (i.e., maintenance and recovery) of institutionalized older adults and verify the incidence and risk factors for mobility decline. A two-year longitudinal prospective study was conducted with 358 participants aged ≥ 60 years and institutionalized in ten nursing homes in Natal-RN (Brazil). Mobility was assessed using the "walking" item of the Barthel index. Sociodemographic, institution-related, and health-related variables were considered at baseline. Poisson regression was used to build a multiple model. The incidence of mobility decline during walking was 10.6% (95% confidence interval [95% CI] = 7.4 to 13.8) after 12 months and 37.7% (95% CI = 18.0 to 26.6) after 24 months. Age ≥ 83 years (relative risk = 1.58; 95% CI = 1.24 to 2.02; p < 0.001) and hospitalization (relative risk = 3.16; 95% CI = 1.55 to 6.45; p = 0.002) were predictors of mobility decline. The rate of mobility maintenance was 31.8% after 12 months (95% CI = 31.8 to 42.9) and 23.2% after 24 months (95% CI = 26.8 to 38.5). Also, the rate of recovery was 2.5% (95% CI = 1.0 to 5.0) and 1% (95% CI = 0.2 to 2.6) after 12 and 24 months, respectively. The trajectory of mobility during walking of institutionalized older adults in northeastern Brazil was dynamic (i.e., increasing incidence of mobility decline after 24 months) and associated with advanced age and hospitalization. The chances of recovering walking performance are minimal, and maintenance of independent mobility is challenging. [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]

Background: The rapid population ageing has been accompanied by a growing number of older adults experiencing chronic conditions, especially diabetes and hypertension, which are conditions associated to the decline in physical functioning. The aim of this study was to investigate changes in the strength of the association between mobility and two chronic conditions (hypertension and diabetes) in a large representative sample of Brazilian older adults over a ten year period. Methods: The data came from the Brazilian National Household Sample Survey (PNAD) of 1998, 2003 and 2008. The sample comprised 28,943 participants aged 60 years and older investigated in 1998, 35,042 in 2003 and 41,269 in 2008, totalling 105,254 older adults. The dependent variable was the physical mobility index (PMI) constructed based on the Item Response Theory (IRT) using five physical mobility indicators. The chronic conditions were self-reported and the confounders included: age, sex, schooling, ethnicity, family income, household composition, other co-morbidities and use of health services. The association between physical mobility (three different groups) and chronic conditions (hypertension and diabetes) was performed using multinomial logistic regression. Results: Over the ten year period the prevalence of hypertension increased from 44 % (1998), 49 % (2003) to 53 % (2008) (p < 0.001). Similar pattern was observed for the prevalence of diabetes: 10 % in 1998, 13 % in 2003 and 16 % in 2008 (p < 0.001). Overall, physical mobility showed a statistical significant association with both chronic diseases studied even after adjusting for potential confounders. The time-disease interaction term was significant (p < 0.05) for the two chronic conditions studied, and the strength of the associations decreased over the first five years, but it was not sustained between 2003 and 2008. Conclusions: Despite the increases observed in the prevalence of the hypertension and diabetes over the ten year period, the decrease in strength of the association with physical mobility during the first period could be explained by improvements in health services and treatment of older adults. Special attention should be given to the treatment and management of diabetes in order to avoid declines in physical mobility levels. [ABSTRACT FROM AUTHOR]

• Among the tested algorithms, random forest presented the best performances. • Performing separate predictions for each task leads to improved results. • The task with the best prediction was the difficulty of crouching and kneeling. • Age, schooling, back pain and hypertension were some of most important predictors. : The early identification of individuals at risk of mobility decline can improve targeted strategies of prevention. : To evaluate the predictive performance of machine learning (ML) algorithms in identifying older individuals at risk of future mobility decline. : We used data from the SABE Study (Health, Well-being and Aging Study), a representative sample of people aged 60 years and more, living in the Municipality of São Paulo, Brazil. Mobility decline was assessed 5 years after admission in the study by self-reported difficulty to walk a block, climb steps, being able to stoop, crouch and kneel, or lifting or carrying weights greater than 5 kg. Popular machine learning algorithms were trained in 70% of the sample with 10-fold cross-validation, and predictive performance metrics were obtained from applying the trained algorithms to the other 30% (test set). : Of the 1,615 individuals, 48% developed difficulty in at least one of the four tasks, 32% in stooping, crouching and kneeling, and 30% in carrying weights. The random forest algorithm had the best predictive performance for most outcomes. The tasks that the algorithm was able to predict with better performance were crouching and kneeling (AUC-ROC: 0.81[0.76–0.85]), and lifting or carrying weights (AUC-ROC: 0.80[0.75–0.84]). Age was the most important variable for the algorithms, followed by education and back pain, according to the SHAP (SHapley Additive exPlanations) values. : Applications of ML algorithms are a promising tool to identify older patients at risk of mobility decline, with the potential of improving targeted preventive programs. [ABSTRACT FROM AUTHOR]

This paper investigated the organic matter removal in waste stabilization ponds (WSP) based on ten full-scale wastewater treatment plants (WWTP) located in Rio Grande do Norte, Northeast Brazil. Although many systems are operating at high organic loading rates, in some cases, over 1000 kg BOD5 ha−1 d−1, the ponds promoted satisfactory removals of biochemical oxygen demand (BOD5) and chemical oxygen demand (COD). The first-order removal rates (k) for BOD5 and COD were obtained by assuming the ideal hydraulic patterns of completely mixed and plug-flow models. The k values proved to be a function of physical and operational parameters that affect fluid movement in a pond. The increase in the organic loading rate caused an increase in first-order removal rates. Moreover, increasing the ratio between hydraulic retention time (HRT) and depth (H) led to a reduction in k values. This information can be adapted into predictive models to be applied in WSP designs with similar characteristics. In comparison with the empirical equations reported in the literature, these models lead to removal rates more appropriate to the local reality. [ABSTRACT FROM AUTHOR]