Objective: to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. Method: a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer’s Exact tests. Results: among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. Conclusion: the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.

Objetivo: identificar el riesgo de depresión durante el embarazo en gestantes de riesgo habitual incluidas en el control prenatal y los factores asociados. Método: estudio transversal, realizado con 201 gestantes, en el consultorio de prenatal de riesgo habitual de una maternidad universitaria. Para la recolección de datos se utilizó un formulario electrónico que contenía un instrumento de caracterización y la Escala de Riesgo de Depresión del Embarazo. La variable dependiente fue el riesgo de depresión en el embarazo. El análisis estadístico se realizó mediante el cálculo de la razón de posibilidades (Odds Ratio) y utilizando las pruebas de Chi-cuadrado y exacta de Fischer. Resultados: entre las participantes, 68,2% tenían mayor riesgo de depresión durante el embarazo. Hubo asociación estadísticamente significativa entre mayor riesgo de depresión durante el embarazo y la variable ocupación (p=0,04), o sea, la ausencia del trabajo (OR = 2,00) duplicó la probabilidad de ocurrencia. Conclusión: la alta prevalencia de riesgo de depresión durante el embarazo destaca la necesidad de planificación, priorización e integración de la salud mental en los servicios de salud prenatal, especialmente en el ámbito de la Atención Primaria de Salud, por parte de los gestores de salud y de los formuladores de políticas.

Objetivo: identificar o risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de risco habitual e os fatores associados. Método: estudo transversal, realizado com 201 gestantes, no ambulatório de pré-natal de risco habitual de uma maternidade universitária. A coleta de dados utilizou um formulário eletrônico contendo um instrumento de caracterização e a Escala de Risco de Depressão na Gravidez. A variável dependente foi o risco de depressão na gravidez. A análise estatística deu-se pelo cálculo da razão de chances (Odds Ratio) e pelos testes Qui-quadrado e Exato de Fischer. Resultados: entre as participantes, 68,2% apresentaram maior risco de depressão na gravidez. Houve associação estatisticamente significativa entre o maior risco de depressão na gravidez e a variável ocupação (p=0,04), ou seja, a ausência de emprego (OR = 2,00) aumentou em duas vezes a chance de ocorrência. Conclusão: a alta prevalência de risco de depressão na gravidez evidencia a necessidade de planejamento, priorização e integração da saúde mental nos serviços de saúde pré-natal, principalmente no ambiente da Atenção Primária à Saúde, por parte de gestores de saúde e formuladores de políticas.

ABSTRACT Introduction The purpose of this retrospective bibliometric study was to assess the discrepancies between coloproctology surgery meeting abstracts and subsequent full-length manuscript publications. Methods Abstracts presented at the Brazilian Congress of Coloproctology Surgery from 2015 to 2019 were compared with matching manuscript publications. Discrepancies between the abstract and therefore the subsequent manuscript were categorized as major (changes within the purpose, methods, study design, sample size, statistical analysis, results, and conclusions) and minor (changes within the title, authorship, and number of female authors) variations. Results The conversion rate of abstracts in published manuscripts was 6,9% (121 abstracts). There were inconsistencies between the study title (66,1%), authorship (69,5%), study design (3,3%), sample size (39,2%), statistical analysis (24,8%), results (25,6%), and conclusions (12,4%) of manuscripts compared with their corresponding meeting abstracts. Conclusion As changes occur before manuscript publication of coloproctology surgery meeting abstracts, caution should be exercised in referencing abstracts or altering surgical practices based on abstracts content.

Abstract Introduction The presentation of abstracts in a congress is an important step for the dissemination of scientific information. The American Congress of Coloproctology is promoted by the American Society of Colon & Rectal Surgeons (ASCRS), and it is the largest in number of participants within the specialty, followed by the Brazilian Congress of Coloproctology. The present study aims to evaluate variables related to the quality of the scientific production of the abstracts presented in these two events and their conversion rate to published manuscripts. Materials and Methods The present bibliometric study assesses secondary data from the review of abstracts presented in these 2 important conferences in 2016, followed by a research of the publications from these congress presentations. Results The total number of abstracts evaluated was 854. The rate of articles containing statistical analyses was of 73.7% in the American congress, and of 34.1% in the Brazilian congress. Multicentric studies were more prevalent in the American congress (23.1%). Regarding study design, the most common were case reports in the Brazilian (44.8%) congress and retrospective studies in the American congress (67.7%). As for the works presented, the rate of conversion into full manuscripts in the American congress was of 24.2% compared with 10.6% in the Brazilian congress. Most papers from the American congress (93.7%) have citations compared with 68.6% of the other event evaluated. Conclusion The scientific performance demonstrated by the conversion rate of abstracts into publications is below ideal, mainly in relation to the Brazilian meeting; yet, there were significant differences between the two events in terms of the profile of the presentations and several variables analyzed.

Abstract The purpose of this article is to analyze how the Covid-19 pandemic contributed to the increase in the number of people in situations of vulnerability and, consequently, to the increase of social and economic inequalities that, historically, have thriven in Brazil. Therefore, it starts with an analytical reconstruction of the concepts of necropolitics and democratic legitimacy, proposed by Achille Mbembe and Pierre Rosanvallon, respectively. Thus, it seeks to show, preliminarily, how public policies and government management during the crisis contributed to the worsening of the post-pandemic chaotic scenario, with the resulting ratification and, even, resurgence of the invisibility of vulnerable groups, through the implementation of increasingly indifferent policies and, in some cases, refractory to the desires and needs of these groups, which will be considered mainly from the perspective of Achille Mbembe's necropolitics. Then, within the scope of this analysis, the forms of legitimacy (impartiality, proximity and reflexivity). Through this sophisticated conception of the democratic experience, viewed as irreducible to its electoral dimension (delegation democracy), an attempt will be made to explain the extent to which the increased vulnerability of various social groups in the context of the pandemic can be considered as an expression of greater democratic deficit in Brazil.

Resumo Este ensaio propõe analisar de que maneira a pandemia da Covid-19 contribuiu para o incremento do número de pessoas em situação de vulnerabilidade e, consequentemente, para o aumento das desigualdades sociais e econômicas que, historicamente, ocorrem no Brasil. Para tal, parte de uma reconstrução analítica dos conceitos de necropolítica e de legitimidade democrática, propostos por Achille Mbembe e Pierre Rosanvallon, respectivamente. Assim, busca mostrar, preliminarmente, como as políticas públicas e a gestão governamental durante a crise contribuíram para o agravamento do cenário caótico pós-pandêmico, com a decorrente ratificação e, inclusive, recrudescimento da invisibilidade dos grupos vulneráveis, mediante a implementação de políticas cada vez mais indiferentes e, em alguns casos, refratárias aos anseios e necessidades desses grupos, o que será contemplado principalmente a partir da ótica da necropolítica de Achille Mbembe. Em seguida, no bojo dessa análise, serão focadas as formas de legitimidade (imparcialidade, proximidade e reflexividade) que, segundo Pierre Rosanvallon, caracterizam a experiência democrática contemporânea. Mediante o manejo dessconcepção sofisticada da experiência democrática, que a considera irredutível à sua dimensão eleitoral (democracia de delegação), procurar-se-á explicitar em que medida o agravamento da situação de vulnerabilidade de diversos grupos sociais no contexto da pandemia da Covid-19 pode ser considerado expressão de um incremento do déficit democrático no Brasil.

ABSTRACT BACKGROUND: Developmental dysplasia of the hip (DDH) encompasses a broad spectrum of hip pathologies, including femoral or acetabular dysplasia, hip instability, or both. According to the medical literature, ultrasonography is the most reliable diagnostic method for DDH. Several techniques for the assessment of hips in newborns and infants, using ultrasonography, have been described. OBJECTIVE: To compare the accuracy of the Graf technique and other diagnostic techniques for DDH. DESIGN AND SETTING: A systematic review of studies that analyzed ultrasound techniques for the diagnosis of DDH within an evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, and LILACS databases for articles published up to May 5, 2020, relating to studies evaluating the diagnostic accuracy of different ultrasound techniques for diagnosing DDH. The QUADAS 2 tool was used for methodological quality evaluation. RESULTS: All hips were analyzed using the Graf method as a reference standard. The Morin technique had the highest rate of sensitivity, at 81.12–89.47%. The Suzuki and Stress tests showed 100% specificity. The Harcke technique showed a sensibility of 18.21% and specificity of 99.32%. CONCLUSION: All the techniques demonstrated at least one rate (sensibility and specificity) lower than 90.00% when compared to the Graf method. The Morin technique, as evaluated in this systematic review, is recommended after the Graf method because it has the highest sensitivity, especially with the three-pattern classification of 89.47%. REGISTRATION NUMBER: Identifier: CRD42020189686 at the International Prospective Register of Systematic Reviews (identifier: CRD42020189686).

Abstract Objective The aim of the present study is to determine whether previous shoulder and knee injuries were associated with isokinetic fatigue index and agonist/antagonist ratio of shoulder internal/external rotators and knee flexors/extensors in male volleyball athletes. Methods The current study is a cross-sectional investigation of 49 male elite volleyball players competing at a high level in Brazil. Isokinetic fatigue index and agonist/antagonist profiles were assessed during the preseason. Additionally, in order to record previous injuries, the athletes answered a standardized questionnaire. We conducted a receiver operating characteristic (ROC) curve analysis to determine the association strength and the clinically relevant cut-off point for variables presenting statistical significance for the area under the curve (AUC) (α = 0.05). An independent t-test was used to compare isokinetic variables between athletes with and without previous injury (α = 0.05). Results The results of the ROC curve analysis indicated that hamstring fatigue index values at 300o/s were associated with the presence of previous knee injury (area under the curve [AUC] = 73%, p= 0.004), and shoulder external rotators fatigue index values at 360°/s were not associated with the presence of previous shoulder injury (AUC = 68%, p= 0.053). Conclusions Elite volleyball athletes who reported previous knee injuries were prone to a higher fatigue index than those reporting no injuries. Knee flexor resistance training might be useful for those athletes who reported knee injuries in the previous season.

Resumo Objetivo O objetivo deste estudo é determinar se lesões prévias de ombro e joelho estavam associadas ao índice de fadiga isocinética e razão agonista/antagonista dos rotadores internos/externos do ombro e flexores/extensores do joelho em jogadores de voleibol. Métodos Esta é uma investigação transversal com 49 jogadores de voleibol de elite que competem em alto nível no Brasil. O índice de fadiga isocinética e os perfis de agonistas/antagonistas foram avaliados durante a pré-temporada. Além disso, para registro de lesões anteriores, os atletas responderam a um questionário padronizado. Conduzimos uma análise da curva de característica de operação do receptor (receiver operating characteristic, ROC) para determinar a força de associação e o ponto de corte clinicamente relevante de variáveis com significância estatística na área sob a curva (AUC) (α = 0,05). Um teste t independente comparou as variáveis isocinéticas entre atletas com e sem lesão prévia (α = 0,05). Resultados Os resultados da análise da curva ROC indicam que os valores do índice de fadiga dos isquiotibiais a 300o/s foram associados à presença de lesão prévia no joelho (área soba a curva [AUC] = 73%, p= 0,004), enquanto os valores do índice de fadiga dos rotadores externos do ombro a 360°/s não foram associados à presença de lesão prévia no ombro (AUC = 68%, p= 0.053). Conclusões Atletas de voleibol de elite que relataram lesões anteriores no joelho estavam propensos a um índice de fadiga maior do que aqueles que não relataram lesões. O treinamento de resistência de flexores do joelho pode ser útil para atletas com relatos de lesões no joelho na temporada anterior.

ABSTRACT Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. Methods: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. Results: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). Conclusion: This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.

Resumen El objetivo fue analizar las características estructurales, las funciones y los atributos de los vínculos en las redes sociales de usuarios de un Centro de Atención Psicosocial. Para ello, se desarrolló un estudio cualitativo en el que participaron 16 usuarios de un Centro de Atención Psicosocial. Se realizaron entrevistas en profundidad y semiestructuradas con base en el diagrama del mapa de Red. Se identificaron redes sociales extensas y con concentración de relaciones íntimas, circunscritas a los familiares y a los servicios de salud. Después de la enfermedad, los participantes relataron relaciones familiares fragilizadas. La apropiación de los espacios en la comunidad y en las redes incluye una herramienta de análisis, indicando a la producción del cuidado de salud mental los rumbos para la atención psicosocial.

Abstract The objective was to analyze the structural characteristics, functions and attributes of bonds in the social networks of users of a Psychosocial Care Center. For this purpose, a qualitative study was developed in which 16 users of a Psychosocial Care Center participated. In-depth and semi-structured interviews were carried out based on the Network Map diagram. Extensive social networks were identified, with a concentration of intimate relationships, limited to family members and health services. After the illness, the participants reported fragile family relationships. The appropriation of spaces in the community and in friendship relationships favored the structuring of networks. The analysis of the network map comprises an analysis tool indicating the pathways for psychosocial care to reach the production of mental health care.

Resumo Objetivou-se analisar as características estruturais, as funções e os atributos dos vínculos, nas redes sociais, de usuários de um Centro de Atenção Psicossocial (Caps). Para isso, desenvolveu-se um estudo qualitativo em que participaram 16 usuários de um Caps. Foram realizadas entrevistas em profundidade e semiestruturadas com base no diagrama do Mapa de Redes. Identificaram-se redes sociais extensas e com concentração de relações íntimas, circunscritas aos familiares e aos serviços de saúde. Após o adoecimento, os participantes relataram relações familiares fragilizadas. A apropriação dos espaços na comunidade e nas relações de amizade favoreceu a estruturação das redes. A análise do Mapa de Redes compreende uma ferramenta analisadora indicando, à produção do cuidado em Saúde Mental, os rumos para a Atenção Psicossocial.

RESUMO OBJETIVO Avaliar fatores sociodemográficos associados ao consumo de alimentos ultraprocessados e a evolução temporal do consumo no Brasil entre 2008 e 2018. MÉTODOS Foram utilizados dados do consumo alimentar de indivíduos com idade ≥ 10 anos das Pesquisas de Orçamentos Familiares (POF) 2008–2009 e 2017–2018. Os alimentos foram agrupados segundo a classificação Nova. Modelos de regressão linear brutos e ajustados foram utilizados para avaliar a associação entre características sociodemográficas e o consumo de ultraprocessados em 2017–2018 e a variação temporal de seu consumo entre 2008 e 2018. RESULTADOS Alimentos ultraprocessados representaram 19,7% das calorias em 2017–2018. A análise ajustada mostrou que seu consumo foi maior no sexo feminino ( versus masculino) e nas regiões Sul e Sudeste ( versus Norte), e menor em negros ( versus brancos) e na área rural ( versus urbana), além de diminuir com o aumento da idade e aumentar com escolaridade e renda. O consumo de ultraprocessados aumentou 1,02 pontos percentuais (pp) de 2008–2009 a 2017–2018, sendo este aumento mais expressivo em homens (+1,59 pp), negros (+2,04 pp), indígenas (+5,96 pp), na área rural (+2,43 pp), naqueles com até 4 anos de estudo (+1,18 pp), no quinto mais baixo de renda (+3,54 pp) e nas regiões Norte (+2,95 pp) e Nordeste (+3,11 pp). Por outro lado, seu consumo se reduziu na maior faixa de escolaridade (-3,30 pp) e no quinto mais alto de renda (-1,65 pp). CONCLUSÕES Os segmentos socioeconômicos e demográficos que tiveram menor consumo relativo de ultraprocessados em 2017–2018 são justamente os que apresentaram um aumento mais expressivo na análise temporal, apontando para uma tendência de padronização nacional em um patamar de consumo mais alto.

ABSTRACT OBJECTIVE To evaluate sociodemographic factors associated with the consumption of ultra-processed foods and the temporal evolution of their consumption in Brazil between 2008 and 2018. METHODS The study used food consumption data of individuals aged ≥ 10 years from 2008–2009 and 2017–2018 Pesquisas de Orçamentos Familiares (POF - Household Budget Surveys), grouping the foods according to the Nova classification. We used crude and adjusted linear regression models to assess the association between sociodemographic characteristics and consumption of ultra-processed foods in 2017–2018 and the temporal variation in their consumption between 2008 and 2018. RESULTS Ultra-processed foods accounted for 19.7% of calories in 2017–2018. The adjusted analysis showed that their consumption was higher in women (versus men) and the South and Southeast regions (versus North) and lower in blacks (versus whites) and rural areas (versus urban), in addition to decreasing with the increased age and increasing with higher education and income. Consumption of ultra-processed foods increased by 1.02 percentage points (pp) from 2008–2009 to 2017–2018. This increase was significantly higher among men (+1.59 pp), black people (+2.04 pp), indigenous (+5.96 pp), in the rural area (+2.43 pp), those with up to 4 years of schooling (+1.18 pp), in the lowest income quintile (+3.54 pp), and the North (+2.95 pp) and Northeast (+3.11 pp) regions. On the other hand, individuals in the highest level of schooling (-3.30 pp) and the highest income quintile (-1.65 pp) reduced their consumption. CONCLUSIONS The socioeconomic and demographic segments with the lowest relative consumption of ultra-processed foods in 2017–2018 are precisely those that showed the most significant increase in the temporal analysis, pointing to a trend towards national standardization at a higher level of consumption.

RESUMO: Com o objetivo de avaliar a ocorrência de depressão pós-parto e alguns fatores sociodemográficos associados, entre mulheres acompanhadas na Atenção Primária à Saúde, um questionário sociodemográfico e a Escala de Depressão Pós-parto de Edimburgo foram aplicados a 123 puérperas entre a segunda semana e o sexto mês após o parto. A frequência de depressão pós-parto na amostra foi determinada e sua associação com variáveis sociodemográficas foi avaliada por meio do teste do qui-quadrado. A provável depressão pós-parto foi identificada em 19,51% das participantes, e essa condição foi associada à faixa etária (36 a 44 anos), idade do bebê (4 ou 6 meses), estado civil (divorciado), baixa renda e não houve associação com a escolaridade materna. Assim, a depressão pós-parto precisa ser investigada na atenção primária à saúde, atentando para os aspectos sociodemográficos e individuais. Esses aspectos precisam ser valorizados pelo enfermeiro, que deve estabelecer um plano assistencial integral desde o pré-natal, para prevenir esse frequente transtorno puerperal.

RESUMEN: Con el objetivo de rastrear la depresión pos parto entre las mujeres em Atención Primaria de Salud, se aplicó un cuestionario sociodemográfico y la Escala de Depresión Postnatal de Edimburgo a 123 puérperas entre la segunda semana y el sexto mes después del parto. Se determinó la frecuencia de depresión pos parto en la muestra y se evaluó su asociación con variables sociodemográficas mediante la prueba de chi-cuadrado. Se identifico depresión posparto probable en el 19,51% de las participantes, y esta condición se asoció con el grupo de edad (36 a 44 años), edad del bebé (4 o 6 meses), estado civil (divorciada), bajos ingresos y no había asociación con la escolarización materna. Por lo tanto, la depresión del parto necesita ser investigada en la atención primaria de salud, prestando atención a los aspectos sociodemográficos e individuales. Estos aspectos necesitan ser valorados por las enfermeras, qui deben establecer un plan de cuidados integral desde el prenatal, para prevenir este frecuente trastorno puerperal.

ABSTRACT: Aiming to track postpartum depression among women followed in Primary Health Care, a sociodemographic questionnaire and the Edinburgh Postnatal Depression Scale were applied to 123 postpartum women between the second week and the sixth month after delivery. The frequency of postpartum depression in the sample was determined, and its association with sociodemographic variables was assessed using the chi-square test. Probable postpartum depression was identified in 19.51% of the participants, and this condition was associated with age group (36 to 44 years), age of the baby (4 or 6 months), marital status (divorced), low income and there was no association with maternal schooling. Thus, postpartum depression needs to be investigated in primary health care, paying attention to sociodemographic and individual aspects. These aspects need to be valued by nurses, who must establish a comprehensive care plan from prenatal care, to prevent this frequent puerperal disorder.

ABSTRACT Objective: To assess whether the use of ELMO, a helmet for noninvasive ventilation created in Brazil, had a positive impact on the prognosis of patients with hypoxemic respiratory failure caused by severe COVID-19. Methods: This is a retrospective study of 50 critically ill COVID-19 patients. Epidemiological, clinical, and laboratory data were collected on ICU admission, as well as before, during, and after ELMO use. Patients were divided into two groups (success and failure) according to the outcome. Results: ELMO use improved oxygenation parameters such as Pao2, Fio2, and the Pao2/Fio2 ratio, and this contributed to a gradual reduction in Fio2, without an increase in CO2, as determined by arterial blood gas analysis. Patients in the success group had significantly longer survival (p < 0.001), as determined by the Kaplan-Meier analysis, less need for intubation (p < 0.001), fewer days of hospitalization, and a lower incidence of acute kidney injury in comparison with those in the failure group. Conclusions: The significant improvement in oxygenation parameters, the longer survival, as reflected by the reduced need for intubation and by the mortality rate, and the absence of acute kidney injury suggest that the ELMO CPAP system is a promising tool for treating ARDS and similar clinical conditions.

RESUMO Objetivo: Avaliar se o uso do ELMO, um capacete para ventilação não invasiva criado no Brasil, teve impacto positivo no prognóstico de pacientes com insuficiência respiratória hipoxêmica por COVID-19 grave. Métodos: Estudo retrospectivo com 50 pacientes críticos com COVID-19. Dados epidemiológicos, clínicos e laboratoriais foram coletados na admissão na UTI e antes, durante e após o uso do ELMO. Os pacientes foram divididos em dois grupos (sucesso e falha) de acordo com o desfecho. Resultados: O uso do ELMO melhorou parâmetros de oxigenação como Pao2, Fio2 e relação Pao2/Fio2, e isso contribuiu para uma redução gradual da Fio2, sem aumento do CO2, conforme determinado pela gasometria arterial. Os pacientes do grupo sucesso apresentaram sobrevida significativamente maior (p < 0,001), conforme determinado pela análise de Kaplan-Meier, menor necessidade de intubação (p < 0,001), menos dias de hospitalização e menor incidência de lesão renal aguda em comparação com os do grupo falha. Conclusões: A significativa melhora nos parâmetros de oxigenação, a maior sobrevida, refletida pela menor necessidade de intubação e pela taxa de mortalidade, e a ausência de lesão renal aguda sugerem que o sistema ELMO CPAP é uma ferramenta promissora para o tratamento da SDRA e de condições clínicas semelhantes.

ABSTRACT Objective: To estimate the prevalence and to analyze the factors associated with the death of older people hospitalized due to Covid-19 in the state of Paraná. Method: Cross-sectional study conducted with secondary data from older people with a positive diagnosis of Covid-19 living in the State of Paraná, collected from March 1, 2020 to August 31, 2021. Prevalence ratios were obtained by adjusting the regression model. Results: A total of 16,153 deaths of older people hospitalized in the State of Paraná were analyzed. The adjusted model revealed an association between death and some factors such as: belonging to the age group of 75 to 84 years (PR = 1.28; CI95% = 1.24–1.32) and 85 years or over (PR = 1.52; CI95% = 1.45–1.59); male (PR = 1.17; CI95% = 1.13–1.21); obesity (PR = 1.23; CI95% = 1.16–1.29); other morbidities (PR = 1.25; CI95% = 1.20–1.30); and having used ventilatory support (PR = 2.60; CI95% = 2.33–2.86). Older people vaccinated against influenza had a probability of death reduced by 11% (PR = 0.89; CI95% = 0.86–0.93). Conclusion: The association of age, sex, and diagnosis of previous comorbidities with unfavorable outcomes from Covid-19 was identified. Having received the flu vaccine provided protection to elderly people who contracted SARS-CoV-2.

RESUMEN Objetivo: Prevalencia y factores asociados a la muerte de personas mayores hospitalizadas por Covid-19 en el estado de Paraná* Método: Estudio transversal realizado con datos secundarios de personas mayores con diagnóstico positivo de Covid-19 residentes en el Estado de Paraná, recolectados del 1 de marzo de 2020 al 31 de agosto de 2021. Las razones de prevalencia se obtuvieron ajustando el modelo de regresión. Resultados: Se analizaron 16.153 muertes de personas mayores hospitalizadas en el Estado de Paraná. El modelo ajustado reveló asociación entre la muerte y algunos factores como: pertenecer al grupo etario de 75 a 84 años (RP = 1,28; IC95% = 1,24–1,32) y 85 años o más (RP = 1,52; IC95% = 1,45–1,59); masculino (RP = 1,17; IC95% = 1,13–1,21); obesidad (RP = 1,23; IC95% = 1,16–1,29); otras morbilidades (RP = 1,25; IC95% = 1,20–1,30); y haber utilizado soporte ventilatorio (RP = 2,60; IC95% = 2,33–2,86). Las personas mayores vacunadas contra la influenza tuvieron una probabilidad de muerte reducida en un 11% (RP = 0,89; IC95% = 0,86–0,93). Conclusión: Se identificó la asociación de la edad, el sexo y el diagnóstico de comorbilidades previas con resultados desfavorables por Covid-19. Haber recibido la vacuna contra la gripe brindó protección a las personas mayores que contrajeron el SARS-CoV-2.

RESUMO Objetivo: Estimar a prevalência e analisar os fatores associados ao óbito de idosos hospitalizados por Covid-19 no Estado do Paraná. Método: Estudo transversal conduzido com dados secundários de idosos com diagnóstico positivo de Covid-19 residentes no Estado do Paraná, coletados no período de 01 de março de 2020 a 31 de agosto de 2021. As razões de prevalências foram obtidas por meio do ajuste de modelo de regressão. Resultados: Foram analisados 16.153 óbitos de idosos hospitalizados no Estado do Paraná. O modelo ajustado revelou associação do óbito a alguns fatores como: pertencer a faixa etária dos 75 a 84 anos (RP = 1,28; IC95% = 1,24–1,32) e 85 anos ou mais (RP = 1,52; IC95% = 1,45–1,59); sexo masculino (RP = 1,17; IC95% = 1,13–1,21); obesidade (RP = 1,23; IC95% = 1,16–1,29); outras morbidades (RP = 1,25; IC95% = 1,20–1,30); e ter utilizado suporte ventilatório (RP = 2,60; IC95% = 2,33-2,86). Idosos vacinados contra a gripe tiveram probabilidade de morte reduzida em 11% (RP = 0,89; IC95% = 0,86–0,93). Conclusão: Identificou-se a associação da idade, sexo e diagnóstico de comorbidades prévias aos desfechos desfavoráveis da Covid-19. Ter recebido o imunizante contra a gripe conferiu proteção aos idosos que contraíram o SARS-CoV-2.

ABSTRACT OBJECTIVE To evaluate sociodemographic factors associated with the consumption of ultra-processed foods and the temporal evolution of their consumption in Brazil between 2008 and 2018. METHODS The study used food consumption data of individuals aged ≥ 10 years from 2008–2009 and 2017–2018 Pesquisas de Orçamentos Familiares (POF - Household Budget Surveys), grouping the foods according to the Nova classification. We used crude and adjusted linear regression models to assess the association between sociodemographic characteristics and consumption of ultra-processed foods in 2017–2018 and the temporal variation in their consumption between 2008 and 2018. RESULTS Ultra-processed foods accounted for 19.7% of calories in 2017–2018. The adjusted analysis showed that their consumption was higher in women (versus men) and the South and Southeast regions (versus North) and lower in blacks (versus whites) and rural areas (versus urban), in addition to decreasing with the increased age and increasing with higher education and income. Consumption of ultra-processed foods increased by 1.02 percentage points (pp) from 2008–2009 to 2017–2018. This increase was significantly higher among men (+1.59 pp), black people (+2.04 pp), indigenous (+5.96 pp), in the rural area (+2.43 pp), those with up to 4 years of schooling (+1.18 pp), in the lowest income quintile (+3.54 pp), and the North (+2.95 pp) and Northeast (+3.11 pp) regions. On the other hand, individuals in the highest level of schooling (-3.30 pp) and the highest income quintile (-1.65 pp) reduced their consumption. CONCLUSIONS The socioeconomic and demographic segments with the lowest relative consumption of ultra-processed foods in 2017–2018 are precisely those that showed the most significant increase in the temporal analysis, pointing to a trend towards national standardization at a higher level of consumption.

RESUMO OBJETIVO Avaliar fatores sociodemográficos associados ao consumo de alimentos ultraprocessados e a evolução temporal do consumo no Brasil entre 2008 e 2018. MÉTODOS Foram utilizados dados do consumo alimentar de indivíduos com idade ≥ 10 anos das Pesquisas de Orçamentos Familiares (POF) 2008–2009 e 2017–2018. Os alimentos foram agrupados segundo a classificação Nova. Modelos de regressão linear brutos e ajustados foram utilizados para avaliar a associação entre características sociodemográficas e o consumo de ultraprocessados em 2017–2018 e a variação temporal de seu consumo entre 2008 e 2018. RESULTADOS Alimentos ultraprocessados representaram 19,7% das calorias em 2017–2018. A análise ajustada mostrou que seu consumo foi maior no sexo feminino ( versus masculino) e nas regiões Sul e Sudeste ( versus Norte), e menor em negros ( versus brancos) e na área rural ( versus urbana), além de diminuir com o aumento da idade e aumentar com escolaridade e renda. O consumo de ultraprocessados aumentou 1,02 pontos percentuais (pp) de 2008–2009 a 2017–2018, sendo este aumento mais expressivo em homens (+1,59 pp), negros (+2,04 pp), indígenas (+5,96 pp), na área rural (+2,43 pp), naqueles com até 4 anos de estudo (+1,18 pp), no quinto mais baixo de renda (+3,54 pp) e nas regiões Norte (+2,95 pp) e Nordeste (+3,11 pp). Por outro lado, seu consumo se reduziu na maior faixa de escolaridade (-3,30 pp) e no quinto mais alto de renda (-1,65 pp). CONCLUSÕES Os segmentos socioeconômicos e demográficos que tiveram menor consumo relativo de ultraprocessados em 2017–2018 são justamente os que apresentaram um aumento mais expressivo na análise temporal, apontando para uma tendência de padronização nacional em um patamar de consumo mais alto.

ABSTRACT Introduction: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. Methods: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. Results: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale “perceived need”, PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The “access” barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. Conclusion: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.