20 research outputs found
Análise longitudinal do tempo de retorno e fatores associados para doação de sangue em primodoadores voluntários
Introduction: Different factors related to blood donation can generate situations that affect their return and, when not elucidated and solved, can compromise loyalty to blood centers. Objective: The purpose of this paper was to estimate first-time blood donors return time and associated factors. Method: Cohort studies were designed after consulting State Blood Center’s database in Apucarana, PR, Brazil. Donor medical records were analyzed from January 1, 2005 to June 30, 2009, and their returns were monitored until the year 2011. It was considered as the dependent variable the turnaround time for second donation and its prevalence after the first donation. Anthropometric, clinical and laboratory data were collected, followed by a structured interview. Data were submitted to Kaplan-Meier survival analysis comparing them with the log-rank test. The proportional hazards regression Cox model was used to identify risk factors associated with the return, calculating the proportional risk and interval 95% confidence interval (95%CI). Results: 41.5% returned: 26.1% temporarily were unfit and 50.0% fit. Donors who returned more quickly were Rh negative, under 19 years old and with hypotension. The proportional risk for the main impeditive were older age (RP = 0.190; 95%CI 0.071–0.510), farther distance (RP = 0.276; 95%CI 0.124–0.616), arterial hypotension (RP = 0.540; 95%CI 0.385–0.759), risky behavior (RP = 0.533; 95%CI 0.473–0.601), anemia (RP = 0.402; 95%CI 0.348–0.464) and arterial hypertension (RP = 0.377; 95%CI 0.277–0.513). Conclusions: This study showed a significant decrease in first-time donors who return to the service for other donations and identified that young people and those who were apt were the groups with the highest frequency of return. Knowledge of the causes of temporary inability to donate provides conditions to encourage those temporary unable to donate to return for future donations.Introdução: Diferentes fatores inerentes à doação de sangue podem gerar situações que intervêm no retorno dos doadores, as quais, quando não elucidadas e não solucionados os problemas delas derivados, comprometem a fidelização aos hemocentros. Objetivo: Estimar o tempo de retorno à doação de sangue em primodoadores e fatores associados. Método: Estudo de delineamento de coorte por meio da análise do Banco de Dados do Hemonúcleo da Regional de Saúde em Apucarana (PR). Foram analisados os prontuários de doadores no período de 1º de janeiro de 2005 a 30 de junho de 2009, cujos retornos foram acompanhados até o ano de 2011. Considerou-se como variáveis dependentes o tempo de retorno para segunda doação e sua frequência após a primeira doação. Foram coletados dados antropométricos, clínicos e laboratoriais e, em seguida, entrevista estruturada. Os dados foram submetidos à análise de sobrevida de Kaplan-Meier comparando-os pelo teste log-rank. O modelo de regressão de risco proporcional de Cox foi utilizado para identificar os fatores de risco associados ao retorno, calculando-se o risco proporcional com intervalo de 95% de confiança (IC95%). Resultados: Observou-se uma proporção de retorno de 41,5%, sendo 26,1% dos inaptos temporariamente e 50,0% dos aptos. Doadores que retornaram mais rapidamente foram os Rh negativos, idade menor de 19 anos e com hipotensão arterial. Os riscos proporcionais (RP) para fatores impeditivos do retorno estiveram associados a idade mais avançada (RP = 0,190; IC95% 0,071–0,510), procedência mais distante (RP = 0,276; IC95% 0,124–0,616), hipotensão arterial (RP = 0,540; IC95% 0,385–0,759), comportamento de risco (RP = 0,533; IC95% 0,473–0,601), anemia (RP = 0,402; IC95% 0,348–0,464) e hipertensão arterial (RP = 0,377; IC95% 0,277–0,513). Conclusões: Este estudo mostrou diminuição significativa de primodoadores que retornam ao serviço para outras doações e identificou que os jovens e aqueles aptos foram os grupos com maior frequência de retorno. O conhecimento das causas de inaptidão temporária propicia condições para incentivar os inaptos temporários a retornarem para doações futuras
Inflammatory markers and occurrence of falls: Bambuí Cohort Study of Aging
OBJECTIVE: Analyze whether inflammatory markers are associated with falls among older adults living in Bambuí. METHODS: Study that analyzed baseline data from a Bambuí Cohort Study of Aging, involving 1,250 participants. Data about falls were collected from previous 12 months, classified as single or multiple occurrence and severity (participant seeking health services). Information about sociodemographic characteristics, health behaviors and health condition was also collected and used as confounding factors. The exposures of interest included interleukins (IL-1β, IL-6, IL-8, IL-10, IL-12), tumor necrosis factor (TNF), ultra-sensitive C-reactive protein (us-CRP) and chemokines (CXCL9, CCL5, CCL10, MCP1). Data were processed through logistic regression, obtaining odds ratio and 95% confidence interval (95%CI). RESULTS: The prevalence of falls was 27.1%; 40.1% of the older adults reported multiple falls and 33.3% sought health services. After adjustments, the following elevated levels were associated with falls: us-CRP (OR = 1.46, 95%CI 1.04–2.03), CCL5 (OR = 1.38, 95%CI 1.01–1.90) and CXCL9 (OR = 1.43, 95%CI 1.02–2.02). An association was observed between the number of elevated markers and the occurrence of falls: two (OR = 1.47, 95%CI 1.02–2.12) and three (OR = 2.08, 95%CI 1.12–3.87) elevated biomarkers indicated fall probability of 32.0% and 39.4%, respectively. CONCLUSIONS: Elevated levels of us-CRP, CCL5 and CXCL9, which were associated with falls, may contribute to a proper understanding of the mechanism associated with the occurrence of falls among older people.OBJETIVO: Analisar se marcadores inflamatórios estão associados a quedas em idosos vivendo na comunidade. MÉTODOS: Estudo da coorte de idosos de Bambuí, envolvendo 1.250 participantes da linha de base do projeto. Foram coletadas informações sobre quedas nos últimos 12 meses, classificadas quanto à ocorrência (única ou múltipla) e gravidade (procura por serviços de saúde). O inquérito também continha informações a respeito das características sociodemográficas, comportamentais e condições de saúde, as quais foram utilizadas como fatores de confusão. As exposições pesquisadas incluíram: interleucinas (IL-1β, IL-6, IL-8, IL-10 e IL-12), fator de necrose tumoral (TNF), proteína C reativa ultrassensível (PCRus) e quimiocinas (CXCL9, CCL5, CCL10 e MCP1). O tratamento dos dados foi realizado por meio de regressão logística, obtendose odds ratio e intervalo de 95% de confiança (IC95%). RESULTADOS: A prevalência de queda foi 27,1%; 40,1% dos idosos relataram quedas múltiplas e 33,3% procuraram serviços de saúde. Após ajustes, permaneceram associados às quedas os níveis elevados de PCRus (OR = 1,46; IC95% 1,04–2,03), CCL5 (OR = 1,38; IC95% 1,01–1,90) e CXCL9 (OR = 1,43; IC95% 1,02–2,02). Houve associação entre o número de marcadores elevados e a ocorrência de quedas: dois (OR = 1,47; IC95% 1,02–2,12) e três (OR = 2,08; IC95% 1,12–3,87) biomarcadores aumentados predisseram probabilidades de quedas iguais a 32,0% e 39,4%, respectivamente. CONCLUSÕES: Os níveis elevados de PCRus, CCL5 e CXCL9, que estiveram associados a quedas, podem contribuir para o adequado entendimento do mecanismo associado à ocorrência desse evento em idosos
Discontinuation of health interventions among Brazilian older adults during the COVID-19 pandemic: REMOBILIZE Study
The objective of this study was to analyze changes in access to health interventions during the pandemic among Brazilian older adults and to investigate the factors associated with social and health inequalities. We conducted an online survey with Brazilian adults aged 60 + years between May and June 2020. A multidimensional questionnaire was used to investigate access to health interventions during the pandemic and associated factors. Of 1482 participants, 56.5% reported health care before the pandemic, and 36.4% discontinued it during the pandemic. The discontinuation rate was 64.4% (95% CI 61.1-67.6). Participants with higher educational level (nine or more years of education: OR 0.34; 95% CI 0.17-0.70) and higher income (eight or more times the minimum wage: OR 0.54; 95% CI 0.36-0.81) were associated with less probability of discontinuation. Presenting multimorbidity (OR: 1.42; 95% CI 1.06-1.90) and polypharmacy (OR: 0.61; 95% CI 0.46-0.81) were associated with discontinuity in health interventions. Our study showed that structural health inequities in access to health care shaped the rates of discontinuation in health care interventions during the COVID-19 pandemic. Strategic actions should be set up to actively monitor socially vulnerable older adults and strengthen community-based services to mitigate the discontinuation of health care interventions
Marcadores inflamatórios associados às quedas em idosos: Coorte de Base Populacional de Bambuí
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Previous issue date: 2018CAPES, FAPEMIGFundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.Os marcadores inflamatórios como contribuintes de quedas em idosos ainda não foram detalhadamente explorados na literatura e esse conhecimento pode contribuir na compreensão do inflammaging, tratando-se de importante abordagem nas práticas de saúde pública. O objetivo deste trabalho foi explorar os marcadores inflamatórios associados às quedas gerais, recorrentes e graves, em idosos vivendo na comunidade. Estudo de delineamento transversal, utilizando dados da linha de base da Coorte de Idosos de Bambuí, um estudo de base populacional conduzido entre moradores da cidade de Bambuí (MG), com 60 anos ou mais. As informações a respeito de quedas nos últimos 12 meses, gerais, recorrentes (≥2) e graves (procura por serviços de saúde), foram consideradas variáveis dependentes. Os biomarcadores séricos foram as exposições investigadas e incluíram interleucinas (IL-1β, IL-6, IL-12 e IL-
10), receptor solúvel do fator de necrose tumoral (TNF), quimiocinas (CXCL8, CXCL9, CXCL10 e CCL5) e Proteína C-Reativa Ultra-Sensível (PCRus). Para essas dosagens foi realizada coleta de cinco mL de sangue por punção venosa por meio do sistema de coleta a vácuo e analisados por citometria de fluxo em ensaios multiplex. Foram incluídas como potenciais variáveis de confusão as características sociodemográficas (idade, sexo e escolaridade), comportamentos em saúde (consumo de álcool, tabagismo, nível de atividade física), condições de saúde (multimorbidade e incapacidade funcional) e uso de medicamentos. Foi realizada estatística descritiva da amostra total e segundo os desfechos
analisados, além de análise múltipla por meio de regressão logística, estimando-se os valores de odds ratio e respectivos intervalos de confiança (95%). Todas as análises foram realizadas no software Stata 13.0, considerando-se o nível de significância de 5%. A prevalência de alguma queda nos últimos 12 meses foi de 27,1%, de queda recorrente foi igual a 10,7% e 9,0% de queda grave. Após todos os ajustes, permaneceram associados às quedas gerais os níveis elevados de PCRus (OR: 1,46; IC95%: 1,04-2,03), CCL5 (OR: 1,38; IC95%: 1,01-1,90) e CXCL9 (OR: 1,43; IC95%: 1,02-2,02), à queda recorrente níveis séricos superiores de
IL-12 (OR: 1,92; IC95%: 1,09-3,37) e CXCL9 (OR:1,67; IC9
5%: 1,05-2,66), e por fim, os maiores níveis de TNF (OR: 1,58; IC95%: 1,01-2,50), IL-12 (OR: 2,04; IC95%: 1,13-3,70), CXCL10 (OR: 1,75; IC95%: 1,04-2,92) e CCL5 (OR: 1,90; IC95%: 1,18-3,07) com o relato de queda grave. Esses resultados revelam novos marcadores associados, além dos já classicamente descritos na literatura, podendo contribuir para o adequado entendimento do perfil de biomarcadores séricos associados a quedas em idosos.nflammatory markers as contributors to falls in th
e older adults have not yet been explored in
detail in the literature and this knowledge may con
tribute to the understanding of
inflammaging, being an important approach in public
health practices. The objective of this
study was to explore the inflammatory markers assoc
iated with general, recurrent and severe
falls in older adults community-dwelling. Cross-sect
ional study using data from the Bambuí
Elderly Cohort, a population-based study conducted am
ong residents of the city of Bambuí
(MG) aged 60 and over. Data on falls in the last 12
months, general, recurrent (≥2) and severe
(health care demand) were considered dependent vari
ables. Serum biomarkers were the
investigated exposures and included interleukins (I
L-1β, IL-6, IL-12 and IL-10), soluble
tumor necrosis factor receptor (TNF), chemokines (CXCL8
, CXCL9, CXCL10 and CCL5)
and Ultra Sensitive C-Reactive Protein (PCRus). For th
ese dosages, five mL of blood was
collected by venipuncture through the vacuum collec
tion system and analyzed by flow
cytometry in multiplex assays. Potential confoundin
g variables included socio-demographic
characteristics (age, sex and schooling), health be
haviors (alcohol consumption, smoking,
physical activity level), health conditions (multim
orbity and functional disability) and
medication use. Descriptive statistics of the total
sample and the outcomes analyzed were
performed, as well as multiple analysis using logis
tic regression, estimating the odds ratio and
respective confidence intervals (95%). All analyzes
were performed in the Stata 13.0
software, considering the significance level of 5%.
The prevalence of some fall in the last 12
months was 27.1%, recurrent fall was equal to 10.7%
and 9.0% of severe fall. After all
adjustments, elevated CRP levels (OR: 1.46; 95%CI: 1.
04-2.03), CCL5 (OR: 1.38; 95%CI:
1.01-1.90) and CXCL9 (OR: 1.43; 95%CI: 1.02-2.02), to
the recurrent decrease in serum
levels of IL-12 (OR: 1.92; 95%CI: 1.09-3.37) and CXCL9
(OR: 1.67; 95%CI: 1.05-2.66), and
finally, higher levels of TNF (OR: 1.58; 95%CI: 1.01-2
.50), IL-12 (OR: 2.04; 95%CI: 1.13-
3.70), CXCL10 (OR: 1.75; 95%CI: 1.04-2.92) and CCL5 (OR:
1.90; 95%CI: 1.18-3.07) with
the report of severe fall. These results reveal new
associated markers, in addition to those
already classically described in the literature, an
d may contribute to the adequate
understanding of the profile of serum biomarkers as
sociated with falls in the older adults
REVISÃO DA LITERATURA SOBRE A ATUAÇÃO DO FISIOTERAPEUTA NA ATENÇÃO PRIMÁRIA À SAÚDE: DESAFIOS, COMPETÊNCIAS E EXPERIÊNCIAS
Atenção Primária à Saúde se caracteriza por ações de saúde que abrangem a promoção e a proteção da saúde, a prevenção de agravos, o diagnóstico, o tratamento, a reabilitação e a manutenção da saúde. Esta vem passando por um processo de expansão de suas atividades, a inserção da fisioterapia neste âmbito foi uma estratégia que tem como objetivo ampliar o escopo de atuação, a resolutividade bem como a ampliação das ações no Brasil. Este estudo objetivou revisar através da literatura a atuação dos fisioterapeutas na atenção primária à saúde. Foi realizada uma revisão nas bases de dados: LILACS, SciELO e banco de teses/dissertações da CAPES. Foram selecionados nove artigos, reunidos em três eixos temáticos: dilemas profissionais, competências e habilidades profissionais e práticas fisioterapêuticas na atenção primária de saúde. Os dilemas profissionais mencionados foram a ampliação do papel do fisioterapeuta em colaboração com outros serviços de saúde. As competências e habilidades abordaram a identificação de sintomas clínicos e socioculturais e a capacidade de trabalhar em equipe. Os relatos de prática discorreram sobre a realidade dos atendimentos deste profissional na atenção primária. O baixo número de estudos sugere desconhecimento quanto ao modo que a fisioterapia se insere na atenção primaria à saúde, provavelmente, quanto às habilidades profissionais necessárias nesse ambiente. Assim, são necessários mais estudos para melhor compreensão do tema
Functional capacity associated with work ability in older university staff employed by the state
Abstract Introduction: The increase in numbers of older adults in the workplace and in the number of years they spend in work prior to retiring has challenged health professionals to provide enable health conditions such that they may undertake occupational activity. Objective: To analyze the variables for functional ability, associated with work ability, in older adults who were government employees at a university. Methods: A cross-sectional design, with older workers aged 60 years old or over, located in different university centers and departments. A structured sociodemographic questionnaire was used to characterize the sample, and the Work Ability Index was used as an outcome variable for the associations, using the Timed Up and Go test, the handgrip strength test, the walking speed test and the chair sit to stand test. The Chi-squared test and Pearson correlation coefficient were used in the statistical analysis. The association of the factors of functional capacity was based on the odds ratio and 95% confidence interval, calculated using the Logistic Regression Model, as part of the SPSS statistical package for Windows. Results: A total of 258 staff participated in the investigation, with men (57.7%) and a lower age range (60 to 62 years old) predominating. Women differed in relation to falls after the age of 60 (p = 0.007) and in the last 12 months (p = 0.017). The mean Work Ability Index was 39.70 ± 5.64 points and a statistical association was ascertained between performance in the chair sit to stand test (OR = 2.26; p = 0.043). Muscle strength (r = 0.72; p < 0.000) and the chair sit to stand test (r = 0.73; p < 0.000) showed excellent correlation with work ability. Conclusion: The variables for functional capacity were associated with work ability
Factors associated with work ability in the elderly: systematic review
OBJECTIVE: To synthesize the evidence on factors associated with the maintenance of work ability during the aging process. METHODS: SciELO, LILACS and PubMed databases were consulted, in order to find out studies in Portuguese, English and Spanish published from 2000 to 2013. Descriptors which encompassed terms related to work ability, aging and elderly were used. Quantitative observational studies were included to investigate the work ability and the effect of aging. Studies aiming at analyzing the clinical course of illnesses related to aging and/or papers and publications in the form of editorials, interviews, projects, clinical notes and preliminary or conceptual data were excluded. RESULTS: A total of 924 articles were obtained, but 27 were included in the analyses. Later on, 2 intervention and 8 repeated studies were excluded. Variables that showed negative correlations with work ability were the following: age, smoking, service time and physical demands in occupational activities. Satisfaction with life, sufficient income, physical activity, volunteerism and mental workload were considered positive associations that protect the elderly from functional loss. CONCLUSION: This study was reported as a protective mechanism against depression, disability and fragility, maintaining the well-being, good cognitive function and autonomy in daily activities. Increased investments in the health care of this population are needed regarding musculoskeletal and cardiorespiratory capacity. Physical activity must be encouraged by policies to foster health promotion
Functional capacity associated with work ability in older university staff employed by the state
<div><p>Abstract Introduction: The increase in numbers of older adults in the workplace and in the number of years they spend in work prior to retiring has challenged health professionals to provide enable health conditions such that they may undertake occupational activity. Objective: To analyze the variables for functional ability, associated with work ability, in older adults who were government employees at a university. Methods: A cross-sectional design, with older workers aged 60 years old or over, located in different university centers and departments. A structured sociodemographic questionnaire was used to characterize the sample, and the Work Ability Index was used as an outcome variable for the associations, using the Timed Up and Go test, the handgrip strength test, the walking speed test and the chair sit to stand test. The Chi-squared test and Pearson correlation coefficient were used in the statistical analysis. The association of the factors of functional capacity was based on the odds ratio and 95% confidence interval, calculated using the Logistic Regression Model, as part of the SPSS statistical package for Windows. Results: A total of 258 staff participated in the investigation, with men (57.7%) and a lower age range (60 to 62 years old) predominating. Women differed in relation to falls after the age of 60 (p = 0.007) and in the last 12 months (p = 0.017). The mean Work Ability Index was 39.70 ± 5.64 points and a statistical association was ascertained between performance in the chair sit to stand test (OR = 2.26; p = 0.043). Muscle strength (r = 0.72; p < 0.000) and the chair sit to stand test (r = 0.73; p < 0.000) showed excellent correlation with work ability. Conclusion: The variables for functional capacity were associated with work ability.</p></div
Fatores associados à ótima capacidade para o trabalho em servidores idosos de uma universidade no Sul do Brasil
Resumo Objetivo: investigar a associação entre o índice de capacidade para o trabalho e os fatores sociodemográficos, ocupacionais, estilo de vida e saúde em idosos. Métodos: estudo transversal, com amostra de servidores idosos de uma instituição de ensino superior. Foram coletadas informações sociodemográficas e dados referentes a comportamento social, saúde, e trabalho. Utilizou-se análise uni e multivariada pelo Modelo de Regressão Logística para determinar os fatores associados à ótima capacidade para o trabalho. Resultados: na amostra prevaleceram os homens (57,8%), entre 60 e 64 anos (75,6%), com ensino superior (57,8%). A maioria declarou ser sedentária (89,1%) e com exigência mental de trabalho (62,8%). Mais da metade da amostra era de idosos em sobrepeso (53%), que relataram quedas (21,3%) e uso regular de múltiplos medicamentos (25,6%). As variáveis associadas à menor chance de ótima capacidade para o trabalho foram sexo feminino (OR=0,39; IC95%=0,18-0,83); cor não branca (OR=0,37; IC95%=0,16-0,84); exigência física para o trabalho (OR=0,40; IC95%=0,17-0,97); hospitalização (OR=0,14; IC95%=0,03-0,57); dificuldades no sono (OR=0,12; IC95%=0,04-0,43); autopercepção de saúde ruim (OR=0,22; IC95%=0,09-0,54); queixas de sintomas osteomusculares nos últimos 7 dias (OR=0,29, IC95%=0,10-0,87); e sintomas que comprometem o trabalho (OR=0,25; IC95%=0,08-0,82). Conclusão: fatores sociodemográficos, ocupacionais e condição de saúde comprometeram a ótima capacidade para o trabalho em idosos