Relationship between functional fitness, medication costs and mood in elderly people

Objective: to verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Qualidade do preenchimento da Caderneta de Saúde da Criança e fatores associados Quality of data on the Child Health Record and related factors

A Caderneta de Saúde da Criança (CSC) é um documento imprescindível para a promoção da saúde infantil. Foi realizado um estudo transversal com amostra aleatória simples de crianças acompanhadas no Sistema Único de Saúde (SUS), visando analisar os fatores associados à qualidade do preenchimento da CSC. Foram realizadas entrevistas e verificação direta das cadernetas de 365 crianças das nove regionais de saúde de Belo Horizonte, Minas Gerais, Brasil. Foi criado um sistema de escore para classificar as CSC quanto à qualidade do seu preenchimento e relacioná-la às variáveis explicativas. O odds ratio foi calculado por regressão logística. O preenchimento dos vinte itens do escore variou de 3,1% (uso de ferruginoso) a 99,7% (data de nascimento). Os fatores associados aos piores escores foram: crianças > 12 meses de idade (OR = 1,77), mães < 6 anos de estudo (OR = 1,97), crianças não acompanhadas por médicos generalistas (OR = 3,18) e mães que não receberam explicações sobre a CSC na maternidade (OR = 1,77). Os resultados apontam a precária utilização da CSC, reforçando a necessidade de investimentos em capacitação dos profissionais e organização dos serviços para que ela cumpra seu papel na promoção da saúde infantil.<br>The Child Health Record (CHR) is an essential document for children's health care activities. A cross-sectional study was performed with simple random sampling, aimed at analyzing factors related to quality of data completion on the CHR. Interviews and direct verification of 365 CHRs from 9 health districts in Belo Horizonte, Minas Gerais State, Brazil, were performed. A scoring system was created to classify the CHRs in terms of quality of data completion and to relate them to explanatory variables. Odds ratios were calculated by logistic regression. Completion of the 20 scoring items varied from 3.1% (use of iron supplements) to 99.7% (date of birth). Factors associated with worse scores were: children > 12 months old (OR = 1.77), mothers with < 6 years of schooling (OR = 1.97), children not treated by general practitioners (OR = 3.18), and mothers who had not received explanations on the CHR while in the maternity ward (OR = 1.77). The results show poor use of the CHR and emphasize the need for on-going efforts to train health professionals and prepare health services for their important role in the promotion of children's health