Quality of life in elderly people that have suffered falls : integrative literature review

Foi realizada uma Revisão Integrativa da Literatura com o objetivo de avaliar o conhecimento científico produzido relacionado à qualidade de vida do idoso que sofreu quedas. Métodos: foram selecionados artigos publicados nas bases de dados Lilacs, CINAHL e Medline, com os seguintes descritores: qualidade de vida, idoso e acidentes por quedas, nos idiomas português, inglês e espanhol, entre 1999 e 2009. Resultados: nove artigos atenderam aos critérios de inclusão. Encontrou-se que as quedas são frequentes nos idosos, sendo que aqueles com mais fatores de risco intrínsecos e que já caíram apresentaram mais medo e possuem mais chance de caírem novamente; e também relataram déficits nas funções física, mental/emocional, dor corporal e relacionados ao meio ambiente e que programas de prevenção de quedas podem melhorar sua qualidade de vida com o tempo. Conclusão: evidenciou-se como lacunas no conhecimento: escassa produção científica nacional, principalmente de autores enfermeiros, e predomínio de estudos descritivos e com nível de evidência considerado fraco. Sugere-se a atuação dos profissionais de saúde em pesquisas de intervenções para prevenção de quedas as quais possam ser aplicadas na prática clínica e que possibilitem melhorar a qualidade de vida dos idosos. ____________________________________________________________________________________ ABSTRACTAn Integrative Literature Review was conducted in order to evaluate the scientific knowledge produced regarding quality of life of the elderly who have suffered falls. Published articles between 1999 and 2009 were selected from the LILACS, CINAHL and MEDLINE databases, and the following search words in Portuguese, English and Spanish were used: quality of life, the elderly and accidents involving falls. Nine articles met the inclusion criteria. It was revealed that falls are frequent among the elderly, and especially the elderly with more intrinsic risk factors and who have suffered falls are those who are more afraid and more prone to fall again. They also reported physical, mental and emotional impairments, body pains and environmental problems. It was revealed that programs to prevent falling can improve the quality of life of the elderly over time. It was clear that there are knowledge gaps, especially a low level of national scientific output, especially by nurses and the predominance of descriptive studies, with low levels of data. We suggest that health professionals conduct research into interventions to prevent falls that can be used in clinical practice in improving the quality of life of the elderly

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Happiness and pleasurable activities in the elderly: a comparative study

Introdução: O Bem-Estar Subjetivo (BES) é um constructo por meio do qual a ciência avalia a Felicidade das pessoas. Melhores estados de BES são associados à melhor saúde e longevidade. Contudo, não há um consenso sobre as relações entre a Hemodiálise (HD) e BES de idosos que fazem o tratamento. Objetivo: O principal objetivo foi analisar as associações do BES com: as características sociodemográficas e clínicas; o número de doenças e autoavaliação do estado de saúde; a realização de atividades e a agradabilidade percebida sobre as mesmas; e o uso do tempo entre os idosos em HD e aqueles que residem na comunidade e não realizam o tratamento. Materiais e método: Trata-se de um estudo observacional, quantitativo e comparativo com delineamento transversal, realizado em três etapas: a) aferição psicométrica dos instrumentos; b) estudo comparativo entre grupos (HD e Comunidade) quanto às variáveis de interesse; e c) estudo da associação entre a Felicidade, medida por meio da satisfação com a vida, afetos positivos e negativos, com variáveis sociodemográficas, clínicas, atividades prazerosas e uso do tempo. A amostra populacional consistiu em idosos em HD no Serviço de Nefrologia de São Carlos-SP e pareada por gênero e idade de idosos da comunidade cadastrados no Programa HIPERDIA e voluntários do mesmo município. Para as entrevistas, foram utilizados os instrumentos: a) Questionário Sociodemográfico e Clínico; b) Mini Exame do Estado Mental; c) Escala de Depressão em Geriatria - versão reduzida; d) Escala de Satisfação com a Vida; e) Escala de Afetos Positivos e Negativos; e) Older Person\'s Pleasant Events Schedule - BR; e f) Relógio de Atividades. Dados clínicos foram coletados dos prontuários médicos. Foram realizadas Análises Fatoriais Confirmatórias dos instrumentos. Para comparação entre grupos, foram usados testes t de Student e Análises de Variância - ANOVAS e, para associação entre as variáveis, foi calculado Coeficiente de correlação de Pearson. O nível de significância adotado foi de 5%. O projeto foi aprovado pelo Comitê de Ética em Pesquisa conforme Ofício nº 074/2016. Resultados: Os instrumentos apresentaram propriedades psicométricas adequadas para uso. Participaram 42 idosos no grupo HD e 84 no grupo comunidade, a maioria homens (64,3%) com idade entre 60 e 81 anos. Os idosos do grupo HD eram menos escolarizados (p = 0,016) e os da comunidade apresentavam mais doenças (p = 0,024). A realização de HD não teve efeito sobre a satisfação com a vida [F (1,122) = 0,392, p = ,533, &eta;²p = ,003 &pi; = ,095], os afetos positivos [F (1,122) = 1,941, p = ,166, &eta;²p = ,016 &pi; = ,282] e afetos negativos [F (1,122) = 0,470, p = ,494, &eta;²p = ,004 &pi;= ,104), bem como nos sintomas depressivos [F (1,122) = 0,546, p = ,461, &eta;²p = ,004 &pi;= ,114]. A realização de HD reduz o tempo do idoso com a família, nas atividades de lazer e na realização diária das Atividades de Vida, independente do nível escolar e do número de doenças. Observou-se que o BES está associado positivamente à melhor autoavaliação do estado de saúde, à realização de atividades prazerosas de socialização, às atividades relaxantes e às de competência (satisfação com a vida, afetos positivos e negativos com p < 0,001 em todas as associações). Tais atividades quando percebidas como agradáveis contribuem com o BES. Mais horas destinadas às atividades de socialização, em dias da semana, associaram-se positivamente ao BES (satisfação com a vida, afetos positivos e negativos p < 0,001). Em contrapartida, os sintomas depressivos (satisfação com a vida, afetos positivos e negativos p < 0,001) e o tempo sozinho aos domingos (satisfação com a vida p < 0,05 e afetos positivos p < 0,001) apresentaram associação negativa em relação ao BES. Conclusão: A Felicidade dos idosos não esteve associada à realização de HD, ou seja, os idosos em tratamento não são menos felizes comparados aos que não fazem o tratamento. O BES dos idosos esteve associado positivamente com a melhor autoavaliação do estado de saúde, atividades de socialização, relaxantes e de competência, enquanto os sintomas depressivos e o tempo sozinho associaram-se negativamente ao constructo. O grupo de idosos em HD foi mais sensível à realização de atividades com melhora no BES.Introduction: Subjective Well-Being (SWB) is a construct through which science evaluates people\'s happiness. Better states of SWB are associated with better health and longevity. However, there is no consensus on the relationship between haemodialysis (HD) and SWB in the elderly who undergo the treatment. Objective: The main objective was to analyse the associations of SWB with: sociodemographic and clinical characteristics; number of diseases and self-rated health; activities performances and their perceived appreciation; and the use of time among the elderly in HD and those who community-dwelling and do not perform the treatment. Materials and method: This is an observational study, quantitative and comparative using a cross-sectional design, performed in three steps: first, psychometric assessment of instruments; second, comparative study between groups (HD and Community) regarding the variables of interest; and the study of the association between happiness, evaluated by satisfaction with life, positive and negative affect, with sociodemographic and clinical variables, pleasurable activities and time use. The population sample consisted of elderly people in HD treatment at the Nefrological Service of São Carlos-SP and matched by gender and age of the community\'s elderly enrolled in the public health program for systemic arterial hypertension and diabetes mellitus, and volunteers from the same city. The following instruments were used in the interviews: a) Sociodemographic and Clinical Questionnaire; b) Mini Mental State Examination; c) Geriatric Depression Scale - brief version; d) Scale of Satisfaction with Life; e) Positive and Negative Affect Scale; e) Older Person\'s Pleasant Events Schedule - BR; and f) Activity Clock. Clinical data were collected from the medical records. Confirmatory Factorial Analysis of the instruments were performed. For comparison between groups, Student t-tests and Analysis of Variance - ANOVAS were used and, for association between variables, Pearson\'s correlation coefficient was calculated. The level of significance was 5%. The project was approved by the Research Ethics Committee according to Official Letter 074/2016. Results: The instruments presented adequate psychometric properties for use. Participated in the study 42 elderly in the HD group and 84 in the Community group, predominantly men (64.3%) aged between 60 and 81 years. The elderly in the HD group were less educated (p = 0.016) and those in the Community had more diseases (p = 0.024). The HD treatment had no effect on life satisfaction [F (1,122) = 0.392, p = ,533, &eta;²p = ,003 &pi; = ,095], positive affect [F (1,122) = 1.941, p = ,166, &eta;²p = ,016 &pi; = ,282] and negative affect [F (1,122) = 0.470, p = ,494, &eta;²p = ,004 &pi;= ,104), as well as on depressive symptoms [F (1,122) = 0.546, p = ,461, &eta;²p = ,004 &pi; = ,114]. HD sessions reduce the time of the elderly with the family, in leisure activities and in the daily life activities, regardless of educational level and number of diseases. It was observed that SWB is positively associated with a better self-rated health, pleasurable activities of socialization, relaxing and those of being effective (satisfaction with life, positive and negative affect with p < 0.001 in all associations). Such activities when perceived as pleasant contribute to SWB. More hours for socialization activities, on weekdays, were positively associated with SWB (satisfaction with life, positive and negative affect p < 0.001). On the other hand, depressive symptoms (life satisfaction, positive and negative affect p < 0.001) and time alone on Sundays (life satisfaction p < 0.05 and positive affect p < 0.001) had a negative association with SWB. Conclusion: Happiness of the elderly was not associated with HD, in other words, the elderly in treatment are not less happy compared to those who do not. The elderly SWB was positively associated with the better self-rated health, socialization, relaxing and being effective activities, while depressive symptoms and time alone were negatively associated with the construct. The elderly in HD were more sensitive to the performance of activities with improvement in BES

Occupational therapy in the hospital context: an integrative literature review

This study evaluated the scientific knowledge produced and published in journals indexed in major international databases, covering the area of Occupational Therapy (OT) in hospitals. To this end, an integrative literature review was carried out with 17 selected articles published between 2004 and 2009, indexed in the following databases: LILACS, SciELO and MEDLINE. Studies show that the performance of an occupational therapist with hospitalized patients provides improvements in the hospitalization condition, higher levels of independence, function and quality of life, and facilitates the resumption of everyday life and social participation of individuals. The recent scientific production in Occupational Therapy regarding hospital contexts seems to be more directed to the report of experiences than to the evidence for effectiveness of actions developed through planned and controlled clinical and/or experimental studies. This type of production certainly contributes not only to a better dissemination and development of successful and effective therapeutic practices, but also to greater recognition of the need and importance of the occupational therapist in the composition of health teams in hospitals. However, productions with greater scientific consistency within internationally accepted standards are necessary

Terapia Ocupacional na universidade pública e ações de enfrentamento à Covid-19: singularidades e/nas multiplicidades/Occupational therapy at the public university and actions to confront Covid-19: singularities and/in multiplicities

Frente aos impactos causados pela pandemia de COVID–19 tem-se inaugurado experiências em diversas áreas profissionais, dentre as quais se destaca a Terapia Ocupacional. Identifica-se contribuições da área a partir da universidade pública e a produção de ações integradas de gestão, ensino, pesquisa, extensão e produção acadêmica. A partir do relato de experiências vividas na Universidade Federal de São Carlos (UFSCar), ilustra-se como a dinamicidade do momento que tem convocado a (re)pensar a função social da universidade e imposto a necessidade de adotar novas reflexões e estratégias para a continuidade e/ou reorientação do trabalho para responder demandas de proporções pandêmicas, na interação entre docentes e discentes. Além disso, nota-se que o fomento de ações de apoio, acolhimento e cuidado, para além de questões administrativas e de caráter acadêmico pedagógicas, têm sido uma diretriz comum.AbstractConsidering the impacts caused by CoVid–19 pandemic, experiences have been opened in several professional areas, among which the occupational therapy performance stands out. Identify themselves contributions from public universities and from integrated actions of management, teaching, research, extension and academic production. From lived experience's at the Federal University of São Carlos (UFSCar) reports, it is illustrated how the moment's dynamism called us to (re) think the university social function and imposed the need to adopt new reflections and strategies for continuity and / or work reorientation , in response of pandemic proportions demands, in the interaction between teachers and students. In addition, it is noted that promoting support, welcoming and care actions, beyond the administrative and pedagogical issues, have been a common guideline.Key words: Teaching; Search; Extension; Pandemic; Professional qualification. ResumenAnte los impactos causados por la pandemia de COVID-19, se han lanzado experiencias en varias áreas profesionales, entre las cuales se destaca la Terapia Ocupacional. Identifica contribuciones para la disciplina desde la universidad pública y la producción de acciones integradas para la gestión, la enseñanza, la investigación, la extensión y la producción académica. A partir de la narrativa de experiencias vividas en la Universidad Federal de São Carlos (UFSCar), se ilustra cómo el dinamismo del momento que llamó a (re)pensar la función social de la universidad e impuso la necesidad de adoptar nuevas reflexiones y estrategias para el continuidad y/o reorientación del trabajo para responder a demandas de proporciones pandémicas, entre la interacción de docentes y alumnos. Además, se observa que la promoción de acciones de apoyo, acogida y atención, además de cuestiones pedagógicas administrativas y académicas, ha sido una guía común.Palabras clave: Enseñanza; Investigación; Extensión; Pandemia; Formación profesional.

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially