Psychosocial health challenges of the elderly in Nigeria: a narrative review

Background: Globally, national health systems are challenged to build successful aging models to prepare for biomedical, psychological and social changes. The integral component of psychosocial health in overall quality of life and well-being, however, is underscored and requires greater focus. Changing demographics in Nigeria, in addition to cultural considerations and absence of a social security system, present unique challenges to elderly.Objective: We aimed to review the literature that describes the current situation and challenges in psychosocial health status in the elderly in Nigeria and provide recommendations that promote health and well-being during the aging process.Results: Four primary factors affect psychosocial health status of elderly Nigerians, namely: changes in family dynamics, increased demand for healthcare services, increased economic stress, and decreased functional independence.Conclusion: Like other developing countries, the Nigerian national system faces similar challenges in preparing a national framework that can maximize coverage to citizens in the midst of demographic changes in aging. By focusing on five target areas such as the educational system, health services, community-based initiatives, local or regional policies and national strategies, current framework in Nigeria can be modified to prepare for changing demographics in aging.Keywords: Aging, family support, Nigeria, psychosocia

Seguridad en smart cities e infraestructuras críticas

Numerosas ciudades están desarrollando plataformas smart city con el fin de lograr una mejor coordinación, eficacia, reducción de costes y en general una gestión más eficiente de la ciudad, a través de la integración de infraestructuras y servicios. Entre los subsistemas que se integran en una smart city hay un grupo de especial interés formado por las infraestructuras críticas. Con la integración de estas se busca dar un mejor servicio, pero al aumentar la complejidad y la dependencia de unas infraestructuras con otras y con las TIC, crece el riesgo de que una vulnerabilidad o fallo en una infraestructura pueda extenderse y ocasionar fallos en otra, y así sucesivamente provocando un fallo en cascada. En este artículo describimos un diagrama común de muchos proyectos para smart cities y analizamos los problemas de seguridad y privacidad que aparecen al interconectar las infraestructuras y al tender hacia una filosofía de datos abiertos.Este trabajo está financiado parcialmente por el Ministerio de Economía y Competitividad a través de los proyectos TIN2011-27076-C03-02 “CO-PRIVACY” y CONSOLIDER INGENIO 2010 CSD2007-0004 “ARES”; y por la Generalitat de Catalunya a través de la subvención de doctorado industrial ECO/2497/2013

Schizophrenic Psychosis and Crime Prevention: An Intervention Project

The implementation of a clinical treatment project in any mental health service is critical. More than just thinking about clinical cases, it is essential to prevent the occurrence of decompensation in many of our patients. Individuals deemed Not Guilty by Reason of Insanity (NGRI) have often committed very serious crimes. The main goal is to investigate the monitoring and treatment of patients who suffer from a schizophrenic psychosis, specially. A total of 72 patients participated in the study. The participants were individuals deemed NGRI by the courts, under Article 20 of the Portuguese Criminal Code. Results demonstrated the unequivocally need to follow up decompensated patients after the court order extinguished and these individuals were free and responsible for their own paths. Literature shows that many of them recidivate and become dangerous. Suggestions are presented for a better framing and psychiatric follow-up. Thanks to the implementation of this project centered in outpatients’ treatment, patients could be treated before its clinical decompensation would cause more serious criminal behavior than those perpetrated until that time. The importance of the implementation of this program is demonstrated by the clinical presentation of one case

Avaliação do nível de literacia em saúde de alunos do ensino superior: Evolução ao longo da formação

Objectives: This work has two objectives: contribute to evaluate the level of health literacy of students in higher education, in the area of health and to contribute to the formulation of strategies to adapt the content of training to the needs of students. Methods: In this longitudinal observational study, a health literacy assessment questionnaire (NVS) was applied to students from 3 Health Schools and 2 different courses (Nursing and Dental Hygiene), at the beginning of the first school year, and at the end of the third year. Results: Less than 5% of the students participating in this study had inadequate health literacy at the entrance to the course. Women had a better level of health literacy than men, although no statistical significance was found (p=0.153). The health literacy gains are different among the courses. Nursing students began with a higher level of health literacy but were overtaken by oral hygiene students at the end of the 3rd year. However, the level of health literacy did not differ statistically throughout the training, although an increase in the level of health literacy was observed. Conclusions: The relationship between health literacy and health is recognized. Higher education institutions need to formulate strategies to adapt the content of training to the needs of students and to the level of health literacy in order to train students for lifelong learning.Objetivos: Este trabalho tem dois objetivos: contribuir para avaliar o nível de literacia em saúde dos estudantes do ensino superior, na área da saúde e contribuir para a formulação de estratégias para adaptar os conteúdos da formação às necessidades dos estudantes. Métodos: Neste estudo longitudinal observacional foi aplicado um questionário de avaliação da literacia em saúde (NVS) a estudantes de 3 Escolas de Saúde e 2 cursos diferentes (Enfermagem e Higiene Oral), no início do primeiro ano escolar, e no final do terceiro ano. Resultados: Menos de 5% dos estudantes participantes neste estudo tinham uma literacia de saúde inadequada à entrada para o curso. As mulheres apresentam um melhor nível de literacia de saúde do que os homens, embora não tenha sido encontrado qualquer significado estatístico (p=0,153). Os ganhos do nível de literacia de saúde são diferentes entre os cursos. Os estudantes de enfermagem começaram com um nível mais elevado de literacia de saúde, mas foram ultrapassados pelos estudantes de higiene oral no final do 3º ano de escolaridade. No entanto o nível de literacia em saúde não diferiu, estatisticamente, ao longo da formação, embora se tenha observado um aumento do nível de literacia em saúde. Conclusões: A relação entre literacia em saúde e saúde é reconhecida. As instituições de ensino superior precisam de formular estratégias para adaptar os conteúdos da formação às necessidades dos estudantes e ao seu nível de literacia em saúde de modo a capacitar os estudantes para a aprendizagem ao longo da formaçãoinfo:eu-repo/semantics/publishedVersio

Psychiatric monitoring of not guilty by reason of insanity outpatients

Individuals deemed Not Guilty by Reason of Insanity (NGRI) by the courts, under Article 20 of the Portuguese Criminal Code, have often committed very serious crimes. It is unreasonable to consider that these patients were usually kept without adequate supervision after the security measure had been declared extinct. They often decompensated after leaving the institution where they complied with the security measure, and/or relapsed to alcohol and drug abuse. Very often, severe repeated crime erupted again. Considering this, there was an urgent need to keep a follow-up assessment of these patients in order to prevent them from relapsing in crime. This work presents the results of a psychiatric follow-up project with NGRI outpatients. The main goals of the project were: ensuring follow-up and appropriate therapeutic responses for these patients, maintaining all individuals in a care network, and preventing them from decompensating. The team consisted of a psychiatrist, a nurse, and a psychologist. Seventytwo patients were monitored during two years. Results demonstrated the unequivocal need to follow up decompensated patients after the court order is extinguished. Suggestions are presented for a better framing and psychiatric follow-up of these patients

Evaluation of auditory processing and phonemic discrimination in children with normal and disordered phonological development

AbstractAuditory processing and phonemic discrimination are essential for communication. Type of study: Retrospective.AimTo evaluate auditory processing and phonemic discrimination in children with normal and disordered phonological development.Material and MethodsAn evaluation of 46 children was carried out: 22 had phonological disorders and 24 had normally developing speech. Diotic, monotic and dichotic tests were applied to assess auditory processing and a test to evaluate phonemic discrimination abilities.DesignCross-sectional, contemporary.ResultsThe values of normally-developing children were within the normal range in all auditory processing tests; these children attained maximum phonemic discrimination test scores. Children with phonological disorders performed worse in the latter, and presented disordered auditory processing.ConclusionAuditory processing and phonemic discrimination in children with phonological disorders are altered

Influence of brushing with natural dentifrices on color change : in vitro study

To evaluate in vitro the influence of daily brushing with the use of natural toothpastes on the color change of enamel in bovine teeth. Four dentifrices were used, one conventional Colgate Total 12 - Clean Mint (G1), and three natural, Contented Toothp

Localização de áreas para infiltração de águas residuais tratadas de pequenos aglomerados urbanos

Na região da Beira Interior algumas origens de água não apresentam características compatíveis com algumas utilizações, devido a fenómenos de poluição (descarga de efluentes) ou por se encontrarem sobre-exploradas. Contudo, as necessidades de água tenderão a crescer nesta região para satisfazer as exigências de actividades sócio-económicas, o que implicará a procura de recursos hídricos alternativos. Após uma campanha de monitorização de dois anos na ETAR de Vila Fernando (Guarda), as características do efluente tratado sugerem que poderia ser utilizado para infiltração no solo. A partir de seis cartas temáticas e de critérios ambientais, técnicos e económicos, seleccionou-se uma área de estudo de 6687,1 ha. Esta área foi analisada com base na manipulação de informação complexa com recurso a Sistemas de Informação Geográfica (SIGs), na sobreposição de áreas de exclusão e inclusão e utilizando uma análise multicritério, obtendo-se uma Carta de Aptidão com uma área favorável para infiltração de 6,4 ha

Certifieringars betydelse för livsmedelsaktörer - Explicita och implicita effekter för säkrare livsmedel

Certifieringar påverkar aktörerna inom livsmedelsbranschen. Vi menar, efter vår studie av producenter i Svenska frukt och gröntbranschen, att certifieringar har både explicita och implicita effekter för att säkra livsmedel. Dels bidrar de till att förebygga osäkra livsmedel genom att kvalitetssäkra processer genom hela värdekedjan. Att de flesta aktörerna inom branschen har som krav att bara arbeta med certifierade leverantörer samtidigt som systemet bygger på tredjepartsgranskningar leder det till att man måste jobba med de interna processerna för att nå vissa standarder som mäts i granskningarna för att vara med på marknaden. Förutom att säkra livsmedel, påverkas aktörer även indirekt av certifieringar. Bland annat kan certifieringar spela en viktig roll som kunskapsspridare för organisationer och för de människor som arbetar inom den. Vidare innebär tredjepartskontrollerna, som certifieringssystemen bygger på, att producenter som köper råvaror och själva slipper lägga tid och pengar på att göra grundläggande kontroller. Detta friar upp resurser för att göra kompletterande kontroller, som annars inte skulle utföras. Indirekt leder detta till en förhöjd kvalitetsnivå inom branschen då aktörer granskas mer på djupet än de skulle gjorts utan ett etablerat certifieringssystem. Certifieringar signalerar även ett kvalitetsvärde, detta i sin tur betyder att det skapas en polarisering mellan certifierade och icke certifierade aktörer inom branschen. För de certifierade aktörerna leder certifieringen till en marknadsfördel, med andra ord, man får tillgång till marknaden, medan det för icke certifierade aktörer kan leda till en marknadsbarriär och utanförskap. Det har visserligen negativa aspekter för den fria marknaden men samtidigt positivt för att säkra livsmedel

Possible pharmacological interactions in hypertensive and/or diabetic elderly in family health units at Blumenau (SC)

The aim of this study was to examine the possible adverse drug-drug interactions in the elderly population (>;60 years) diagnosed either with diabetes, arterial hypertension or both, at a Family Health Unit (FHU) clinic in Blumenau, state of Santa Catarina, Brazil. For this purpose 318 subjects were interviewed using a pretested form with social and demographic aspects regarding their disease and its complications. All drugs used by this population were grouped, and the drug-drug interactions were detected by using the "Drug Interaction Checker" software, and classified for frequency and severity. The average age of patients was 70.6 years, with a higher number of female patients (216; 67.9%). Most subjects were being treated for both diseases (149; 46.86%). Out of a total of 1,541 medications prescribed, the most prevalent were: hydrochlorothiazide (131; 8.4%) and enalapril maleate (130; 8.4%). A total of 295 possible drug-drug interactions were detected in 152 patients (1.9 interactions per subject), 275 (93.2%) moderate and 20 (6.8%) severe or highly severe. The possible interaction prevalence was 0.93 (0.55 to 1.40 depending on health unit). The most frequent possible interaction was that between acetylsalicylic acid and enalapril maleate (37; 12.5%). Patients had an average consumption of 6.6 drugs and 9.8% of subjects reported physical discomfort when using medicines. Elderly patients use many medications that could cause adverse reactions and possible drug-drug interactions, where this issue warrants closer attention of prescribers and health providers.Buscou-se identificar possíveis interações medicamentosas em pessoas idosas com diabetes melito (DM) e/ou hipertensão arterial sistêmica (HAS) sendo atendidas em unidades de Saúde da Família, em Blumenau (SC). Entrevistaram-se 318 pessoas com 60 e mais anos, portadoras de DM e/ou HAS, mediante questionário estruturado pré-testado, com variáveis sócio-demográficas da doença e do tratamento. As interações medicamentosas foram verificadas através do aplicativo "Drug Interaction Checker" e classificadas quanto a freqüência e severidade. A maioria dos pacientes era do sexo feminino (216; 67,9%), com média de idade de 70,6 anos (DP = 6,9), recebendo tratamento por ambas as doenças (149; 46,86%). Dentre 1.541 medicamentos prescritos, os mais prevalentes foram: hidroclorotiazida (131; 8,4%) e maleato de enalapril (130; 8,4%). Foram detectadas 295 possíveis interações medicamentosas em 152 idosos (média 1,9 interações), das quais (275; 93,2%) foram moderadas e (20; 6,8%) severas ou muito severas. A prevalência de possíveis interações foi de 0,93 (0,55 a 1,40, dependendo da unidade de saúde). A possível interação mais freqüente foi entre ácido acetilsalicílico e maleato de enalapril (37; 12,5%). Cada paciente fazia uso de 6,6 medicamentos em média e 9,8% relataram algum desconforto físico com o uso de medicamentos. Idosos utilizam grande quantidade de medicamentos que resultam em reações adversas e possíveis interações medicamentosas, merecendo maior atenção dos prescritores e gestores