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Xavier LN, do Nascimento VB. Professional Narratives about Older Adults and Health Services Responsive to Fall-Inducing Frailty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6975. [PMID: 37947533 PMCID: PMC10650384 DOI: 10.3390/ijerph20216975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/21/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023]
Abstract
The second external cause of death from unintentional injuries is falls in people over 60 and is a worldwide Public Health problem. Associated factors are identified early in Primary Health Care. Thus, we analyze professional narratives about older adults/old age and the organization of services in the presence of fall-inducing frailty. A structured narrative was applied under the following stages: understanding the context, setting/plot/character analysis, and interpretive synthesis. Data were collected from August to November 2022, distributing 21 health professionals in three Narrative Focus Groups. In the analyses, the collective conceptions dialogued with Bourdieu's Epistemology of field, habitus, and capital. Technical and common sense representations of older adults were simultaneously observed among the results, along with the belief of old age as a problematic life stage. Care is centered on the installed disease/ailment. Encouraging autonomy and self-care emerges in integrative health practices, which older adults underestimate. Professionals access the lives of older adults according to their habitus, which, in turn, is structured (structuring) in the disputes for installed capital. Thus, the care provided disregards subjectivities and symbolic systems associated with falls.
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Affiliation(s)
- Laudicéia Noronha Xavier
- Doctoral Program in Health Sciences at Centro Universitário Faculdade de Medicina do ABC (FMABC), Santo André 09060870, SP, Brazil
| | - Vânia Barbosa do Nascimento
- Department of Public Health, Centro Universitário Faculdade de Medicina do ABC (FMABC), Santo André 09060870, SP, Brazil
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Leal JC, Belo VS, Santos IM, Ferreira RV, de Melo SN, da Silva ES. Exergames in Older Adult Community Centers and Nursing Homes to Improve Balance and Minimize the Risk of Falls in Older Adults: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:1872. [PMID: 37444706 DOI: 10.3390/healthcare11131872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/02/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
There is a substantial gap in our knowledge regarding the efficacy of exergames on the reduction of fall risk in older adults. This systematic review analyzes the findings of clinical trials describing the efficacy of exergames to improve balance or reduce the risk of falls in individuals above 60 years of age who are residents in community centers or nursing homes. We searched Google Scholar, PubMed, and Embase up to January 2023. Initially, 52,294 records were screened. After applying the inclusion and exclusion criteria, 20 studies were included in this systematic review. Meta-analyses revealed statistically significant reductions in the risk of falls and improvements in balance. Exergaming tended to produce positive benefits according to the results obtained using different instruments (TUG, PPA, BBS, and others), control groups, and times of intervention. Nevertheless, a substantial proportion of studies exhibited a high risk of bias and only one had a long follow-up period. Although a large body of evidence supports the view that exergaming is suitable for reducing fall risk and improving balance in older adults, some gaps remain in our knowledge about such benefits.
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Affiliation(s)
- José Carlos Leal
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
- Physical Education Course, University Center of Formiga, Formiga 35574-530, Minas Gerais, Brazil
| | - Vinícius Silva Belo
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
| | - Ingrid Morselli Santos
- Medicine Course, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
| | - Rodrigo Vinícius Ferreira
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
- Physical Education Course, University Center of Formiga, Formiga 35574-530, Minas Gerais, Brazil
| | - Saulo Nascimento de Melo
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
| | - Eduardo Sérgio da Silva
- Graduate Program in Health Sciences, Federal University of São João Del Rei, CCO Campus, Divinópolis 35501-296, Minas Gerais, Brazil
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Chen D, Jiang L, Ma M, Wan X. Association of Blood Selenium Level with Estimated Glomerular Filtration Rate in the Aging Population: a Cross-sectional Study. Biol Trace Elem Res 2023; 201:2258-2265. [PMID: 35809184 DOI: 10.1007/s12011-022-03351-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/01/2022] [Indexed: 11/02/2022]
Abstract
The relationship between blood selenium level and estimated glomerular filtration rate (eGFR) had been explored in previous studies. However, there are few studies about the correlation between blood selenium level and eGFR in the elderly population. This study was undertaken to investigate the relationship between blood selenium level and eGFR in the aged. The present study was a cross-sectional study and used the National Health and Nutrition Examination Survey (NHANES) 2011-2018 dataset. We investigated the association between blood selenium level and eGFR among participants aged 60 years or older. Totally, 4423 participants were enrolled, and the average age was 69.7 ± 6.9 years old. The means of blood selenium level and eGFR were 192.9 ± 29.5 ug/L and 74.1 ± 19.9 mL/min/1.73 m2, respectively. After adjusting potential confounders (age, gender, body mass index, ethnicity, marital status, education, family income to poverty ratio, smoking, hypertension, and diabetes mellitus), non-linear relationship was detected between blood selenium level and eGFR, whose inflection point was 202 ug/L. The effect sizes (β) and the confidence intervals on the left and right sides of inflection point were 0.07 (0.04 to 0.11) and 0.01 (- 0.02 to 0.04), respectively. In addition, subgroup analysis showed that blood selenium level was positively associated with eGFR, and the test for interactions was not statistically significant in various subgroups. In conclusion, the relationship between blood selenium level and eGFR is non-linear. Blood selenium level is positively related with eGFR when blood selenium level is less than 202 ug/L.
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Affiliation(s)
- Dawei Chen
- Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, Jiangsu, China
| | - Linglin Jiang
- Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, Jiangsu, China
| | - Mengqing Ma
- Department of Nephrology, Sir Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Wan
- Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, Jiangsu, China.
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Souza RT, Brasileiro M, Ong M, Delaney L, Vieira MC, Dias MAB, Pasupathy D, Cecatti JG. Investigation of stillbirths in Brazil: A systematic scoping review of the causes and related reporting processes in the past decade. Int J Gynaecol Obstet 2022; 161:711-725. [PMID: 36373189 DOI: 10.1002/ijgo.14573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recognizing the causes of stillbirths and their associated conditions is essential to reduce its occurrence. OBJECTIVE To describe information on stillbirths in Brazil during the past decade. SEARCH STRATEGY A literature search was performed from January 2010 to December 2020. SELECTION CRITERIA Original observational studies and clinical trials. DATA COLLECTION AND ANALYSIS Data were manually extracted to a spreadsheet and descriptive analysis was performed. RESULTS A total of 55 studies were included; 40 studies (72.2%) used the official data stored by national public health systems. Most articles aimed to estimate the rate and trends of stillbirth (60%) or their causes (55.4%). Among the 16 articles addressing the causes of death, 10 (62.5%) used the International Classification of Diseases; most of the articles only specified the main cause of death. Intrauterine hypoxia was the main cause reported (ranging from 14.3% to 54.9%). CONCLUSION Having a national system based on compulsory notification of stillbirths may not be sufficient to provide quality information on occurrence and, especially, causes of death. Further improvements of the attribution and registration of causes of deaths and the implementation of educational actions for improving reporting systems are advisable. Finally, expanding the investigation of contributing factors associated with stillbirths would create an opportunity for further development of prevention strategies in low- and middle-income countries such as Brazil.
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Affiliation(s)
- Renato T Souza
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP), School of Medical Sciences, Cidade Universitaria, Campinas, Brazil
| | - Mariana Brasileiro
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP), School of Medical Sciences, Cidade Universitaria, Campinas, Brazil
| | - Melissa Ong
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, Women's Health Academic Centre KHP, London, UK
| | - Louisa Delaney
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, Women's Health Academic Centre KHP, London, UK
| | - Matias C Vieira
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP), School of Medical Sciences, Cidade Universitaria, Campinas, Brazil.,Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, Women's Health Academic Centre KHP, London, UK
| | - Marcos A B Dias
- Fernandes Figueira Institute, Oswaldo Cruz Foundation/FIOCRUZ, Rio de Janeiro, Brazil
| | - Dharmintra Pasupathy
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, Women's Health Academic Centre KHP, London, UK.,Westmead Reproduction and Perinatal Medicine Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - José G Cecatti
- Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP), School of Medical Sciences, Cidade Universitaria, Campinas, Brazil
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Ribeiro ECDSA, Sgambato MR, Castro PCPD, Meira KC, Salles-Costa R, Ferreira AA. Social inequalities among Brazilian older adults: a secondary cross-sectional analysis of a national survey. GERIATRICS, GERONTOLOGY AND AGING 2022. [DOI: 10.53886/gga.e0220017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: This study aimed to evaluate sociodemographic and economic differences among Brazilian older adults according to region. METHODS: This cross-sectional, descriptive-analytical study was conducted with individuals ≥ 60 years of age based on a secondary analysis of public data from a nationally representative survey called the Family Budget Survey. The data were separated according to the 5 regions of the country and were associated with sociodemographic and economic characteristics. Analyses were performed of categorical and numerical variables and their associations using multinomial logistic regression. RESULTS: Among all participants in the Family Budget Survey, 26 199 (15%) were older adults. It was found that the southeast and south had better living conditions and higher proportions of older adults. Regarding race, the southern region had the highest proportion of self-declared Whites, the southeastern region had the highest mean education level, and the northern and northeastern regions had the lowest levels of education and household income. CONCLUSIONS: The results suggest that the aging process is heterogeneous due to marked regional inequalities, which are related to social issues. Regional differences can be determinant in socioeconomic and demographic inequalities among the older population.
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Perfil epidemiológico, padrões espaciais e evitabilidade da mortalidade fetal em Pernambuco. ACTA PAUL ENFERM 2021. [DOI: 10.37689/actaape/2021ao001355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Neto JBF, de Moraes GLA, de Souza Aredes J, Giacomin KC, de Melo LP, Sempe L, Lloyd-Sherlock P. Building the capacity of community health workers to support health and social care for dependent older people in Latin America: a pilot study in Fortaleza, Brazil. BMC Geriatr 2021; 21:526. [PMID: 34600482 PMCID: PMC8487332 DOI: 10.1186/s12877-021-02477-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 09/17/2021] [Indexed: 11/29/2022] Open
Abstract
Background Brazil is seeing rapid population ageing, which is leading to new demands on primary health care services. There is a need to develop and assess the effectiveness of new interventions to build the capacity of staff, including community health workers, to meet the needs of groups such as care-dependent older people and their care-givers. This study examines the feasibility of a small training intervention piloted in the Brazilian city of Fortaleza. Methods The study evaluated participants’ own assessments of key knowledge and skills related to the needs of care-dependent older people, both before and after the training intervention. It also assessed their capacity to implement a simple screening tool of geriatric risk factors. Results The participant self-assessments indicate significant improvements in their perceived knowledge and capacity in responding to the health needs of care-dependent older people. Additionally, participants were able to successfully conduct the home visits and screening for risk factors. Conclusions The study demonstrates the feasibility of developing interventions to enhance the capacity of community health workers to meet the needs of dependent older people in countries like Brazil. The evidence of effectiveness, though limited and subjective, provides justification for a larger, formally evaluated intervention. The experience of Fortaleza provides valuable lessons for other cities and countries in the region which are facing similar challenges.
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Affiliation(s)
| | - Gerídice Lorna Andrade de Moraes
- Universidade Estadual do Ceará. Av. Dr. Silas Munguba, 1700 - Campus do Itaperi Fortaleza, CE (85) 31019800 / 3101-9795. CEP: 60.714.903, Fortaleza, Brazil
| | - Janaína de Souza Aredes
- Centre for Studies in Public Health and Aging, René Rachou Institute, Fiocruz, Minas Gerais, Brazil
| | | | | | - Lucas Sempe
- University of East Anglia, School of International Development, Norwich, UK
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Silva Junior JF, Eckeli AL, Ribeiro CCC, Batista RFL, da Silva AAM, Alves CMC. Influence of excessive daily sleeping and sleep quality on BDNF and NGF serum levels in adolescents. Sleep Med 2021; 84:415-423. [PMID: 34329829 DOI: 10.1016/j.sleep.2021.06.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The brain-derived neurotrophic factor (BDNF) and neural growth factor (NGF) are widely expressed in the brain and play an important role in neuroplasticity, neurogenesis, and increased neuronal connections. Previous studies have shown that reduced serum levels of these proteins are associated with disorders in human sleep. OBJECTIVE Current study evaluates the prevalence in adolescents of excessive daytime sleepiness (EDS) and sleep quality, and analyzes the influence of these factors on BDNF and NGF serum levels. METHODS A cross-section population-based study was conducted with data from a Brazilian birth cohort, with a sample of five hundred and thirteen 18-19-year-old adolescents. Sleep quality was assessed by the Pittsburgh Sleep Quality Index and EDS by Epworth Sleepiness Scale. Neurotrophins serum levels were measured by Luminex™ technology kits. Analysis consisted of marginal structural models which compared people who were exposed and not exposed to sleep quality and EDS. RESULTS Poor sleep quality and EDS were detected in 62.57% and 36.35% of the sample. Adolescents with poor sleep quality and EDS had -0.39 (p-value = 0.049) and -0.51 pg/ml in NGF (p-value = 0.009). Individuals with self-reported sleep disorder had lower serum levels of NGF (Coef. -0.41, p-value = 0.045). CONCLUSION High prevalence of EDS and low sleep quality in a population of adolescents were evidenced. Poor sleep quality and EDS were associated with lower NGF levels, whilst adolescents with self-reported sleep disorder had lower serum levels of NGF.
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Affiliation(s)
| | - Alan Luiz Eckeli
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Effect of chronic non-communicable diseases (CNCDs) on the sleep of Brazilians during the COVID-19 pandemic. Sleep Med 2021; 91:205-210. [PMID: 33736945 PMCID: PMC9017860 DOI: 10.1016/j.sleep.2021.02.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022]
Abstract
This study aimed to investigate the effect of Chronic Noncommunicable Diseases (CNCDs) on the onset or increase in sleep problems during the COVID-19 pandemic period. The role of the report of sadness or nervousness during the pandemic was also evaluated as a mediator of this association. Data from a behavior survey during COVID-19, conducted in Brazil with 45,161 people (18 years old or older), from April 24 to May 24, 2020, were used. The outcome variable was the onset or increase in sleep problems, and the exposure variable was the presence of CNCDs. The adjusted Odds Ratio of the association between CNCDs and sleep was estimated, and a mediation analysis was performed to test the effect of the report of sadness or nervousness on this association, using the Karlson Holm Breen method. The increase in sleep problems was reported by 44.9% of the population, and 33.9% reported at least one CNCD. The chance of sleep problems was higher among people with diabetes (1.34; 1.05–1.71), hypertension (1.26; 1.06–1.50), and with coronary heart diseases (1.36; 1.13–1.65) or respiratory diseases (1.42; 1.04–1.93). Compared to people without CNCDs, individuals with at least one CNCD had a 36% greater chance of impaired sleep (1.36; 1.19–1.55). The report of sadness or nervousness explained 45.1% of the association between CNCD and sleep. Our findings alert us to care for the emotional state and sleep of chronic patients during the waves of the COVID-19 pandemic, and indicate the need for sleep monitoring in this population.
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Damaceno DG, Lazarini CA, Chirelli MQ. Caring for institutionalized elderly: representations of managers and professionals. ESCOLA ANNA NERY 2019. [DOI: 10.1590/2177-9465-ean-2019-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: Analyze the social representations of professionals and managers of long-term care institution for the elderly about the care and the influence of this conception in the practice of caring. Method: This is a qualitative research carried out with twenty-nine professionals and four managers of a long-term institution for the elderly in a city in the interior of São Paulo. The data, collected in two phases through individual interviews and workshops, were analyzed through the techniques of the Collective Subject Discourse and Content Analysis in the thematic modality. Results: About their representations about care, three main ideas were identified for managers: "giving affection"; "Supply basic needs"; and "look broadened." For the professionals, the main ideas were "to help and to give affection"; "Supply needs"; and "extended care". It also identified that the representations of the elderly influence the care practice. Final considerations and implications for the practice: The maintenance of the caregiving vision of the care process and the charitable model of producing health in these institutions are reflections of the representations of the elderly. Thus, it is necessary to review the social roles of the elderly, recognizing them as protagonists of their care process aiming at a better quality of care for this population.
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