LA SEXUALIDAD EN LA VEJEZ: VIVENCIAS DE PROFESIONALES DE LA SALUD Y DE ANCIANOS

Objetivo: verificar las vivencias de profesionales de la salud y de ancianos en relación con la sexualidad en la vejez. Método: estudio cualitativo realizado entre marzo y abril de 2021 con 23 profesionales de la salud y 12 ancianos que se atienden en Atención Primaria de la Salud, en Queimadas/PB, Brasil. Se utilizó un cuestionario y entrevistas, cuyos datos se procesaron en el programa de software IRAMUTEQ. Resultados: corpus textual compuesto por 35 textos y 131 Segmentos de Texto, lo que equivalente a un 71,2% de retención, dando origen a cinco clases: las clases uno y cuatro relacionadas con la población de ancianos y las clases dos, tres y cinco atribuidas a los profesionales de la salud. Conclusión: se evidenció la necesidad de informar y educar a los ancianos en materia de salud, en el sentido de proveerles conocimiento, modificando concepciones preestablecidas sobre la sexualidad, además de la necesidad de capacitar a los profesionales para debatir y trabajar el tema. Se enfatiza la importancia de la educación en salud como estrategia para mejorar la calidad de vida de los ancianos.

OLDER ADULTS' SEXUALITY: EXPERIENCES OF HEALTH PROFESSIONALS AND AGED INDIVIDUALS

Objective: to verify the experiences of health professionals and aged individuals related to older adults' sexuality. Method: a qualitative study conducted from March to April 2021 with 23 health professionals and 12 aged individuals treated in Primary Health Care in Queimadas/PB - Brazil. A questionnaire and an interview were used, whose data were processed in the IRAMUTEQ software. Results: text corpus with 35 texts and 131 Text Segments, which equals to 71.2% retention, giving rise to five classes, of which classes one and four are related to the population of older adults. In turn, classes two, three and five are assigned to the health professionals. Conclusion: the need to inform and educate older adults in terms of health was evidenced, empowering them with knowledge, changing pre-established conceptions about sexuality; as well as to train the professionals to discuss and work on the theme. The importance of health education as a strategy to improve older adults' quality of life is emphasized.

SEXUALIDADE DA PESSOA IDOSA: VIVÊNCIAS DE PROFISSIONAIS DE SAÚDE E IDOSOS

Objetivo: verificar as vivências de profissionais de saúde e idosos relacionadas à sexualidade da pessoa idosa. Método: qualitativo, realizado com 23 profissionais de saúde e 12 idosos da Atenção Primária à Saúde, em Queimadas/PB - BR, no período de março a abril de 2021. Utilizou-se questionário e entrevista, cujos dados foram processados pelo software IRAMUTEQ. Resultados: corpus textual com 35 textos e 131 Segmentos de Textos, equivalente a 71,2% de retenção, originando cinco classes, sendo as classes um e quatro relacionadas à população de idosos. Já as classes dois, três e cinco são atribuídas aos profissionais de saúde. Conclusão: evidenciou-se a necessidade de informar e educar os idosos em saúde, no sentido de empoderá-los de conhecimento, mudando concepções pré-estabelecidas sobre a sexualidade; e de capacitação dos profissionais para discutir e trabalhar a temática. Enfatiza-se a importância da educação em saúde como estratégia para ampliar a qualidade de vida dos idosos.

Avaliação em saúde: dimensão processual e estrutural da saúde da criança na atenção primária

RESUMO O estudo teve como objetivo avaliar os atributos da dimensão processual e estrutural da atenção primária à saúde da criança em dois modelos de atenção à saúde. Estudo quantitativo, realizado com dados secundários de estudo multicêntrico, com cuidadores de crianças em unidades de saúde da família e unidades de atenção básica tradicional, de dois municípios de médio porte brasileiros, cuja coleta de dados ocorreu em 2012 e 2013. O Primary Care Assessment Tool (PCATool-Brasil) versão criança foi utilizado para a avaliação da efetividade dos modelos. Análise estatística inferencial. Na avaliação dos atributos essenciais, o escore médio foi igual ou superior ao esperado (6,6) e o escore geral ficou abaixo (6,4). Na perspectiva do cuidador da criança, os dois modelos de atenção estão orientados à atenção primária apenas nos atributos essenciais, porém, não no escore geral. As fragilidades e potencialidades dos modelos de atenção indicam a necessidade de mudanças na organização dos serviços para contemplar o cuidado integral à criança.

Managing care for older adults with tuberculosis in Primary Care: an integrative review

Abstract Objective: to analyze the available knowledge on the management of care for older adults with tuberculosis in primary care. Method: an integrative literature review was performed in the following databases, based on articles from 2008 to 2017: the Latin American and Caribbean Health Sciences (LILACS), International Health Sciences Literature (MEDLINE) and the Cumulative Index to Nursing and Allied Health Literature (CINALH). The sample consisted of six scientific articles, considering the established inclusion and exclusion criteria. Data collection took place in June 2018, using an instrument with information relevant to the proposed objective. Results: the selected studies identified weaknesses and challenges in primary health care health services regarding professional skills and knowledge, the entry point to the diagnosis of tuberculosis, the link between professionals and patients, and the logistics of health services. Conclusion: a health policy that expands the response of the government and health professionals to the needs of older adults with tuberculosis is recommended, in line with the principles of the Brazilian National Health Service. This health policy would support improving the skills and knowledge of professionals at the entry point to the diagnosis of the disease and enhancing the link between professionals and patients, and the logistics of health services. Health technology could be used to accompany the nursing team in the management of care in geriatric and gerontological research and practice.

Knowledge of sex workers about HIV/AIDS and its influence on sexual practices

OBJECTIVE

assess the knowledge of sex workers about HIV/AIDS and its influence on sexual practices.

METHOD

Ninety women participated in the study. The Scientific Knowledge Test about HIV/AIDS and sexual practices was used. The Wald test was applied to verify the relationship between knowledge and sexual practices with statistical significance of p<0.05.

RESULTS

the score of 61.7% of correct answers in all three dimensions stands out; 72.2% have sexual intercourse without a condom in exchange for a large amount of money; 53.3% have sex during the menstrual period; 62.2% have sexual intercourse with drug users; 75.6% have sex with clients showing lesions on the penis or anus. The B coefficient (-0.19) showed that the higher the knowledge about HIV/AIDS, the lower the practice of risky sexual behaviors.

CONCLUSION

the influence of knowledge about HIV/AIDS on sexual practices was not statistically significant, but the sexual practices and insufficient knowledge about prevention, physiological and behavioral attributes were observed.

[Presence and extent of primary care characteristics under different models for children's healthcare]

The aim of this study is to compare traditional primary care units and family health units to determine which of the two models is better oriented towards primary care for children, considering the existence and scope of essential and intermediate attributes of primary care. We interviewed a total of 1,484 parents and guardians of children under 10 years of age enrolled in family health units in João Pessoa, Paraíba State, Brazil, as well as in traditional primary care units in Cascavel, Paraná State, Brazil, and mixed primary care units in Londrina, Paraná State, Brazil. The Primary Care Assessment Tool Brazil, children's version, was used for this purpose. The parametric one-way ANOVA test was used to identify statistically significant differences between the models of care, followed by the Tukey post hoc multiple comparison test to identify which model presented differences. The study design's limitations notwithstanding, the findings raised the hypothesis that mixed primary care units were the model best oriented to primary care for children. The difference may relate to the fact that the different models belonged to different municipalities, without the possibility of adjusting the variables linked to the different contexts in the variables. Thus, this hypothesis may be proven by future studies with more robust designs and expanded to include other users and health professionals.

Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses

OBJECTIVE

to know the beliefs of older adults about their vulnerability to HIV/Aids, and to identify nursing diagnoses.

METHOD

a field research implemented in Family Health Units, in João Pessoa, Brazil. The sample included 250 older adults of both genders with data collected from April to July of 2011. A Test of Free Word Association was applied using the term HIV/Aids. A content analysis and cross-mapping of the most frequent terms with the International Classification for Nursing Practice, 2011 were performed.

RESULTS

202 terms were identified in terms, with an overall frequency of 1156. Of the 202 terms, 16 were more frequent and were used to construct the nursing diagnoses. The diagnoses identified were knowledge about appropriate sexual behavior, ability for partial protection, fear of death and hopelessness.

CONCLUSION

understanding these beliefs drew from knowledge about factors related to, vulnerability to HIV/Aids aimed at planning health care actions for this population segment.

Changes and events over life course: a comparative study between groups of older adults

OBJECTIVE

to identify the changes which had occurred over the last year in the life of older adults, as well as the values attributed to these changes.

METHOD

this is a multicentric, cross-sectional study, of the inquiry type, undertaken in three cities of the Brazilian Northeast, investigating two distinct groups of older adults.

RESULTS

among the 236 older adults interviewed, it was observed that 30.0% reported health as the main change in their life course in the last year, this category being the most significant response among the older adults aged between 80 and 84 years old (37.7%). Changes in the family were mentioned by 11.5% of the older adults; death (9.6%) and alterations in routine activities (9.6%). In relation to the value attributed to these changes, it was ascertained that for 64.7% of the older adults aged between 65 and 69 years old, these changes were positive. In the older group, 49.4% of the older adults believe that their changes were related to losses.

CONCLUSION

the knowledge of the changes mentioned, the value attributed to these changes, and the self-evaluation of health provide information which assists in formulating actions which are more specific to the real needs of these age groups. They also provide the health professionals with a better understanding of how some experiences are experienced in the life trajectories of these older adults.

Quality of life, clinical characteristics and treatment adherence of people living with HIV/AIDS

OBJECTIVES

to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence.

METHOD

cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used.

RESULTS

of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends.

Staphylococcus epidermidis RP62A adhesion to chemically modified cellulose derivatives

The adhesion of coagulase negative Staphylococcus epidermidis expressing capsular polysaccharide/adhesin (PS/A) to cellulose diacetate (CDA), as well as to primary reference low-density polyethylene, was assessed in vitro. Attached bacteria were released by gentle sonication and quantified as colony forming units. Surface free energy of cells and materials and the free energy of interaction between cells, each type of material and water molecules was calculated through contact angle measurement, also enabling the determination of materials surface hydrophobicity. The influence of CDA surface modification by deacetylation and phosphorylation on bacterial adhesion was studied. Chemical modifications of CDA by deacetylation and by phosphorylation were effective in lowering bacterial adhesion.

[Etiologic diagnosis of viral meningitis. Study of 142 cases]

Viral meningitis is a common disease, most often benign and striking predominantly children. In 1997, there was an outbreak of viral meningitis in the North of Portugal and this pathology accounted for 496 admissions to the Infectious Diseases Department of S. João Hospital. The authors' aim was to determine the etiology of the cases of viral meningitis admitted to the S. João Hospital by, in a first phase, searching enterovirus and serology for mumps in a sample of 142 patients with symptoms, signs and cerebrospinal fluid (CSF) cytochemical abnormalities typical of viral meningitis, in the absence of any bacterial or fungal growth (in blood and/or CSF) and with negative soluble bacterial antigens in CSF. The enterovirus was detected by polymerase chain reaction (PCR) and, in a small number of cases, by shell vial culture. The diagnosis of mumps was made by the detection of specific IgM antibodies in serum, using an enzyme-linked immunosorbent assay. The diagnosis was reached in 70 patients (49.3%): 47 (33.1%) had mumps meningitis and 23 (16.2%) enterovirus infection (PCR positive in all; culture positive in only 2 cases). In 72 patients (50.7%), the agent was not identified. Although only two agents were searched for, the diagnosis was made in a high proportion of cases. The culture method used for the isolation of enterovirus was found to have a low sensitivity.

Atopy and enteroparasites

There are not many studies about the intestinal parasitosis (IP) and atopic asthma (AA) relationship, and these show discordant results, possibly due to different studies design and differences in population selection. On the basis of personal results obtained by an epidemiological inquiry designed to estimate the prevalence of enteroparasitoses in asthmatic children and vice vesa, the aim of this study was to compare the prevalence of IP in AA and in a control group (CG) by a cross sectional study using clinical and laboratorial parameters, applied to 63 children (47 with AA and 16 in CG) aged 6 to 11 years, 37 males and 26 females, Caucasians, with the same socioeconomical conditions, consecutively selected in our Hospital. The results showed: The IP in AA children was 21.3%; the IP in CG was 25%; in the group with AA and IP, 40% of them had symptomology of IP; in the CG with IP, 100% had symptoms.

CONCLUSIONS

The IP prevalence in AA was not statistically different from the IP in CG (p > 0.05) More data are needed to clarify the significant differences between the symptomatology rates of IP in asthmatic and non asthmatics; the reduced number of patients with symptoms in AA may reflect modulation of IP in AA and/or different parasite load.

Update on the use of cefotaxime for pediatric meningitis in Portugal

We treated 256 children who had identified bacterial meningitis with cefotaxime. Causative organisms were: Neisseria meningitidis in 108 cases, Streptococcus pneumoniae in 61, Haemophilus influenzae in 60, enteric Gram-negative bacilli in 21, and Staphylococcus spp. in six. Daily doses of cefotaxime were 150-200 mg/kg. A total of 240 patients (93.7%) were cured. In the cured patients, sterilization of cerebrospinal fluid was obtained in the first 72 h of treatment in 214 (80.0%). Cefotaxime is an effective and safe drug for the treatment of childhood bacterial meningitis.