Antonia Oliveira Silva

Geographic distribution of hepatitis C virus genotypes in Brazil

Brazil is a country of continental dimension with a population of different ethnic backgrounds. Thus, a wide variation in the frequencies of hepatitis C virus (HCV) genotypes is expected to occur. To address this point, 1,688 sequential samples from chronic HCV patients were analyzed. HCV-RNA was amplified by the RT-PCR from blood samples collected from 1995 to 2000 at different laboratories located in different cities from all Brazilian States. Samples were collected in tubes containing a gel separator, centrifuged in the site of collection and sent by express mail in a refrigerated container to Laboratório Bioquímico Jardim Paulista, São Paulo, SP, Brazil. HCV-RNA was extracted from serum and submitted to RT and nested PCR using standard procedures. Nested PCR products were submitted to cycle sequencing reactions without prior purification. Sequences were analyzed for genotype determination and the following frequencies were found: 64.9% (1,095) for genotype 1, 4.6% (78) for genotype 2, 30.2% (510) for genotype 3, 0.2% (3) for genotype 4, and 0.1% (2) for genotype 5. The frequencies of HCV genotypes were statistically different among Brazilian regions (P = 0.00017). In all regions, genotype 1 was the most frequent (51.7 to 74.1%), reaching the highest value in the North; genotype 2 was more prevalent in the Center-West region (11.4%), especially in Mato Grosso State (25.8%), while genotype 3 was more common in the South (43.2%). Genotypes 4 and 5 were rarely found and only in the Southeast, in São Paulo State. The present data indicate the need for careful epidemiological surveys throughout Brazil since knowing the frequency and distribution of the genotypes would provide key information for understanding the spread of HCV.

Avaliação do risco de quedas em idosos atendidos em Unidade Básica de Saúde

The world population is aging rapidly, which poses a greater challenge for the institutions involved which, in turn, require new public health policies that include the prevention of falls. The objective of this study was to assess the risk of falls in the elderly. This epidemiological, cross-sectional study was performed at a family health unit, using a quantitative approach. The sample consisted of 150 elderly individuals evaluated from January to April 2009. Data were collected using the Fall Risk Score, which was analyzed using SPSS 17.0. Of all seniors evaluated, 58.8% did not suffer falls. However, 63 seniors did suffer falls, 71.4% of this total experienced 1 to 2 falls, and the main intrinsic cause they reported was dizziness/vertigo, whereas the extrinsic cause was wet or slippery floors. Therefore, it is concluded that it is important to assess the risk of falls among the elderly so that preventive measures can be taken, with a view to maximizing their quality of life.The world population is aging rapidly, which poses a greater challenge for the institutions involved which, in turn, require new public health policies that include the prevention of falls. The objective of this study was to assess the risk of falls in the elderly. This epidemiological, cross-sectional study was performed at a family health unit, using a quantitative approach. The sample consisted of 150 elderly individuals evaluated from January to April 2009. Data were collected using the Fall Risk Score, which was analyzed using SPSS 17.0. Of all seniors evaluated, 58.8% did not suffer falls. However, 63 seniors did suffer falls, 71.4% of this total experienced 1 to 2 falls, and the main intrinsic cause they reported was dizziness/vertigo, whereas the extrinsic cause was wet or slippery floors. Therefore, it is concluded that it is important to assess the risk of falls among the elderly so that preventive measures can be taken, with a view to maximizing their quality of life.

O envelhecimento ativo sob o olhar de idosos funcionalmente independentes

Esta pesquisa teve como objetivo apreender as representacoes sociais de idosos sobre o envelhecimento ativo. Foi realizada na cidade de Joao Pessoa, Paraiba, com 100 idosos funcionalmente independentes. Como instrumentos, utilizaram-se entrevistas semi-estruturadas. Os dados foram organizados e analisados pelo software Alceste. Os resultados demonstraram que os discursos dos idosos sobre o envelhecimento ativo sao permeados por conteudos positivos. No entanto, quando nao esta associado a palavra ativo, o envelhecimento ainda e representado como perdas e incapacidades. Mesmo com a existencia de perdas durante o processo, o envelhecimento de maneira ativa deve ser estimulado entre os idosos, uma vez que ele e sinonimo de vida plena e com qualidade. Manter os idosos funcionalmente independentes e o primeiro passo para se atingir um envelhecimento ativo e com melhor qualidade de vida.Esta investigacion tuvo como objetivo captar las representaciones sociales de ancianos sobre el envejecimiento activo. Fue realizada en la ciudad de Joao Pessoa - PB, con 100 ancianos funcionalmente independientes. Como instrumento, fue utilizada la entrevista semiestructurada. Los datos se organizaron y procesaron a traves del software Alceste. Los resultados demostraron que los testimonios de los ancianos acerca del envejecimiento activo estan impregnados por contenidos positivos. Sin embargo, cuando no esta asociado a la palabra activo, el envejecimiento aun es representado como perdidas e incapacidades. Incluso con la existencia de perdidas durante el proceso, el envejecimiento activo debe ser estimulado entre los ancianos, toda vez que es sinonimo de vida plena y con calidad. Mantener a los ancianos funcionalmente independientes es el primer paso para alcanzar un envejecimiento activo y con mejor calidad de vida.

Prevalencia de quedas de idosos em situacao de fragilidade

OBJECTIVE To measure the prevalence in frail elderly people, their consequences and associated demographic factors. METHODS This was an epidemiological and cross-sectional study with a probabilistic sample composed of 240 elderly people (≥ 60 years) living in Ribeirão Preto, Sao Paulo state. Data were collected between November 2010 and February 2011, through a questionnaire that included socio-demographic data, fall assessment and the Edmonton Frailty Scale. Uni-variate and bivariate analyses were carried out. RESULTS The mean age was 73.5 (± 8.4), with higher ages among women; 25% of the interviewees were aged 80 or older; 11.3% presented moderate frailty and 9.6% severe frailty. The prevalence of falls in frail elderly participants corresponded to 38.6%; higher levels were found among women and younger subjects (60 to 79 years old); 26.8% were victims of 1 to 2 falls, 27.1% of which occurred in the bedroom, 84.7% fell from their own height, 55.9% lost their balance, 54.2% suffered scratches and 78% were afraid of suffering a new fall. Higher fall prevalence levels were found in frail elderly 1,973 (1,094-3,556) compared to non-frail. CONCLUSIONS We highlight the importance of addressing the health of frail elderly people, especially regarding the risk of falls, as well as of increasing investment in prevention strategies of these syndromes and in the formation of train like a virgin ed human resources to better care for this population.OBJECTIVE To measure the prevalence in frail elderly people, their consequences and associated demographic factors. METHODS This was an epidemiological and cross-sectional study with a probabilistic sample composed of 240 elderly people (≥ 60 years) living in Ribeirao Preto, Sao Paulo state. Data were collected between November 2010 and February 2011, through a questionnaire that included socio-demographic data, fall assessment and the Edmonton Frailty Scale. Uni-variate and bivariate analyses were carried out. RESULTS The mean age was 73.5 (± 8.4), with higher ages among women; 25% of the interviewees were aged 80 or older; 11.3% presented moderate frailty and 9.6% severe frailty. The prevalence of falls in frail elderly participants corresponded to 38.6%; higher levels were found among women and younger subjects (60 to 79 years old); 26.8% were victims of 1 to 2 falls, 27.1% of which occurred in the bedroom, 84.7% fell from their own height, 55.9% lost their balance, 54.2% suffered scratches and 78% were afraid of suffering a new fall. Higher fall prevalence levels were found in frail elderly 1,973 (1,094-3,556) compared to non-frail. CONCLUSIONS We highlight the importance of addressing the health of frail elderly people, especially regarding the risk of falls, as well as of increasing investment in prevention strategies of these syndromes and in the formation of train like a virgin ed human resources to better care for this population.

A terapia comunitária como um novo instrumento de cuidado para saúde mental do idoso

A Terapia Comunitaria vem surgindo como uma nova tecnologia de cuidado nos programas de insercao e apoio a saude mental da populacao. Esta pesquisa exploratoria tem como objetivo identificar o numero de grupos de terapia comunitaria com idosos no municipio de Joao Pessoa - PB, conhecer os principais temas apresentados pelos idosos e as estrategias utilizadas para o enfrentamento das dificuldades e revelar depoimentos relacionados a melhoria da qualidade de vida dos idosos. Os dados foram coletados nas fichas de registro das terapias, analisado numa abordagem quantitativa. Os resultados demonstraram que o problema mais frequente nos idoso e o estresse, a estrategia de enfrentamento mais utilizada e a espiritualidade. A Terapia Comunitaria vem contribuindo para saude mental do idoso.

Envelhecimento ativo e sua relação com a independência funcional

This studys objective was to analyze the factors determining active aging and its relationship to functional independence. It was conducted with a hundred elderly individuals cared for in a Family Health Unit in Joao Pessoa, PB, Brazil. The Functional Independence Measure and a socio-demographic questionnaire were used to assess the elderly participants. Data were analyzed using the SPSS. According to the results, all the participants were functionally independent for the performance of the studied activities. Data also showed that functional independence promotes greater integration of elderly individuals within the community, through strengthening social and family bonds, friendship and leisure, factors considered to be determinants of an active aging process. DESCRIPTORS: Aging actively. Independence. Functionality.

Assessing the risk of falls for the elderly in Basic Health Units

The world population is aging rapidly, which poses a greater challenge for the institutions involved which, in turn, require new public health policies that include the prevention of falls. The objective of this study was to assess the risk of falls in the elderly. This epidemiological, cross-sectional study was performed at a family health unit, using a quantitative approach. The sample consisted of 150 elderly individuals evaluated from January to April 2009. Data were collected using the Fall Risk Score, which was analyzed using SPSS 17.0. Of all seniors evaluated, 58.8% did not suffer falls. However, 63 seniors did suffer falls, 71.4% of this total experienced 1 to 2 falls, and the main intrinsic cause they reported was dizziness/vertigo, whereas the extrinsic cause was wet or slippery floors. Therefore, it is concluded that it is important to assess the risk of falls among the elderly so that preventive measures can be taken, with a view to maximizing their quality of life.The world population is aging rapidly, which poses a greater challenge for the institutions involved which, in turn, require new public health policies that include the prevention of falls. The objective of this study was to assess the risk of falls in the elderly. This epidemiological, cross-sectional study was performed at a family health unit, using a quantitative approach. The sample consisted of 150 elderly individuals evaluated from January to April 2009. Data were collected using the Fall Risk Score, which was analyzed using SPSS 17.0. Of all seniors evaluated, 58.8% did not suffer falls. However, 63 seniors did suffer falls, 71.4% of this total experienced 1 to 2 falls, and the main intrinsic cause they reported was dizziness/vertigo, whereas the extrinsic cause was wet or slippery floors. Therefore, it is concluded that it is important to assess the risk of falls among the elderly so that preventive measures can be taken, with a view to maximizing their quality of life.

Sintomatologia de depressão autorreferida por idosos que vivem em comunidade

The scope of this quantitative exploratory study was to evaluate the symptomatology of self-referred depression by the elderly, taking socio-demographic variables into consideration. The data collected by means of semi-structured interviews and the Abbreviated Geriatric Depression Scale involving 240 elderly residents in Joao Pessoa in the state of Paraiba between October and December 2010 were analyzed by Excel and SPSS software. It was found that 75.8 % had no degree of symptomatology of depression, and 24.2 % manifested mild or severe depression. According to these variables, in the elderly patients with depression it was found that: in relation to age, the elderly with mild and severe depression appear more frequently between 71 to 76 years - 31%; in relation to gender, females stand out with 86%; on marital state, married couples with 41.3 %, and widowers with 34.5 %; considering family income, from 1 up to 3 minimum wages, 50 %, revealed mild incidence; with respect to schooling, elderly people who have no depression, 84.6 %, can read and write. Therefore, it can be said that the symptomatology of depression in the elderly is related to socio-economic and cultural conditions, emphasizing the need for public health policies that ensure comprehensive care and quality considering these variables.

A prática do fonoaudiólogo nos Núcleos de Apoio à Saúde da Família em municípios paraibanos

PURPOSE To analyze the discourse of speech language pathologists regarding the practice developed at Family Health Support Centers (FHSC) based on the concepts of center and field in Collective Health. METHODS A qualitative investigation was conducted between April 2011 and June 2011 with 12 speech language pathologists working at the FHSCs of different municipalities of Paraíba. The empirical material was obtained by means of semi-directed interviews and analyzed through the French Discourse Analysis. RESULTS Regarding the work of speech language pathologists, the curative perspective prevails, exercised through individual rehabilitation initiatives. Health promotion activities are focused on education and aimed at changing the behavior of individuals and specific groups through lectures and group formation. We verified difficulties to develop teamwork and problems of interaction among the professionals at the various FHSCs. These difficulties disregard the guidelines of the Ministry of Health in relation to the organization of work processes. The participants charged the managers with lack of knowledge about their jobs and remained silent about intersectoral actions and the empowerment of the population, which are consistent with the modern concept of health promotion. CONCLUSION The work of speech language pathologists at FHSCs in the municipalities of Paraíba has been revealed from a nuclear perspective. In order for it to be effective from the perspective of Collective Health, the barriers that prevent the intersection between center and field must be analyzed.

Promoção da saúde mental do idoso na atenção básica: as contribuições da terapia comunitária

Para a Politica Nacional de Saude da Pessoa Idosa ha dois megagrupos populacionais. Representando o primeiro grupo, estao idosos considerados independentes e o segundo envolve idosos frageis. Nessa realidade se encontra inserida a Terapia Comunitaria como espaco de partilha e promocao da saude mental do idoso. Este estudo teve como objetivo conhecer as contribuicoes da Terapia Comunitaria na vida dos idosos. Trata-se de um estudo exploratorio com uma abordagem qualitativa, realizado com 19 idosos, em um municipio do Rio Grande do Norte. Utilizou-se um roteiro de entrevista e um caderno de campo. Emergiram as categorias tematicas: sentimento de empoderamento, partilha de experiencias, contribuicoes da terapia comunitaria e mudanca de comportamentos revelandoque a Terapia Comunitaria representa uma estrategia de enfrentamento de desafios vivenciados no cotidiano dos idosos que frequentam os encontros, possibilitando uma significativa melhoria da autoestima e construcao da teia de solidariedade na comunidade.