Elizabete Regina Araújo de Oliveira

Performance of the waist-to-height ratio in identifying obesity and predicting non-communicable diseases in the elderly population: A systematic literature review

A systematic review was carried out aiming to collect evidence on the use of the waist-to-height ratio (WHtR) on the elderly population, focusing on validity measures to identify the best anthropometric indicator in assessing obesity associated with non-communicable diseases. The review consisted in a search of papers published on the databases Pubmed, Web of Science, and Lilacs, with no restriction regarding period of publication, using the following combinations: abdominal fat or overweight or obesity and waist-to-height ratio or waist height or waist ht or WHtR or waist to stature ratio or wst stature or WSR or stature and girth. Sixteen papers were selected, most of which with high methodological quality. The receiver-operating characteristic (ROC) curves was the validity measure explored in 13 papers, followed by sensitivity and specificity measures. In all studies, the body mass index (BMI) and waist circumference (WC) received special attention for analysis along with WHtR. Five manuscripts showed evidence of WHtR being the best anthropometric index when used alone, four showed that both WHtR and WC had the best discriminatory power in predicting cardiovascular risk factors compared to the other indices, and two ranked WHtR at the same performance level as waist-to-hip ratio (WHR) and BMI. An association was shown of the obesity assessed by WHtR in predicting risk factors for cardiovascular diseases, metabolic syndrome, and diabetes compared to other anthropometric parameters.

Gênero e qualidade de vida percebida: estudo com professores da área de saúde

The rapid process of change in the global economy in recent years and the organization of labor have influenced gender relations in the teaching profession. These transformations have been disadvantageous for women, leaving them in a situation of occupational overload. The scope of this study was to analyze the working conditions of female teachers in higher education in the health education area in the city of Vitoria, State Espirito Santo, and their implications on health and quality of life. This is qualitative research into data gathered from interviews upon which Bardin content analysis was also employed. This technique revealed three categories: leisure, rest and health; sense of loss of social and family interaction; and perceived quality of life. The results show that insufficient leisure time may lead to sleep disturbances predisposing the individual to psychic illness; overwork; significant alterations in labor organization compromising social and family interaction with repercussions on health and quality of life. The work performed by female professors in the health area contributes to the onset of illness, with pejorative effects on their family, love, social, environmental and professional lives, with consequent loss of quality of life.

Treatment Outcomes in Tuberculosis Patients with Diabetes: A Polytomous Analysis Using Brazilian Surveillance System

Background The impact of non-communicable diseases on tuberculosis incidence has received significant attention. It has been suggested that the risk of tuberculosis is higher among subjects with diabetes and these subjects also has poor TB treatment outcomes.This study was aimed at assessing the socio-demographic and clinical factors that may influence different outcome of TB in patients with DM (TB-DM) identified in the Brazilian national database from 2001 to 2011. Methods TB-DM cases reported in the Brazilian information system were identified and compared.Covariates associated with the outcomes of interest (cure, default, deaths, and development of TB MDR) were included in a hierarchical regression model. Results TB-DM cases increased from 380/100,000/year in 2001 to 6,150/100,000/year in 2011. Some of the main associations found are pointed. The odds of default was higher among those in the age group 20–39 years (OR = 2.07, 95%CI 1.32–3.24); alcoholics (OR = 2.17, 95%CI 1.86–2.54), and HIV/AIDS (OR = 2.16, 95%CI 1.70–2.74);positive monitoring smear (OR = 1.94, 95%CI 1.55–2.43); prior default (OR = 5.41, 95%CI 4.47–6.54), and unknown type of treatment (OR = 3.33, 95%CI 1.54–7.22). The odds of death was greater for subjects ≥60 years old (OR = 2.74, 95%CI 1.74–4.29); institutionalized in shelter (OR = 2.69, 95%CI 1.07–6.77); alcoholics (OR = 2.70, 95%CI 2.27–3.22); HIV/AIDS (OR = 2.87, 95%CI 2.13–3.86); pulmonary+extrapulmonary TB (OR = 2.49, 95%CI 1.79–3.46); with unknown type of treatment (OR = 14.12, 95%CI 7.04–28.32).Development of MDR TB was more related to relapse (OR = 9.60, 95%CI 6.07–15.14);previous default (OR = 17.13, 95%CI 9.58–30.63); and transfer of treatment center (OR = 7.87, 95%CI 4.74–13.07). Conclusions Older subjects and those with comorbidities and with a previous treatment of TB had poorest outcomes. TB control program in Brazil will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.

PESQUISA EM ENFERMAGEM E O POSITIVISMO

The authors discuss positivism foundations; the most remarkable influences to comtians philosophy structuration; how Comtes ideas, as doctrine in so far as method, dominate societys thoughts, passing beyond XIX century and reaching XX century; and how the positivist doctrine and empirical method influenced Nursing conceptions about science and about human being/environment/disease.Discute-se os fundamentos do positivismo; as influencias mais marcantes para a formulacao da filosofia comtiana; como as ideias de Comte, tanto como doutrina, quanto como metodo, passam a dominar o pensamento da sociedade, ultrapassando o seculo XIX e alcancando o seculo XX; e como a doutrina e o metodo empirico positivista influenciaram a Enfermagem em sua nocao acerca da ciencia e de homem/ ambiente/doenca.The authors discuss positivism foundations; the most remarkable influences to comtians philosophy structuration; how Comtes ideas, as doctrine in so far as method, dominate societys thoughts, passing beyond XIX century and reaching XX century; and how the positivist doctrine and empirical method influenced Nursing conceptions about science and about human being/environment/disease.

Estratégias de identificação, investigação e classificação de desfechos incidentes no ELSA-Brasil

OBJETIVO: O artigo descreve as estrategias do Estudo Longitudinal de Saude do Adulto (ELSA-Brasil) para a manutencao da adesao dos participantes ao longo do tempo e seu seguimento adequado. Isto e fundamental para garantir a validade interna de estudos longitudinais e identificar, investigar e classificar os desfechos incidentes de interesse. METODOS: A metodologia de seguimento da coorte combina contatos telefonicos anuais com re-exames e entrevistas a cada tres ou quatro anos. O objetivo e identificar desfechos incidentes de natureza transitoria, reversiveis ou nao; desfechos finais, de natureza irreversivel; bem como complicacoes relacionadas a evolucao das doencas cardiovasculares e diabetes, principais doencas estudadas. RESULTADOS: As entrevistas telefonicas visam monitorar a saude dos participantes e identificar possiveis eventos ocorridos, como internacoes hospitalares, exames ou procedimentos especializados definidos previamente. O participante tambem e incentivado a comunicar a ocorrencia de algum evento de saude ao Centro de Pesquisa. A partir da identificacao de um potencial evento, e iniciado um processo de investigacao, que inclui acesso a prontuarios medicos para verificacao de datas e informacoes detalhadas sobre aquele evento. Os documentos obtidos sao analisados sem identificacao do paciente, profissional ou servico de saude e classificados por um comite de especialistas medicos. A classificacao de desfechos incidentes adotada baseia-se em criterios internacionais consagrados, garantindo comparabilidade e reduzindo o erro de classificacao deles. Alem dessas estrategias, a ocorrencia de desfechos podera ser investigada por meio do relacionamento de dados com bases secundarias do Ministerio da Saude, como as de mortalidade e internacoes. CONCLUSOES: A correta identificacao de desfechos permitira estimar sua incidencia na coorte e investigar o efeito das exposicoes estudadas no ELSA-Brasil em sua linha de base e nas ondas posteriores.

Fatores associados a não adesão medicamentosa entre idosos de um ambulatório filantrópico do Espírito Santo

Resumo Objetivos: Estimar a frequencia da nao adesao ao tratamento medicamentoso entre idosos acompanhados ambulatorialmente, bem como analisar seus fatores associados. Metodologia: Foi conduzido estudo transversal com 263 idosos atendidos no ambulatorio de especialidades medicas de um hospital filantropico, localizado no municipio de Vitoria-ES. Foi realizada entrevista utilizando roteiro estruturado em tres blocos que contemplavam questoes sociodemograficas, condicoes de saude e estilo de vida e medicamentos em uso. Para verificar a nao adesao ao tratamento medicamentoso, foi aplicado o instrumento de Medida de Adesao Terapeutica (MAT). Os dados foram analisados por meio do teste Qui-quadrado para variaveis categoricas. Foram consideradas significativas as variaveis com valor de p<0,05 no modelo final de regressao multipla de Poisson. Resultados: Os resultados mostraram uma frequencia de nao adesao ao tratamento medicamentoso de 26,7% da amostra. A nao adesao ao tratamento medicamentoso nessa populacao se mostrou positivamente associada a ausencia de vinculo empregaticio anterior a aposentadoria (RP=1,12; p<0,010); presenca de declinio cognitivo (RP=1,13; p<0,010) e habitos alimentares inadequados (RP=1,12; p<0,005). Conclusao: Com o estudo, foi possivel identificar os fatores associados a nao adesao medicamentosa nos idosos investigados e assim contribuir para o conhecimento do perfil sociodemografico, condicoes de saude e estilo de vida e caracteristicas relacionadas a utilizacao de medicamentos por parte dessa populacao.

Disability after stroke: a systematic review

Introduction Stroke is the most common cause of disability in Western countries, yet there is no consensus in the literature on how to measure and describe disability from stroke. Objective To conduct a systematic literature review on disability in stroke survivors. Method Observational studies published in the PubMed, LILACS and SciELO online databases were selected, to evaluate disability in adults and in the elderly after stroke in the period 2002–2012. The Downs and Black checklist for non-randomized studies was used to assess the quality of the articles. Results 212 articles were found from which 16 were selected to compose the study. The mean age of participants was 67 years, and disability affected 24% to 49% of the population evaluated. With regard to measurement instruments, 31% of the studies analyzed presented results of disability by means of the modified Rankin Scale; 19% by means of the World Health Organization’s International Classification of Functioning, Disability and Health; 19% by means of Katz’ Index of Independence in Activities of Daily Living; 12.5% by means of the London Handicap Scale; 12.5 % by means of the Barthel Index; and 6.25% by means of the Functional Independence Measure. Conclusion Literature is not uniform as regards means of measuring disability after stroke, but considering the preference of articles in assessing physical performance in activities of daily living, it can be concluded that a quarter to half of the population that survives stroke has some degree of disability.

Sensibilidade ao Látex e Dosagem de Anticorpos Específicos em Profissionais da Área da Saúde

UNLABELLED The scope of this study was to verify the occurrence of sensitivity to latex and conduct dosage of anti-latex antibodies in health professionals of the Dental, Medical and Nursing Schools of the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil. This was a cross-sectional observational study. The intentional sample was composed of 295 professionals. Sensitivity was evaluated by means of a structured and validated questionnaire and the presence of IgE-latex by means of collection of 10 ml of blood submitted to analysis using the Immunocap-pharmacia® system. The IgE-latex values were categorized in different groups. RESULTS 22.4% (n=66) showed latex sensitivity, class V of the IgE latex (17.5-42 KUA\L); 77.6 % (n=229) showed no sensitivity, class 0 or 1 of the IgE-latex (<0.35KUA\L-8,6KUA\L). Fishers test showed a significant correlation statistic (p<0.05) in relation to the following variables: gender; atopy; eczema of the hands; allergy to medicination; chronic illness; use of anti-inflammatory; prior surgeries. CONCLUSION Positive values of IgE were observed in the professionals with sensitivity, suggesting the adoption of prophylactic measures for the prevention and or adaptation of the work environment, preserving the health of these workers.O objetivo deste estudo foi verificar a ocorrencia da reacao de sensibilidade ao latex e realizar dosagem de anticorpos antilatex em profissionais dos cursos de odontologia, medicina e enfermagem da Universidade Federal do Espirito Santo (UFES), Vitoria-ES, Brasil. Estudo observacional, transversal. A amostra intencional foi composta por 295 profissionais. A sensibilidade foi avaliada por meio de questionario estruturado e validado, e a presenca de IgE-latex por meio da coleta de 10ml de sangue submetido a analise com emprego do sistema Immunocap-Pharmacia®. Os valores IgE-latex foram distribuidos em diferentes classes. Resultados: 22,4,% (n=66) apresentaram sensibilidade ao latex, classe V IgE latex (17,6-42 KUA\L); 77,6 % (n=229) sem sensibilidade, classe 0 IgE-latex (<0,35KUA\L). O teste de Fisher mostrou correlacao estatistica significativa (p<0,05) em relacao as seguintes variaveis: genero; atopia; eczema nas maos; alergia a medicamento; doenca cronica; uso de anti-inflamatorio; cirurgias anteriores. Conclusao: Observou-se valores positivos de IgE-latex nos profissionais com sensibilidade ao latex, sugerindo a necessidade de adocao de medidas profilaticas para a prevencao e ou adequacao do ambiente de trabalho, preservando a saude destes trabalhadores.

Adaptação transcultural do Myocardial Infarction Dimensional Assessment Scale (MIDAS) para a língua portuguesa brasileira

Resumo A partir da avaliacao dos fatores que incidem na qualidade de vida (QV) e possivel planejar as intervencoes que proporcionam melhoria do bem-estar dos pacientes. Realizar a adaptacao transcultural do questionario Miocardial Infarction Dimensional Assessment Scale (MIDAS) para lingua portuguesa, buscando as equivalencias semântica, idiomatica, conceitual e cultural. Foi utilizado o referencial teorico de Guillemin, Bombardier e Beaton, cumprindo as seguintes etapas: traducao, retrotraducao, avaliacao dos autores, banca de juizes e pre-teste. Apos todas as avaliacoes, foram alcancadas as equivalencias semântica, conceitual, idiomatica e cultural. A escala mostrou-se de facil aplicacao e importância clinica. O MIDAS encontra-se validado no que se refere as equivalencias semânticas, idiomaticas, conceituais e culturais. Posteriormente, sera avaliada a equivalencia de mensuracao, para verificar as propriedades psicometricas.From the evaluation of the factors that affect quality of life (QOL) it is possible to plan interventions that lead to the improved well-being of patients. The scope of this study was to conduct the cross-cultural adaptation of the Myocardial Infarction Dimensional Assessment Scale (MIDAS) questionnaire to the Portuguese language, seeking the necessary semantic, idiomatic, conceptual and cultural equivalence. The theoretical framework of Guillemin, Bombardier and Beaton was used, fulfilling the following steps: translation, back translation, evaluation of the authors, peer review and pre-testing. After all the tests, the semantic, idiomatic, conceptual and cultural equivalence was achieved. The scale proved to be easy to use and was clinically important. MIDAS was validated in terms of its semantic, idiomatic, conceptual and cultural equivalences. Subsequently, the measurement equivalence will be evaluated to verify the psychometric properties.

Perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e a população geral

This paper aimed to compare the profile of mortality from external causes among Seventh-day Adventists and the general population of Espírito Santo from 2003 to 2009. A search of Adventists was performed in the nominal database of the Mortality Information System containing data on Adventists provided by the administrative offices of the institution. Deaths from external causes occurred during the study period were then divided into two groups: Adventists and the general population. Adventists had lower proportional mortality from external causes (10%) than the general population (19%), and males were the main reason for this difference. In both groups, deaths prevailed in the 20-29 years age group. Deaths from accidental causes were most significant among Adventists (68.08%), while deaths from intentional causes related to assault and self-inflicted injuries were more significant in the general population (53.67% of all deaths). The standardized mortality ratio for external causes was 41.3, thus, being Adventist reduced mortality by 58.7%. It is believed that the benefit of Adventists observed for mortality from external causes is related to this groups abstinence from alcohol consumption.