Fabiane Ribeiro Ferreira

Saúde urbana: "a cidade é uma estranha senhora, que hoje sorri e amanhã te devora"

More than half of the worlds population is living in cities and the world is turning more and more urbanized. This literature review explores the ramifications of urban transformation, showing how cities take shape and impact human health in our times. While cities can offer positive opportunities, their negative impacts related to the lack of social organization, precarious urban living and working conditions, lack of governance and opportunities as well as the lack of strategies for promoting social equity tend to increase the adverse effects on the health of the urban communities. The article also advocates the study of urban health as a branch of knowledge related to public health, proposing a common conceptual model and taxonomy for urban health. Future directions for research and practice are discussed in the light of some examples from the Brazilian scientific literature.

Functional performance and social relations among the elderly in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil: a population-based epidemiological study

This study was conducted in a probabilistic sam- ple of 2,055 elderly in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil, to examine components of social network (conjugal status and visits by the children, other relatives, and friends) and social support (satisfaction with personal relations and having persons on whom to rely) associated with limitations in performing basic activities of daily living (ADL). Multivariate analysis used the Hurdle model. Performance of ADL showed independent and statistically significant associations with social network (fewer meetings with friends and not having children) and personal support (dissatisfaction/indifference towards personal relations). These associations remained after adjusting for social and demographic characteristics, health status, and other indicators of social relations. Our results emphasize the need for greater attention to social network and social support for elderly with functional limitations and those with weak social networks and social support.Este trabalho foi conduzido em uma amostra probabilistica de 2.055 idosos da Regiao Metropolitana de Belo Horizonte, Minas Gerais, Brasil, com o objetivo de examinar componentes da rede social (situacao conjugal, visita de filhos, outros parentes e amigos) e do apoio social (satisfacao com as relacoes pessoais e existencia de pessoas com quem contar) associados a limitacao para realizar atividades basicas da vida diaria(ABVDs). A analise multivariada foi baseada no modelo Hurdle. A performance na realizacao de ABVDs apresentou associacoes independentes e significantes com a rede social (menos encontros com amigos e nao possuir filhos) e o apoio social (insatisfacao/indiferenca com as relacoes pessoais). Essas associacoes persistiram apos ajustamentos por caracteristicas sociodemograficas, condicao de saude e outros indicadores das relacoes sociais. Nossos resultados reforcam a necessidade de maior atencao para a rede social e apoio social aos idosos com limitacoes funcionais, e para idosos com redes sociais e apoio social frageis.

Capacidade funcional de idosos: análise das questões de mobilidade, atividades básicas e instrumentais da vida diária via Teoria de Resposta ao Item

O objetivo deste estudo foi avaliar as questoes sobre capacidade funcional utilizadas no Inquerito de Saude da Regiao Metropolitana de Belo Horizonte, Minas Gerais, Brasil, realizado em 2010, utilizando a Teoria de Resposta ao Item. Foram analisados: dimensionalidade da escala, posicao dos itens na escala, poder de discriminacao dos itens e precisao da estimativa da capacidade funcional. O estudo teve como base uma amostra de 2.174 idosos, com idades entre 60 e 99 anos, 61% mulheres e escolaridade mediana de 4 anos de estudos. O instrumento de 21 itens com 4 opcoes de respostas forneceu coeficiente alfa de Cronbach de 0,98; a analise fatorial mostrou existir um fator explicando 92% da variabilidade entre as questoes. Os resultados indicaram: (i) redundância nas questoes; (ii) precisao na estimacao da capacidade funcional apenas para os idosos que estao abaixo da mediana na escala; e (iii) dificuldade dos idosos em discernir entre as opcoes de resposta. A analise sugere a necessidade de se discutir as questoes a serem incluidas no instrumento, com vistas a uma maior cobertura da escala e melhor adequacao das opcoes de respostas.

Development of a first-contact protocol to guide assessment of adult patients in rehabilitation services networks

Objective: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR), a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF). Development of the protocol: The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD); summary of the BFD; and PLPR results. Further testing of the final version will be conducted. Conclusions: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time.

[Functional capacity in the elderly: analyzing questions on mobility and basic and instrumental activities of daily living using Item Response Theory].

O objetivo deste estudo foi avaliar as questoes sobre capacidade funcional utilizadas no Inquerito de Saude da Regiao Metropolitana de Belo Horizonte, Minas Gerais, Brasil, realizado em 2010, utilizando a Teoria de Resposta ao Item. Foram analisados: dimensionalidade da escala, posicao dos itens na escala, poder de discriminacao dos itens e precisao da estimativa da capacidade funcional. O estudo teve como base uma amostra de 2.174 idosos, com idades entre 60 e 99 anos, 61% mulheres e escolaridade mediana de 4 anos de estudos. O instrumento de 21 itens com 4 opcoes de respostas forneceu coeficiente alfa de Cronbach de 0,98; a analise fatorial mostrou existir um fator explicando 92% da variabilidade entre as questoes. Os resultados indicaram: (i) redundância nas questoes; (ii) precisao na estimacao da capacidade funcional apenas para os idosos que estao abaixo da mediana na escala; e (iii) dificuldade dos idosos em discernir entre as opcoes de resposta. A analise sugere a necessidade de se discutir as questoes a serem incluidas no instrumento, com vistas a uma maior cobertura da escala e melhor adequacao das opcoes de respostas.

Aspectos da participação social e a percepção da vizinhança: ELSI-Brasil

ABSTRACT OBJECTIVE To determine the impact of the physical and social surroundings of the neighborhood, which are presented as facilitators or barriers for the social participation of Brazilian older adults. METHODS The study was conducted in a probabilistic representative sample of the Brazilian population aged 50 years and older and who lived in urban areas (n = 7,935). The response variable was social participation, which was defined from two questions about activities performed with other persons: visited friends or relatives in their homes in the last 12 months (yes, no); went out with other persons to public places, such as restaurant, movies, club, park, in the last 12 months (yes, no). The explanatory variables included fear of falling because of defects in sidewalks, concern about the difficulty to get on a bus, subway, or train, difficulty to cross streets, and perception of violence in the neighborhood. Potential confounding variables included age, marital status, education level, self-rated health, living in an asphalted or paved street, time living in the municipality, and socioeconomic position score. Prevalence ratios and respective confidence intervals were estimated using Poisson regression. RESULT Difficulty to cross streets presented an independent association with restricted social participation (PR = 0.95; 95%CI 0.93–0.98) among both women (PR = 0.96; 95%CI 0.92–0.99) and men (PR = 0.94; 95%CI 0.90–0.99). Concern about the difficulty to get on a bus, subway, or train was associated with the outcome only among men (PR = 0.95; 95%CI 0.91–0.99). The fear of falling because of defects in sidewalks and the perception of violence in the neighborhood were not associated with social participation. CONCLUSIONS Urban characteristics that hinder the crossing of streets and accessibility to public transport can be inferred as important barriers for the social participation of Brazilian older adults.RESUMO OBJETIVO Determinar o impacto do entorno fisico e social da vizinhanca, que se apresentam como facilitadores ou barreiras, para a participacao social de adultos mais velhos brasileiros. METODOS O estudo foi conduzido em amostra probabilistica representativa da populacao brasileira, residente em areas urbanas, com 50 anos ou mais de idade (n = 7.935). A […]

Factors associated with inadequate work ability among women in the clothing industry

BACKGROUND Work ability depends on a balance between individual resources and work demands. OBJECTIVE This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry. METHOD We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry. RESULTS The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability. CONCLUSIONS Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.

La capacidad funcional de los ancianos: análisis de las preguntas sobre actividades de la vida diaria, utilizando la Teoría de Respuesta al Ítem

O objetivo deste estudo foi avaliar as questoes sobre capacidade funcional utilizadas no Inquerito de Saude da Regiao Metropolitana de Belo Horizonte, Minas Gerais, Brasil, realizado em 2010, utilizando a Teoria de Resposta ao Item. Foram analisados: dimensionalidade da escala, posicao dos itens na escala, poder de discriminacao dos itens e precisao da estimativa da capacidade funcional. O estudo teve como base uma amostra de 2.174 idosos, com idades entre 60 e 99 anos, 61% mulheres e escolaridade mediana de 4 anos de estudos. O instrumento de 21 itens com 4 opcoes de respostas forneceu coeficiente alfa de Cronbach de 0,98; a analise fatorial mostrou existir um fator explicando 92% da variabilidade entre as questoes. Os resultados indicaram: (i) redundância nas questoes; (ii) precisao na estimacao da capacidade funcional apenas para os idosos que estao abaixo da mediana na escala; e (iii) dificuldade dos idosos em discernir entre as opcoes de resposta. A analise sugere a necessidade de se discutir as questoes a serem incluidas no instrumento, com vistas a uma maior cobertura da escala e melhor adequacao das opcoes de respostas.

Funcionalidad y relaciones sociales de ancianos en el área metropolitana de Belo Horizonte, Minas Gerais, Brasil: un estudio de base poblacional

This study was conducted in a probabilistic sam- ple of 2,055 elderly in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil, to examine components of social network (conjugal status and visits by the children, other relatives, and friends) and social support (satisfaction with personal relations and having persons on whom to rely) associated with limitations in performing basic activities of daily living (ADL). Multivariate analysis used the Hurdle model. Performance of ADL showed independent and statistically significant associations with social network (fewer meetings with friends and not having children) and personal support (dissatisfaction/indifference towards personal relations). These associations remained after adjusting for social and demographic characteristics, health status, and other indicators of social relations. Our results emphasize the need for greater attention to social network and social support for elderly with functional limitations and those with weak social networks and social support.Este trabalho foi conduzido em uma amostra probabilistica de 2.055 idosos da Regiao Metropolitana de Belo Horizonte, Minas Gerais, Brasil, com o objetivo de examinar componentes da rede social (situacao conjugal, visita de filhos, outros parentes e amigos) e do apoio social (satisfacao com as relacoes pessoais e existencia de pessoas com quem contar) associados a limitacao para realizar atividades basicas da vida diaria(ABVDs). A analise multivariada foi baseada no modelo Hurdle. A performance na realizacao de ABVDs apresentou associacoes independentes e significantes com a rede social (menos encontros com amigos e nao possuir filhos) e o apoio social (insatisfacao/indiferenca com as relacoes pessoais). Essas associacoes persistiram apos ajustamentos por caracteristicas sociodemograficas, condicao de saude e outros indicadores das relacoes sociais. Nossos resultados reforcam a necessidade de maior atencao para a rede social e apoio social aos idosos com limitacoes funcionais, e para idosos com redes sociais e apoio social frageis.

Funcionalidade e relações sociais entre idosos da Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil: um estudo epidemiológico de base populacional

This study was conducted in a probabilistic sam- ple of 2,055 elderly in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil, to examine components of social network (conjugal status and visits by the children, other relatives, and friends) and social support (satisfaction with personal relations and having persons on whom to rely) associated with limitations in performing basic activities of daily living (ADL). Multivariate analysis used the Hurdle model. Performance of ADL showed independent and statistically significant associations with social network (fewer meetings with friends and not having children) and personal support (dissatisfaction/indifference towards personal relations). These associations remained after adjusting for social and demographic characteristics, health status, and other indicators of social relations. Our results emphasize the need for greater attention to social network and social support for elderly with functional limitations and those with weak social networks and social support.Este trabalho foi conduzido em uma amostra probabilistica de 2.055 idosos da Regiao Metropolitana de Belo Horizonte, Minas Gerais, Brasil, com o objetivo de examinar componentes da rede social (situacao conjugal, visita de filhos, outros parentes e amigos) e do apoio social (satisfacao com as relacoes pessoais e existencia de pessoas com quem contar) associados a limitacao para realizar atividades basicas da vida diaria(ABVDs). A analise multivariada foi baseada no modelo Hurdle. A performance na realizacao de ABVDs apresentou associacoes independentes e significantes com a rede social (menos encontros com amigos e nao possuir filhos) e o apoio social (insatisfacao/indiferenca com as relacoes pessoais). Essas associacoes persistiram apos ajustamentos por caracteristicas sociodemograficas, condicao de saude e outros indicadores das relacoes sociais. Nossos resultados reforcam a necessidade de maior atencao para a rede social e apoio social aos idosos com limitacoes funcionais, e para idosos com redes sociais e apoio social frageis.