Ronaldo Rocha Bastos

Prevalência de quedas e fatores associados em idosos

OBJECTIVE To estimate the prevalence of falls in elderly individuals and to analyze associated factors. METHODS Cross-sectional study with 420 elderly subjects (aged 60 years or older) living in the city of Juiz de Fora (Southeastern Brazil) in 2010. A household survey was conducted and the occurrence of falls in the 12 previous months was described. For the analysis of factors associated with the outcome, a theoretical determination model with three hierarchical blocks was built. The variables were adjusted among each other within each block; those with level of significance < 0.20 were included in the Poisson regression model and adjusted to the immediately higher level, with 5% significance level. RESULTS The prevalence of falls among the elderly was 32.1% (95%CI: 27.7; 36.9). Among those who experienced falls, 53% had a single fall and 19% had fractures as a consequence. Most of the falls (59%) occurred at the elderly persons home. The occurrence of falls was associated with old age, female sex, need of help for locomotion and self-reported diagnosis of osteoporosis. CONCLUSIONS Falls are frequent among the elderly. Knowledge of the factors associated with the occurrence of this event can aid the development of prevention strategies and adequate health services.OBJETIVO: Estimar la prevalencia de caidas en ancianos y analizar factores asociados. METODOS: Estudio transversal con 420 ancianos (60 anos o mas) residentes en Juiz de Fora, Sureste de Brasil, en 2010. Se realizo pesquisa domiciliaria y se describio la ocurrencia de caida en los ultimos 12 meses. Para analisis de los factores asociados al resultado, se construyo un modelo teorico de determinacion con tres bloques jerarquizados. Las variables fueron ajustadas entre si dentro de cada bloque; las que presentaron nivel de significancia < 0,20 fueron incluidas en el modelo de regresion de Poisson y ajustadas al nivel superior al de cada una, con el nivel de 5% de significancia. RESULTADOS: La prevalencia de caidas entre los ancianos fue de 32,1% (IC95% 27,7;36,9). Entre aquellos que sufrieron caida, 53% tuvieron una unica caida y 19% tuvieron fractura como consecuencia. La mayor parte de las caidas (59%) ocurrio en el domicilio del anciano. La ocurrencia de caidas se asocio con edad avanzada, sexo femenino, necesidad de auxilio para locomocion y diagnostico auto-referido de osteoporosis. CONCLUSIONES: Las caidas son frecuentes entre ancianos. El conocimiento de los factores asociados a la ocurrencia de este evento puede auxiliar en la elaboracion de estrategias de prevencion y servicios de salud adecuados.

Mental health conditions, individual and job characteristics and sleep disturbances among firefighters.

This study aimed to assess the associations between mental health conditions, individual and job characteristics and sleep disturbances among firefighters. Of 303 participants, 51.2% reported sleep disturbances. Psychological distress and psychosomatic disturbances were significantly associated with sleep disturbances. Suicidal ideation, unhealthy alcohol use and time as a firefighter were also associated with sleep disturbances but at a borderline level of significance (0.05 < p < .085). These findings may be related to the psychological and physical hazards of firefighting and indicate the importance of research on associated professions.

Insatisfação corporal em adolescentes brasileiros de municípios de pequeno porte de Minas Gerais

objective. To analyze the prevalence of body dissatisfaction and its correlations with age, sex and the nutritional status of teenagers. Methods : The sample consisted of high school students in cities with up to five thousand inhabitants in the state of Minas Gerais, Brazil. The Body Shape Questionnaire (BSQ) and the Escala Evaluacion de Insatisfacion Corporal para Adolescentes (EEICA) were instruments used to assess the adolescents’ body dissatisfaction. The age, sex, weight and height to calculate body mass index was also collected in schools. For statistical analyses the variance test and correspondence analysis were used. results: Out of 413 participants, 49.2% and 50.8% were in the intermediate and final phases of adolescence, respectively. Of this total, 178 were boys and 235 were girls and, most (71.9%) eutrophic. The BSQ score mean was 66.78 ± 29.63 and 26.4% had some level of body dissatisfaction; the EEICA average score for body dissatisfaction was 17.96 ± 11.7. The single and multiple correspondence analyses have shown that

Prevalence of falls and associated factors in elderly individuals

OBJECTIVE To estimate the prevalence of falls in elderly individuals and to analyze associated factors. METHODS Cross-sectional study with 420 elderly subjects (aged 60 years or older) living in the city of Juiz de Fora (Southeastern Brazil) in 2010. A household survey was conducted and the occurrence of falls in the 12 previous months was described. For the analysis of factors associated with the outcome, a theoretical determination model with three hierarchical blocks was built. The variables were adjusted among each other within each block; those with level of significance < 0.20 were included in the Poisson regression model and adjusted to the immediately higher level, with 5% significance level. RESULTS The prevalence of falls among the elderly was 32.1% (95%CI: 27.7; 36.9). Among those who experienced falls, 53% had a single fall and 19% had fractures as a consequence. Most of the falls (59%) occurred at the elderly persons home. The occurrence of falls was associated with old age, female sex, need of help for locomotion and self-reported diagnosis of osteoporosis. CONCLUSIONS Falls are frequent among the elderly. Knowledge of the factors associated with the occurrence of this event can aid the development of prevention strategies and adequate health services.OBJETIVO: Estimar la prevalencia de caidas en ancianos y analizar factores asociados. METODOS: Estudio transversal con 420 ancianos (60 anos o mas) residentes en Juiz de Fora, Sureste de Brasil, en 2010. Se realizo pesquisa domiciliaria y se describio la ocurrencia de caida en los ultimos 12 meses. Para analisis de los factores asociados al resultado, se construyo un modelo teorico de determinacion con tres bloques jerarquizados. Las variables fueron ajustadas entre si dentro de cada bloque; las que presentaron nivel de significancia < 0,20 fueron incluidas en el modelo de regresion de Poisson y ajustadas al nivel superior al de cada una, con el nivel de 5% de significancia. RESULTADOS: La prevalencia de caidas entre los ancianos fue de 32,1% (IC95% 27,7;36,9). Entre aquellos que sufrieron caida, 53% tuvieron una unica caida y 19% tuvieron fractura como consecuencia. La mayor parte de las caidas (59%) ocurrio en el domicilio del anciano. La ocurrencia de caidas se asocio con edad avanzada, sexo femenino, necesidad de auxilio para locomocion y diagnostico auto-referido de osteoporosis. CONCLUSIONES: Las caidas son frecuentes entre ancianos. El conocimiento de los factores asociados a la ocurrencia de este evento puede auxiliar en la elaboracion de estrategias de prevencion y servicios de salud adecuados.

Cervical cancer mortality trends in Minas Gerais State, Brazil, 1980-2005.

This study evaluated the cervical cancer mortality trend from 1980 to 2005 in the State of Minas Gerais, Brazil. The demographic and mortality data available on the website of the Statistics Department of the Unified National Health System (DATASUS) were used to estimate the mortality rate for uterine cervical cancer and unspecified uterine cancer for the State during the period. Linear regression was performed, with mortality rate as the response variable and year of diagnosis as the explanatory variable. Mortality varied from 9.18/100,000 in 1980 to 5.70/100,000 in 2005. The log-linear model showed a 1.93% annual reduction in mortality due to cervical cancer for the State during the study period (p = 0.000), and this drop was observed mainly in cases classified as unspecified uterine cancer. The downward mortality trend observed for this disease suggests improved access to timely and adequate diagnosis and treatment in Minas Gerais in recent years, although coverage of screening is still unsatisfactory.

Oportunidades do ambiente domiciliar para o desenvolvimento motor

OBJETIVO: Avaliar as oportunidades presentes no ambiente domiciliar para o desenvolvimento motor de lactentes. METODOS: Estudo epidemiologico de base populacional, transversal, realizado com 239 lactentes com idade entre tres e 18 meses, residentes no municipio de Juiz de Fora, MG, em 2010. Os participantes foram selecionados por amostragem aleatoria estratificada, conglomerada, em multiplos estagios. Para avaliar a qualidade e quantidade de estimulo motor no ambiente domiciliar foi utilizado o instrumento Affordance in the Home Environment for Motor Development - Infant Scale. Procedeu-se a analise bivariada com aplicacao do teste qui-quadrado, seguida de regressao logistica multinomial para verificar a associacao entre as oportunidades presentes no domicilio e fatores biologicos, comportamentais, demograficos e socioeconomicos. RESULTADOS: As oportunidades de estimulacao ambiental foram relativamente baixas. Na analise bivariada, para a faixa etaria de tres a nove meses, foi encontrada associacao com os fatores: ordem de nascimento (p = 0,06), classificacao socioeconomica (p = 0,08), renda mensal (p = 0,06) e renda per capita (p = 0,03). No modelo de regressao, prevaleceu a classificacao socioeconomica (RC = 7,46; p = 0,03). Para a faixa etaria de dez a 18 meses, os fatores associados, na analise bivariada, foram: estado civil materno (p < 0,01), convivio da crianca com o pai (p = 0,08), chefe da familia (p = 0,04), numero de pessoas no domicilio (p = 0,05), escolaridade materna (p < 0,01) e paterna (p < 0,01), classificacao socioeconomica (p < 0,01) e renda per capita (p = 0,03). No modelo de regressao, o estado civil materno (RC = 4,83; p = 0,02), escolaridade materna (RC = 0,29; p = 0,03) e paterna (RC = 0,33; p = 0,04) permaneceram associados as oportunidades de estimulacao ambiental. CONCLUSOES: A uniao estavel dos pais, maior escolaridade materna e paterna e maior nivel economico foram os fatores associados as melhores oportunidades de estimulacao motora no lar.

Parenting Styles and Alcohol Consumption Among Brazilian Adolescents

Aim: This study evaluates the correlation between alcohol consumption in adolescence and parenting styles of socialization among Brazilian adolescents. The sample was composed of 273 adolescents, 58% whom were males. Instruments were: 1) Sociodemographic Questionnaire; 2) Demand and Responsiveness Scales; 3) Drug Use Screening Inventory (DUSI). Study analyses employed multiple correspondence analysis and logistic regression. Results: Maternal, but not paternal, authoritative and authoritarian parenting styles were directly related to adolescent alcohol intake. Conclusions: The style that mothers use to interact with their children may influence uptake of high-risk behaviors.

Oportunidades perdidas de imunização antitetânica de gestantes de Juiz de Fora, Minas Gerais, Brasil

OBJECTIVE To estimate the missed opportunities for tetanus vaccination and to determine the immunization coverage at the end of pregnancy in women living in the city of Juiz de Fora, which is in the state of Minas Gerais, Brazil. METHODS A cross-sectional study was carried out of 430 women who were randomly selected from all the maternity hospitals in the city, from February through August 1996. The women were interviewed regarding prenatal care, their knowledge of tetanus, and tetanus immunization before or during the latest pregnancy. RESULTS The age of the participants ranged from 14 to 45 years (mean = 26.4 +/- 6.9 years); 420 women lived in urban areas and 10 in rural areas. Prenatal care was from the Brazilian public Unified Health System in 69.5% of the women (299 of 430); 27.6% (119) received prenatal care through other types of providers; and 2.8% (12) did not receive prenatal care. Of the 430 participants, 352 of them (81.8%) had their prenatal care card with them during the interview; 85.6% (368) had four or more prenatal care visits. Regarding their knowledge of tetanus, 92.1% (396) knew about the disease and its severity. Out of the 430 women, 359 of them (83.5%) started the latest pregnancy without having had a tetanus vaccination; 104 were vaccinated during the latest pregnancy, so 255 had not been vaccinated by the time of delivery. This was in spite of the significant increase in the opportunities for being vaccinated with an increase in the number of prenatal visits. The odds ratio for pregnant women with four or more prenatal visits being vaccinated by the end of the pregnancy was 2.7 times that of the women with zero to three visits. Seventy percent of the opportunities for tetanus immunization were missed in the study population. The overall tetanus immunization coverage was 40.6% by the end of pregnancy. CONCLUSIONS The low immunization coverage was below the level recommended by the World Health Organization. In combination with the high rate of missed opportunities for vaccination, this points to the need to implement a tetanus vaccination promotion strategy directed at health professionals in general but especially at those who provide care for pregnant women, in both public and private health clinics. In addition, the vaccination practices in Juiz de Fora should be strengthened.

Screening and brief intervention for alcohol and other drug use in primary care: associations between organizational climate and practice

BackgroundNumerous studies have demonstrated that positive organizational climates contribute to better work performance. Screening and brief intervention (SBI) for alcohol, tobacco, and other drug use has the potential to reach a broad population of hazardous drug users but has not yet been widely adopted in Brazil’s health care system. We surveyed 149 primary health care professionals in 30 clinics in Brazil who were trained to conduct SBI among their patients. We prospectively measured how often they delivered SBI to evaluate the association between organizational climate and adoption/performance of SBI.MethodsOrganizational climate was measured by the 2009 Organizational Climate Scale for Health Organizations, a scale validated in Brazil that assesses leadership, professional development, team spirit, relationship with the community, safety, strategy, and remuneration. Performance of SBI was measured prospectively by weekly assessments during the three months following training. We also assessed self-reported SBI and self-efficacy for performing SBI at three months post-training. We used inferential statistics to depict and test for the significance of associations.ResultsTeams with better organizational climates implemented SBI more frequently. Organizational climate factors most closely associated with SBI implementation included professional development and relationship with the community. The dimensions of leadership and remuneration were also significantly associated with SBI.ConclusionsOrganizational climate may influence implementation of SBI and ultimately may affect the ability of organizations to identify and address drug use.

Leitura contextual e processamento metalingüístico no português do Brasil: um estudo longitudinal

Metalinguistic skill is the ability to reflect upon language as an object of thought. Amongst metalinguistic skills, two seem to be associated with reading and spelling: morphological awareness and phonological awareness. Phonological awareness is the ability of reflecting upon the phonemes that compose words, and morphological awareness is the ability of reflecting upon the morphemes that compose the words. The latter seems to be particularly important for reading comprehension and contextual reading, as beyond phonological information, syntactic and semantic information are required. This study is set to investigate - with a longitudinal design - the relation between those abilities and contextual reading measured by the Cloze test. The first part of the study explores the relationship between morphological awareness tasks and Cloze scores through simple correlations and, in the second part, the specificity of such relationship was inquired using multiple regressions. The results give some support to the hypothesis that morphological awareness offers an independent contribution regarding phonological awareness to contextual reading in Brazilian Portuguese.