Tereza Etsuko da Costa Rosa

Perfil do idoso em área metropolitana na regiäo sudeste do Brasil: resultados de inquérito domiciliar

A multicentre study concerned with the health needs of the elderly population living in urban areas and coordinated by the Panamerican Health Organization was undertaken in 6 Latin-American countries. In Brazil, 1,602 elderly residents (of 60 years of age and over) in the District of S. Paulo, constituting a multistage random sample stratified by socioeconomic status, participated in a household survey using a multidemensional functional assessment questionnaire. The results showed a highly deprived population (70% had a per capita income of less than US

Significance and management of disability among urban elderly residents in Brazil.

100 per month), living mostly in multigenerational households (59% were living with children and/or grandchildren), with a high prevalence of chronic physical illnesses (only 14% referred no illness) and psychiatric disorders (27% were considered psychiatric cases), a high proportion of them showing a loss of autonomy (47% needed help in performing at least one of the activities of daily living). The results are put into perspective concerning future needs in terms of specialized health services and social support for the growing population of elderly people in Brazil.Trata-se de estudo multicentrico visando levantar as necessidades de saude da populacao de idosos residentes em zona urbana, conduzido em 6 paises na America Latina e coordenado pela Organizacao Panamericana da Saude. No Brasil, 1.602 idosos (60 anos e +) residentes no Distrito de Sao Paulo, participaram de inquerito domiciliar com questionario de avaliacao funcional multidimensional - amostra populacional aleatoria, em multiplos estagios, estratificada por nivel socioeconomico. Os resultados mostraram uma populacao bastante carente (70% tinha uma renda per capita de menos de 100 dolares por mes), vivendo predominantemente em domicilios multigeracionais (59% viviam com os filhos e/ou com netos), com alta prevalencia de doencas cronicas (somente 14% referiu nao ter nenhuma doenca) e disturbios psiquiatricos (27% foram considerados casos psiquiatricos), e com uma elevada proporcao de pessoas com perda de autonomia (47% precisavam de ajuda para realizar pelo menos uma das atividades da vida diaria). Os resultados sao analisados tendo em vista as demandas futuras por servicos de saude especializados e suporte social por parte da crescente populacao de idosos no Brasil.

Fatores associados à interrupção do aleitamento materno exclusivo de lactentes nascidos com baixo peso assistidos na atenção básica.

Brazils population is aging very rapidly, and the care for the elderly is an emerging priority. The results of a multidimensional functional assessment of elderly residents in Sao Paulo showed extreme poverty and massive cohabitation in multigenerational households. The health profile showed a high prevalence of chronic illnesses, mental disorders, and disability. Using a Guttman scale, a set of activities of daily living was validated as an indicator of dependency. Attention was given to the dependency associated factors, and in particular to the association between chronic illness and loss of independence among the aged. Fortunately, for the existing health care system in Brazil, cultural values are still keeping the family in the front line of caregiving, but this situation is not likely to withstand the increasing burden of a growing elderly population with an ever higher rate of disability.

Segurança alimentar em domicílios chefiados por idosos, Brasil

This study aimed to identify factors associated with interruption of exclusive breastfeeding (EBF) in low birth weight infants receiving primary care. This was a cross-sectional study of 170 infants treated at primary care units on the urban periphery of Sao Paulo, Brazil. The sample included infants with birth weight ≤ 2,500g (including twins) and 5-minute Apgar ≥ 7, followed until the third month of life, and excluded infants/mothers with complications that would impede EBF, besides infant/maternal deaths. Data were collected from forms completed during consultations and patient records. Prevalence ratios were obtained by Poisson regression. The following factors were associated with interruption of EBF in the first three months of life: maternal age ≤ 18 years; informal employment (protective factor); alcohol intake during pregnancy; < 6 prenatal visits; multiple gestations; birth weight ≤ 2,000g; difficulty breastfeeding in the first month; complaints in breastfeeding during the first month; and use of pacifiers in the first two months. Prior knowledge of these factors can help plan measures and policies to increase EBF rates among low birth weight infants.

Atenção integral à hipertensão arterial e diabetes mellitus: implementação da Linha de Cuidado em uma Região de Saúde do estado de São Paulo, Brasil

Food security in households headed by elderly people has special dimension as for health and welfare, since it is clearly important to ensure that they go on contributing to society in an active and productive way. OBJECTIVE: To determine the prevalence of food insecurity in households whose heads are older, according to socio-demographic characteristics. METHODS: It is a descriptive study with households whose heads have 60 years of age or over declared, selected from the National Sample Household Survey - PNAD 2004. We applied the Brazilian Food Insecurity Scale, ranking the households into food security and food insecurity, moderate and severe. Descriptive analysis of data included the frequency distribution of households according to levels of food insecurity in the strata of socio-demographic variables, taking into account the design effect. RESULTS: The study showed that 29.8% of households were in the condition of food insecurity and that this condition was significantly associated with less affluent regions (north / northeast, rural), with the most vulnerable population segments (the poorest and least educated) and also with characteristics of gender (women) and race (Indian, mulatto and black) which is known to occupy the lower levels of social hierarchy. CONCLUSION: The distribution of food insecurity in households headed by elderly people, following a similar trend of Brazilian households, confirms the higher prevalence of this condition in socioeconomic disadvantaged population or characteristics associated with poverty.

Fatores determinantes da capacidade funcional entre idosos

Objetivou-se avaliar a implementacao da Linha de Cuidado (LC) em hipertensao arterial e diabetes mellitus em uma Regiao de Saude do estado de Sao Paulo. Trata-se de uma pesquisa avaliativa desenvolvida em tres etapas: caracterizacao das regioes para selecao da regiao-caso; entrevistas com gestores e profissionais de saude que atuam na Atencao Basica, Media e Alta Complexidade e entrevistas com pacientes em Ambulatorios Medicos de Especialidades. A analise baseou-se em um modelo logico que considera a influencia da macro e micropolitica na construcao da LC. De modo geral, insuficiencias foram identificadas nas dimensoes da macropolitica (organizacao da rede de servicos e utilizacao de protocolos) e micropolitica (coordenacao do cuidado pela AB, vinculacao e responsabilizacao do cuidador). Conclui-se que, apesar dos avancos alcancados, grandes desafios se impoem para o alcance da integralidade da atencao a hipertensao arterial e diabetes mellitus, sendo necessarios investimentos nos processos da macro e micropolitica.