The Associations Between Physician-Patient Communication and Adjustment Outcomes of Patients and Physicians: A Systematic Review and Meta-Analysis of Correlations.

Physician-Patient communication (PPC) has been linked to patient adjustment outcomes. However, conflicting results have been reported and previous systematic reviews showed some methodological weaknesses. It has also been suggested that PPC is related to physicians' own adjustment outcomes. This systematic review aims to explore and synthesize the associations between PPC and both patient and physician adjustment outcomes. A systematic search was conducted primarily in five databases and 11.488 non-duplicated articles were identified. Forty-five studies met the eligibility criteria and data extraction was performed for sample characteristics, PPC measurement, adjustment outcomes under examination and main outcomes. The observed results showed that the majority of the included studies were cross-sectional, assessed PPC by proxy-report and reported an overall positive association with patients' adjustment outcomes. None of the studies examined the association between PPC and physicians' adjustment outcomes. Thirty-three studies were meta-analyzed and showed a positive and significant association between PPC and patients' adjustment outcomes (r = .16). Due to the small number of studies included in the meta-analysis, the heterogeneity was high. Subgroup analysis could not identify sources for heterogeneity. Research on the associations between PPC and physicians' own adjustment outcomes is warranted. Future studies should be rigorous in defining clear PPC definitions, directionality of communication processes, and study design.

Steps toward understanding the impact of early emotional experiences on disordered eating: The role of self-criticism, shame, and body image shame.

In research, it has been suggested that early threatening emotional experiences, characterized by abuse, rejection, neglect or absence of affiliative signals may activate maladaptive defensive responses. Further, several studies have emphasised the association between the recall of early emotional experiences and eating psychopathology. However, this relationship does not seem to be direct. Thus, the current study explored the mediator roles of self-criticism and shame (general and body image-focused shame) in the link between early emotional experiences and the engagement in disordered eating, while controlling for the effect of body mass index. The sample of this study included 552 female participants, aged between 18 and 40 years old. The path analysis indicated that the absence of early positive emotional experiences was associated with disordered eating behaviours, through an increased perception of being negatively perceived as inferior or unattractive by others, self-critical attitudes, and body image-focused shame. The tested model accounted for 63% of body image shame and for 67% of disordered eating's variance, and showed an excellent model fit. These findings suggest that shame and self-criticism are defensive mechanisms associated with early threatening emotional experiences, which may trigger disordered eating behaviours. These data appear to offer important research and clinical implications supporting the development of intervention community programs for body and eating difficulties, that specifically target shame (general and body image-focused shame) and self-criticism, through the development of more adaptive emotional regulation strategies.

Blended Psychological Interventions for Emotional Disorders in Youth: Acceptability and Intention to Use in a Sample of Portuguese Psychologists.

INTRODUCTION: The rise of mental health problems in youth highlights the need for accessible and cost-effective psychological interventions. Blended interventions, which combine face-to-face and online sessions, can be an adequate response to the increase in demands for youth mental health services. Although this can be a promising approach, effective dissemination depends on the professionals´ acceptance. OBJECTIVES: This study aimed to explore the acceptability of and intention to use blended interventions by psychologists working with children with emotional disorders and to examine their predictors, including previous knowledge, expectancies (i.e., performance expectancy, effort expectancy, social influence, and facilitating conditions), and attitudes toward evidence-based practices. METHODS: The sample consisted of 76 Portuguese psychologists (Mage = 37.26 years, SD = 10.47; 92.1% female) working in youth mental health services. The participants completed an online protocol to evaluate the different dimensions included in the study. RESULTS: The results showed that most participants demonstrated moderate to high acceptability of blended psychological interventions for emotional disorders in youth and intend to use them in the future. Regression analysis showed that performance expectancy and positive attitudes toward evidence-based practices were significant predictors of acceptance of blended interventions and that social influence was a significant predictor of both acceptance of and intention to use blended interventions. CONCLUSION: These results emphasize the importance of sharing the findings of blended interventions, changing professionals' attitudes toward evidencebased practices, and collaborating more closely with organizations and institutions to advance standards that encourage the adoption of this intervention format.

The Factorial Structure, Psychometric Properties and Sensitivity to Change of the Distress Tolerance Scale for Children with Emotional Disorders.

BACKGROUND: The Distress Tolerance Scale (DTS) was adapted for American and Chinese youth, but never for European youth. Moreover, the factor structures found in these previous studies were not consistent. METHODS: The DTS was adapted for Portuguese children and then validated among 153 children aged 6-13 years with emotional disorders. A confirmatory factor analysis (CFA) was conducted; the DTS reliability and validity were analyzed, and sex and age differences were explored. A sub-sample of children who received a transdiagnostic CBT (Unified Protocol for Children) was used to analyze the DTS's sensitivity to therapeutic change. RESULTS: The five tested models (based on previous studies) exhibited adequate fit in the CFA. However, the model previously reported for use in American children with emotional disorders was selected as the most appropriate. The DTS demonstrated adequate psychometric properties, and its validity was established through significant negative associations with measures of anxiety, depression and negative affect, as well as positive associations with positive affect. Age and sex differences were discussed. The DTS scores significantly increased from pre- to post-treatment, demonstrating sensitivity to therapeutic change. CONCLUSIONS: The DTS is a suitable and useful measure for assessing children's distress tolerance and to assess the efficacy of CBT.

Edible insects: Understanding benzo(a)pyrene toxicokinetics in yellow mealworms for safe and sustainable consumption.

The global interest in edible insects as sustainable protein sources raises concerns about the bioaccumulation of contaminants, including polycyclic aromatic hydrocarbons (PAHs), to problematic levels. Understanding the accumulation dynamics of PAHs in edible insects is highly relevant due to the widespread sources and toxicological profiles; however, the bioaccumulative potential of PAHs in edible insects is unexplored. This study examined the uptake and elimination dynamics of benzo(a)pyrene (B(a)P), a representative and carcinogenic PAH, in yellow mealworm larvae (YMW, Tenebrio molitor). Larvae were exposed to feeding substrate with varying B(a)P concentrations (0.03, 0.3, and 3 mg kg-1), and uptake (21 days in B(a)P-contaminated substrate) and elimination (21 days in B(a)P-free substrate) kinetics were subsequently assessed. The results showed that YMW can eliminate B(a)P, revealing dose-dependent B(a)P bioaccumulation in these insects. Larvae fed on a substrate with 0.03 mg kg-1 accumulated B(a)P over 21 days, presenting values of 0.049 (Standard deviation - 0.011) mg kg-1 and a kinetic-based (BAFkinetic) of 1.93 g substrate g organism-1, exceeding the EU regulatory limits for food. However, with a B(a)P half-life (DT50) of 4.19 days in the larvae, an EU legislation safety criterion was met after a 13-day depuration period in clean substrate. Larvae exposed to substrates with 0.3 and 3 mg kg-1 showed B(a)P accumulation, with BAFkinetic values of 3.27 and 2.09 g substrate g organism-1, respectively, not meeting the current legal standards for food consumption at the end of the exposure to B(a)P. Although the B(a)P half-life values after 35 days were 4.30 and 10.22 days (DT50s), the larvae retained B(a)P levels exceeding permitted food safety limits. These findings highlight a significant oversight in regulating PAHs in animal feed and the need for comprehensive safety evaluations of PAH hazards in edible insects for improved PAH feeding guidelines.

Study protocol for a randomized controlled trial testing the efficacy of Emotion Detectives In-Out: a blended version of the unified protocol for transdiagnostic treatment of emotional disorders in Portuguese children.

BACKGROUND: Childhood emotional disorders (EDs; i.e., anxiety and depressive disorders) are currently a public health concern. Their high prevalence, long-term effects, and profound influence on the lives of children and families highlight the need to identify and treat these disorders as early and effectively as possible. This clinical trial will examine the efficacy of a blended version (i.e., combining face-to-face and online sessions into one treatment protocol) of the Unified Protocol for Children (the "Emotion Detectives In-Out" program). This program is a manualized cognitive-behavioral therapy for the transdiagnostic treatment of EDs in children aged 7 to 12 years that aims to reduce the intensity and frequency of strong and aversive emotional experiences by helping children learn how to confront those emotions and respond to them in more adaptive ways. METHODS: This study is designed as a multicenter equivalence randomized controlled parallel-group two-arm trial comparing the Emotion Detectives In-Out program with an evidenced-based group intervention for children with anxiety disorders (the Coping Cat program). Participants will be children aged between 7 and 12 years with an anxiety disorder or with clinically significant anxiety symptoms as well as one of their parents or a legal representative. A minimum sample size of 138 children (69 per group) is needed to test whether the efficacy of the proposed intervention is equivalent to that of the well-established Coping Cat intervention. DISCUSSION: We expect Emotion Detectives In-Out to be a feasible and efficacious alternative intervention for treating children's EDs by allowing for a greater increase in children's access to care. A blended format is expected to overcome common barriers to treatment (e.g., parents´ lack of time to attend regular sessions) and make the intervention more accessible to families. TRIAL REGISTRATION: The clinical trial is registered at ClinicalTrials.gov (Identifier: NCT05747131, date assigned February 28, 2023).

Parenting During the COVID-19 Pandemic in Portugal: The Mediating Role of Work-Family Guilt in the Relationship Between Self-Compassion and Mindful Parenting in a Sample of Working Mothers.

Objectives: The current study explored the mediating role of work interference on family guilt (WIFG) and family interference on work guilt (FIWG) in association with parents' self-compassion and mindful parenting during the COVID-19 pandemic, while controlling for the effects of educational level and marital status. Method: In May 2020, a sample of 398 mothers (26-50 years) participated in the study and completed an online survey that included a sociodemographic form and measures of self-compassion, work-family guilt, and mindful parenting. A parallel multiple mediation model was tested to explore the indirect effect of parents' self-compassion on mindful parenting through WIFG and FIWG. Independent samples t-tests were performed to compare study variables by mothers' working conditions during the pandemic. Results: The mediation analysis indicated that parents' higher levels of self-compassion were indirectly associated with higher levels of mindful parenting through lower levels of WIFG/FIWG. Comparison analyses indicated that mothers who were working in their workplace during the pandemic reported higher levels of WIFG than those working from home; conversely, mothers who were working from home reported higher levels of FIWG than those working in their workplace. Conclusions: These data highlight the importance of research in this field and support the development of intervention community programs for promoting mindful parenting, by developing more adaptive emotional regulation strategies such as self-compassion, which specifically target parents who experience higher levels of guilt associated with work and family conflict. Preregistration: This study is not pre-registered.

Parents' acceptability of blended psychological interventions for children with emotional disorders.

Objectives: This study aims to (1) describe parents' knowledge and use of online resources to address children's mental health issues and the family's general internet and technology usage patterns; (2) examine parents' acceptance of blended interventions for children with emotional disorders (ED); and (3) analyse the predictors of parents' intention to use a blended intervention if their children experienced an ED. Method: The sample included 164 Portuguese parents (95.7 % mothers) of children between the ages of 6 and 13 years who completed an online survey. The study was disseminated through social networks, personal contacts of the researchers, and among parents participating in a randomized controlled trial investigating the efficacy of a psychological intervention for children with ED. Results: Only 4.3 % of parents knew about online psychological interventions for children, and only 1.2 % had used them before. Most parents (73.2 %) reported that they would choose face-to-face individual therapy as their first option if their child had any ED, followed by blended therapy (14.8 %). Regression analyses showed that higher levels of parents' intention to use a blended intervention were predicted by their perceptions of the utility or efficacy of this type of delivery format. Discussion/conclusion: These results suggest that although most parents show unfamiliarity with blended psychological interventions for children, they consider it a treatment modality to which they would resort if their children had emotional difficulties. Their intention to use such an intervention seems to be more likely if they perceive it as useful and effective.

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) in Portugal: Feasibility Study Results.

The Unified Protocol for Children (UP-C) is a transdiagnostic Cognitive-Behavioral Therapy group intervention for children and caregivers targeting the treatment of children's emotional disorders (EDs). The present study aims to assess the feasibility and acceptability of the UP-C in the Portuguese population using a single-armed design. The participants were 32 children (6-12 years of age) with an ED (anxiety and/or depressive disorder) as a main diagnosis and their parents. All participants received the UP-C intervention and were assessed at pretreatment, midtreatment, posttreatment, and 3 months posttreatment. Children, parents, the clinicians, and an external observer completed questionnaires to assess the feasibility and acceptability of the UP-C (e.g., satisfaction, motivation, and adherence). Children and parents also completed self-report measures assessing the children's anxiety and depression and its interference and severity. The results of the present study support the feasibility and acceptability of the UP-C in Portugal; low dropout rates, high adherence rates, and high levels of child and parent satisfaction and motivation were observed. Moreover, significant reductions over time in children's levels of anxiety and/or depression and of its interference and severity were found and were maintained after 3 months of follow-up. These results are promising and warrant a subsequent randomized controlled trial (RCT).

Antiproliferative and toxicological properties of methanolic extract obtained from Solanum capsicoides All. seeds and carpesterol.

Natural products are considered important sources of potential chemotherapeutic agents. Here, we evaluated the antiproliferative activity and the toxicological effects of the methanolic extract and a pure compound obtained from Solanum capsicoides seeds. The phytochemical profile was analyzed by chromatographic and spectroscopy methods. The acute toxicity was assessed in mice orally treated with the extract (2000 mg/kg), in vitro hemolytic activity and micronucleus test. The mutagenicity, developmental toxicity, and lethal dose (LD50) of carpesterol were estimated by the Toxicity Estimation Software Tool (TEST) software. A sulforhodamine B assay was employed to evaluate the antiproliferative activity. The toxicological assays did not observe signs of toxicity, either during the behavioral observations or in the autopsies, as well as no mutagenicity and hemolytic activity. The carpesterol did not present mutagenic effect and hemolytic activity but presents developmental toxicology and LD50 of 410 mg/kg in toxicity estimations by the TEST software. The S. capsicoides extract exhibited antiproliferative activity mainly in leukemia (K562) cell lineage. However, carpesterol presented antiproliferative activity in glioma (U251), breast (MCF-7), kidney (786-0), ovary (OVCAR-03), and K562 cell lineages. The data obtained show that S. capsicoides extract presents antiproliferative and does not present toxicological effects. In addition, it was shown for the first time the antiproliferative and toxicological parameters of carpesterol.

Probing the aurone scaffold against Plasmodium falciparum: design, synthesis and antimalarial activity.

A library comprising 44 diversely substituted aurones derivatives was synthesized by straightforward aldol condensation reactions of benzofuranones and the appropriately substituted benzaldehydes. Microwave enhanced synthesis using palladium catalyzed protocols was introduced as a powerful strategy for extending the chemical space around the aurone scaffold. Additionally, Mannich-base derivatives, containing a 7-aminomethyl-6-hydroxy substitution pattern at ring A, were also prepared. Screening against the chloroquine resistant Plasmodium falciparum W2 strain identified novel aurones with IC50 values in the low micromolar range. The most potent compounds contained a basic moiety, with the ability to accumulate in acidic digestive vacuole of the malaria parasite. However, none of those aurones revealed significant activity against hemozoin formation and falcipain-2, two validated targets expressed during the blood stage of P. falciparum infection and functional in digestive vacuole of the parasite. Overall, this study highlight (i) the usefulness of aurones as platforms for synthetic procedures using palladium catalyzed protocols to rapidly deliver lead compounds for further optimization and (ii) the potential of novel aurone derivatives as promising antimalarial compounds.

The hemozoin conundrum: is malaria pigment immune-activating, inhibiting, or simply a bystander?

In malaria, hemozoin (Hz) is released during erythrocyte rupture, and subsequent phagocytosis appears to cause important immune-modulatory effects. Hz obtained from Plasmodium falciparum cultures or synthesized from heme is used to study this modulation in vitro. Immune-activating and suppressive effects have been reported, and these discrepant results are often attributed to the different types of Hz that were used. However, it remains unclear which type of Hz accurately reproduces what happens in vivo. Importantly, Hz remains in the body for long periods and appears to be actively redistributed. Thus, phagocytosis of Hz in the body is not static but probably happens more than once, and the characteristics of Hz may change over time, eventually causing different immune-modulatory effects.

Structural optimization of quinolon-4(1H)-imines as dual-stage antimalarials: toward increased potency and metabolic stability.

Discovery of novel effective and safe antimalarials has been traditionally focused on targeting erythrocytic parasite stages that cause clinical symptoms. However, elimination of malaria parasites from the human population will be facilitated by intervention at different life-cycle stages of the parasite, including the obligatory developmental phase in the liver, which precedes the erythrocytic stage. We have previously reported that N-Mannich-based quinolon-4(1H)-imines are potent antiplasmodial agents but present several stability liabilities. We now report our efforts to optimize quinolon-4(1H)-imines as dual-stage antiplasmodial agents endowed with chemical and metabolic stability. We report compounds active against both the erythrocytic and exoerythrocytic forms of malaria parasites, such as the quinolon-4(1H)-imine 5p (IC50 values of 54 and 710 nM against the erythrocytic and exoerythrocytic forms), which constitute excellent starting points for further lead optimization as dual-stage antimalarials.

A novel way to grow hemozoin-like crystals in vitro and its use to screen for hemozoin inhibiting antimalarial compounds.

BACKGROUND: Hemozoin crystals are normally formed in vivo by Plasmodium parasites to detoxify free heme released after hemoglobin digestion during its intraerythrocytic stage. Inhibition of hemozoin formation by various drugs results in free heme concentration toxic for the parasites. As a consequence, in vitro assays have been developed to screen and select candidate antimalarial drugs based on their capacity to inhibit hemozoin formation. In this report we describe new ways to form hemozoin-like crystals that were incidentally discovered during research in the field of prion inactivation. METHODS: We investigated the use of a new assay based on naturally occurring "self-replicating" particles and previously described as presenting resistance to decontamination comparable to prions. The nature of these particles was determined using electron microscopy, Maldi-Tof analysis and X-ray diffraction. They were compared to synthetic hemozoin and to hemozoin obtained from Plasmodium falciparum. We then used the assay to evaluate the capacity of various antimalarial and anti-prion compounds to inhibit "self-replication" (crystallisation) of these particles. RESULTS: We identified these particles as being similar to ferriprotoporphyrin IX crystal and confirmed the ability of these particles to serve as nuclei for growth of new hemozoin-like crystals (HLC). HLC are morphologically similar to natural and synthetic hemozoin. Growth of HLC in a simple assay format confirmed inhibition by quinolines antimalarials at potencies described in the literature. Interestingly, artemisinins and tetracyclines also seemed to inhibit HLC growth. CONCLUSIONS: The described HLC assay is simple and easy to perform and may have the potential to be used as an additional tool to screen antimalarial drugs for their hemozoin inhibiting activity. As already described by others, drugs that inhibit hemozoin crystal formation have also the potential to inhibit misfolded proteins assemblies formation.

[Information on seniors' morbidity upon internments on the Brazilian Unified Health System]. / Informações sobre a morbidade hospitalar em idosos nas internações do Sistema Único de Saúde do Brasil.

Considering the high hospital costs of the elderly, this study aimed to compare the seven highest frequencies of morbidity in the elderly using data from Hospital Information System. The methodology used was the evaluation of information obtained in the database Datasus/Ministry of Health on the morbidity of hospital admissions in the elderly, in 2005 and 1994. Additionally, it was performed the calculation of standard and adjusted rates by the direct standardization method using Epidat 3.1. The main results were the diseases of the circulatory system remained prevalent in 2005 (28%) and 1994 (32%), with a reduction of 4% between these years. The number of cases of neoplasms doubled from 1994 (4%) to 2005 (8%), and infectious and parasitic diseases were basically maintaining the same percentage of 7% in 1994 and 2005. It can be concluded that in Brazil, the hospital morbidity in elderly remains the prevalence of cardiovascular diseases. At the same time, there is a reduction of non-infectious and parasitic diseases, and also signs of recent and sharp increase of neoplasms. It is recommended the use of comparison studies between periods become as a tool used in management.

Programa de educação em reanimação cardiorrespiratória: ensinando a salvar vidas / Cardiopulmonary resuscitation education program: teaching people how to save lives

Parada cardiorrespiratória é a principal causa de morte no mundo. Observa-se falta de capacitação adequada da população para agir de forma eficaz diante dessa situação e, assim, aumentar as chances de sobrevivência das vítimas. Tendo em vista esse fato, foi criado, em 1996, o Programa de Educação em Reanimação Cardiorrespiratória (Perc), que tem como objetivo difundir conhecimentos acerca da reanimação cardiorrespiratória mediante a capacitação de leigos, acadêmicos e profissionais de saúde no Estado do Ceará. Ao longo de 16 anos, aproximadamente 8 mil pessoas foram capacitadas diretamente pelo Perc. Entretanto, é difícil mensurar o benefício total pela difusão em cadeia do conhecimento pessoa a pessoa. Graças à experiência adquirida pelo Perc em reanimação, confirmamos a deficiência do tema no Ceará para os mais diversos públicos. Contudo, seguindo as diretrizes lançadas pela American Heart Association (AHA) a cada cinco anos, o projeto vem conseguindo conscientizar leigos, acadêmicos e profissionais da saúde sobre a importância da reanimação e capacitá-los para agir satisfatoriamente diante de uma vítima de PCR.

Cardiac arrest is the biggest cause of death in the world. There is a lack of adequate training of the public in how to act effectively in these situations and thus increase the victim's chances of survival. Therefore, the Cardiopulmonary Resuscitation Education Program (PERC) was created in 1996 with the principal aim of promoting knowledge about CPR by training laymen, health students and professionals in the Brazilian state of Ceará. Over the course of sixteen years, roughly 8,000 people have been trained directly by the PERC. However, it is hard to gauge the full extent of the benefits of this program due to the unlimited, chain diffusion of knowledge from person to person. Thanks to the experience acquired by PERC in CPR, it has been possible to confirm the level ignorance about the issue among the Ceará public. However, following the American Heart Association (AHA) guidelines released every five years, the program is raising awareness about the importance of resuscitation, training people to act satisfactorily when faced with a cardiac arrest situation.

Informações sobre a morbidade hospitalar em idosos nas internações do Sistema Único de Saúde do Brasil / Information on seniors' morbidity upon internments on the Brazilian Unified Health System

Considering the high hospital costs of the elderly, this study aimed to compare the seven highest frequencies of morbidity in the elderly using data from Hospital Information System. The methodology used was the evaluation of information obtained in the database Datasus/Ministry of Health on the morbidity of hospital admissions in the elderly, in 2005 and 1994. Additionally, it was performed the calculation of standard and adjusted rates by the direct standardization method using Epidat 3.1. The main results were the diseases of the circulatory system remained prevalent in 2005 (28 percent) and 1994 (32 percent), with a reduction of 4 percent between these years. The number of cases of neoplasms doubled from 1994 (4 percent) to 2005 (8 percent), and infectious and parasitic diseases were basically maintaining the same percentage of 7 percent in 1994 and 2005. It can be concluded that in Brazil, the hospital morbidity in elderly remains the prevalence of cardiovascular diseases. At the same time, there is a reduction of non-infectious and parasitic diseases, and also signs of recent and sharp increase of neoplasms. It is recommended the use of comparison studies between periods become as a tool used in management.

Tendo em vista os altos custos hospitalares dos idosos, o presente estudo teve como objetivo comparar as sete maiores frequências de morbidade hospitalar em idosos no ano de 2005 com o ano de 1994, através dos dados do Sistema de Informações Hospitalares (SIH/MS). Metodologia: estudo de avaliação das informações obtidas na base de dados do Datasus, do Ministério da Saúde, sobre a morbidade hospitalar das internações em idosos, nos anos de 2005 e de 1994. Adicionalmente, procedeu-se ao cálculo das taxas padrão e ajustadas, pelo método direto de padronização com o uso do programa Epidat 3.1. Principais resultados: as doenças do aparelho circulatório se mantiveram predominantes em 2005 (28 por cento) e em 1994 (32 por cento), com uma redução de 4 por cento entre estes anos; houve o aumento em dobro das neoplasias de 1994 (4 por cento) para 2005 (8 por cento), e as doenças infecciosas e parasitárias apresentaram a manutenção basicamente do mesmo percentual de 7 por cento, em 1994 e em 2005. Pode-se concluir que, no Brasil, a morbidade hospitalar em idosos mantém o predomínio das doenças do aparelho circulatório, ao mesmo tempo que se observa a não redução das doenças infecciosas e parasitárias; e ainda sinaliza-se o aumento recente e acentuado das neoplasias. Recomenda-se que os estudos de comparações entre períodos sejam umas das ferramentas de uso na gestão.

Equilíbrio funcional e orientado em idosos institucionalizados / Functional and oriented balance in institutionalized elderly

Introdução: Desequilíbrio afeta a qualidade de vida de idosos. Objetivo: verificar a ocorrência para quedas em idosos asilares de Sergipe. Método: Utilizou-se o Teste de Equilíbrio Orientado pelo Desempenho e Escala de Equilíbrio de Berg. Resultados: 56,1% da amostra apresentou risco de quedas na Escala de Equilíbrio de Berg com associação significante com idade e tendência para o gênero feminino. No Teste do Equilíbrio Orientado pelo Desempenho, 27,5% estiveram alterados. Constatou-se a associação entre risco de quedas nos dois testes. Conclusão: Ocorreu associação significante para risco de queda em idosos institucionalizados, principalmente nos de gênero feminino e nos mais velhos.

Introduction: Balance disorder affects the quality of life in elderly. Purpose: to verify the occurence of falls in institutionalized elderly of Sergipe. Method: It was used the Performance Oriented Mobility Assessment of Gait and Balance and Berg Balance Scale. Results: 56.1% of the sample presented risk of falls in the Berg Balance Scale with significant association with age and tendency for females. 27.5% presented abnormal results in Performance Oriented Mobility Assessment of Gait. It was found the association between risks of falls in both tests. Conclusion: there was significant association for risk of falls in institutionalized elderly, mainly in the female and older.

Acupuntura, especialidade multidisciplinar: uma opção nos serviços públicos aplicada aos idosos / Acupuncture, multidisciplinary specialty: an option in public services designed for the elderly

Tendo em vista a indicação de modalidades multidisciplinares como forma eficaz de atendimento e o aumento da utilização da acupuntura nos serviços de saúde no Brasil, o presente estudo teve como objetivo contribuir para o conhecimento da acupuntura e ampliação do seu uso na rede pública. Utilizou-se o método de revisão de literatura, realizando-se uma coleta de dados nos prontuários dos pacientes atendidos pelos acupunturistas de formação multidisciplinar do Instituto Municipal de Medicina Física Oscar Clark, no Rio de Janeiro, a fim de que a prática profissional pudesse contribuir para o melhor desenvolvimento do mesmo. Resultados: a idade se concentrou entre 60 e 80 anos (61 por cento); a maior freqüência entre as doenças ou queixas encaminhadas coube às algias (39 por cento); quanto à melhora com o tratamento ministrado, o maior índice indicou melhora de 26 a 50 por cento. Conclusão: a acupuntura oferece um bom resultado, inclusive no caso de doenças crônicas e nos idosos.Aconselha-se manter a base filosófica científica dos orientais, exercendo-se a acupuntura de forma multidisciplinar e livre de disputas por monopólio como garantia de sua qualidade. Recomenda-se, ainda, sua ampliação nos demais serviços públicos e nas ações públicas multidisciplinares como opção eficaz, natural e de baixo custo.

Fisioterapia domiciliar aplicada ao idoso / Home physiotherapy applied to the elderly

O trabalho teve como objetivo verificar a prevalência dos tipos de fisioterapia realizada num grupo de pacientes em atendimento domiciliar no Estado do Rio de Janeiro, no período de 1999 até 2002, e sua resposta ao tratamento. Com relação aos pacientes, verificaram-se a predominância da faixa de idade, os tipos de doenças e o levantamento de tempo de lesão. Quanto ao tratamento domiciliar de fisioterapia, foram considerados o tipo, o objetivo e o nível de melhora obtido com o tratamento realizado. A importância deste trabalho está no aumento da assistência domiciliar como um fenômeno observado em diversos países, inclusive no Brasil, devido ao aumento da população idosa no mundo e ao perfil epidemiológico das doenças crônicas, levando, conseqüentemente, ao aumento da improdutividade e dos custos governamentais. Utilizou-se o método de epidemiologia em prevalência descritiva. Os resultados evidenciaram que a fisioterapia domiciliar predominou entre os idosos, sendo o tipo prevalente a motora, com 56 por cento dos achados, e que a melhora obtida foi de 35 por cento dos fatores relacionados ao quadro de restrição no leito. Recomenda-se que o atendimento domiciliar de fisioterapia seja priorizado precocemente, para uma melhor resposta na atuação terapêutica.