Factors associated with use of assistive walking devices among older adults in Brazil / Fatores associados ao uso de tecnologia assistiva para auxiliar na mobilidade entre idosos no Brasil

Abstract Background Walking devices and other forms of assistive technology (AT) can benefit older adults by supporting mobility and social interactions, but usage outside of high-income countries is generally low. Objective To examine the factors associated with AT use and whether AT use is associated with higher levels of social participation among older adults in Brazil. Method The 2013 Brazilian National Health Survey interviewed 23,815 individuals 60 years or older. Descriptive and logistic regression analyses were used to examine AT use, including canes and walkers, to assist with walking and social participation. Results Among older adults with mobility difficulty, 34.0% (95% CI 31.2- 36.9) reported using AT. Prevalence of the use of AT for walking increases with age: 21.4% of those 60-69 years reported using AT while 58.5% of those 90 years or older did. AT was negatively associated with participation in social activities. Conclusion Our analyses focused on older adults with mobility limitations who need appropriate transportation and environment adaptations to engage socially. Contrary to studies in more developed countries, among Brazilians, AT use is negatively associated with social interactions. The resulting confinement seems to lead to social isolation.

Resumo Introdução Os dispositivos de tecnologia assistiva (TA) podem ajudar idosos na mobilidade e nas interações sociais, mas o uso fora de países de alta renda é geralmente baixo. Objetivo Analisar os fatores associados ao uso de TA e se o uso de TA está associado a níveis mais elevados de participação social entre idosos no Brasil. Método A Pesquisa Nacional de Saúde - PNS 2013 no Brasil entrevistou 23.815 indivíduos com 60 anos ou mais. Análises descritivas e de regressão logística foram utilizadas para examinar a utilização de TA para auxiliar na mobilidade e participação social. Resultados Entre idosos com dificuldade de locomoção, 34,0% (95% IC 31,2-36,9) relataram uso de TA. A prevalência do uso de TA para se locomover aumenta com a idade: 21,4% dos 60-69 anos relataram usar TA enquanto a proporção aumenta para 58,5% entre os de 90 anos ou mais. Uso de TA está negativamente associado à participação em atividades sociais. Conclusão Entre idosos no Brasil com limitações de mobilidade que necessitam de adaptações adequadas de transporte e meio ambiente para engajar socialmente, o uso de TA foi associado negativamente às interações sociais. Esse resultado difere de estudos em países mais desenvolvidos.

Prevalence and perceived importance of racial matching in the psychotherapeutic dyad: a national survey of addictions treatment clinical practices.

BACKGROUND: Despite conflicting results in the literature concerning its efficacy in practice, racial matching has been identified as a component of culturally sensitive treatment. METHODS: This study examined the perceived importance and prevalence of racial matching by surveying a national sample of substance use disorder (SUD) centers from the Substance Abuse and Mental Health Services Administration (SAMHSA). RESULTS: Using univariate statistical analysis, results for the prevalence of racial matching revealed that in 58% of the clinics, there was the potential to match a counselor with a racially similar client, while in 39% of the clinics, there was no potential to provide such a match. Among the agencies that displayed a potential for racial matching, 26% of the respondents indicated that they never racially matched clients and therapists, 71% reported that they sometimes practice racial matching, 15% indicated that they usually racially match, and only 7% purported to always racially match clients and therapists. Results for the perceived importance of racial matching revealed that in both situations where treatment centers had the potential for racial matching and did not have the potential for racial matching, supervisors reported that it was relatively important to provide culturally sensitive treatment but that it was not as important to match clients in SUD centers with racially/ethnically similar counselors. CONCLUSION: The topic of racial matching can be very complex and has shown variation amongst SUD centers; however, this study emphasizes the importance of providing culturally sensitive treatment and an appreciation of differences among members within each racial group.

Community violence and African American male health outcomes: An integrative review of literature.

Community violence exposure is essential when considering African American male adult health outcomes. This integrative review of literature is guided by the research questions: (a) How has community violence been measured in African American male adults? and (b) What impact does community violence have on African America male health outcomes? This study synthesises eight current articles identified by the search terms-community violence, impact, African Americans, care, and men. Of the eight identified articles, there were quantitative (n = 5), qualitative (n = 1) and mixed methods (n = 2). Findings indicate a wide array of screening tools for violent experiences and highlight the potential negative impacts of violence in communities; however, literature regarding strategies for identification and treatment of psychosocial and physical health status of African American male adults experiencing direct and indirect community violence remains limited. Further work in clinical care and community health settings related to violence is warranted.