The impact of implementing the 10-valent pneumococcal conjugate vaccine on hospitalizations for pneumonia among children.

Pneumonia is a major cause of morbidity and mortality in children, with pneumococcus as the main etiologic agent. In Brazil, the 10-valent pneumococcal conjugate vaccine (PCV-10) was introduced into the childhood immunization schedule in 2010. The aim of this study was to assess the impact caused by implementing PCV-10 on the hospitalizations of children with pneumonia, between 2005 and 2015, in the state of Pernambuco, Brazil. An ecological time series study and a forecasting analysis were conducted. A comparison was made between the hospitalizations of children aged between seven months and four years due to pneumonia in the Brazilian Unified Health System, in the 5 years before (2005-2009) and after (2011-2015) implementation of PCV-10. Descriptive analysis included absolute and relative values, means and rates of hospitalization. The chi-square test was used to compare the annual incidence of hospitalizations and the t-Student test to compare the five-year mean values. For the temporal modeling of hospitalizations, an autoregressive integrated moving average was used, adjusted with seasonal-SARIMA (Box-Jenkins methodology), with a prediction of the monthly number of hospitalizations for 2011-2015. The predicted and observed values for 2011-2015 were then compared. The number of hospitalizations after implementing PCV-10 was reduced by 24.5 %. The monthly average of hospitalizations dropped from 681 (2005-2009) to 514 (2011-2015). The hospitalization rate dropped from 56.1 per thousand live births in the five-year period prior to PCV-10 to 43.4 in the following five-year period (a 22.7% reduction). Comparing the values predicted by the SARIMA model for a scenario without PCV-10 in the second five-year period, with those reported after implementing PCV-10, the estimated number of prevented hospitalizations was 8,682 in the five years following the introduction of the vaccine. In conclusion, in the five years following implementation of PCV-10, hospitalizations of children with pneumonia in Pernambuco decrease by 22%.

Quality of life of caregivers of octogenarians: a study using the WHOQOL-BREF / Calidad de vida de los cuidadores de octogenarios: un estudio utilizando el Whoqol-Bref / A qualidade de vida dos cuidadores de octogenários: um estudo com o Whoqol-Bref

Objective.To evaluate the quality of life of octogenarians and to identify the domains related to quality of life and health.Methodology. A cross-sectional, quantitative study conducted in 2010 in the Family Health Units of Campina Grande/PB, Brazil. The study sample consisted of 52 subjects that met the eligibility criteria of: 18 years or older, being a lay caregiver of octogenarians, and having no apparent cognitive problem. A questionnaire containing a sociodemographic section and the WHOQOL-BREF that is composed of two questions about the perceptions of quality of life and health, and 24 on the physical, psychological, social relationships and environmental domains. The Cronbach's-alpha test and the logical regression analysis of the data were conducted using SPSS. The project was approved by the Research Committee of the Center for Development and Higher Education (CAAE nº0490.0.133.000-08). Results. The Cronbach's alpha was 0.72, attesting to the reliability of the instrument used. The domain scores were: environmental (59.43), psychological (59.01), social relationships (46.77) and physical (43.86), whose values indicate dissatisfaction of subjects with regard to aspects related to quality of life. The environmental domain was correlated with quality of life (p=0.014) and the physical domain with perceptions of health (p=0.019); the daily safety and pain aspects had the highest correlations with quality of life (p=0.001). Conclusion. The perception of the caregivers regarding quality of life was not good. The environmental and physical domains had the highest correlations with quality of life and health.

Objetivo.Evaluar la calidad de vida de los cuidadores de octogenarios e identificar los dominios relacionados con la calidad de vida y la salud.Metodología. Investigación de tipo transversal, realizada en 2011 en las Unidades de Salud de la Familia de Campina Grande/PB, Brasil. La muestra estuvo compuesta por 52 personas que cumplieron los criterios de elegibilidad: edad > 18 años, ser cuidador informal de octogenarios y no presentar problemas cognitivos aparentes. Se aplicó un formulario sobre datos sociodemográficos y el instrumento Whoqol-bref, el cual contiene dos preguntas sobre la percepción de la calidad de vida y de la salud y de 24 referentes a los dominios físico, psicológico, relaciones sociales y ambiental. Resultados. El alfa de Cronbach total fue 0.72, mostrando la alta confiabilidad del instrumento utilizado. Los dominios obtuvieron los siguientes puntajes: ambiental (59.4), psicológico (59.0), aspectos sociales (46.8) y físico (43.8), cuyos valores indican la insatisfacción de los cuidadores en los aspectos relacionados con la calidad de vida. Se encontraron correlaciones con significancia estadística entre el dominio ambiental y la calidad, y entre el dominio físico y la salud, teniendo los ítems de seguridad diaria y dolor las mayores correlaciones con la calidad de vida y salud. Conclusión. La percepción de los cuidadores de octogenarios sobre su calidad de vida no es satisfactoria. Enfermería debe preparar a estas personas para que puedan cumplir con su función de cuidar al octagenario y, a la vez, para que puedan disponer de tiempo para cuidar de sí mismos.

Objetivo.Avaliar a qualidade de vidados cuidadores de octogenários e identificar os domínios correlacionados com a qualidade de vida e saúde.Metodologia. Pesquisa transversal, quantitativa, realizada em 2011, nas Unidades de Saúde da Família de Campina Grande/PB. A amostra compôs-se de 52 sujeitos que atenderam aos critérios de elegibilidade: idade > 18 anos, ser cuidador informal de octogenários e não apresentar problema cognitivo aparente. Aplicaram-se um formulário sobre dados sócio-demográficos e o questionário Whoqol-bref, composto de duas questões referentes à percepção da qualidade de vida e da saúde e 24 referentes aos domínios: físico, psicológico, relações sociais e ambiental. Os dados foram analisados no SPSS, sendo efetuados os testes Alfa de Cronbach e regressão logística. O projeto foi aprovado pelo Comitê de ética do Centro de Ensino Superior e Desenvolvimento (CAAE nº0490.0.133.000-08). Resultados. O Alfa de Cronbach total foi 0.72, atestando a confiabilidade do instrumento utilizado. Os domínios obtiveram os seguintes escores: ambiental (59.43), psicológico (59.01), aspectos sociais (46.77) e físico (43.86), cujos valores indicam a insatisfação dos sujeitos no tocante às facetas relacionadas com a qualidade de vida. O domínio ambiental possui maior correlação com a qualidade de vida (p=0.014) e o domínio físico com a saúde (p=0.019), tendo as facetas segurança diária e dor as maiores correlações com a qualidade de vida e saúde (p=0.001). Conclusão. A percepção dos cuidadores de octogenários sobre sua qualidade de vida não é satisfatória. Os domínios mais relacionados com a qualidade de vida e a saúde são, respectivamente, Ambiental e Físico.

Quality of life of caregivers of octogenarians: a study using the WHOQOL-BREF.

OBJECTIVE: To evaluate the quality of life of octogenarians and to identify the domains related to quality of life and health. METHODOLOGY: A cross-sectional, quantitative study conducted in 2010 in the Family Health Units of Campina Grande/PB, Brazil. The study sample consisted of 52 subjects that met the eligibility criteria of: 18 years or older, being a lay caregiver of octogenarians, and having no apparent cognitive problem. A questionnaire containing a sociodemographic section and the WHOQOL-BREF that is composed of two questions about the perceptions of quality of life and health, and 24 on the physical, psychological, social relationships and environmental domains. The Cronbach's-alpha test and the logical regression analysis of the data were conducted using SPSS. The project was approved by the Research Committee of the Center for Development and Higher Education (CAAE nº0490.0.133.000-08). RESULTS: The Cronbach's alpha was 0.72, attesting to the reliability of the instrument used. The domain scores were: environmental (59.43), psychological (59.01), social relationships (46.77) and physical (43.86), whose values indicate dissatisfaction of subjects with regard to aspects related to quality of life. The environmental domain was correlated with quality of life (p=0.014) and the physical domain with perceptions of health (p=0.019); the daily safety and pain aspects had the highest correlations with quality of life (p=0.001). CONCLUSION: The perception of the caregivers regarding quality of life was not good. The environmental and physical domains had the highest correlations with quality of life and health.

Lifestyle and health conditions of adults with spinal cord injury.

OBJECTIVE: . To describe the lifestyle of adults with spinal cord injury and explore its relation with some health conditions. METHODOLOGY: Cross sectional study, in which a questionnaire containing sociodemographic, habits and health conditions variables was used. Forty-seven people with spinal cord injury participated and answered the self-report questionnaire. RESULTS: The group under study was predominantly male (92%), under 40 years of age (47%), and had low educational level (76%). The most frequent risk factors related to the lifestyle were: smoking (28%), alcohol consumption (36%), coffee consumption (92%) and being physically inactive (64%). Association was found between having four or more risk factors related to lifestyle and the loss of appetite, as well as constipation. CONCLUSION: . The actual inadequate lifestyle is associated with the health conditions of patients, and the nursing team should pay special attention to the education and promotion of health related to people with spinal cord injury.