Factors associated with expression of extrapyramidal symptoms in users of atypical antipsychotics.

PURPOSE: The aim of this study was to investigate factors associated with the occurrence of extrapyramidal symptoms (EPS) in users of second-generation antipsychotics (SGA). METHODS: Observational cross-sectional study based on a random sample of subjects from three outpatient clinics. Inclusion criteria were age between 18 and 65 years, of both genders, with a diagnosis of schizophrenia and under the use of a single SGA agent. Subjects who had received i.m. long-acting antipsychotics in the past were excluded. The families of eligible patients were contacted by phone and, if willing to participate in the study, a household visit was scheduled. Informed consent was obtained from all study subjects and their next of kin. The risk of EPS associated with sociodemographic, clinical features and medications used was analyzed by logistic regression. RESULTS: The study population consisted of 213 subjects. EPS were observed in 38.0% of subjects. The more commonly used SGA were olanzapine (76, 35.7%), risperidone (74, 34.3%), quetiapine (26, 12.2%), and ziprasidone (23, 10.8%). Among the drugs used as adjunctive therapy for schizophrenia, benzodiazepines were the most prevalent (31.5%), followed by carbamazepine (24.4%) and antidepressants (20.2%). Multivariate analysis showed that the risk of EPS was associated with the use of carbamazepine (odds ratio 3.677, 95% CI 1.627-8.310). We found no evidence that the type of SGA modified the risk of EPS. CONCLUSION: The occurrence of EPS in SGA users is a common finding, with no difference of antipsychotics studied in relation to the risk of extrapyramidal manifestations. The adjunctive use of carbamazepine may predispose the user of SGA to the occurrence of EPS.

[Social representations on aging by primary care health workers]. / Representações sociais de trabalhadores da atenção básica de saúde sobre envelhecimento.

The objective of this study was to get to know the social representations on aging developed by primary care health workers. This is an exploratory study involving 204 primary health care workers, in the city of João Pessoa, in the state of Paraíba. For data collection we used a semi-structured interview. The data obtained from 204 interviews was analyzed with the help of the Alceste software version 2010. The results indicated five classes or categories: vision of aging,psychosocial dimensions, a time of doubts, aging as a process, and aging versus disease, with positive content: joy, care, children, retirement, caregiver rights, maturity and wisdom, as well as negative factors: impairments, decadence, neglect, fragility, limitation, wrinkles, dependency and disease. It was observed that these meanings associated with aging express the need for total and humanized elderly care.

[Bibliometric analysis of the scientific evidence on violence perpetrated against the elderly]. / Análise bibliométrica das evidências científicas sobre violência contra a pessoa idosa.

The scope of this study is violence perpetrated against the elderly. It aims to analyze the international scientific production on violence against the elderly. It involved bibliometric research carried out in the ISI Web of Knowledge/Web of ScienceTM database, in which the search terms "elder,"violence" or "abuse" and "health care" were used, in the period between the years 1991 and 2016. The data were analyzed considering the evolution of the annual publications, the journals with the highest number of records, the authors with the highest number of publications, the number of articles distributed by authors' country of origin, and articles with the highest impact. A total of 267 published records in 174 different journals indexed to the database in question were identified and were written by 901 authors with links to 410 institutions located in 39 countries. In the descriptive analysis of the content of the top journals on the topic and of the most cited articles there was potential for the development of the topic, since there is a need for more data on interventions in cases of violence against the elderly, with a multidisciplinary approach, as well as conducting more research on clinical manifestations, quality of life and its economic impact on the use of health services.

O estudo tem como objeto as violências contra a pessoa idosa. Objetiva analisar a produção científica internacional sobre violência contra a pessoa idosa. Trata-se de uma pesquisa bibliométrica realizada na base de dados "ISI Web of Knowledge/Web of Sciencetm", na qual foram usados os termos de busca: "elder*, violence* ou abuse* e health care", no recorte temporal entre os anos 1991 e 2016. Os dados foram analisados considerando a trajetória de evolução anual das publicações, os periódicos com maior quantidade de registros, os autores com maior quantidade de publicações, a quantidade de artigos distribuídos por país de origem dos autores e os artigos de maior impacto. Foram identificados 267 registros de publicação em 174 periódicos distintos indexados à base de dados em questão e foram escritos por 901 autores que possuem vínculos a 410 instituições, localizadas em 39 países. Na análise descritiva do conteúdo dos "top journals" da temática e dos artigos mais citados verificou-se potenciais para o desenvolvimento do tema visto que existe a necessidade de mais dados sobre intervenções em casos de violências contra a pessoa idosa, com abordagem multidisciplinar, bem como a realização de mais pesquisas sobre as manifestações clínicas, qualidade vida e seu impacto econômico na utilização dos serviços de saúde.

[Perception of students on the elderly and their duties: the case of the health]. / Percepção dos estudantes sobre o idoso e seus direitos: o caso da saúde.

This is a retrospective study which aimed at examining college students' perceptions about the elderly and their rights, and to investigate knowledge about the elderly rights. Participated in this study 63 students from different courses (both sexes) in the academic realm. We collected information in a semi-structured interview focused on issues pertinent to the rights of the aged and the elderly Data were analyzed with the technique of thematic content analysis. The results are presented in categories under the Constitution are interpreted Federal Civil Code and the National Policy for the Elderly, in particular the rights to health. The results showed negative perceptions of students about the elderly and little knowledge about the rights of the elderly, particularly the larger, such as receiving special medication, be treated primarily in hospitals, do not suffer from embarrassment in public health services, right to full health, among others.

[Damage liability of nursing professionals in the invasive procedures]. / Responsabilidade civil dos profissionais de enfermagem nos procedimentos invasivos.

This study had as objective to apprehend the Social Representation of damage liability of nursing in the invasive procedures elaborated by the professionals of the area. It treats of a qualitaitve research, developed in a public hospital with 64 fellows. The data were produced from the free association words test, processed by software Tri-Deux Mots, being done Correspondence Factorial Analysis. The fellow's representational field indicated favorable attitudes in relation to the invasive procedures stimulus. The conceptions about hospital infection stimulus demonstrated a broad vision of hospital infection problem and its serious consequences. However it was not observed preoccupation and manifestation in the fellow's social representations about the civil responsibilities of Nursing professional.

[Ethnic evaluation of hospital humanization by the users of the Brazilian Unified Health System and their mediators]. / Etno-avaliação da humanização hospitalar pelo usuário do Sistema Unico de Saúde (SUS) e seus mediadores.

This study was aimed at evaluating the humanization of hospital care ethnically, as perceived by the hospitalized patients. Data were collected from 13 inpatients from January to July/2005 in a public hospital in Fortaleza, Ceará, Brazil, according to the patient's circuit. This analysis yielded the following categories: ethnic evaluation of the hospital structure and dynamics, hospital and professional image, human and technical competence. The subjects used multiple aspects to soften their opinions, unveiling factors named mediators of the ethnical evaluation. Such aspects were categorized into: conditions of the interview, socio-economic status, user's personality and religiousness, ironic speech, somber diagnosis and necessities met, and prior hospitalization experiences. The elements revealed by the patients are significant in order to encourage professionals and mediators to mobilize towards humanizing changes, including the user as a social and critical ethnic evaluator.

[Inequality and damaged teeth: oral sequelae from living in poverty in the Dendê community, Fortaleza, Ceará, Brazil]. / Dentes da desigualdade: marcas bucais da experiência vivida na pobreza pela comunidade do Dendê, Fortaleza, Ceará, Brasil.

This anthropological study focuses on the experience of dental disease in the context of poverty in Northeast Brazil. For six months in 2004, ethnographic interviews, narratives, and participatory observation were conducted with 31 residents of the low-income Dendê neighborhood in Fortaleza, Ceará, and the results were analyzed using a hermeneutic-dialectic method. Precarious living conditions make healthcare a difficult priority. Even when individuals experience acute toothache, seeking dental care is perceived as a "luxury" rather than a citizen's right. Difficult access to services and poor-quality restorations favor tooth extraction as the most effective intervention. Local residents complain about their deteriorating oral health and seek help from substandard clinics, patronizing politicians, and traditional healers. In this context, dental disease differs according to social class, leaves the sequelae of inequality, jeopardizes self-esteem, and hinders social inclusion. Dealing with such inequality requires a deeper understanding of the social determinants of health, reducing injustices in access to quality care, eliminating stigma, and empowering community members to confront the structural forces affecting their lives.

Promoting public health through nutrition labeling - a study in Brazil.

BACKGROUND: Food and nutrition education allows individuals to build knowledge and values, reframe their food practices, and develop strategies for a healthy diet. Food choices within the diet represent a determinant of individual health status. Regardless of the food quality, the consumption of calorie-dense foods does not promote better health conditions for the population and can worsen emerging health problems. The present study aimed to describe and analyze the effectiveness of educational activities related to nutrition information for enabling healthy food choices, as a tool to promote public health. METHODS: To describe and analyze the effectiveness of an educational intervention regarding nutrition labeling as a tool to promote healthy food choices, 702 individuals were enrolled in the present quasi-experimental study. The Wilcoxon and McNemar tests were used to compare the pre- and post-intervention data, and a p value <0.05 was considered statistically significant. RESULTS: Of the 702 participants (mean age, 26.6 years), 17.4 % were male, and 82.6 % were female. The education level was high school for 53.2 % of the participants. The mean income was R$ 1969.54 (about 500 USD). In the pre-test, 55.8 % of the respondents reported consulting the nutrition information provided on packaged foods. At the post-test, 72.0 % of respondents reported consulting this information (p < 0.001; Table 1). However, the change in the response regarding the purchase of packaged products was borderline significant. CONCLUSIONS: The results indicate that the intervention was feasible and acceptable and improved knowledge regarding the role of nutrition labeling in promoting healthy eating. These results support the importance of an educational intervention to reinforce healthy food choices.

[Outside clinical setting experience in a public hospital and oral health promotion]. / Experiência extramural em hospital público e a promoção da saúde bucal coletiva.

OBJECTIVE: To describe a teaching aid activity aimed at providing experience for promoting collective oral health to graduating dental students. METHODS: This experience was based on the evaluation of students' performance as oral health educators as they had, among other duties, to motivate inpatients and their families to practice healthy habits aiming at a comprehensive and more human care of hospitalized patients. RESULTS: The results show that oral hygiene was incorporated into hospital routine, evidenced by the differences between baseline and final dental biofilm indices (1.72 and 1.17, respectively). Using the U-Mann-Whitney test, this difference was extremely significant (p<0.001) and reveals that mother-child were highly motivated with respect to oral hygiene. CONCLUSIONS: It is concluded that teaching-learning experiences derived from interdisciplinary and interdisciplinary activities have allowed for a better understanding of the health-disease process by dental students. It is also an opportunity for learning about planning and implementing education-prevention activities, which complement these students' technical-professional experience and promotes social sensitivity, which is essential to professional training.

[Construction of knowledge in odontology: the scientific production in debate]. / A construção do conhecimento na odontologia: a produção científica em debate.

PURPOSE: Analyze, quantitatively, which odontology magazines are being consulted and read by surgeon-dentists, and evaluate the profiles of the mostly cited. METHODS: 370 polls were made, during the XVII Congresso Pernambucano de Odontologia (Pernambucan Congress of Odontology) and the IX Congresso de Odontologia do Rio Grande do Norte (Congress of Odontology of Rio Grande do Norte), which took place, respectively, in April and September 2004. The participants were volunteering professionals divided among General Practice (37.84%) and ten differing specialties (62.16%); of which 77.02% had up to ten years of graduation. RESULTS: Resulting the researches made, 620 quotes were generated, in which, 35 different magazines, national and international, were quoted. By analyzing the data collected, we observe that three magazines summed more than half of the quota (52.74%), which are: Revista da Associação Paulista de Cirurgiões Dentistas-APCP (Magazine of the Paulista Association of Surgeon-Dentists), Revista da Associação Brasileira de Odontologia - ABO national (Magazine of the Brazilian Association of Odontology) and the Revista Brasileira de Odontologia-RBO (Brazilian Magazine of Odontology). CONCLUSION: Despite the participants of the research being, in their majority, specialists, we observe a tendency of a greater consultation of the magazines of general characteristic. These magazines predominantly tackle clinical and technical subjects and present an expressive circulation, great penetration in the odontologic world, easy accessibility and a long time in the market (two of them are over 50 years-old). According to CAPES - QUALIS, all possess a B national concept. Therefore, it is necessary a deepening of this study, so as to analyze qualitatively what kind of subjects and themes these magazines touch, since they influence the odontologic formation and practice.

Mortalidade por queda em idosos: uma revisão integrativa / Fall mortality in the elderly: an integrative review / Muerte por caída en los ancianos: una revisión integradora

Introdução: A Organização Mundial de Saúde avalia que aproximadamente 28% a 42% das pessoas acima de 65 anos sofrem quedas anualmente, e 5 a 10% destas evoluem para óbito. Objetivo: Verificar o perfil epidemiológico de óbitos por quedas em idosos entre 2007 e 2016. Método: Busca de artigos com descritores: Idoso; Óbito; Envelhecimento; Perfil de Saúde; Acidentes por Quedas; nas bases de dados CAPES, SciELO, BVS; entre 2007 e 2016; utilizando Idiomas: Inglês, português, espanhol; Incluídos artigos cujo objetivo avaliou os óbitos por quedas em idosos excluindo os que não possuíam informações sobre quedas ou continham a informação queda como fator de risco para mortalidade sem o desfecho óbito. Resultados: Triados oito artigos, seis utilizaram estudos retrospectivos entre 1996 a 2011 tendo o Sistema de Informação de Mortalidade (SIM) como base. Foram encontrados percentuais gerais de óbitos por quedas em idosos entre 0,61% e 0,69% e 7,15% das causas externas. A Mortalidade Específica por quedas variou entre 15 a 29%. O Coeficiente de Mortalidade Específico variou de 24,06 a 35,83/100000hab. Gênero, raça, estado civil e escolaridade não apresentaram avaliações que permitissem análise mais efetiva. Todos os estudos apontaram que quanto maior a idade, maior o risco de óbito por queda. Os estudos baseados no SIM apontaram para a limitação da qualidade do dado coletado, onde o óbito por queda pode estar mascarado por outras causas. Conclusões: Encontradas informações insuficientes para traçar o perfil epidemiológico da populaçãoidosa que vem a óbito por quedas, assim como disparidades entre taxas gerais e específicas de mortalidade. Mostra-se importante a qualificação da causa básica do óbito no preenchimento das informações do SIM, uma vez que o preenchimento incorreto pode mascarar a magnitude deste agravo, suas proporções e coeficientes, prejudicando a avaliação e alocação de políticas públicas que possam reduzir esta mortalidade (AU).

Introduction:The World Health Organization estimates that approximately 28% to 42% of people over 65 suffer falls annually, and 5 to 10% of them die. Objective: To verify the epidemiological profile of deaths due to falls in the elderly between 2007 and 2016. Method: Search for articles with descriptors: Elderly; Death; Aging; Health Profile; Falls Accidents; in the CAPES, SciELO, BVS databases; between 2007 and 2016; using Languages: English, Portuguese, Spanish; Included were articles whose objective evaluated deathsfrom falls in the elderly, excluding those who did not have information about falls or contained information about falls as a risk factor for mortality without the outcome of death. Results: Screened eight articles, six used retrospective studies between 1996 to 2011 using the Mortality Information System (SIM) as a database. General percentages of deaths from falls were found in the elderly between 0.61% and 0.69% and 7.15% of external causes. Specific mortality from falls ranged from 15 to 29%. The Specific Mortality Coefficient ranged from 24.06 to 35.83 / 100000hab. Gender, race, marital status and education did not present evaluations that would allow more effective analysis. All studies pointed out that the older the age, the greater the risk of deathfrom falls. Studies based on SIM pointed to the limitation of the quality of the data collected, where death from falls may be masked by other causes. Conclusions: Insufficient information was found to trace the epidemiological profile of the elderly population that dies from falls, as well as disparities between general and specific mortality rates. It is important to qualify the basic cause of death when filling out SIM information, since incorrect filling can mask the magnitude of this condition, its proportions and coefficients, impairing the evaluation and allocation of public policies that can reduce this mortality (AU).

Introducción:la Organización Mundial de la Saludestima que aproximadamente 28% al 42% de las personas mayores de 65 años sufren caídas anuales, y del 5 al 10% de ellas mueren. Objetivo: verificar el perfil epidemiológico de las muertes por caídas en los ancianos entre 2007-2016. Método: buscar artículos con descriptores: ancianos; Muerte; Envejecimiento Perfil de salud; Accidentes de caídas; en las bases de datos CAPES, SciELO, BVS; entre 2007 y 2016; idiomas: inglés, portugués, español; Se incluyeron artículos cuyo objetivo evaluó las muertes por caídas en los ancianos, excluyendo a aquellos que no tenían información sobre caídas o que contenían información sobre caídas como factor de riesgo de mortalidad sin el resultado de la muerte. Resultados: Ocho artículosencontrados, seis utilizaron estudios retrospectivos entre 1996 y 2011 utilizando el Sistema de Información de Mortalidad (SIM). Porcentajes generales de muertes entre 0,61% y 0,69% y 7,15% de causas externas. La mortalidad específica por caídas osciló entre 15 y 29%. El coeficiente de mortalidadespecífico varió de 24.06 a 35.83 / 100000hab. El género, la raza, el estado civil y la educación no presentaron evaluaciones que permitieran un análisis más efectivo. Todos los estudios señalaron que cuanto mayor es la edad, mayor es el riesgo de muerte por caídas. Los estudios basados en SIM señalaron la limitación de la calidad de los datos, donde la muerte por caídas puede estar enmascarada por otras causas. Conclusiones: se encontró información insuficiente para rastrear el perfil epidemiológico de la población anciana que muere por caídas, edisparidades entre las tasas de mortalidad general y específica. Es importante calificar la causa básica de muerte en laSIM, ya que un llenado incorrecto puede enmascarar la magnitud de esta condición, perjudicando la evaluación y asignación de políticas públicas que puden reducir esta mortalidad (AU).

A perspectiva do usuário na atenção básica sobre o acolhimento ao idoso / The user's perspective in the basic attention on the hospitality of the elderly

Introdução: O acolhimento, uma das diretrizes da Politica Nacional de Humanização, constitui-se em tecnologia para reorganização dos serviços, permitindo a garantia de acesso universal e humanização do atendimento. Objetivo: Este trabalho analisou a perspectiva do usuário na Atenção Básica sobre o acolhimento ao idoso.Metodologia: Trata-se de um estudo descritivo e analítico composto por usuários, com idade igual e superior a 60 anos, vinculados a Unidade de Saúde da Família do município de Natal/RN. A pesquisa foi aprovada com parecer nº 1.808.237. Para a coleta dos dados utilizou-se a entrevista semiestruturada e os dados foram analisados por meio da Análise de Conteúdo de Bardin.Resultados: Emergiram as seguires categorias: (1)Cuidado -o acolhimento foi correlacionado ao cuidado e respeito com a pessoa, visto como uma concepção ampla; (2) Acesso -verificou-se a relação direta com a espera prolongada no gerenciamento de consultas e de assistência médica; Resolutividade (3) ­evidenciou novamentea burocratização do sistema de saúde e a busca por serviços privados demonstrou ser a opção de escolha.Conclusão: Concluiu-se que a perspectiva sobre o acolhimento à pessoa idosa na Atenção Básica é visto com muitas fragilidades, sobressaindo as contradições na humanização das ações em saúde (AU).

Introduction: The host, one of the guidelines of the National Humanization Policy, is a technology for the reorganization of services, allowing the guarantee of universal access and humanization of care. Objective: This study analyzed the perspective of the user in the Basic Care about the reception to the elderly. Methodology: This is a descriptive and analytical study composed of users, aged 60 and over, linked to the Family Health Unit of the city of Natal / RN. The research was approved with an opinion nº 1,808,237. For the data collection, the semi-structured interview was used and the data were analyzed through the Bardin Content Analysis.Results: Emergent follow categories: (1) Caution -the host was correlated to care and respect with the person, seen as a broad conception; (2) Access -the direct relationship with the long wait in the management of consultations and medical care was verified; Resolutivity (3) -again evidenced the bureaucratization of the health system and the search for private services proved to be the option of choice.Conclusion: It was concluded that the perspective on the reception of elderly people in Primary Care is seen with many weaknesses, highlighting the contradictions in the humanization of health actions (AU).

Violência e maus tratos contra a pessoa idosa: representações sociais de jovens, adultos e idosos / Violence and abuse against the elderly: social representations of young people, adults and the elderly / Violencia y maltrato contra la persona mayor: representaciones sociales de jóvenes, adultos y ancianos

Objetivo: analisar as representações sociais sobre violência e maus tratos contra a pessoa idosa, construídas por jovens, adultos e idosos. Método estudo exploratório de abordagem qualitativa, utilizando o aporte teórico das representações sociais, realizado com 150 participantes, escolhidos aleatoriamente, no período de março/setembro de 2015. Dados foram coletados por entrevista semiestruturada utilizando estímulos indutores: violência e maus tratos contra pessoa idosa. O material empírico foi organizado em dois corpora e processados com o auxílio do software IRaMuTeQ ®. Os dados processados apontaram para o estimulo violência três classes semânticas; para maus tratos , duas classes. O projeto foi aprovado em Comitê de ética e pesquisa (protocolo 0516/14). Resultados jovens falam de tipos de violência; adultos falam sobre contravenções relacionadas; idosos associam dimensões de cunho afetivo. Conclusão espera-se que os achados contribuam para dimensionamento de ações educativas-protetivas para efetivação de políticas públicas ao idoso.

Objective: to examine social representations constructed by young people, adults and the elderly regarding violence and abuse against older people. Method this exploratory, qualitative study used social representations theory in the period from March to September 2015 with 150 randomly chosen participants. Data were collected by semi-structured interview using two stimulus-terms: violence and abuse against elderly persons. The empirical material was organized into two corpuses and processed with IRaMuTeQ® software. The processed data pointed to three semantic classes for the stimulus-term violence, and two for the stimulus-term abuse. The project was approved by the research ethics committee (Protocol 0516/14). Results younger participants mentioned types of violence; adults talked about violence-related offenses; and the elderly associated violence and abuse with dimensions of affect. Conclusion it is hoped that the findings will contribute to scaling educational and protective actions for effective application of policies for the elderly.

Objetivo analizar las representaciones sociales sobre violencia y maltrato contra la persona mayor, construidas por jóvenes, adultos y ancianos. Método estudio exploratorio de enfoque cualitativo, utilizando el aporte teórico de las representaciones sociales, realizado con 150 participantes, elegidos al azar, en el período de marzo / septiembre de 2015. Los datos fueron recolectados por entrevista semiestructurada utilizando estímulos inductores: violencia y maltrato contra el anciano. El material empírico fue organizado en dos corpus y procesado con la ayuda del software IRaMuTeQ®. Los datos procesados apuntaron hacia el estímulo violencia, tres clases semánticas; hacia maltratos, dos clases. El proyecto fue aprobado en el Comité de ética e investigación (protocolo 0516/14). Resultados jóvenes hablan sobre tipos de violencia; los adultos hablan sobre contravenciones relacionadas; los ancianos asocian dimensiones de carácter afectivo. Conclusión se espera que los hallazgos contribuyan a dimensionar acciones educativas-protectoras para volver efectivas las políticas públicas en cuanto al anciano.

Scientific production on falls and deaths among elderly persons: a bibliometric analysis / Produção científica sobre quedas e óbitos em idosos: Uma análise bibliométrica

Objective: To map international scientific production on falls and deaths among the elderly. Method: A bibliometric study of academic papers was carried out in the ISI Web of Knowledge/Web of ScienceTM. The search terms "elderly*", "fall*" and "death*" were used for studies between 1990 and 2016. Articles from events or those still in the editing process and studies in the form of "conference proceedings", "editorial material" and "letters" were excluded, with only finished studies and complete "articles" and "reviews" considered. Results: After applying the refinement filters, 668 articles were identified during the 26 year evaluation period, published in 364 different journals indexed to the database in question. These were written by 2,958 authors with links to 1131 research institutions located in 63 countries. The articles included 22,093 references, with an average of approximately 33 references per study. Conclusion: The articles on falls and deaths among the elderly emphasize the need for more specific studies on the subject and its potential for exploration in future research. This study revealed the need for this issue to be discussed in the training of health professionals, as it represents an opportunity to deconstruct and reconstruct concepts and values that are established throughout the life of individuals, such as care related to the avoidability of falls, to improve the quality of life of this population.

Objetivo: Mapear a produção científica internacional sobre quedas e óbitos na pessoa idosa. Método: Foi realizado um estudo bibliométrico com trabalhos acadêmicos na base de dados ISI Web of Knowledge/Web of ScienceTM. Foram usados os termos de busca constantes nos Descritores em Ciências da Saúde (DeCS): "elder*", "fall*" e "death*" no recorte temporal entre 1990 e 2016, excluindo-se dos resultados os artigos provenientes de eventos ou considerados ainda em edição e registros oriundos de "proceedings papers", "editorial material" e "letter", resultando apenas trabalhos finais e completos "article" e "review" (artigos e revisões). Resultados: Após aplicados os filtros de refinamento, foram identificados 668 artigos nos 26 anos de avaliação, publicados em 364 periódicos distintos indexados à base de dados em questão, escritos por 2.958 autores que possuem vínculos com 1.131 instituições de pesquisa, localizadas em 63 países. Para a consecução desses artigos foram utilizadas 22.093 referências, com uma média de aproximadamente 33 referências por artigo. Conclusão: Os artigos sobre quedas e óbitos em idosos destacam a necessidade de estudos mais específicos sobre o tema e o seu potencial de exploração em futuros estudos. Esse estudo apontou a necessidade de discussão dessa temática na revisão de conceitos estabelecidos ao longo da vida e dos cuidados inerentes à evitabilidade da queda para melhorar a qualidade de vida dessa população.

Atorvastatin decreases bone loss, inflammation and oxidative stress in experimental periodontitis.

The aim of this study is to determine the effects of Atorvastatin treatment, an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, in periodontal disease. Male Wistar albino rats were randomly divided into five groups of ten rats each: (1) non-ligated treatment (NL), (2) ligature only (L), (3) ligature plus 1 mg/kg Atorvastatin daily for 10 days, (4) ligature plus 5 mg/kg Atorvastatin daily for 10 days, and (5) ligature plus 10 mg/kg Atorvastatin daily for 10 days. Following the treatment course, the periodontal tissue of the animals was analyzed by Measurement of alveolar bone loss, Histopathology and immunohistochemistry to determine of the expression of COX-2, MMP-2, MMP9, and RANKL/RANK/OPG. ELISA assay was used to quantitate the levels of IL-1ß, IL-10, TNF-α, myeloperoxidase, malondialdehyde, and glutathione. The periodontal group treated with 10 mg/kg of Atorvastatin (3.9±0.9 mm; p<0.05) showed reverse the alveolar bone loss caused Experimental Periodontal Disease compared to (L) (7.02±0.17 mm). The periodontal group treated with 10 mg/kg of Atorvastatin showed a significant reduction in MPO and MDA (p<0.05) compared to ligature only group (L). Similarly in this group, the levels of the proinflammatory cytokines IL-1ß and TNF-α were significantly decreased (p<0.05). Furthermore, MMP-2, MMP-9, RANKL/RANK, and COX-2 were all downregulated by Atorvastatin treatment, while OPG expression was increased. The findings support a role of Atorvastatin for reducing the bone loss, inflammatory response, oxidative stress, and expression of extracellular matrix proteins, while reducing RANK/RANKL and increase OPG in periodontal disease.

O atendimento em unidades de saúde da família: um estudo de representações sociais com idosos / The attendance in family health units: a study of social representations with elderly people

Objetivo: apreender as representações sociais construídas por idosos sobre o atendimento nas Unidades deSaúde da Família. Método: estudo exploratório, de abordagem qualitativa, realizado com 102 idosos assistidosna Estratégia Saúde da Família de Natal/RN e subsidiado pelo aporte da Teoria das Representações Sociais. Osdados foram obtidos por meio do Teste de Associação Livre de Palavras e entrevista semiestruturada eanalisados com o auxílio do software EVOC. Resultados: verificou-se que os conteúdos e a estruturarepresentacional acerca do atendimento nas Unidades de Saúde da Família mostraram-se essencialmentenegativas. Conclusões: a deficitária estrutura organizacional dos serviços, a precária estrutura física daunidade, dentre outros problemas mostrados neste trabalho, colaboram para a construção de representaçõesnegativas sobre o atendimento nas Unidades de Saúde da Família.

[The symptomatology of self-referred depression by elderly people who live in a shantytown]. / Sintomatologia de depressão autorreferida por idosos que vivem em comunidade.

The scope of this quantitative exploratory study was to evaluate the symptomatology of self-referred depression by the elderly, taking socio-demographic variables into consideration. The data collected by means of semi-structured interviews and the Abbreviated Geriatric Depression Scale involving 240 elderly residents in João Pessoa in the state of Paraíba between October and December 2010 were analyzed by Excel and SPSS software. It was found that 75.8 % had no degree of symptomatology of depression, and 24.2 % manifested mild or severe depression. According to these variables, in the elderly patients with depression it was found that: in relation to age, the elderly with mild and severe depression appear more frequently between 71 to 76 years - 31%; in relation to gender, females stand out with 86%; on marital state, married couples with 41.3 %, and widowers with 34.5 %; considering family income, from 1 up to 3 minimum wages, 50 %, revealed mild incidence; with respect to schooling, elderly people who have no depression, 84.6 %, can read and write. Therefore, it can be said that the symptomatology of depression in the elderly is related to socio-economic and cultural conditions, emphasizing the need for public health policies that ensure comprehensive care and quality considering these variables.

A comunidade como local de protagonismo na integração ensino-serviço e atuação multiprofissional / The community as a place of leadership in education-service integration and multi-professional performance / La comunidad como local de protagonismo en la integración enseñanza-servicio y actuación multiprofesional

Resumo A discussão atual sobre educação e saúde tem mostrado a necessidade de maior integração entre os serviços de saúde e a academia. A Política Nacional de Educação Permanente em Saúde propõe a disseminação de capacidade pedagógica no Sistema Único de Saúde, de modo que a rede pública de saúde passe a constituir-se num espaço de ensino-aprendizagem no exercício do trabalho. O objetivo que se estabeleceu foi o de conhecer o processo de integração entre o ensino e o serviço de saúde na Atenção Básica em Saúde, a partir da atuação dos preceptores no processo de formação dos estudantes dos cursos de graduação da área da saúde na Universidade Federal do Rio Grande do Norte. A entrevista semiestruturada e a observação direta foram as técnicas escolhidas, e a análise dos dados, feita com base na abordagem hermenêutica-dialética, mostrou que a atuação dos preceptores se constitui em uma importante estratégia para viabilizar a integração ensino-serviço. A conclusão indica para a compreensão de que os profissionais envolvidos na preceptoria se educam enquanto educam, bem como de que o processo educativo é permeado por saberes e experiências heterogêneas, fator altamente favorável à formação dos estudantes e profissionais.

Abstract The current discussion on education and health has shown the need for greater integration between health services and the academy. The National Policy of Permanent Health Education proposed the dissemination of pedagogical capacity in the National Health System, so that the public health system would become a teaching and learning space while one performs his or her work. The goal was to get to know the process of integration between education and health services in Primary Health Care, from the actions of professors in the training process of students in the undergraduate courses in health care at the Federal University Rio Grande do Norte. Semi-structured interviews and direct observation were the techniques chosen, and data analysis, based on the hermeneutic-dialectic approach, showed that the professor's performance is an important strategy to facilitate integration between teaching and service. The conclusion points to the realization that the professionals involved in teaching are educated while they educate, and that the educational process is permeated by heterogeneous knowledge and experience, a highly favorable factor for the training of students and professionals.

Resumen La discusión actual sobre educación y salud viene mostrando la necesidad de mayor integración entre los servicios de salud y la academia. La Política Nacional de Educación Permanente en Salud propone la diseminación de capacidad pedagógica en el Sistema Único de Salud, de modo que la red pública de salud pase a constituir un espacio de enseñanza-aprendizaje en el ejercicio del trabajo. El objetivo que se estableció fue el de conocer el proceso de integración entre la enseñanza y el servicio de salud en la Atención Básica en Salud, a partir de la actuación de los preceptores en el proceso de formación de los estudiantes de los cursos de graduación del área de la salud en la Universidad Federal de Río Grande do Norte. La entrevista semiestructurada y la observación directa fueron las técnicas seleccionadas, y el análisis de los datos, realizado en base al abordaje hermenéutico y dialéctico, mostró que la actuación de los preceptores constituye una importante estrategia para permitir la integración enseñanza-servicio. La conclusión señala hacia la comprensión de que los profesionales involucrados en la preceptoría se educan mientras educan, así como el proceso educativo está permeado por saberes y experiencias heterogéneas, factor altamente favorable a la formación de los estudiantes y profesionales.

Comparando a qualidade de vida de idosos institucionalizados e nãoinstitucionalizados / Comparing the quality of life of institutionalized and non-institutionalized older adults / Comparación de la calidad de vida de ancianos institucionalizados y no-institucionalizados

Objetivo: avaliar comparativamente a qualidade de vida de idosos institucionalizados e não institucionalizados. Método: estudo observacional realizado em Cuité-PB com amostra constituída por 40 idosos, subdivididos igualmente para cada categoria. Os dados foram coletados utilizando-se o questionário World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-Old) e analisados com base na estatística descritiva, após aprovação do Comitê de Ética em Pesquisa, CAAE 09871412.0.0000.5188. Resultados: os idosos não institucionalizados apresentaram maior satisfação em cinco domínios: funcionamento sensório; autonomia; atividades passadas, presentes e futuras; participação social; e intimidade, com exceção apenas do domínio relacionado à morte e morrer. Conclusão: é necessária a efetiva implementação de políticas públicas direcionadas aos idosos, sobretudo àqueles institucionalizados, favorecendo-lhes melhores níveis de qualidade de vida, principalmente ao considerar o rápido crescimento da população idosa no país, com grande parte vivendo em instituições de longa permanência.

Objective: to evaluate comparatively the quality of life of institutionalized and non-institutionalized older adults. Method: observational study conducted in Cuité, Paraíba, with a sample of 40 older adults divided equally between the two categories. Data were collected using the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-Old) questionnaire and analyzed using descriptive statistics, after approval by the Research Ethics Committee (CAAE 09871412.0.0000.5188). Results: the non-institutionalized older adults showed greater satisfaction in five areas: sensory functioning, autonomy, past, present and future activities, social participation, and intimacy; the only exception being in relation to death and dying. Conclusion: it is necessary to implement effective public policies in favor of better levels of quality of life for the elderly, especially those who are institutionalized, particularly in view of rapid growth in Brazil's elderly population, many of whom live in long-stay institutions.

Objetivo: evaluar comparativamente la calidad de vida de los ancianos institucionalizados y no institucionalizados. Método: estudio observacional realizado en Cuité-PB con muestra constituida por 40 ancianos, subdivididos igualmente para cada categoría. Los datos han sido recolectados utilizando el cuestionario World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-Old) y analizados mediante estadística descriptiva, luego de la aprobación por el Comité de Ética en Investigación, CAAE 09871412.0.0000.5188. Resultados: los ancianos no institucionalizados mostraron una mayor satisfacción en cinco áreas: funcionamiento sensorial, autonomía, actividades pasadas, presentes y futuras, participación social e intimidad, exceptuando el área relacionada a la muerte y el morir. Conclusión: es necesaria la implementación efectiva de políticas públicas que se dirijan a los ancianos, especialmente a los institucionalizados, favoreciendo mejores niveles de calidad de vida, principalmente cuando se considera el rápido crecimiento en el país de la población de ancianos, cuya mayor parte vive en instituciones de larga estadía.

As implicações das práticas pedagógicas no desenvolvimento das competências / The implications of pedagogical practices in competences development

Introdução: As Universidades passam por mudanças que buscam uma formação critico-reflexiva, devido à pressão exercida por diversos setores da sociedade. Compreende-se a necessidade de práticas pedagógicas sustentáveis que possibilitem o desenvolvimento de competências que estão sendo demandadas no processo de formação. Logo, para nortear o processo ensino aprendizagem por competência como orientado pelas Diretrizes Curriculares Nacionais (DCN), é fundamental que este seja assumido por toda Instituição de Ensino Superior (IES). Objetivo: Investigar a compreensão sobre as competências gerais estabelecidas pelas DCN que se encontram presentes no processo de formação profissional através das falas dos alunos. Métodos: Trata-se de um estudo descritivo com abordagem qualitativa que utilizou a entrevista com situação problema para coleta de dados. Os sujeitos participantes do estudo são concluintes voluntários do curso de Odontologia/UFRN. As falas dos participantes foram gravadas e transcritas, gerando um Corpus que foi processado e analisado mediante o auxílio do software ALCESTE. Resultados: O corpus foi dividido em 131 Unidades de Contexto Elementares (UCE), distribuído e agrupado em cinco classes lexicais, que compõem o conteúdo essencial presente nas entrevistas analisadas denominadas de: Problemas de Saúde que aparecem na ESF, Dificuldades de comunicação, Lacunas da formação profissional, Espaços formativos articulados e Determinantes sociais em saúde. Conclusões: É lícito concluir que durante a formação, há dificuldades na articulação da academia com os serviços de saúde, além da escassez de componentes curriculares com práticas pedagógicas e conteúdos integrados à realidade social. Apesar dos avanços, com a inclusão das clínicas multidisciplinares e a inserção de vivências formativas conectadas ao mundo do trabalho, induzidas pelas políticas oficiais de educação superior recentes, os estudantes apresentam limitações para mobilizar conhecimentos, interpretar informações essenciais e atuar em equipe multiprofissional no enfrentamento dos problemas de saúde (AU).

Introducion: At present, the Universities search to promote a critical-reflexive education because to pressure from different society's sectors. It is understood the necessity of sustainable pedagogical practices that enable the development of competences that are associated to training process. As soon, to guide the teaching and learning process by competency as recommended by National Curriculum Guidelines (NCG), it is essential that the Universities assume this role. Objective: Investigate the comprehension about general competencies established by NGC that are present in the training process through speech of students. Methods: It is a descriptive study with qualitative approach which used an interview based in a problem situation for data collection. The subjects were graduating volunteers of Department of Dentistry of Federal University of Rio Grande do Norte. The speech of participants was recorded and transcribed which was analyzed with the ALCESTE software. Results: The corpus were divided in 131 Elementary Context Units (ECU), distributed and clustered in five lexical classes that composes the essential content present in interviews analyzed and denominated of Health problems that appear in Public Health System, communication difficulties, shortcomings of training process, articulated forming spaces and social determinants of health. Conclusions: It is conclude that during training process, there are difficulties in articulation of Academy with health services, beyond of shortage curriculum components with pedagogical practices and disciplines connected to social reality. Despite advances with the inclusion multidisciplinary clinics and insertion formative experiences linked to working world induced by recent higher education politics, the undergraduates present limitations to mobilize knowledge, interpret essential information and work in multi-professional team in face of health problems (AU).