Microalgae-based domestic wastewater treatment: a review of biological aspects, bioremediation potential, and biomass production with biotechnological high-value.

This review aims to perform an updated bibliographical survey on the cultivation of microalgae in domestic wastewater with a focus on biotechnological aspects. It was verified that the largest number of researches developed was about cultures in microalgae-bacteria consortium and mixed cultures of microalgae, followed by researches referring to the species Chlorella vulgaris and to the family Scenedesmaceae. According to published studies, these microorganisms are efficient in the biological treatment of domestic wastewater, as well as in the production of high value-added biomass, as they are capable of biosorbing the organic and inorganic compounds present in the culture medium, thus generating cells with high levels of lipids, proteins, and carbohydrates. These compounds are of great importance for different industry sectors, such as pharmaceuticals, food, and also for agriculture and aquaculture. In addition, biomolecules produced by microalgae can be extracted for several biotechnological applications; however, most studies focus on the production of biofuels, with biodiesel being the main one. There are also other emerging applications that still require more in-depth research, such as the use of biomass as a biofertilizer and biostimulant in the production of bioplastic. Therefore, it is concluded that the cultivation of microalgae in domestic wastewater is a sustainable way to promote effluent bioremediation and produce valuable biomass for the biobased industry, contributing to the development of technology for the green economy.

Coxsackievirus infection induces direct pancreatic ß cell killing but poor antiviral CD8+ T cell responses.

Coxsackievirus B (CVB) infection of pancreatic ß cells is associated with ß cell autoimmunity and type 1 diabetes. We investigated how CVB affects human ß cells and anti-CVB T cell responses. ß cells were efficiently infected by CVB in vitro, down-regulated human leukocyte antigen (HLA) class I, and presented few, selected HLA-bound viral peptides. Circulating CD8+ T cells from CVB-seropositive individuals recognized a fraction of these peptides; only another subfraction was targeted by effector/memory T cells that expressed exhaustion marker PD-1. T cells recognizing a CVB epitope cross-reacted with ß cell antigen GAD. Infected ß cells, which formed filopodia to propagate infection, were more efficiently killed by CVB than by CVB-reactive T cells. Our in vitro and ex vivo data highlight limited CD8+ T cell responses to CVB, supporting the rationale for CVB vaccination trials for type 1 diabetes prevention. CD8+ T cells recognizing structural and nonstructural CVB epitopes provide biomarkers to differentially follow response to infection and vaccination.

New insights on the role of nitrogen in the resistance to environmental stress in an endosymbiotic dinoflagellate.

Endosymbiotic dinoflagellates provide the nutritional basis for marine invertebrates, especially reef-building corals. These dinoflagellates are sensitive to environmental changes, and understanding the factors that can increase the resistance of the symbionts is crucial for the elucidation of the mechanisms involved with coral bleaching. Here, we demonstrate how the endosymbiotic dinoflagellate Durusdinium glynnii is affected by concentration (1760 vs 440 µM) and source (sodium nitrate vs urea) of nitrogen after light and thermal stress exposure. The effectiveness in the use of the two nitrogen forms was proven by the nitrogen isotopic signature. Overall, high nitrogen concentrations, regardless of source, increased D. glynnii growth, chlorophyll-a, and peridinin levels. During the pre-stress period, the use of urea accelerated the growth of D. glynnii compared to cells grown using sodium nitrate. During the luminous stress, high nitrate conditions increased cell growth, but no changes in pigments composition was observed. On the other hand, during thermal stress, a steep and steady decline in cell densities over time was observed, except for high urea condition, where there is cellular division and peridinin accumulation 72 h after the thermal shock. Our findings suggest peridinin has a protective role during the thermal stress, and the uptake of urea by D. glynnii can alleviate thermal stress responses, eventually mitigating coral bleaching events.

Risk of violence and frailty syndrome among older adults treated at a hospital service.

OBJECTIVES: to assess the association between risk of violence and frailty syndrome among hospitalized older adults. METHODS: quantitative, analytical and cross-sectional research, carried out with older adults in two university hospitals. Data collection was performed using the Brazil Old Age Schedule, Hwalek-Sengstock Elder Abuse Screening Test and Edmonton Frail Scale instruments. It was analyzed using descriptive statistics and inferential statistics. RESULTS: risk of violence was higher among women (68.9%), over 70 years old (64.7%), with more than 3 years of study (68.9%), without relationship (67.1%), who do not work (65.1%) and with income above 1 minimum wage (65.2%). There is a significant association between risk of violence and frailty (72.3%; p<0.001) and a positive correlation between the instrument scores (r=0.350; p-value<0.001). CONCLUSIONS: risk of violence was associated with being female and frailty. The study is expected to encourage further discussions related to the theme and nursing practice.

Human thymopoiesis produces polyspecific CD8+ α/ß T cells responding to multiple viral antigens.

T-cell receptors (TCRs) are formed by stochastic gene rearrangements, theoretically generating >1019 sequences. They are selected during thymopoiesis, which releases a repertoire of about 108 unique TCRs per individual. How evolution shaped a process that produces TCRs that can effectively handle a countless and evolving set of infectious agents is a central question of immunology. The paradigm is that a diverse enough repertoire of TCRs should always provide a proper, though rare, specificity for any given need. Expansion of such rare T cells would provide enough fighters for an effective immune response and enough antigen-experienced cells for memory. We show here that human thymopoiesis releases a large population of clustered CD8+ T cells harboring α/ß paired TCRs that (i) have high generation probabilities and (ii) a preferential usage of some V and J genes, (iii) which CDR3 are shared between individuals, and (iv) can each bind and be activated by multiple unrelated viral peptides, notably from EBV, CMV, and influenza. These polyspecific T cells may represent a first line of defense that is mobilized in response to infections before a more specific response subsequently ensures viral elimination. Our results support an evolutionary selection of polyspecific α/ß TCRs for broad antiviral responses and heterologous immunity.

Interferon-α promotes neo-antigen formation and preferential HLA-B-restricted antigen presentation in pancreatic ß-cells.

Interferon (IFN)-α is the earliest cytokine signature observed in individuals at risk for type 1 diabetes (T1D), but its effect on the repertoire of HLA Class I (HLA-I)-bound peptides presented by pancreatic ß-cells is unknown. Using immunopeptidomics, we characterized the peptide/HLA-I presentation in in-vitro resting and IFN-α-exposed ß-cells. IFN-α increased HLA-I expression and peptide presentation, including neo-sequences derived from alternative mRNA splicing, post-translational modifications - notably glutathionylation - and protein cis-splicing. This antigenic landscape relied on processing by both the constitutive and immune proteasome. The resting ß-cell immunopeptidome was dominated by HLA-A-restricted ligands. However, IFN-α only marginally upregulated HLA-A and largely favored HLA-B, translating into a major increase in HLA-B-restricted peptides and into an increased activation of HLA-B-restricted vs. HLA-A-restricted CD8+ T-cells. A preferential HLA-B hyper-expression was also observed in the islets of T1D vs. non-diabetic donors, and we identified islet-infiltrating CD8+ T-cells from T1D donors reactive to HLA-B-restricted granule peptides. Thus, the inflammatory milieu of insulitis may skew the autoimmune response toward epitopes presented by HLA-B, hence recruiting a distinct T-cell repertoire that may be relevant to T1D pathogenesis.

Coxsackievirus infection induces direct pancreatic ß-cell killing but poor anti-viral CD8+ T-cell responses.

Coxsackievirus B (CVB) infection of pancreatic ß cells is associated with ß-cell autoimmunity. We investigated how CVB impacts human ß cells and anti-CVB T-cell responses. ß cells were efficiently infected by CVB in vitro, downregulated HLA Class I and presented few, selected HLA-bound viral peptides. Circulating CD8+ T cells from CVB-seropositive individuals recognized only a fraction of these peptides, and only another sub-fraction was targeted by effector/memory T cells that expressed the exhaustion marker PD-1. T cells recognizing a CVB epitope cross-reacted with the ß-cell antigen GAD. Infected ß cells, which formed filopodia to propagate infection, were more efficiently killed by CVB than by CVB-reactive T cells. Thus, our in-vitro and ex-vivo data highlight limited T-cell responses to CVB, supporting the rationale for CVB vaccination trials for type 1 diabetes prevention. CD8+ T cells recognizing structural and non-structural CVB epitopes provide biomarkers to differentially follow response to infection and vaccination.

Assessment tools for elder abuse: scoping review.

OBJECTIVE: to map assessment tools for elder abuse and determine the psychometric properties of each one. METHOD: scoping review developed according to recommendations of the JBI Institute Reviewer's Manual in databases and gray literature. RESULTS: seventeen tools were identified for measuring situations of elder abuse. They were categorized into 1) Tools for assessment of risk for abuse, and 2) Tools for identification of abuse. According to risk for abuse, Vulnerability to Abuse Screening Scale was the most prevalent in the literature, with factorial analysis acceptable through four domains, and good internal reliability (0,74). Therefore, Assessment Tool for Domestic Elder Abuse comprises the assessment of six types of elder abuse; however, the study shows psychometric limitation since the internal structure was not evaluated by validity evidences. CONCLUSION: seventeen tools to determine the occurrence or risk for elder abuse were identified with different psychometric properties. We recommend the use of more than one of the tools identified for an appropriate measurement of elder abuse situations given the complexity of the phenomenon and the lack of a single instrument that contemplates all its consequences and forms of expression.

Risk of violence and functional capacity of hospitalized elderly: a cross-sectional study.

OBJECTIVE: To analyze the risk of violence associated to functional capacity and sociodemographic characteristics of hospitalized elderly. METHOD: Quantitative, cross-sectional, multicenter study conducted with elderly receiving care at university hospitals of the municipalities of João Pessoa and Campina Grande, in the state of Paraíba, Brazil. The scales Katz and Hwalek-Sengstock Elder Abuse Screening Test were applied. The data was analyzed through descriptive and inferential statistics using Chi-squared Pearson test, Spearman correlation test, and multiple logistic regression. RESULTS: The participating elderly amounted to 323. The risk of violence was predominant among female elders aged 60 to 70 who are unable to read or write, live with someone, perform no labor activity, and whose income is higher than a minimum wage. Elders who were dependent for basic and instrumental activities presented a 2.11 score (Confidence Interval = 1.22-3.64; p = 0.000) and 1.70 (1.01-2.85; p = 0.044) and a higher risk of violence. CONCLUSION: Elders who depended on other people to perform both complex and basic activities are the most exposed to situations of violence.

Influence of burnout syndrome on the quality of life of nursing professionals: quantitative study.

OBJECTIVE: To estimate the prevalence and factors associated with the burnout syndrome and quality of life among nursing professionals. METHODS: Cross-sectional, analytical study, developed with 83 professionals in emergency care units in the city of Campina Grande-PB. A questionnaire was used to characterize the sample, the Maslach Burnout Inventory scale and the SF-36. Data was analyzed using descriptive and inferential statistics. RESULTS: Most professionals showed low professional effectiveness (78.3; n=65), average depersonalization (53.0%; n=44) and average emotional exhaustion (55.4%; n=46). There was a statistical difference between the scores of the syndrome and the pain (p=0.03), vitality (p=0.04) and social aspect (p=0.03); significant correlation between the syndrome and vitality (p<0.001), mental health (p=0.01) and general quality of life (p=0.04). CONCLUSION: The burnout syndrome has an influence on the outcome of quality of life of nursing professionals, being more prevalent among professionals with older age, high income and among nurses.

CD8+ T Cells Variably Recognize Native Versus Citrullinated GRP78 Epitopes in Type 1 Diabetes.

In type 1 diabetes, autoimmune ß-cell destruction may be favored by neoantigens harboring posttranslational modifications (PTMs) such as citrullination. We studied the recognition of native and citrullinated glucose-regulated protein (GRP)78 peptides by CD8+ T cells. Citrullination modulated T-cell recognition and, to a lesser extent, HLA-A2 binding. GRP78-reactive CD8+ T cells circulated at similar frequencies in healthy donors and donors with type 1 diabetes and preferentially recognized either native or citrullinated versions, without cross-reactivity. Rather, the preference for native GRP78 epitopes was associated with CD8+ T cells cross-reactive with bacterial mimotopes. In the pancreas, a dominant GRP78 peptide was instead preferentially recognized when citrullinated. To further clarify these recognition patterns, we considered the possibility of citrullination in the thymus. Citrullinating peptidylarginine deiminase (Padi) enzymes were expressed in murine and human medullary epithelial cells (mTECs), with citrullinated proteins detected in murine mTECs. However, Padi2 and Padi4 expression was diminished in mature mTECs from NOD mice versus C57BL/6 mice. We conclude that, on one hand, the CD8+ T cell preference for native GRP78 peptides may be shaped by cross-reactivity with bacterial mimotopes. On the other hand, PTMs may not invariably favor loss of tolerance because thymic citrullination, although impaired in NOD mice, may drive deletion of citrulline-reactive T cells.

Relationship between oral intake and severity of Acute Stroke. / Relação entre ingestão oral e gravidade do Acidente Vascular Cerebral Agudo.

PURPOSE: To correlate stroke severity with oral intake level of the studied population and compare the two factors at the time of admission and after swallowing management. METHODS: A total of 137 patients hospitalized in the cerebral vascular accident unit (CVAU) of a teaching hospital participated. During the stay at CVAU, the patients were submitted to daily neurological evaluation and application of National Institutes of Health Stroke Scale (NIHSS), to evaluate the severity of stroke, ranging from zero (without evidence of neurological deficit) to 42 (in coma and unresponsive). Functional Oral Intake Scale (FOIS), which is a marker for evolution of oral intake and ranges from level one (nothing oral) to seven (oral total restrictions). Data from the NIHSS and FOIS scales of admission and discharge were analyzed and compared to verify association between improvement of oropharyngeal dysphagia with functional improvement of individuals. RESULTS: At admission, 63 (46.0%) patients had mild strokes, 38 (27.7%) had severe and very severe stroke; 46 (33.6%) had oral intake and need for special preparation or compensations. At discharge, there was an increase in patients with mild stroke (76 - 55.5%); oral intake without special preparation or compensations, but with food restrictions (18 - 13.1%), and oral intake without restrictions (44 - 32.1%). CONCLUSION: The level of oral intake increased as the severity of stroke decreased. Speech and language therapy contributed to a decrease in stroke severity and improvement in oral intake.

OBJETIVO: Correlacionar gravidade do AVC com nível de ingestão oral desta população e comparar os dois fatores mencionados na admissão e após gerenciamento da deglutição. MÉTODO: Participaram 137 pacientes internados na Unidade de Acidente Vascular Cerebral (UAVC) de um hospital de ensino. Durante a permanência na UAVC, os pacientes foram submetidos diariamente a avaliação neurológica e aplicação da escala National Institutes of Health Stroke Scale (NIHSS), para avaliação da gravidade do AVC, que varia de zero (sem evidência de déficit neurológico) a 42 (paciente irresponsivo, em coma). Após cada atendimento fonoaudiológico diário, foi aplicada a escala de ingestão oral Functional Oral Intake Scale (FOIS), que consiste em um marcador para evolução da ingestão por via oral e varia do nível um (nada por via oral) a sete (via oral total sem restrições). Os dados das escalas NIHSS e FOIS de admissão e alta foram analisados e comparados, para verificar associação entre melhora da disfagia orofaríngea com melhora funcional dos indivíduos. RESULTADOS: Na admissão, 63 (46,0%) pacientes apresentaram AVC leve e 38 (27,7%), grave e gravíssimo; 46 (33,6%) com ingestão oral e necessidade de preparo especial ou compensações. Na alta, houve aumento de pacientes com AVC leve (76 - 55,5%); ingestão oral sem necessidade de preparo especial ou compensações, porém com restrições alimentares (18 - 13,1%), e ingestão oral sem restrições (44 - 32,1%). CONCLUSÃO: O nível de ingestão oral aumentou conforme a gravidade do AVC diminuiu. O atendimento fonoaudiológico contribuiu para diminuição da gravidade do AVC e melhoria da ingestão oral.

Cognition and quality of life relationship among the elderly community: a cross-sectional study.

OBJECTIVE: to assess cognitive functions and their association with quality of life among elderly people enrolled in a Family Health Unit (FHU) of Primary Health Care in Recife-PE. METHODS: a quantitative, descriptive, cross-sectional study in which elderly aged 60 years and over were studied. RESULTS: 76.7% of the elderly were women and the age group was less than or equal to 70 years. 68.6% had cognitive impairment, and in the quality of life assessment it was found that the social participation facet had the highest mean score among the elderly (14.25), while the lowest was observed in the sensory functioning facet (9.10). There was an association between cognitive decline and quality of life. CONCLUSION: most of the elderly had good quality of life rates, but low cognitive level. Using screening tools allows early detection of health problems, guiding the nursing staff in the construction of preventive measures.

Relationship between oral transit time and functional performance in motor neuron disease.

Oral phase swallowing impairment in motor neuron disease (MND) is caused by tongue weakness, fasciculation and atrophy, which may compromise oral transit time and total feeding time. OBJECTIVE To describe and correlate total oral transit time (TOTT) with functional performance in MND using different food consistencies. METHODS The study was conducted on 20 patients with MND, regardless of type or duration of the disease, of whom nine were excluded due to issues on the videofluoroscopic swallowing images. The remaining 11 patients (nine men and two women) ranged from 31 to 87 years of age (mean: 57 years) with scores on the Penetration Aspiration Scale ranging from ≤ 2 to ≤ 4. The Amyotrophic Lateral Sclerosis Functional Rating Scale - revised questionnaire was applied to classify individuals according to global, bulbar and bulbar/respiratory parameters. Videofluoroscopy of swallowing using 5ml of different consistencies was performed and a quantitative temporal analysis of the TOTT was carried out with the aid of specific software. RESULTS There was a wide variation in the TOTT within the same food consistency among MND patients. There was a correlation between the TOTT and overall functional performance for the thickened liquid consistency (r = -0.691) and between the TOTT and bulbar performance for the pureed consistency (r = -0.859). CONCLUSION Total oral transit time in MND varies within the same food consistency and the longer the TOTT, regardless of food consistency, the lower the functional performance in MND.

Correlation between bulbar functionality and laryngeal penetration and/or laryngotracheal aspiration on motor neuron disease. / Correlação entre funcionalidade bulbar e penetração e/ou aspiração laringotraqueal na doença do neurônio motor.

OBJECTIVE: Describe and correlate bulbar functionality with laryngeal penetration and/or laryngotracheal aspiration for different food consistencies in Motor Neuron Disease (MND). METHODS: Study participants were 18 individuals diagnosed with MND regardless of the type and time of onset of disease. The Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised/BR (ALSFRS-R/BR) was applied, and only the bulbar parameter, which includes speech, salivation and swallowing, was analyzed, with scores raging from 0 (disability) to 12 (normal functionality). Swallowing videofluoroscopy was performed using the Penetration-Aspiration Scale (PAS) described by Rosenbek et al. (1996). The Pearson correlation test was used for data analysis. RESULTS: According to food consistency, the PAS level ranged from 1 to 5 for puree consistency, 1 to 4 for thickened liquid, and 1 to 3 for liquid, and no laryngotracheal aspiration was observed. Negative correlation between bulbar functionality and laryngeal penetration was observed for all food consistencies (pasty: r=-0.487, p=0.041; thickened liquid: r=-0.442, p=0.076; liquid r=0.460, p=0.073), but statistically significant difference was found only for the puree consistency, that is, individuals with poor bulbar functionality presented higher levels of laryngeal penetration. CONCLUSION: Negative correlation was observed between bulbar functionality and laryngeal penetration in MND. The bulbar parameters of the ALSFRS-R/BR are significant for predicting risk of laryngotracheal aspiration for pasty consistency in MND.

OBJETIVO: Descrever e correlacionar a funcionalidade bulbar com penetração e aspiração laringotraqueal em distintas consistências de alimento na Doença do Neurônio Motor (DNM). MÉTODO: Participaram do estudo 18 indivíduos diagnosticados com DNM, independentemente do tipo e tempo da doença. Foi aplicada a escala Amyotrophic Lateral Sclerosis Functional Rating Scale­Revised/BR (ALSFRS-R/BR), sendo analisado apenas o parâmetro bulbar que compreende fala, salivação e deglutição, com pontuação de 0 (incapacidade) a 12 (funcionalidade normal). Realizou-se videofluoroscopia da deglutição com aplicação da Penetration-Aspiration Scale (PAS) descrita por Rosenbek et al. (1996). Realizado Teste de Correlação de Pearson. RESULTADOS: Considerando a consistência do alimento, o nível da PAS variou de 1 a 5 na consistência pastosa, de 1 a 4 na líquida espessada e de 1 a 3 na líquida rala, e não houve aspiração laringotraqueal. Para todas as consistências de alimentos, houve correlação negativa entre funcionalidade bulbar e penetração laríngea (pastoso: r=-0,487, p=0,041; líquido espessado: r=-0,442, p=0,076; líquido ralo: r=-0,460, p=0,073), porém somente na consistência pastosa houve diferença estatística significante, ou seja, indivíduos com baixa funcionalidade bulbar apresentaram maior nível de penetração laríngea. CONCLUSÃO: Houve correlação negativa entre funcionalidade bulbar e penetração laríngea na DNM. Os parâmetros bulbares da escala ALSFRS-R/BR mostraram-se significantes para predizer risco de penetração laringotraqueal na consistência pastosa na DNM.

Síndrome da fragilidade e qualidade de vida em pessoas idosas hospitalizadas / Frailty syndrome and quality of life in hospitalized older adults

Resumo Objetivo analisar a relação entre a síndrome de fragilidade e qualidade de vida em pessoas idosas hospitalizadas. Métodos estudo de abordagem quantitativa e corte transversal, desenvolvido com uma amostra de 323 pessoas idosas assistidas em hospitais universitários da Paraíba, durante agosto de 2019 a julho de 2020. Os dados foram tabulados no SPSS, versão 26.0, mediante teste qui-quadrado de Pearson, teste de correlação de Spearman e regressão logística múltipla entre variáveis sociodemográficas, de fragilidade e qualidade de vida. Resultados dos participantes, 60,7% eram mulheres, 49,2% tinham idade entre 60 e 69 anos, 51% tinham cônjuge, 67,8%, sabiam ler e escrever, 89,2% moravam com pelo menos uma pessoa, 78,3% não exercia atividade laboral e 57,9% recebiam até um salário mínimo. A síndrome de fragilidade foi significativa com gênero, idade, letramento, atividade laboral, renda e qualidade de vida. Já a qualidade de vida foi estatisticamente significativa com gênero e atividade laboral, somente. Foi visto que não saber ler, não exercer atividade laboral e ter baixa qualidade de vida aumentava em 3,04 (IC95%; 1,70-5,44), 4,51 (IC95%; 2,39-8,49) e 3,81 (IC95%; 2,22-6,53), a probabilidade de ter síndrome da fragilidade, respectivamente; enquanto que não exercer atividade remunerada acrescia em 2,61 (IC95%; 1,45-4,73) a probabilidade de ter baixa qualidade de vida. Conclusões a síndrome da fragilidade está associada a uma redução na qualidade de vida de pessoas hospitalizadas, o que sinaliza propostas de melhorias para gestores hospitalares no que tange a assistência além das condições clínicas já estudadas no cotidiano laboral.

Abstract Objective to analyze the relationship between frailty syndrome and quality of life in hospitalized older adults. Methods a quantitative cross-sectional study of 323 older individuals was carried out at university hospitals of Paraíba from August 2019 to July 2020. Data were analyzed by SPSS, version 26.0, using Pearson´s chi-square, Spearman´s correlation and multiple logistic regression for sociodemographic, frailty and quality of life variables. Results regarding participant profile, 60.7% were women, 49.2% aged 60-69 years, 51% had a partner, 67.8% were literate, 89.2% lived with at least 1 other person, 78.3% were not working, and 57.9% received ≤ 1 minimum wage. Frailty syndrome was significantly associated with gender, age, literacy, work status, income, and quality of life. Quality of life was statistically significantly associated with only gender and work status. Results showed that illiteracy, not working and low quality of life increased the probability of frailty syndrome by 3.04 (95%CI; 1.70-5.4), 4.51 (95%CI; 2.39-8.49), and 3.81 (95%CI; 2.22-6.53), respectively; while not working increased the probability of low quality of life.by 2.61 (95%CI;1,45-4,73). Conclusions frailty syndrome was associated with low quality of life in the hospitalized older adults, indicating the need for measures by hospital managers to improve care beyond the clinical conditions addressed in routine practice.

Aspectos sociodemográficos e capacidade funcional associados à violência física em pessoas idosas hospitalizadas / Sociodemographic aspects and functional capacity associated with physical violence in hospitalized elderly people

RESUMO Objetivo analisar a associação dos aspectos sociodemográficos e capacidade funcional com a violência física em pessoas idosas hospitalizadas. Métodos estudo multicêntrico, transversal, com 323 pessoas idosas atendidas em dois hospitais universitários. Foram utilizados o Conflict Tactics Scales, as escalas para avaliação das atividades básicas e instrumentais de vida diária e um questionário adaptado para avaliação de atividades avançadas de vida diária. Os dados foram analisados por estatística descritiva e inferencial. Resultados as atividades individuais de vida diária estiveram associadas à violência física maior, apontando haver uma relação inversamente proporcional entre as variáveis, e pessoas idosas independentes para essas atividades são aquelas que não vivenciam violência física maior (p=0,037). Conclusão a independência funcional para as atividades instrumentais de pessoas idosas internadas apresenta relação com menor probabilidade de ser vítima de violência física. Contribuições para a prática o estudo aponta achados singulares na relação entre violência física e a capacidade funcional, de modo que cada tipo de atividade de vida diária pode resultar em um desfecho diferente para a violência física. Outrossim, ratifica-se a relevância de avaliações individuais e contextualizadas no ambiente hospitalar, o qual pode influenciar os fatores condicionantes a esse agravo.

ABSTRACT Objective to analyze the association of sociodemographic aspects and functional capacity with physical violence in hospitalized elderly people. Methods this was a multi-center, cross-sectional study of 323 elderly people treated at two university hospitals. The Conflict Tactics Scales, the scales for assessing basic and instrumental activities of daily living and a questionnaire adapted for assessing advanced activities of daily living were used. The data was analyzed using descriptive and inferential statistics. Results individual activities of daily living were associated with major physical violence, indicating an inversely proportional relationship between the variables, and independent elderly people for these activities are those who do not experience major physical violence (p=0.037). Conclusion the functional independence for instrumental activities of elderly inpatients is related to a lower probability of being a victim of physical violence. Contributions to practice the study points to unique findings in the relationship between physical violence and functional capacity, so that each type of activity of daily living can result in a different outcome for physical violence. It also confirms the importance of individual and contextualized assessments in the hospital environment, which can influence the conditioning factors for this condition.

Avaliação da satisfação com a vida e o risco para violência em idosos / Assessment of life satisfaction and risk of violence in elderly / Evaluación de la satisfacción con la vida y riesgo de violencia en personas mayores

Objetivo:descrever a relação da satisfação com a vida e o risco para violência entre homens e mulheres idosos. Método: estudo quantitativo, transversal, realizado com 159 idosos, utilizando a Escala de Satisfação com a Vida e Hwalek-Sengstock Elder Abuse Screening Test. Os dados foram analisados mediante estatística descritiva (frequência absoluta e relativa, medidas de tendência central e dispersão) e inferencial (Teste t de Student; Regressão Linear). Resultados: a satisfação com a vida segundo o gênero apresentou diferença significativa entre as médias do risco para violência, verificando que os homens idosos que apresentavam risco para violência estavam menos satisfeitos com a vida. Observou-se correlação negativa para o grupo masculino (ß=-0,416) e feminino (ß=-0,293) entre essas variáveis. Conclusão: homens idosos que apresentam risco para violência exibem menores escores de satisfação, apontando que a satisfação com a vida aumenta à medida em que o risco para violência diminui

Objective: to describe the relationship between life satisfaction and risk of violence among elderly men and women. Method: quantitative study, cross-sectional, conducted with 159 elderlies, using the Life Satisfaction Scale and Hwalek-Sengstock Elder Abuse Screening Test. Data were analyzed through descriptive statistic (absolute and relative frequency, measures of central tendency and dispersion) and inferential (Student's t-test; Linear regression). Results: life satisfaction according to gender presented significant difference between the averages of the risk of violence, verifying that older men that presented risk of violence were less satisfied with life. It was observed negative correlation for male group (ß=-0,416) and female between these variables. (ß=-0,293). Conclusion: older men that presented risk of violence exhibit lower satisfaction scores, pointing out that life satisfaction increases as the risk of violence decreases

Objetivo: describir la relación entre la satisfacción vital y el riesgo de violencia entre hombres y mujeres ancianos. Método: estudio cuantitativo, transversal, realizado con 159 ancianos, utilizando la Escala de Satisfacción con la Vida y Hwalek-Sengstock Elder Abuse Screening Test. Los datos se analizaron mediante estadísticas descriptivas (frecuencia absoluta y relativa, medidas de tendencia central y dispersión) y estadísticas inferenciales (prueba t de Student; regresión lineal). Resultados: la satisfacción con la vida según el género mostró diferencia significativa entre las medias de riesgo de violencia, verificando que los hombres ancianos que presentaban riesgo de violencia estaban menos satisfechos con la vida. Se observó correlación negativa para el grupo de hombres (ß=-0,416) y mujeres (ß=-0,293) entre estas variables. Conclusión: los hombres ancianos que presentan riesgo de violencia muestran puntuaciones de satisfacción más bajas, lo que indica que la satisfacción con la vida aumenta a medida que disminuye el riesgo de violencia

Risco de violência, doenças autorreferidas e fragilidade em pessoas idosas hospitalizadas / Risk of violence, self-reported diseases and frailty in hospitalized older adults / Risk of violence, self-reported diseases and frailty in hospitalized older adults / Riesgo de violencia, enfermedades autodeclaradas y fragilidad en adultos mayores hospitalizados

Resumo Objetivo Analisar a relação do risco de violência com doenças autorreferidas e síndrome da fragilidade em pessoas idosas atendidas em instituições hospitalares. Métodos Estudo transversal, multicêntrico, realizado com 323 pessoas idosas em dois hospitais universitários da Paraíba. Foram utilizados os instrumentos Hwalek-Sengstock Elder Abuse Screening Test, um questionário de doença autorreferida e o Edmonton Frail Scale. Os dados foram analisados mediante estatística descritiva e inferencial, utilizando o teste Qui-quadrado e Regressão Logística Múltipla. Resultados O risco de violência foi associado em pessoas idosas com depressão (p=0,001), artrite ou reumatismo (p<0,001), osteoporose (p<0,001), síndrome da fragilidade (p<0,001). Ademais, aqueles com artrite e síndrome da fragilidade apresentaram, respectivamente, 2,37 [IC= 1,43-3,91] e 3,07 [IC=1,88-4,92] maior probabilidade de sofrerem risco de violência. Conclusão Pessoas idosas com doenças crônicas e síndrome da fragilidade estão mais susceptíveis ao risco de violência. Assim, a discussão sobre a temática durante a formação de futuros enfermeiros se faz essencial no que tange os cuidados de enfermagem gerontológicos frente a esse fenômeno.

Resumen Objetivo Analizar la relación entre el riesgo de violencia con enfermedades autodeclaradas y el síndrome de fragilidad en adultos mayores atendidos en instituciones hospitalarias. Métodos Estudio transversal, multicéntrico, realizado con 323 adultos mayores en dos hospitales universitarios del estado de Paraíba. Se utilizaron los instrumentos Hwalek-Sengstock Elder Abuse Screening Test, un cuestionario sobre enfermedades autodeclaradas, y el Edmonton Frail Scale. Los datos se analizaron a través de estadística descriptiva e inferencial, utilizando la prueba χ2 de Pearson y Regresión Logística Múltiple. Resultados El riesgo de violencia en adultos mayores estuvo asociado con depresión (p=0,001), artritis o reumatismo (p<0,001), osteoporosis (p<0,001), síndrome de fragilidad (p<0,001). Además, los que tienen artritis y síndrome de fragilidad presentaron, respectivamente, 2,37 [IC= 1,43-3,91] y 3,07 [IC=1,88-4,92] más probabilidades de sufrir riesgo de violencia. Conclusión Adultos mayores con enfermedades crónicas y síndrome de fragilidad están más susceptibles a riesgo de violencia. De esa forma, la discusión sobre la temática durante la formación de futuros enfermeros es esencial en lo que se refiere a los cuidados de enfermería gerontológicos ante ese fenómeno.

Abstract Objective To analyze the relationship between the risk of violence and self-reported illnesses and the frailty syndrome in older adults treated at hospitals. Methods This is a cross-sectional, multicenter study, carried out with 323 older adults in two university hospitals in Paraíba. The Hwalek-Sengstock Elder Abuse Screening Test instruments, a self-reported illness questionnaire and the Edmonton Frail Scale were used. Data were analyzed using descriptive and inferential statistics, using the chi-square test and Multiple Logistic Regression. Results The risk of violence was associated in older adults with depression (p=0.001), arthritis or rheumatism (p<0.001), osteoporosis (p<0.001), frailty syndrome (p<0.001). Furthermore, those with arthritis and frailty syndrome had, respectively, 2.37 [CI= 1.43-3.91] and 3.07 [CI=1.88-4.92] greater probability of being at risk of violence. Conclusion Older adults with chronic diseases and frailty syndrome are more susceptible to the risk of violence. Thus, the discussion on the subject during the training of future nurses becomes essential with regard to gerontological nursing care in the face of this phenomenon.

Violência contra pessoa idosa: análise da consistência interna de instrumentos* / Abuse against the elderly person: analysis of the internal consistency of instruments* / Violencia contra los ancianos: análisis de la coherencia interna de los instrumentos*

RESUMO: Objetivo: avaliar a consistência interna de instrumentos utilizados no Brasil para mensuração de situações de violência contra pessoa idosa em dois estados. Método: estudo de corte transversal, desenvolvido com 481 idosos, em duas amostras, estados e recorte temporal diferentes. Foram aplicados dois instrumentos de mensuração de violência contra pessoa idosa. Os dados foram analisados, e a consistência interna entre os itens foi medida pelo coeficiente de Alfa de Cronbach. Resultados: o Hwalek-Sengstock Elder Abuse Screening Test apresentou o coeficiente de α = 0,08 para amostra coletada na Paraíba, enquanto, em Pernambuco, foi α = 0,57. A Conflict Tactics Scale apresentou alta precisão para definição da violência com coeficiente de α = 0,81 e α = 0,80 para as duas amostras. Conclusões: apenas a Conflict Tactics Scale apresentou-se confiável e estável para determinação da violência de natureza física e psicológica entre idosos, contribuindo assim, como uma possibilidade de desvelar o fenômeno.

ABSTRACT Objective: to evaluate the internal consistency of instruments used in Brazil to measure situations of violence against the elderly in two states. Method: a cross-sectional study with 481 elderly people in two different samples, states, and time periods. Two instruments were used to measure violence against the elderly person. The data was analyzed and the internal consistency between the items was measured by the Cronbach's alpha coefficient. Results: the Hwalek-Sengstock Elder Abuse Screening Test showed a coefficient of α = 0.08 for the sample collected in Paraíba, while in Pernambuco it was α = 0.57. The Conflict Tactics Scale was highly accurate in defining violence, with a coefficient of α = 0.81 and α = 0.80 for the two samples. Conclusions: only the Conflict Tactics Scale turned out to be reliable and stable for determining physical and psychological violence among the elderly, thus contributing as a way of uncovering the phenomenon.

RESUMEN Objetivo: Evaluar la consistencia interna de instrumentos utilizados en Brasil para medir situaciones de violencia contra ancianos en dos estados. Método: Estudio transversal realizado con 481 ancianos en dos muestras, estados y periodos de tiempo diferentes. Se utilizaron dos instrumentos para medir la violencia contra ancianos. Se analizaron los datos y se midió la consistencia interna entre los ítems mediante el coeficiente alfa de Cronbach. Resultados: el Hwalek-Sengstock Elder Abuse Screening Test presentó un coeficiente de α = 0,08 para la muestra recogida en Paraíba, mientras que en Pernambuco fue de α = 0,57. La Escala de Tácticas de Conflicto fue altamente precisa en la definición de violencia, con coeficientes de α = 0,81 y α = 0,80 para ambas muestras. Conclusiones: sólo la Escala de Tácticas de Conflicto demostró ser fiable y estable para determinar la violencia física y psicológica entre ancianos, contribuyendo así a desvelar el fenómeno.