Reflexões sobre o estágio em docência como instrumento formativo do professor universitário: um relato de experiência / Reflections on the teaching internship as a training instrument for university professor: an experience report / Reflexiones sobre la práctica docente como instrumento de formación del profesor universitario: un relato de experiencia

Introdução:A formação de professores é um processo dinâmico que deve ser composto por experiências práticas e teóricas no preparodo discente ao magistério. Desse modo, a compreensão das reflexões relativas ao estágio em docência assistida no âmbito do ensino superior é de suma importância para enriquecer os debates e discussões acerca do papel do estágio em docência como ferramenta formativa do professor universitário. Objetivo:Refletir sobreas experiências vivenciadas durante atividades desenvolvidas noestágio de docência assistidaea importância para a formação pedagógica no ensino superior. Metodologia:Trata-se de um relato de experiênciado estágio emdocência decorrido no segundo semestre de 2022, na disciplina de Fundamentos em epidemiologia e saúde pública do curso de Graduação em Fisioterapia da Universidade Federal do Rio Grande do Norte.Resultados: No presente estudo, foram descritas e analisadas as etapas da experiência do estágio em docência, enfocando as perspectivas, aprendizados e aspirações sob a ótica da literatura científica sobre o papel formativo do estágio para o professor universitário. Os resultados obtidos evidenciam a significânciadas contribuições dessa vivência para o crescimento acadêmico e profissional dos mestrandos. No entanto, salienta-se a necessidade de incorporar ou revisar elementos curriculares, visando promover uma integração mais aprofundada entre as dimensões teóricas e práticas no preparo dos alunos para a docência no ensino superior. Conclusões: O estágio de docência assistida representa uma ferramenta formativa de suma importância, singular e enriquecedora na construção das experiências profissionais e pessoais na formação de professores (AU).

Introduction: Teacher education is a dynamic process that must be composed of practical and theoretical experiences in preparing students to teach. Thus, understanding the reflections related to the internship in assisted teaching in higher education is of paramount importance to enrich the debates and discussions about the role of the internship in teaching as a training tool for university professors.Objective: To reflect on the experiences lived during activities developed in the assisted teaching internship and the importance for pedagogical training in higher education. Methodology: This is an experience report of the teaching internship that took place in the second half of 2022, in the subject of Fundamentals in epidemiology and public health of the Graduation course in Physiotherapy at the Federal University of Rio Grande do Norte.Results: In this study, we described and analyzed the stages of the teaching practicum experience, focusing on perspectives, learnings, and aspirations from the perspective of the scientific literature on the formative role of the teaching practicum for university professors. The obtained results highlight the significance of the contributions of this experience for the academic and professional growth of the participants. However, it is emphasized the need to incorporate or revise curriculum elements to promote a more profound integration of theoretical and practical dimensions in preparing students for teaching in higher education.Conclusions: The supervised teaching practicum represents a valuable, unique, and enriching formative tool in the development of professional and personal experiences in teacher education (AU).

Introducción: La formación docente es un proceso dinámico que debe estar compuesto de experiencias prácticas y teóricas en la preparación de los estudiantes para enseñar. Por lo tanto, comprender las reflexiones relacionadas con la pasantía en la docencia asistida en laeducación superior es de suma importancia para enriquecer los debates y discusiones sobre el papel de la pasantía en la docencia como herramienta de formación de profesores universitarios. Objetivo: Reflexionar sobre las experiencias vividas durante las actividades desarrolladas en el internado docente asistido y la importancia para la formación pedagógica en la educación superior.Metodología: Se trata de un relato de experiencia de la pasantía docente que tuvo lugar en el segundo semestre de 2022, en la asignatura de Fundamentos en epidemiología y salud pública del curso de Graduación en Fisioterapia de la Universidad Federal de Rio Grande do Norte.Resultados: En este estudio, describimos y analizamos las etapas de la experiencia de práctica docente, enfocando perspectivas, aprendizajes y aspiraciones desde la perspectiva de la literatura científica sobre el papel formativo de la práctica docente para profesoresuniversitarios. Los resultados obtenidos destacan la importancia de los aportes de esta experiencia para el crecimiento académico y profesional de los participantes. Sin embargo, se enfatiza la necesidad de incorporar o revisar elementos curriculares parapromover una integración más profunda de las dimensiones teóricas y prácticas en la preparación de los estudiantes para la docencia en la educación superior. Conclusiones: La práctica docente supervisada representa una herramienta formativa valiosa, únicay enriquecedora en el desarrollo de experiencias profesionales y personales en la formación docente (AU).

Gender-Specific Associations between Late-Life Disability and Socioeconomic Status: Findings from the International Mobility and Aging Study (IMIAS).

Disability is a dynamic process and can be influenced by a sociocultural environment. This study aimed to determine whether the associations between socioeconomic status and late-life disability differ by gender in a multi-sociocultural sample from different countries. A cross-sectional study was developed with 1362 older adults from The International Mobility in Aging Study. Late-life disability was measured through the disability component of the Late-Life Function Disability Instrument. Level of education, income sufficiency and lifelong occupation were used as indicators of SES. The results indicated that a low education level ß = -3.11 [95% CI -4.70; -1.53] and manual occupation ß = -1.79 [95% -3.40; -0.18] were associated with frequency decrease for men, while insufficient income ß = -3.55 [95% CI -5.57; -1.52] and manual occupation ß = -2.25 [95% CI -3.89; -0.61] played a negative role in frequency for women. For both men ß = -2.39 [95% -4.68; -0.10] and women ß = -3.39 [95% -5.77; -1.02], insufficient income was the only factor associated with greater perceived limitation during life tasks. This study suggested that men and women had different late-life disability experiences. For men, occupation and education were associated with a decrease in the frequency of participation, while for women this was associated with income and occupation. Income was associated with perceived limitation during daily life tasks for both genders.

HRV Monitoring Using Commercial Wearable Devices as a Health Indicator for Older Persons during the Pandemic.

Remote monitoring platforms based on advanced health sensors have the potential to become important tools during the COVID-19 pandemic, supporting the reduction in risks for affected populations such as the elderly. Current commercially available wearable devices still have limitations to deal with heart rate variability (HRV), an important health indicator of human aging. This study analyzes the role of a remote monitoring system designed to support health services to older people during the complete course of the COVID-19 pandemic in Brazil, since its beginning in Brazil in March 2020 until November 2021, based on HRV. Using different levels of analysis and data, we validated HRV parameters by comparing them with reference sensors and tools in HRV measurements. We compared the results obtained for the cardiac modulation data in time domain using samples of 10 elderly people's HRV data from Fitbit Inspire HR with the results provided by Kubios for the same population using a cardiac belt, with the data divided into train and test, where 75% of the data were used for training the models, with the remaining 25% as a test set for evaluating the final performance of the models. The results show that there is very little difference between the results obtained by the remote monitoring system compared with Kubios, indicating that the data obtained from these devices might provide accurate results in evaluating HRV in comparison with gold standard devices. We conclude that the application of the methods and techniques used and reported in this study are useful for the creation and validation of HRV indicators in time series obtained by means of wearable devices based on photoplethysmography sensors; therefore, they can be incorporated into remote monitoring processes as seen during the pandemic.

Life-Space and Cognitive Decline in Older Adults in Different Social and Economic Contexts: Longitudinal Results from the IMIAS Study.

Psychosocial, socioeconomic and sociocultural aspects can influence cognitive function among community-dwelling older adults. Life-space restriction is potentially related to cognitive status. We examined the longitudinal association between life-space mobility and changes in cognitive function in community-dwelling older adults in different social settings of North and South America and Europe. We used data from 1486 participants of the International Mobility in Aging Study (IMIAS) conducted at five sites: Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston and Saint-Hyacinthe (Canada). Life-space mobility was assessed using the Life-Space Assessment (LSA) questionnaire at baseline (2012), and the Leganes Cognitive Test was used to evaluate cognitive function at baseline and follow-up (2016). The Quantile regressions (QR) were used to evaluate the factors associated with cognitive score in 2016 by adjusting for the cognitive score in 2012, with two distinct models for analyzing variables. A decrease in the cognitive function was observed at all research sites, except in Manizales. Participants with more restricted life-space at baseline had a decrease in their cognitive function 4 years later (ß = -0.79, 95% CI: -1.400 to -0.18, p value<0.01) compared to those with the highest level. This decrease was independent of gender, age, research site, education, income sufficiency, social support, depression, cognitive function at baseline, chronic conditions and physical performance. Restriction in life-space is an important prognostic factor for cognitive function. Maintaining life-space can be a goal in public policies aimed at encouraging healthy aging, and might be useful in clinical practice to promote health status and to monitor older people at higher risk of cognitive decline.

Social and Economic Predictors of Worse Frailty Status Occurrence Across Selected Countries in North and South America and Europe.

BACKGROUND: Frailty, a state of vulnerability to poor resolution of homoeostasis after a health stressor, may be a result of cumulative decline in many physiological systems across the life course and its prevalence and incidence rates vary widely depending on the place and population subgroup. OBJECTIVE: This study aims to examine social and economic factors as predictors of worse frailty status over 2 years of follow-up in a sample of community-dwelling older adults from the International Mobility in Aging Study. METHODS: We analyzed 2012 baseline and 2014 follow-up (n = 1,724) data on participants from a populational-based, longitudinal study conducted in 4 countries (e.g., Brazil, Colombia, Albania, and Canada). Frailty was defined according to the Fried's phenotype and Poisson regression models with robust standard errors were performed to estimate the relative risks of becoming frail. RESULTS: In our study, 366 (21.2%) participants migrated to a worse stage of frailty. After statistical adjustment (e.g., participant age, sex, and study site), insufficient income (RR = 1.40; 95% CI = 1.00-1.96) and having partner support (RR = 0.80; 95% CI = 0.64-1.01) were predictors of incident frailty status. CONCLUSION: Notably, transitions in frailty status were observed even in a short range of time, with sociodemographic factors predicting incident frailty.

Impact of resilience on health in older adults: a cross-sectional analysis from the International Mobility in Aging Study (IMIAS).

OBJECTIVES: Self-rated health (SRH) is a predictor of objective health measures, including mortality and morbidity. The link between resilience and SRH among the elderly is unclear. We aim to examine whether resilience aligns with SRH and, secondarily, whether resilience can override the negative health consequences of adverse childhood experiences (ACE). DESIGN AND SETTING: We use 2012, 2014 and 2016 data from the International Mobility in Aging Study, a longitudinal cohort study that collects survey and biophysical data from Albania, Brazil, Colombia and Canada. The main independent variables were resilience and ACE (social and economic). PARTICIPANTS: Community-dwelling 65-74 year olds (in 2012) were recruited through primary care registers. The sample size of the study was 1506. PRIMARY OUTCOME: The outcome measure was SRH. RESULTS: We found that sex, site, economic ACE, current income sufficiency, current depressive symptoms, current physical function and current resilience were associated with current SRH. In regression analyses, we showed that the association between ACE and SRH disappeared once factors such as sex, site, income, depression, physical health and resilience were considered. CONCLUSIONS: The association between resilience and health poses a compelling argument for building resilience throughout life.

Lifecourse Adversity and Telomere Length in Older Women from Northeast Brazil.

We examined associations between adverse childhood experiences (ACEs) and shorter telomere length (TL) in 83 older women, including 42 women with less than secondary education and 41 with secondary or more education in a city of Northeast Brazil, a region with substantial socioeconomic inequalities. The low education sample was selected from a representative survey at local neighborhood health centers, while the high education group consisted of a convenience sample recruited by advertising in community centers and centers affiliated with the local university. Relative leukocyte TL was measured by quantitative polymerase chain reaction from blood samples. ACEs were self-reported. Spline linear regression was fitted to assess the strength of the associations between ACEs and TL. Among women with low education, median TL was 1.02 compared with 0.64 in the high education group (p = 0.0001). Natural log-transformed T/S ratio as the dependent variable was used in analysis. Women with low education had been exposed to more ACEs, and among them those experiencing two or more ACEs had longer TL than women exposed to ≤1 ACEs (p = 0.03); among women with high education, this difference was not significant (p = 0.49). In analyses adjusted by age, education, and parental abuse of alcohol, the linear trend of higher TL with increasing ACEs was confirmed (p = 0.02), and the mean difference in TL between groups remained significant (p = 0.002). The unexpected positive relationship between low education and ACEs with TL suggests that older adults who have survived harsh conditions prevailing in Northeast Brazil have the longest TL of their birth cohort.

Association between C-reactive protein and physical performance in older populations: results from the International Mobility in Aging Study (IMIAS).

BACKGROUND AND OBJECTIVE: C-reactive protein (CRP) is a widely used cardiovascular risk marker, but questions remain about its role in the disability process in old age. This study examines the associations between CRP levels and physical performance in old age in different societies. METHODS: data were collected during the baseline survey of IMIAS in 2012 in Kingston (Canada), Saint-Hyacinthe (Canada), Manizales (Colombia) and Natal (Brazil). Approximately 200 men and 200 women aged 65-74 were recruited at each site. CRP was assessed using a high sensitivity assay and categorised as low (<1 mg/l), moderate (1-3 mg/l), high (3-10 mg/l) and very high (≥10 mg/l). Participants were interviewed at home; blood pressure, weight and height were measured. Physical function was assessed with the Short Physical Performance Battery (SPPB) and hand grip strength. Data were analysed using descriptive statistics, bivariate analysis (χ²) and linear or logistic regression. RESULTS: CRP was significantly associated with low hand grip strength and poor physical performance in bivariate analyses. Hand grip strength association with CRP disappeared after adjustment by socioeconomic factors and health behaviours. The odds of poor physical function was OR = 2.67 [95% CI 1.43-4.99] comparing the highest and lowest CRP categories after adjustment by relevant covariates. The three SPPB components were assessed separately. Graded associations between low CRP and faster gait speed and shorter time to rise from a chair were observed in adjusted models. Association between impaired balance and CRP was attenuated after adjustment by relevant covariates, OR = 1.15 [0.65-2.04]. CONCLUSIONS: CRP could be a possible pathway from inflammation to physical decline in older populations.

Depressive symptomatology and cortisol concentrations in elderly community residents: a cross-sectional study.

BACKGROUND: Researches seek to understand the links between adverse health outcomes and cortisol concentrations. However, the relationship between depressive symptomatology and cortisol concentrations is controversial in the literature. AIM: To analyze the relationship between the depressive symptomatology and the cortisol concentrations in elderly community residents in the Brazilian Northeast. METHODS: Cross-sectional study is composed of 256 elderly (≥65 years). Depressive symptomatology was evaluated by the Center for Epidemiologic Studies-Depression Scale and cortisol concentrations by salivary collection (upon waking, 30 and 60 min after waking, at 3 pm and before bed), in addition to composite measurements. Sociodemographic and health conditions were evaluated. For analysis of the cortisol measurements in relation to depressive symptomatology, and between genders, the Student's t test was used. For cortisol measurements in every curve, analysis of variance for repeated measurements with Bonferroni post hoc test was used. RESULTS: There were significant salivary cortisol differences upon awakening, among elderly with and without depressive symptomatology (p = 0.04). There was no significance in relation to gender. Between measurements of each curve, elderly with depressive symptomatology showed no significant difference between the 1st measure in relation to the 2nd and 3rd, and also between the 4th and 5th, demonstrating higher cortisol night levels in elderly with depressive symptomatology, without decline, with curve plane aspect. CONCLUSION: The relationship between depressive symptomatology and hypocortisolism throughout the day seems to exist. However, in Brazil, adverse life conditions can lead to chronic stress and be sufficient factors to superpose biggest differences that could exist in relation to the presence of depressive symptomatology.

Socioeconomic status, social relations and domestic violence (DV) against elderly people in Canada, Albania, Colombia and Brazil.

PURPOSE: To determine whether gender, socioeconomic conditions, and/or social relations are related to recent experiences of DV in older adult populations. MATERIALS AND METHODS: Data on socioeconomic status and social relations were collected in 2012 from 1995 community-dwelling older adults in Canada, Colombia, Brazil, and Albania. Violence experienced in the last 6 months was measured using the Hurt, Insulted, Threatened with harm, or Screamed at (HITS) scale and classified according to type (physical or psychological) and perpetrator (partner or family member). Binary logistic regression analyses were used to assess associations between experiences of violence and gender, socioeconomic conditions, and social relations. RESULTS: Physical violence (by partner or family member) was reported by 0.63-0.85% of participants; the prevalence of psychological violence (by partner or family member) ranged from 3.2% to 23.5% in men and 9% to 26% in women. After adjustment for socioeconomic status, social relations, age and site, women experienced more psychological violence perpetrated by family members than did men (odds ratio (OR): 1.8; 95% CI: 1.2-2.6). Social relations, such as multifamily living arrangements and low levels of support from partners, children, and family, were associated with psychological DV. Current working status was associated with greater odds of victimization by partners among men (OR: 2.35 95% CI: 1.34-1.41), but not among women. CONCLUSIONS: Gender and social relations are important determinants of experiencing violence in older adults. The findings of this study demonstrate the importance of a gender-based approach to the study of DV in older adults.

Lifecourse adversity and physical performance across countries among men and women aged 65-74.

BACKGROUND: This study examines the associations between lifecourse adversity and physical performance in old age in different societies of North and South America and Europe. METHODS: We used data from the baseline survey of the International Study of Mobility in Aging, conducted in: Kingston (Canada), Saint-Hyacinthe (Canada), Natal (Brazil), Manizales (Colombia) and Tirana (Albania). The study population was composed of community dwelling people between 65 and 74 years of age, recruiting 200 men and 200 women at each site. Physical Performance was assessed with the Short Physical Performance Battery (SPPB). Economic and social adversity was estimated from childhood adverse events, low education, semi-skilled occupations during adulthood and living alone and insufficient income in old age. RESULTS: A total of 1995 people were assessed. Low physical performance was associated with childhood social and economic adversity, semi-skilled occupations, living alone and insufficient income. Physical performance was lower in participants living in Colombia, Brazil and Albania than in Canada counterparts, despite adjustment for lifecourse adversity, age and sex. CONCLUSIONS: We show evidence of the early origins of social and economic inequalities in physical performance during old age in distinct populations and for the independent and cumulative disadvantage of low socioeconomic status during adulthood and poverty and living alone in later life.

Depressive symptoms and functional decline in an elderly sample of urban center in Northeastern Brazil.

OBJECTIVE: To examine the association between depressive symptoms and functional status in elderly people living in an urban center in northeastern Brazil. METHODS: In this cross-sectional, observational, analytic study, 313 community-dwelling elderly (age≥65 years) individuals of both sexes who resided in Natal, Rio Grande do Norte, were evaluated. The Brazilian version of the Center for Epidemiologic Studies Depression Scale was used to screen for depressive symptoms. Physical performance was assessed using the Short Physical Performance Battery. A multivariate linear regression model adjusted for clinical and socioeconomic variables was used to analyze the association between depressive symptoms and functional performance. RESULTS: Our findings showed that the presence of depressive symptoms influenced functional performance, even when analyses controlled for variables such as age, sex, poor perceived health, cognitive status, and body mass index (BMI). CONCLUSION: The results of this study reinforce the association between depressive symptoms and functional performance in an elderly population in an urban center in northeastern Brazil. These findings provide useful information for the identification of potential targets for research and therapeutic interventions aimed at preventing a decline in mobility in elderly individuals.

[Prevalence of frailty and associated factors in community-dwelling elderly in Belo Horizonte, Minas Gerais State, Brazil: data from the FIBRA study]. / Prevalência de fragilidade e fatores associados em idosos comunitários de Belo Horizonte, Minas Gerais, Brasil: dados do estudo FIBRA.

The prevalence of frailty varies greatly and has received insufficient attention in developing countries. This study aimed to identify the prevalence of frailty and associated factors among the elderly in Belo Horizonte, Minas Gerais State, Brazil. Clinical, functional, and socio-demographic factors were analyzed. An ordinal regression model was used to verify conditions associated with frailty and to determine odds ratios ( α= 0.05). Prevalence rates were 46.3% for pre-frailty was 8.7% for weakness. Pre-frail and frail elderly, respectively, showed higher and increasing odds ratios for dependency in instrumental activities of daily living; restrictions in advanced activities of daily living; use of walking aids; comorbidities; falls; depressive symptoms; lower self-efficacy in preventing falls; hospitalization; and advanced age. The study identified a high percentage of frail states associated with higher odds of adverse health conditions, especially related to disability.

Prevalência de fragilidade e fatores associados em idosos comunitários de Belo Horizonte, Minas Gerais, Brasil: dados do estudo FIBRA / Prevalence of frailty and associated factors in community-dwelling elderly in Belo Horizonte, Minas Gerais State, Brazil: data from the FIBRA study / Prevalencia de la fragilidad y factores asociados en ancianos de una comunidad de Belo Horizonte, Minas Gerais, Brasil: datos del Estudio FIBRA

A fragilidade apresenta elevada variabilidade na prevalência e é pouco investigada em países em desenvolvimento. O objetivo deste estudo foi identificar a prevalência e fatores associados à fragilidade em idosos comunitários de Belo Horizonte, Minas Gerais, Brasil. Aspectos clínicos, funcionais e sociodemográficos foram avaliados. Foi utilizado o modelo de regressão ordinal, para verificar condições associadas à fragilidade e determinar a razão de chance (α = 0,05). A prevalência de pré-fragilidade foi 46,3% e de fragilidade de 8,7%. Os idosos pré-frágeis e frágeis apresentaram, respectivamente, maiores e crescentes razão de chances para dependência em atividades instrumentais de vida diária; restrição em atividades avançadas de vida diária; utilização de dispositivos auxiliares da marcha; comorbidades; quedas; sintomas depressivos; menor autoeficácia para prevenir quedas; hospitalização e idade avançada. Foi identificado elevado percentual de estados de fragilidade associados a maiores chances para condições adversas de saúde, especialmente as relacionadas à incapacidade.

The prevalence of frailty varies greatly and has received insufficient attention in developing countries. This study aimed to identify the prevalence of frailty and associated factors among the elderly in Belo Horizonte, Minas Gerais State, Brazil. Clinical, functional, and socio-demographic factors were analyzed. An ordinal regression model was used to verify conditions associated with frailty and to determine odds ratios ( α= 0.05). Prevalence rates were 46.3% for pre-frailty was 8.7% for weakness. Pre-frail and frail elderly, respectively, showed higher and increasing odds ratios for dependency in instrumental activities of daily living; restrictions in advanced activities of daily living; use of walking aids; comorbidities; falls; depressive symptoms; lower self-efficacy in preventing falls; hospitalization; and advanced age. The study identified a high percentage of frail states associated with higher odds of adverse health conditions, especially related to disability.

El objetivo del estudio fue identificar la prevalencia y los factores asociados a la fragilidad en ancianos que viven en una comunidad de la ciudad de Belo Horizonte, Minas Gerais, Brasil. Se evaluaron los factores clínicos, funcionales y socio-demográficos. Se utilizó un modelo de regresión ordinal, con el fin de verificar las condiciones asociadas con la fragilidad y para determinar el odds ratio (α = 0,05). La prevalencia de prefragilidad fue de un 46,3% y fragilidad un 8,7%. Los ancianos tipificados como pre-frágiles y frágiles tuvieron, respectivamente, una más alta y creciente proporción de probabilidad de dependencia, respecto a las actividades instrumentales de la vida diaria, restricciones en las actividades avanzadas de la vida diaria, además, se caracterizaban por el uso de dispositivos de asistencia al andar; comorbilidades, caídas, síntomas depresivos, baja auto-eficacia para evitar caídas, hospitalización y edad avanzada. Se identificó un alto porcentaje de los estados de fragilidad, asociada con mayores probabilidades de condiciones adversas para la salud, especialmente, las relacionadas con la incapacidad.

Using the Short Physical Performance Battery to screen for frailty in young-old adults with distinct socioeconomic conditions.

AIM: To analyze the Short Physical Performance Battery's (SPPB) ability in screening for frailty in community-dwelling young elderly from cities with distinct socioeconomic conditions. METHODS: Elderly (65-74 years-of-age) from Canada (Saint Bruno; n = 60) and Brazil (Santa Cruz; n = 64) were evaluated with the SPPB to assess physical performance. Frailty was defined as the presence of ≥ 3 of the following criteria: weight loss, exhaustion, weakness, mobility limitation and low physical activity. Linear regression and receiver operating characteristics analyses were carried out. RESULTS: The SPPB correlated with frailty (R(2) = 0.33), with better results for Saint Bruno. A cut-off of 9 in the SPPB had good sensitivity (92%) and specificity (80%) in discriminating frail from non-frail in Saint Bruno (area under the curve [AUC] = 0.81), but showed fair results in Santa Cruz (AUC = 0.61, sensitivity = 81% and specificity = 52%). CONCLUSIONS: The SPPB better discriminated frailty in elderly with higher socioeconomic conditions (Saint Bruno).

Aspectos sociodemográficos e clínicos de homens com lesão medular traumática em um centro urbano do nordeste brasileiro / Sociodemographic and clinical aspects of men with traumatic spinal cord injury in an urban center in northeast brazil

INTRODUÇÃO: A identificação das causas mais frequentes para o acometimento por lesão medular é de suma importância para os gestores de saúde no planejamento de ações de prevenção de acidentes dessa natureza em populações de risco. OBJETIVO: Caracterizar, de acordo com aspectos sociodemográficos e clínicos, uma amostra de homens com lesão medular, residentes na cidade de Natal (RN), Brasil. MÉTODOS: Estudo transversal realizado com 48 indivíduos, nos quais foi utilizado um questionário estruturado e autoaplicável sobre aspectos sociodemográficos e clínicos. Os dados foram tratados e analisados através da análise quantitativa descritiva. RESULTADOS: A média de idade foi de 33,38 anos (desvio padrão - DP=9,87), sendo a maioria solteira (37,5%), com renda de dois a quatro salários-mínimos (47,9%) e tendo como principal causa de lesão a arma de fogo (43,8%). A média do tempo de sequela foi de 9,35 anos (DP=8,16), com tempo mínimo de 3 meses e máximo de 36 anos, a maior parte encontrava-se entre 3 e 10 anos de lesão (41,7%). A sequela mais prevalente foi a paraplegia (66,7%). CONCLUSÃO: Os dados revelaram que os homens jovens são ainda os mais acometidos. Poucos deles voltam a trabalhar após a lesão e a maioria passa a depender de aposentadorias. Há ainda, uma tendência para o crescimento de lesões por arma de fogo, ultrapassando as lesões por acidentes de trânsito e por quedas.

INTRODUCTION: The identification of the most common causesfor the onset of spinal cord injury is of paramount importance forhealth managers in planning actions to prevent accidents of this nature in populations at risk. OBJECTIVE: To characterize, according to sociodemographic and clinical data, a sample of men with spinal cord injury, living in Natal (RN), Brazil. METHODS: Cross-sectional study with 48 subjects, in which was used a structured and self-administered questionnaire about sociodemographic and clinical aspects. The data were processed and analyzed by quantitative descriptive analyses. RESULTS: The mean age was 33.38 years (standard deviation - SD=9.87), most were single (37.5%), earning two to four minimum wages (47.9%). The main cause of the injury was the firearm (43.8%). The average time of sequel was 9.35 years (SD=8.16), with a minimum of 3 months and a maximum of 36 years, most were between 3 and 10 years of injury (41.7%). The sequel more prevalent was paraplegia (66.7%). CONCLUSION: The data revealed that young men are still the most affected. Few of them return to work after injury and most becomes retirement dependent. There is also a tendency for the growth of firearm injuries, overcoming traffic accidents and falls.

[Functional incapacity among low-income elderly women]. / Incapacidade funcional em mulheres idosas de baixa renda.

The scope of this study was to analyze the relationship between socio-demographic and health-related aspects and functional incapacity among low-income elderly women. This cross-sectional study involved a representative sample of 222 women with mean age of 70 years (± 7.27), in community groups in the city of Jequié, in the State of Bahia, Brazil. Anthropometric measurements were taken and interviews staged to examine the socio-demographic, physical and behavioral health variables. The statistical analysis was accomplished with a level of significance of p<0.05, with calculation of the respective odds ratio in the binary logistic regression, for analysis of hierarchically-grouped factors. The prevalence of functional incapacity was 46.8% and, by using hierarchical multivariate analysis, a significant association was detected with increased age, insufficient schooling, hospitalization, lack of physical exercise throughout life and alterations in the cognitive function. The characteristics identified that associated limitations in instrumental activities in daily life suggest a complex causal network in the determination of functional incapacity in low-income elderly women.

Incapacidade funcional em mulheres idosas de baixa renda / Functional incapacity among low-income elderly women

O propósito deste estudo foi o de analisar a relação dos aspectos sociodemográficos e referentes às condições de saúde com a incapacidade funcional em mulheres idosas de baixa renda. O estudo teve delineamento transversal, com uma amostra representativa de 222 mulheres, com média de 70 anos (± 7,27), pertencentes a grupos de convivência no município de Jequié, Bahia. Foram realizadas medidas antropométricas e a aplicação de uma entrevista contemplando as variáveis: sociodemográficas, saúde física e comportamental. A análise estatística foi realizada com nível de significância p<0,05, com cálculo da respectiva razão de chances na regressão logística binária, para análise de fatores hierarquicamente agrupados. A prevalência de incapacidade funcional foi de 46,8 por cento, nos quais a partir de análise multivariada hierarquizada verificaram-se associação significativa com o aumento da idade, baixo nível de educação, hospitalização, ausência de práticas de atividades físicas ao longo da vida e alterações na função cognitiva. As características identificadas que associaram as limitações em atividades instrumentais da vida diária sugerem uma complexa rede causal na determinação da capacidade funcional em mulheres idosas de baixa renda.

The scope of this study was to analyze the relationship between socio-demographic and health-related aspects and functional incapacity among low-income elderly women. This cross-sectional study involved a representative sample of 222 women with mean age of 70 years (± 7.27), in community groups in the city of Jequié, in the State of Bahia, Brazil. Anthropometric measurements were taken and interviews staged to examine the socio-demographic, physical and behavioral health variables. The statistical analysis was accomplished with a level of significance of p<0.05, with calculation of the respective odds ratio in the binary logistic regression, for analysis of hierarchically-grouped factors. The prevalence of functional incapacity was 46.8 percent and, by using hierarchical multivariate analysis, a significant association was detected with increased age, insufficient schooling, hospitalization, lack of physical exercise throughout life and alterations in the cognitive function. The characteristics identified that associated limitations in instrumental activities in daily life suggest a complex causal network in the determination of functional incapacity in low-income elderly women.

Fatores associados às limitações funcionais em idosas de baixa renda / Factors associated to functional limitations in elderly of low income

OBJETIVO: Analisar a relação dos aspectos sociodemográficos e referentes às condições de saúde com as limitações funcionais em mulheres idosas de baixa renda do Nordeste brasileiro. MÉTODOS: Estudo com delineamento transversal, tendo uma amostra representativa de 208 mulheres, com média de 70 anos (± 7,1) pertencentes a grupos de convivência e que eram residentes na zona urbana do município de Jequié/Bahia. Foi realizada uma bateria de testes físicos, coletadas medidas antropométricas e a aplicação de uma entrevista contendo questões relativas às variáveis sociodemográficas, condições clínicas, saúde percebida, condições físicas e comportamentais. A análise estatística foi realizada com nível de significância p<0,05, com cálculo da respectiva razão de chances mediante regressão logística binária, para análise de fatores hierarquicamente agrupados. RESULTADOS: Encontrou-se uma prevalência de 56 por cento de mulheres consideradas com limitações funcionais do tipo moderada ou grave, nos quais a partir de análise multivariada hierarquizada, verificou-se associação significativa com a faixa etária superior a 80 anos (p=0,02), condições de viuvez (p=0,04), presença de hipertensão arterial (p=0,001), e inatividade física no lazer (p=0,03). CONCLUSÃO: As características identificadas que se associaram às limitações funcionais sugerem uma complexa rede causal na determinação da condição funcional em mulheres idosas. No entanto, ações direcionadas ao incentivo da prática de atividades físicas no lazer podem contribuir para uma vida com mais qualidade a estas pessoas.

OBJECTIVE: To analyze the relationship of the partner-demographic and relevant aspects to the conditions of health, with the functional limitations in elderly women of low income in the Brazilian Northeast. METHODS: This cross-sectional study involved a representative sample of 208 women with mean age of 70 years (± 7.1), belonging to coexistence groups and that were resident in the urban zone of the municipal district of Jequié / Bahia. A battery of physical tests was conducted, anthropometric measurements were collected and an interview was made concerning subjects related to partner-demographic variables, clinical conditions and apparent health, physical conditions and behavior. The statistical analysis was carried out with a level of significance of p<0.05. Calculation was made of the respective odds ratio by regression binary logistics for analysis of hierarchically clustered factors. RESULTS: Prevalence of functional limitations of the moderate or serious type was 56 percent. After hierarchical multivariate analysis, significant association was verified with the older age group of 80 years (p=0.02) , conditions of widowhood (p=0.04), presence of arterial hypertension (p=0.001), and physical inactivity at leisure (p=0.03). CONCLUSION: The characteristics identified, associated to functional limitations suggest a complex causal network in the determination of the functional condition of elderly women. However, actions addressed to incentivate practice of physical activities at leisure can contribute to the quality of life of these women.

[Functional limitation and survival of community dwelling elderly]. / Limitação funcional e sobrevida em idosos de comunidade.

OBJECTIVE: The present study aims to analyze the functional limitation as risk factor of death of elderly dwelling in a community and its relationship with socio-demographic, physical health and neuropsychiatric related factors. METHODS: A prospective study was carried out in the city of Santa Cruz, Rio Grande do Norte, Brasil. A total of 310 randomly selected elderly formed the baseline (63.5% women, 73.7+/-9.03 years). The Katz Index was used to evaluate the functional capacity for basic activities of daily living. The follow-up period was of 53 months. The statistical methods used were bivariate analysis (Pearson's chi-square), survival analysis by the Kaplan-Meyer method, followed by Cox regression in multivariate analysis, with the respective hazards ratios (HR). RESULTS: A total of 60 elderly (20.5%) died during the study follow-up; the main cause of death was cardiovascular disease. The mean survival time was of about 24.8 months, and the main risk factors identified at Cox regression were cognitive deficit (HR= 4.30) and stroke (HR= 3.49) besides the dependence for the basic activities of daily living (HR = 3.17). CONCLUSION: The functional limitation was an independent risk factor for death.