Quadriceps femoris performance after resistance training with and without photobiomodulation in elderly women: a randomized clinical trial.

The study assessed if quadriceps femoris muscle performance of older women can be improved by applying photobiomodulation therapy after a resistance training program. This study is a randomized, controlled trial with concealed allocation, intention-to-treat analysis, and blinded outcome evaluators. Forty-five healthy sedentary older women classified as active or insufficiently active were randomized to groups receiving 8 weeks of quadriceps femoris resistance training plus active group or placebo group, or a control group (no training or photobiomodulation). Surface electromyographic fatigue indexes of vastus medialis, rectus femoris, and vastus lateralis; one-maximum repetition (1-MR); and analysis of inflammatory biomarkers (IL-6, IL-8, and TNF-α cytokines, plus CK and LDH enzymes) were measured at baseline and twice in a 24 h-period after 8 weeks. No differences among the three groups were found in fatigue indexes for all three muscles, although in general, the active group presented improved fatigue indexes from baseline to 8-week outcome, while the other groups did not. Both training groups improved in 1-MR over the 8-week period. Inflammatory biomarkers were not different at long- or short-term among the three groups, except differences in groups for long-term IL-8 changes, differences in time for long-term LDH and short-term TNF-α changes, and interactions of time by group for short-term LDH changes. Quadriceps femoris performance of older women was not improved when photobiomodulation was associated to the proposed quadriceps femoris resistance training, when compared to training without photobiomodulation and a sedentary group.

Towards the validation of a new, blended theoretical model of fear of cancer recurrence.

OBJECTIVE: Fear of cancer recurrence (FCR) is defined as "fear, worry, or concern about cancer returning or progressing". To date, only the seminal model proposed by Lee-Jones and colleagues has been partially validated, so additional model testing is critical to inform intervention efforts. The purpose of this study is to examine the validity of a blended model of FCR that integrates Leventhal's Common Sense Model, Mishel's Uncertainty in Illness Theory, and cognitive theories of worry. METHODS: Participants (n = 106) were women diagnosed with stage I to III breast or gynecological cancer who were enrolled in a Randomized Controlled Trial of a group cognitive-existential intervention for FCR. We report data from standardized questionnaires (Fear of Cancer Recurrence Inventory-Severity and Triggers subscales; Illness Uncertainty Scale; perceived risk of recurrence; Intolerance of Uncertainty Scale; Why do people Worry about Health questionnaire; Reassurance-seeking Behaviors subscale of the Health Anxiety Questionnaire, and the Reassurance Questionnaire) that participants completed before randomization. Path analyses were used to test the model. RESULTS: Following the addition of four paths, the model showed an excellent fit (χ2 = 13.39, P = 0.20; comparative fit index = 0.99; root mean square error of approximation = 0.06). Triggers, perceived risk of recurrence, and illness uncertainty predicted FCR. FCR was associated with maladaptive coping. Positive beliefs about worrying and intolerance of uncertainty did not predict FCR but led to more maladaptive coping. CONCLUSIONS: These results provide support for a blended FCR model.

Effects of wrist orthoses in reducing pain in individuals with carpal tunnel syndrome: a systematic review.

PURPOSE: To examine the effectiveness of wrist orthoses in reducing pain in individuals with carpal tunnel syndrome. MATERIALS AND METHODS: The searches were carried out in the CINAHL, Cochrane Library, EMBASE, Regional Portal of the Virtual Health Library, PubMed, Scopus, and Web of Science databases on 18 February 2021, and updated on 16 February 2023. Four independent evaluators performed the steps for inclusion of studies following the recommendations of the PRISMA and methods of the Cochrane Handbook for systematic review. RESULTS: Three randomized clinical trials, two quasi-randomized clinical trials and one cohort study met the inclusion criteria. The visual analogue scale and numeric analog scale were used as a tool to assess pain outcome. The treatment period ranged from 2 weeks to 3 months. The period of use varied between nighttime only, and nighttime plus daytime. Most orthoses promoted a statistically significant reduction in intensity pain at night, at rest or during activities. Only one study carried out follow-up after the end of treatment and showed that pain reduction was maintained up to 6 months after treatment. CONCLUSIONS: The findings suggest that the isolated use of orthoses were effective in reducing pain in individuals with carpal tunnel syndrome.

Orthoses are effective in reducing pain in individuals with carpal tunnel syndrome.Orthoses can be used nighttime or nighttime plus daytime according to the necessity.Prefabricated orthosis may represent lower cost and greater accessibility.Pain reduction can be maintained up to 6 months after the end of treatment.

What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?

OBJECTIVE: To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry. METHODS: This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted. RESULTS: The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18). CONCLUSION: Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.

Association between social network and functional disability in brazilian elderly.

OBJECTIVE: to verify the association between social network and functional disability in elderly Brazilians. METHODS: a cross-sectional study with secondary data of 11,177 elderly people, available on Brazilian Institute of Geography and Statistics' website. Social network components were having trusted friends/relative, living with their spouse, practicing social activity, performing voluntary or paid work. The outcome was functional disability, measured by the difficulty in performing instrumental and basic activities of daily living. Logistic regression models were used. RESULTS: disability prevalence for instrumental activities was 28.0% (95%CI: 26.7-29.4), and for basic activities, 15.5% (95%CI: 14.4-16.6). Not having components social network components was associated with greater chances of functional disability, especially among women. CONCLUSION: there was an association between not having social network components with functional disability. There are differences in this association according to sex. Strengthening actions that expand social network can reduce the chance of this outcome in elderly people.

Prevalence and factors associated with sepsis and septic shock in oncological patients in intensive therapy.

OBJECTIVES: to analyze factors associated with sepsis and septic shock in cancer patients in the Intensive Care Unit. METHODS: cross-sectional, retrospective study with a quantitative approach, with a sample of 239 patients in an oncology hospital. Secondary data from medical records were used. The outcome variable was "presence of sepsis and/or septic shock"; and exposures: sex, length of stay, origin, use of invasive procedures and primary tumor site. Descriptive, bivariate analyzes and multiple logistic regression models were performed. RESULTS: the prevalence of sepsis was 95% CI: 14.7-24.7 and septic shock of 95% CI: 37.7-50.3. In the multiple analysis, sepsis and/or septic shock were associated with hospital stay longer than seven days, being from the Emergency Department, presence of invasive procedures and hematological site. CONCLUSIONS: sepsis and/or septic shock in cancer patients were associated with clinical characteristics and health care factors.

Social vulnerability associated with the self-reported diagnosis of type II diabetes: a multilevel analysis.

OBJECTIVE: To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City. METHODS: Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level. RESULTS: The prevalence of diabetes was 6.2% (95%CI 5.54 - 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics. CONCLUSION: Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications.

[Tuberculosis treatment drop out and relations of bonding to the family health team]. / Abandono do tratamento de tuberculose e relações de vínculo com a equipe de saúde da família.

This study aimed to analyze the relation between the singularities of the sick subject with the history of dropping out of the tuberculosis treatment and the care given by the family health team in light of the bonding concept. The empirical material was built through recorded interviews, in the period from July to September of 2008, using the Thematic Oral History methodology. Interviews were taken with nine users whose drop out was the criteria for closing the treatment to tuberculosis in two municipalities of the metropolitan region of João Pessoa, Paraíba, Brazil. The analysis was performed according to the discourse analysis technique. The study identified that a therapeutic relation, sharing commitments and the user's valuation, strengthens the bonding and produces the care management democratization. On the other hand, a vertical relation, with fragile bonding, is opposed to the purpose of an intersubjective practice in the perspective of the care co-management.

Comparison of the effect of nocturnal use of commercial versus custom-made wrist orthoses, in addition to gliding exercises, in the function and symptoms of carpal tunnel syndrome: A pilot randomized trial.

BACKGROUND: Conservative treatment for carpal tunnel syndrome (CTS) often includes wrist orthosis. However, there is no consensus on whether commercial or custom-made wrist orthosis is better for the treatment. PURPOSE: To assess feasibility of a study comparing nocturnal use of commercial versus custom-made wrist orthosis in the treatment of mild/moderate CTS and estimate their potential effects on function and symptoms. STUDY DESIGN: Randomized clinical trial. METHODS: Twenty-four individuals with mild/moderate CTS were randomized to wear either a commercial orthosis (n = 12) or a custom-made orthosis (n = 12). Participants used the assigned orthosis at night for 45 days and performed gliding exercises at home/work. We collected data on access to eligible population and feasibility of protocol. Data on use of orthosis, performance of exercises, and symptoms were collected through a dairy filled by the participant. Outcomes were pain (using Numeric Pain Rating Scale), symptom severity and functional status (using Boston Questionnaire), pinch strength (by dynamometry), and electromyographic activity of forearm muscles (sampled during a reach-to-grasp task). Outcomes were measured before and after the intervention. RESULTS: There were no loses to follow-up in either intervention group. After treatment, we found increased tripod pinch strength and better symptoms and function in both orthosis groups, with better outcomes for the custom-made orthosis, although the differences were not statistically significant. CONCLUSIONS: The preliminary results showed a potential for better outcomes from the custom-made orthosis. We established that a larger study would be feasible and could be designed and conducted based on the estimates provided by this study. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC) - registration number: RBR-74rqnz.

Prevalência, uso de serviços de saúde e fatores associados à depressão em pessoas idosas no Brasil / Prevalence, healthcare service utilization, and factors associated with depression among older adults in Brazil

Resumo Objetivos estimar a prevalência de depressão em pessoas idosas do Brasil e os fatores associados, e descrever características do uso de serviços de saúde e tratamentos de saúde dispensados aos idosos com depressão. Método Estudo transversal, analítico, com 22.728 pessoas idosas participantes da Pesquisa Nacional de Saúde (PNS), selecionadas aleatoriamente no Brasil, no período de agosto de 2019 a março de 2020. O desfecho foi o autorrelato de depressão e as exposições foram as variáveis sociodemográficas e um escore de rede social. Foram empregadas análises descritivas e múltiplas por meio de regressão logística. Resultados A prevalência de depressão autorrelatada pelas pessoas idosas foi de 11,8% (IC95%: 11,1-12,57). Observou-se que 71,6% (IC95%: 67,9-75,0) da população idosa com depressão faz apenas tratamento medicamentoso. Houve maior chance de depressão entre idosas (OR=2,46; IC95%: 2,06-2,94), de 60 a 69 anos (OR=1,67; IC95%: 1,31-2,14); de cor de pele branca (OR=2,95; IC95%: 1,62-5,39), moradores da região Sul (OR=3,01; IC95%: 2,27-4,00) e com multimorbidade (OR=1,79; IC95%: 1,49-2,14). Conclusão A depressão apresentou-se com frequência considerável entre pessoas idosas, especialmente entre mulheres. Há necessidade de incentivo a adoção de medidas não farmacológicas para tratamento da doença, tais como, uso de práticas integrativas e complementares atividades físicas, mudanças no estilo de vida e fomento a atividades sociais.

Abstract Objectives To estimate the prevalence of depression among older adults in Brazil and the associated factors, and to describe the characteristics of health service utilization and treatments provided to older adults with depression. Method A cross-sectional, analytical study involving 22,728 older adults who participated in the National Health Survey (PNS), randomly selected across Brazil from August 2019 to March 2020. The outcome was self-reported depression, and the exposures were sociodemographic variables and a social network score. Descriptive and multiple analyses using logistic regression were employed. Results The prevalence of self-reported depression among older adults was 11.8% (95% CI: 11.1-12.57). It was observed that 71.6% (95% CI: 67.9-75.0) of the older population with depression only undergoes pharmacological treatment. There was a higher likelihood of depression among older women (OR=2.46; 95% CI: 2.06-2.94), aged 60 to 69 years (OR=1.67; 95% CI: 1.31-2.14), with white skin color (OR=2.95; 95% CI: 1.62-5.39), residents of the South region (OR=3.01; 95% CI: 2.27-4.00), and with multimorbidity (OR=1.79; 95% CI: 1.49-2.14). Conclusion Depression appeared with considerable frequency among older adults, especially among women. There is a need to encourage the adoption of non-pharmacological measures for the treatment of the condition, such as the use of integrative and complementary practices, physical activities, lifestyle changes, and the promotion of social activities.

What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians? / ¿Cuál es la carga de multimorbilidad y los factores asociados a su ocurrencia en personas mayores brasileñas? / Qual é a carga de multimorbidade e os fatores associados à sua ocorrência em pessoas idosas brasileiras?

ABSTRACT Objective: To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry. Methods: This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted. Results: The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18). Conclusion: Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.

RESUMEN Objetivo: Estimar la prevalencia de multimorbilidad en personas mayores y su asociación con características sociodemográficas, estilo de vida y antropometría. Métodos: Estudio transversal, con datos de la Encuesta Nacional de Salud, 2019. Se seleccionaron aleatoriamente 22.728 personas mayores de los 27 estados brasileños. Se emplearon modelos de regresión de Poisson con varianza robusta y se adoptó un nivel de significancia del 5%. Resultados: La prevalencia de multimorbilidad fue del 51,6% (IC95%: 50,4-52,7), siendo las mayores estimaciones observadas en el Sur y Sudeste. La multimorbilidad se asoció con el sexo femenino (RPa=1,33; IC95%: 1,27-1,39), tener 80 años o más (RPa= 1,12; IC95%: 1,05-1,19), baja escolaridad (RPa=1,16; IC95%:1,07-1,25), consumo de cigarrillo en el pasado (RPa=1,16; IC95%:1,11-1,21), práctica insuficiente de actividad física (RPa= 1,13; IC95%:1,06-1,21) y uso de pantallas por 3 horas o más al día (RPa=1,13; IC95%:1,08-1,18). Conclusión: La multimorbilidad afecta a más de la mitad de la población anciana de Brasil y está asociada a factores sociales, demográficos y conductuales.

RESUMO Objetivo: Estimar a prevalência de multimorbidade em pessoas idosas e sua associação com características sociodemográficas, estilo de vida e antropometria. Métodos: Estudo transversal, com dados da Pesquisa Nacional de Saúde, 2019. Foram selecionadas aleatoriamente 22.728 pessoas idosas dos 27 estados brasileiros. Empregaram-se modelos de regressão de Poisson com variância robusta e adotou-se um nível de significância de 5%. Resultados: A prevalência de multimorbidade foi de 51,6% (IC95%: 50,4-52,7), sendo as maiores estimativas observadas no Sul e Sudeste. A multimorbidade foi associada ao sexo feminino (RPa=1,33; IC95%: 1,27-1,39), ter 80 anos ou mais (RPa= 1,12; IC95%: 1,05-1,19), baixa escolaridade (RPa=1,16; IC95%:1,07-1,25), consumo de cigarro no passado (RPa=1,16; IC95%:1,11-1,21), prática insuficiente de atividade física (RPa= 1,13; IC95%:1,06-1,21) e uso de telas por 3 horas ou mais por dia (RPa=1,13; IC95%:1,08-1,18). Conclusão: A multimorbidade afeta mais da metade da população idosa do Brasil e está associada a fatores sociais, demográficos e comportamentais.

Educação em saúde na formação acadêmica em enfermagem / Health education in academic nursing training / Educación de salud en la institución académica de enfermería

Com o objetivo de conhecer os limites e potencialidades da formação acadêmica em enfermagem para as atividades de educação em saúde, foi possível desenvolver um estudo exploratório-descritivo de abordagem qualitativa envolvendo 15 participantes. A coleta de dados ocorreu nos meses de maio e junho de 2022 e o processamento dos dados foi feito pelo software Iramuteq. Os resultados apontaram para a dialética envolvendo as potencialidades e limitações. Como potencialidade foi apontado que a disciplina de Educação em Saúde pode ser vista como uma temática transversal que pode ser trabalhada na prática. No que concerne às limitações, as falas elucidaram poucas oportunidades para atividades práticas, além da disciplina se distanciar da realidade. Como considerações finais, foi possível entender que existem abordagens pedagógicas tradicionais no contexto acadêmico em enfermagem desencadeando discussões para uma formação que estimule o aluno a refletir a realidade social que o cerca e aprenda a aprender constantemente.

Aiming to know the limits and the potential of academic nursing training for health education activities, an exploratory-descriptive study with a qualitative approach was developed with 15 participants. Data collection took place in May and June, 2022, and data processing was carried out using the software Iramuteq. The results pointed to the dialectics involving potentialities and limitations. A potentiality was the fact that health education can be seen as a cross-cutting theme that can be worked in practice. Regarding limitations, the speeches pointed to few opportunities for practical activities and to the distance of the subject from reality. As final considerations, it could be understood that there are traditional pedagogical approaches in the academic context of nursing, leading to discussions focused on training that encourages students to reflect on the social reality surrounding them and to learn how to learn continuously.

Con el objetivo de conocer los límites y potencialidades de la formación académica de enfermeros para actividades de educación en salud, fue posible desarrollar un estudio exploratorio-descriptivo con enfoque cualitativo involucrando a 15 participantes. La recolección de datos se realizó en los meses de mayo y junio de 2022 y el procesamiento de datos se realizó mediante el software Iramuteq. Los resultados señalaron a la dialéctica entre fortalezas y limitaciones. Como potencialidad, se apuntó que la asignatura de la educación en salud se ve como un tema transversal que puede ser trabajado en la práctica. En cuanto a las limitaciones, los discursos dilucidaron pocas oportunidades para actividades prácticas, además del hecho de que la asignatura se distancia de la realidad. Como consideraciones finales, fue posible comprender que existen enfoques pedagógicos tradicionales en el contexto académico de enfermería, desencadenando discusiones para una formación que anime a los estudiantes a reflexionar sobre la realidad social que los rodea y aprender a aprender constantemente.

Fatores associados à elevada exposição ao comportamento sedentário em pessoas idosas: uma análise com dados da Pesquisa Nacional de Saúde, 2019 / Factors associated with high exposure to sedentary behavior in older adults: analysis of data from the National Health Survey, 2019

Resumo Objetivo Analisar os fatores associados ao comportamento sedentário em pessoas idosas. Método Estudo transversal, com dados da Pesquisa Nacional de Saúde, 2019 com 22.728 pessoas idosas do Brasil. O desfecho foi o comportamento sedentário e as exposições: características sociodemográficas, estilo de vida, características do domicílio e doenças crônicas. Foi empregada a regressão logística múltipla e um nível de significância de 5%. Resultados A prevalência do comportamento sedentário foi 32,8% (IC95%: 31,8-33,8).Verificou-se maior chance para o desfecho no sexo feminino (OR =1,20; IC 95%: 1,08-1,34), entre as faixas etárias de 70 a 79 anos (OR = 1,22; IC 95%: 1,09-1,36) e 80 anos ou mais (OR=1,18; IC 95%: 1,02-1,36); entre pessoas idosas quem não tem companheiro (OR= 1,27; IC95%: 1,14-1,41); diabéticos (OR =1,17; IC 95%: 1,06-1,30), hipertensos (OR =1,34; IC 95%: 1,18-1,51), naqueles que tiveram Acidente Vascular Cerebral (OR = 1,61; IC 95%: 1,32-1,96) e naqueles que não têm lugar para praticar atividade física próximo do domicilio (OR =1,16; IC95%:1,05-1,29). Pessoas idosas com baixa escolaridade (OR = 0,71; IC 95%: 0,61- 0,82), e residentes em zona rural (OR = 0,53; IC 95%: 0,47-0,61) possuem menores chances de comportamento sedentário. Conclusão Mulheres, maiores faixas etárias (a partir dos 70 anos), pessoas com diabetes, hipertensão e que já tiveram AVE, e que não possuem locais para prática de atividade física próximo à residência foram associados à elevada exposição ao comportamento sedentário. Enquanto, viver em zonas rurais e possuir menor escolaridade apresentaram associação inversa a esse comportamento de risco.

Abstract Objective To analyze the factors associated with sedentary behavior in older adults. Method A cross-sectional study of data from the 2019 National Health Survey involving 22,728 older Brazilian adults was conducted. The outcome was sedentary behavior and the exposures included sociodemographic characteristics, lifestyle, household characteristics and chronic diseases. Multiple logistic regression was used. with a significance level of 5%. Results The prevalence of sedentary behavior was 32.8% (95%CI: 31.8-33.8) There was a greater chance for the outcome in individuals that were female (OR=1.20; 95%CI: 1.08-1.34); aged 70-79 years (OR= 1.22; 95%CI: 1.09-1.36); aged ≥80 years (OR=1.18; 95% CI: 1.02-1, 36); had no partner (OR= 1.27; 95%CI: 1.14-1.41); were diabetic (OR =1.17; 95%CI: 1.06-1.30), had systemic arterial hypertension (OR =1.34; 95%CI: 1.18-1.51). previous stroke (OR = 1.61; 95%CI: 1.32-1.96), and no place to perform physical activity close to home (OR=1.16; 95%CI: 1.05-1.29). Older adults with low education (OR= 0.71; 95%CI: 0.61-0.82), and that resided in rural areas (OR=0.53; 95%CI: 0.47-0.61) were less likely to be sedentary. Conclusion Individuals that were female, older(ager > 70 years), had diabetes, hypertension, previous stroke, and no place to perform physical activity close to home, were associated with high exposure to sedentary behavior. Living in rural areas and having less education were inversely associated with this risk behavior.

Prevalence and factors associated with sepsis and septic shock in oncological patients in intensive therapy / Prevalencia y factores relacionados a la sepsis y choque séptico en pacientes oncológicos en cuidados intensivos / Prevalência e fatores associados à sepse e choque séptico em pacientes oncológicos em terapia intensiva

ABSTRACT Objectives: to analyze factors associated with sepsis and septic shock in cancer patients in the Intensive Care Unit. Methods: cross-sectional, retrospective study with a quantitative approach, with a sample of 239 patients in an oncology hospital. Secondary data from medical records were used. The outcome variable was "presence of sepsis and/or septic shock"; and exposures: sex, length of stay, origin, use of invasive procedures and primary tumor site. Descriptive, bivariate analyzes and multiple logistic regression models were performed. Results: the prevalence of sepsis was 95% CI: 14.7-24.7 and septic shock of 95% CI: 37.7-50.3. In the multiple analysis, sepsis and/or septic shock were associated with hospital stay longer than seven days, being from the Emergency Department, presence of invasive procedures and hematological site. Conclusions: sepsis and/or septic shock in cancer patients were associated with clinical characteristics and health care factors.

RESUMEN Objetivos: analizar factores relacionados a la sepsis y choque séptico en pacientes oncológicos en Unidad de Cuidados Intensivos. Métodos: estudio transversal, retrospectivo, de abordaje cuantitativo, con muestra de 239 pacientes en un hospital oncológico. Utilizados datos secundarios de los prontuarios. La variable-desfecho fue "presencia de sepsis y/o choque séptico"; y las exposiciones: sexo, tiempo de internación, procedencia, uso de procedimientos invasivos y lugar del tumor primario. Realizados análisis descriptivos, bivariadas y modelos de regresión logística múltiple. Resultados: prevalencia de sepsis fue IC95%: 14,7-24,7 y choque séptico de IC95%: 37,7-50,3. En el análisis múltiple, la sepsis y/o choque séptico se relacionaron al tiempo de internación mayor que siete días (OR=2,29 IC95%:1,25-4,2), ser procedente de Urgencia (OR=3,21; IC 95%: 1,57-6,57), presencia de procedimientos invasivos (OR=11,4 IC95%:1,81-72,0) y lugar hematológico (OR=2,22 IC5%: 1,07-4,61). Conclusiones: la sepsis y/o choque séptico en pacientes oncológicos se relacionaron a características clínicas y factores de asistencia de salud.

RESUMO Objetivos: analisar fatores associados à sepse e choque séptico em pacientes oncológicos em Unidade de Terapia Intensiva. Métodos: estudo transversal, retrospectivo, de abordagem quantitativa, com amostra de 239 pacientes em um hospital oncológico. Utilizaram-se dados secundários dos prontuários. A variável-desfecho foi "presença de sepse e/ou choque séptico"; e as exposições: sexo, tempo de internação, procedência, uso de procedimentos invasivos e sítio do tumor primário. Realizaram-se análises descritivas, bivariadas e modelos de regressão logística múltipla. Resultados: a prevalência de sepse foi IC95%: 14,7-24,7 e choque séptico de IC95%: 37,7-50,3. Na análise múltipla, a sepse e/ou choque séptico associaram-se ao tempo de internação maior que sete dias (OR=2,29 IC95%:1,25-4,2), ser procedente da Urgência (OR=3,21; IC 95%: 1,57-6,57), presença de procedimentos invasivos (OR=11,4 IC95%:1,81-72,0) e sítio hematológico (OR=2,22 IC5%: 1,07-4,61). Conclusões: a sepse e/ou choque séptico em pacientes oncológicos se associaram às características clínicas e fatores da assistência à saúde.

Association between social network and functional disability in brazilian elderly / Asociación entre red social y discapacidad funcional en ancianos brasileños / Associação entre rede social e incapacidade funcional em idosos brasileiros

ABSTRACT Objective: to verify the association between social network and functional disability in elderly Brazilians. Methods: a cross-sectional study with secondary data of 11,177 elderly people, available on Brazilian Institute of Geography and Statistics' website. Social network components were having trusted friends/relative, living with their spouse, practicing social activity, performing voluntary or paid work. The outcome was functional disability, measured by the difficulty in performing instrumental and basic activities of daily living. Logistic regression models were used. Results: disability prevalence for instrumental activities was 28.0% (95%CI: 26.7-29.4), and for basic activities, 15.5% (95%CI: 14.4-16.6). Not having components social network components was associated with greater chances of functional disability, especially among women. Conclusion: there was an association between not having social network components with functional disability. There are differences in this association according to sex. Strengthening actions that expand social network can reduce the chance of this outcome in elderly people.

RESUMEN Objetivo: verificar la asociación entre red social y discapacidad funcional en ancianos brasileños. Métodos: estudio transversal, con datos secundarios de 11.177 ancianos, disponible en el sitio web del Instituto Brasileño de Geografía y Estadística. Los componentes de la red social fueron: tener amigos y familiares de confianza, convivir con el cónyuge, ejercer actividad social, realizar trabajo voluntario o remunerado. El resultado fue la discapacidad funcional, medida por la dificultad para realizar las actividades básicas e instrumentales de la vida diaria. Se utilizaron modelos de regresión logística. Resultados: la prevalencia de discapacidad para actividades instrumentales fue 28,0% (IC 95%: 26,7-29,4), y para actividades básicas, 15,5% (IC 95%: 14,4-16,6). No tener componentes de la red social se asoció con mayores posibilidades de discapacidad funcional, especialmente entre las mujeres. Conclusión: hubo asociación entre no tener componentes de la red social con discapacidad funcional. Existen diferencias en esta asociación según el sexo. Fortalecer las acciones que amplíen la red social puede reducir la posibilidad de este resultado en las personas mayores.

RESUMO Objetivo: verificar associação entre rede social e incapacidade funcional em idosos brasileiros. Métodos: estudo transversal, com dados secundários de 11.177 idosos, disponíveis no site do Instituto Brasileiro de Geografia e Estatítica. Os componentes da rede social foram: possuir amigos e familiares de confiança, viver com o cônjuge, praticar atividade social, realizar trabalho voluntário ou remunerado. O desfecho foi a incapacidade funcional, aferida pela dificuldade no desempenho de atividades instrumentais e básicas da vida diária. Utilizaram-se modelos de regressão logística. Resultados: a prevalência de incapacidade para atividades instrumentais foi 28,0% (IC95%: 26,7-29,4), e para atividades básicas, 15,5% (IC95%: 14,4-16,6). Não possuir componentes da rede social se associou a maiores chances de incapacidade funcional, especialmente entre as mulheres. Conclusão: houve associação entre não possuir componentes da rede social com incapacidade funcional. Há diferenças nessa associação segundo sexo. Fortalecer ações que ampliem a rede social pode reduzir a chance desse desfecho em idosos.

Association between social network and functional disability in brazilian elderly / Asociación entre red social y discapacidad funcional en ancianos brasileños / Associação entre rede social e incapacidade funcional em idosos brasileiros

ABSTRACT Objective: to verify the association between social network and functional disability in elderly Brazilians. Methods: a cross-sectional study with secondary data of 11,177 elderly people, available on Brazilian Institute of Geography and Statistics' website. Social network components were having trusted friends/relative, living with their spouse, practicing social activity, performing voluntary or paid work. The outcome was functional disability, measured by the difficulty in performing instrumental and basic activities of daily living. Logistic regression models were used. Results: disability prevalence for instrumental activities was 28.0% (95%CI: 26.7-29.4), and for basic activities, 15.5% (95%CI: 14.4-16.6). Not having components social network components was associated with greater chances of functional disability, especially among women. Conclusion: there was an association between not having social network components with functional disability. There are differences in this association according to sex. Strengthening actions that expand social network can reduce the chance of this outcome in elderly people.

RESUMEN Objetivo: verificar la asociación entre red social y discapacidad funcional en ancianos brasileños. Métodos: estudio transversal, con datos secundarios de 11.177 ancianos, disponible en el sitio web del Instituto Brasileño de Geografía y Estadística. Los componentes de la red social fueron: tener amigos y familiares de confianza, convivir con el cónyuge, ejercer actividad social, realizar trabajo voluntario o remunerado. El resultado fue la discapacidad funcional, medida por la dificultad para realizar las actividades básicas e instrumentales de la vida diaria. Se utilizaron modelos de regresión logística. Resultados: la prevalencia de discapacidad para actividades instrumentales fue 28,0% (IC 95%: 26,7-29,4), y para actividades básicas, 15,5% (IC 95%: 14,4-16,6). No tener componentes de la red social se asoció con mayores posibilidades de discapacidad funcional, especialmente entre las mujeres. Conclusión: hubo asociación entre no tener componentes de la red social con discapacidad funcional. Existen diferencias en esta asociación según el sexo. Fortalecer las acciones que amplíen la red social puede reducir la posibilidad de este resultado en las personas mayores.

RESUMO Objetivo: verificar associação entre rede social e incapacidade funcional em idosos brasileiros. Métodos: estudo transversal, com dados secundários de 11.177 idosos, disponíveis no site do Instituto Brasileiro de Geografia e Estatítica. Os componentes da rede social foram: possuir amigos e familiares de confiança, viver com o cônjuge, praticar atividade social, realizar trabalho voluntário ou remunerado. O desfecho foi a incapacidade funcional, aferida pela dificuldade no desempenho de atividades instrumentais e básicas da vida diária. Utilizaram-se modelos de regressão logística. Resultados: a prevalência de incapacidade para atividades instrumentais foi 28,0% (IC95%: 26,7-29,4), e para atividades básicas, 15,5% (IC95%: 14,4-16,6). Não possuir componentes da rede social se associou a maiores chances de incapacidade funcional, especialmente entre as mulheres. Conclusão: houve associação entre não possuir componentes da rede social com incapacidade funcional. Há diferenças nessa associação segundo sexo. Fortalecer ações que ampliem a rede social pode reduzir a chance desse desfecho em idosos.

Assistência e gerência no contexto da estratégia saúde da família sob a ótica dos enfermeiros assistenciais / Assistance and management in the context of the family health strategy from the perspective of nursing assistance nurses / Asistencia y gestión en el contexto de la estrategia de salud familiar desde la perspectiva de enfer-meras de asistencia en enfermería

Objetivo: Entender como ocorre a assistência e a gerência no contexto da Estratégia Saúde da Família sob a ótica dos enfermeiros assistenciais. Método: Estudo exploratório-descritivo de abordagem qualitativa, fundamentado no Materialismo Histórico Dialético. A coleta realizou-se através de entrevista que originaram as categorias empíricas, posteriormente analisadas pela Técnica da Análise de Discurso. Resultados: A assistência de enfermagem é considerada em sua totalidade uma forma de cumprimento dos programas estabelecidos pelo Ministério da Saúde, tornando-a, por vezes, inflexível. Os conteúdos burocráticos são vistos como empecilho por limitar a assistência direta ao cliente, além de sobrecarregá-los. Conclusão: Existe a compreensão que assistência e gerência sejam atividades interligadas e não dicotomizadas. No entanto, possui um conflito na conciliação entre essas duas dimensões. As dificuldades de conciliação refletem a fragilidade no preparo e atualização do profissional quanto ao enfrentamento das atividades no ambiente de trabalho (Au).

Objective: Understand how assistance and management occurs in the context of the Family Health Strategy from the perspective of the nursing assistants. Method: Exploratory-descriptive study with a qualitative approach, based on Historical Dialectical Materialism. The collection was carried out through interviews that originated the empirical categories, later analyzed by the Discourse Analysis Technique. Results: Nursing care is considered in its entirety as a way of complying with the programs established by the Ministry of Health, making it, at times, inflexible. Bureaucratic content is seen as an obstacle for limiting direct customer assistance, in addition to overloading them. Conclusion: There is an understanding that assistance and management are interconnected and not dichotomized activities. However, there is a conflict in the reconciliation between these two dimensions. The conciliation difficulties reflect the fragility in the preparation and updating of the professional regarding coping with activities in the work environment (Au).

Objetivo: Entender cómo se realiza la asistencia y la gestión en el contexto de la Estrategia Salud de la Familia desde la perspectiva de los enfermeros asistenciales. Método: Estudio exploratorio descriptivo con un enfoque cualitativo, basado en el Materialismo Histórico Dialéctico. La recolección se realizó a través de entrevistas que originaron las categorías empíricas, que luego fueron analizadas mediante la Técnica de Análisis del Discurso. Resultados: La atención de enfermería se considera en su totalidad como una forma de cumplir con los programas establecidos por el Ministerio de Salud, haciéndola, en ocasiones, inflexible. El contenido burocrático es visto como un obstáculo para limitar la asistencia directa al usuario, además de sobrecargarlos. Conclusión: Se sabe que la asistencia y la gestión están interconectadas y no son actividades dicotómicas. Sin embargo, existe un conflicto en la reconciliación de las dos dimensiones. Las dificultades de conciliación reflejan que hay una debilidad en la preparación y actualización del profesional para el manejo de actividades en el entorno laboral (Au).

Infecções de corrente sanguínea relacionada a cateteres centrais: entendimento e prática da equipe de enfermagem / Bloodstream infections related to central catheters: understanding and practice of the nursing team / Infecciones corrientes de sangre relacionadas con los catéteres centrales: entendimiento y práctica del equipo de enfermería

Objetivo: Investigar a compreensão e prática da equipe de enfermagem acerca das medidas de prevenção de infecções da corrente sanguínea relacionada ao cateter venoso central em unidade de terapia intensiva. Método: Estudo qualitativo, realizado de 14 de novembro de 2016 a 31 de janeiro de 2017, por uma entrevista semiestruturada com 24 profissionais da enfermagem atuantes na unidade de terapia intensiva adulto e pediátrica de um hospital escola. Utilizou-se a técnica de análise de conteúdo. Resultados: Observou-se que 16 (66,6%) não souberam definir clinicamente essa infecção, 11 (45,8%) entendem limitadamente suas vias fisiopatológicas; nenhum profissional mencionou a prática da aplicação do check list de inserção do cateter, junto à equipe médica; 12 (50%) desconhecem as diretrizes nacionais e internacionais de manutenção do dispositivo. Conclusão: Em geral, houve fragilidades na compreensão da maioria dos profissionais quanto conceito clínico, vias fisiopatológicas e medidas de inserção e manutenção do cateter

Objective: To investigate the understanding and practice of the nursing staff about measures to prevent central venous catheter-related bloodstream infections in an intensive care unit. Method: Qualitative study, conducted from November 14, 2016 to January 31, 2017, by a semi-structured interview with 24 nursing professionals working in the adult and pediatric intensive care unit of a teaching hospital. The technique of content analysis was used. Results: It was observed that 16 (66.6%) could not clinically define this infection, 11 (45.8%) understand their pathophysiological pathways; no professional mentioned the practice of applying the catheter insertion checklist to the medical team; 12 (50%) are unaware of national and international device maintenance guidelines. Conclusion: In general, there were weaknesses in the understanding of most professionals regarding the clinical concept, pathophysiological pathways and catheter insertion and maintenance measures

Objetivo: Investigar la comprensión y la práctica del personal de enfermería sobre las medidas para prevenir las infecciones del torrente sanguíneo relacionadas con el catéter venoso central en una unidad de cuidados intensivos. Método: Estudio cualitativo, realizado del 14 de noviembre de 2016 al 31 de enero de 2017, mediante una entrevista semiestructurada con 24 profesionales de enfermería que trabajan en la unidad de cuidados intensivos para adultos y pediátricos de un hospital universitario. Se utilizó la técnica de análisis de contenido. Resultados: Se observó que 16 (66,6%) no podían definir clínicamente esta infección, 11 (45,8%) entienden sus vías fisiopatológicas; ningún profesional mencionó la práctica de aplicar la lista de verificación de inserción del catéter al equipo médico; 12 (50%) desconocen las pautas de mantenimiento de dispositivos nacionales e internacionales. Conclusión: En general, hubo debilidades en la comprensión de la mayoría de los profesionales con respecto al concepto clínico, las vías fisiopatológicas y las medidas de inserción y mantenimiento del catéter

Social vulnerability associated with the self-reported diagnosis of type II diabetes: a multilevel analysis / Vulnerabilidade social se associa com o diagnóstico autorreferido de diabetes tipo II: uma análise multinível

ABSTRACT: Objective: To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City. Methods: Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level. Results: The prevalence of diabetes was 6.2% (95%CI 5.54 - 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics. Conclusion: Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications.

RESUMO: Objetivo: Analisar os fatores contextuais associados ao diabetes mellitus tipo II em Belo Horizonte (MG). Métodos: Estudo transversal com 5.779 adultos residentes em Belo Horizonte, participantes do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, nos anos de 2008, 2009 e 2010. Foram utilizados modelos de regressão multinível para testar a associação entre indicadores contextuais do ambiente físico e social e diagnóstico autorreferido de diabetes, ajustados por fatores individuais sociodemográficos e de estilo de vida. Utilizaram-se análises descritivas e modelos de regressão logística multinível, considerando um nível de significância de 5%. Resultados: A prevalência de diabetes foi de 6,2% (IC95% 5,54-6,92), e 3,1% da variabilidade da chance de diabetes nas áreas de abrangência estudadas foi explicada por características contextuais. Residir em áreas com alta densidade de locais privados para prática de atividade física e com alta renda associou-se a menor chance de ter diabetes. As áreas com alto índice de vulnerabilidade social foram fortemente associadas ao diabetes, independentemente de características individuais. Conclusão: A ocorrência de diabetes está associada com as características do ambiente físico e social. Centros urbanos com oportunidades para adoção de comportamentos saudáveis podem ajudar a reduzir a ocorrência de diabetes e as suas complicações.

Fatores relacionados ao conhecimento de profissionais de enfermagem sobre farmacovigilância / Factors related to the knowledge of nursing professionals about pharmacovigilance

RESUMO Objetivo verificar os fatores relacionados ao conhecimento de profissionais de enfermagem sobre farmacovigilância. Métodos estudo transversal, realizado com 271 profissionais de enfermagem, de nível superior e médio, por meio da amostragem por conveniência. Utilizou-se de questionário, formado por duas partes: uma acerca do perfil sociodemográfico e profissional, e outra sobre o conhecimento em farmacovigilância e a prática de notificação de eventos adversos relacionados a medicamentos. Os dados foram analisados de maneira descritiva e inferencial, por intermédio de testes de comparação e correlação, considerando nível de significância de 5%. Resultados o escore de conhecimento apresentou diferenças estatísticas em relação à formação profissional, função exercida na instituição e idade dos profissionais, enquanto a prática de notificações não obteve diferenças significativamente estatísticas. Conclusão os fatores relacionados ao conhecimento em farmacovigilância de profissionais de enfermagem foram a formação profissional, a função exercida na instituição e a idade dos profissionais.

ABSTRACT Objective to verify the factors related to the knowledge of nursing professionals about pharmacovigilance. Methods cross-sectional study, carried out with 271 nursing professionals, with university and school level, through convenience sampling. A questionnaire, consisting of two parts, was used: one about the sociodemographic and professional profile, and the other about knowledge in pharmacovigilance and the practice of reporting adverse events related to medications. The data were analyzed in a descriptive and inferential manner, through comparison and correlation tests, considering a significance level of 5%. Results the knowledge score showed statistical differences in relation to professional training, function performed in the institution and the age of the professionals, while the practice of notifications did not obtain significantly statistical differences. Conclusion the factors related to the knowledge in pharmacovigilance of nursing professionals were professional training, the role played in the institution and the age of the professionals.