Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition.

This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.

Equipos de protección personal en odontología antes y después de la COVID-19

El uso de equipamientos de protección personal durante los tratamientos odontológicos garantiza la salud de profesionales y pacientes. Este trabajo tiene como propósito analizar, en la literatura científica, el conocimiento de estudiantes y profesionales de odontología sobre el uso de equipos de protección personal, antes y después de la pandemia COVID-19. Para ello se realizó una revisión integrativa en las bases de datos: Scielo, Pubmed, BVS y Web of Science, incluyendo artículos publicados entre agosto del 2010 y agosto del 2022. Fueron seleccionados 14 artículos, disponibles íntegramente en las bases de datos seleccionadas. Se excluyeron tesis, artículos de revisión, duplicados y aquellos donde la metodología no respondía al objetivo propuesto. En los 14 artículos seleccionados, el método para obtención de datos fue el cuestionario. Los estudios fueron realizados en Brasil, Yemen, Cuba, México, Líbano, Turquía, India, Londres, y Colombia. Seis estudios se realizaron antes de la pandemia y 8 de ellos después de su inicio. Todas las investigaciones evaluaban conocimientos, actitudes, prácticas y factores relacionados con el uso de equipos de protección personal. Se concluye que el uso de equipos de protección personal antes de la pandemia ya era una práctica esencial para garantizar la seguridad de profesionales, estudiantes y pacientes durante los procedimientos odontológicos; con la pandemia de COVID-19 nuevos protocolos fueron establecidos y con ellos nuevos equipamientos como el uso del protector facial y la mascarilla N95.

The use of personal protective equipment during dental treatments guarantees the professionals and patients' health. This researcher's purpose is to analyze in scientific literature the dental students and professionals' knowledge regarding the use of personal protective equipment, before and after the COVID-19 pandemic. An integrative review was carried out in the databases: Scielo, Pubmed, BVS and Web of Science, including articles published between August 2010 and August 2022. 14 articles were selected, available in full in the selected databases. Theses, review articles, duplicates and those where the methodology did not respond to the proposed objective were excluded. In the 14 selected articles, the method for obtaining data was the questionnaire. The studies were carried out in Brazil, Yemen, Cuba, Mexico, Lebanon, Turkey, India, London, and Colombia. Six studies were carried out before the pandemic and 8 of them after its start. All researches evaluated knowledge, attitudes, practices and factors related to the use of personal protective equipment. It is concluded that the use of personal protective equipment before the pandemic was already an essential practice to guarantee the safety of professionals, students and patients during dental procedures; with the COVID-19 pandemic, new protocols were established and with them new equipment such as the use of the face shield and the N95 mask.

Reacondicionamiento de la Atención Primaria de Salud para enfrentar la pandemia COVID-19 y percepción de los profesionales sobre las medidas emprendidas en un municipio brasileño / Primary Healthcare reconditioning to face the COVID-19 pandemic, and perception by professionals of the measures implemented in a Brazilian district

Objetivo: describir las condiciones de la Atención Primaria de Salud (APS) con respecto al reacondicionamiento, equipamiento y organización de los servicios para enfrentar la pandemia y medir la percepción de los profesionales sobre las adecuaciones. Método: investigación de métodos mixtos en una ciudad del estado de San Pablo (Brasil). En la etapa cuantitativa se realizó un estudio descriptivo transversal en 222 profesionales de APS, en quienes se aplicó el cuestionario adaptado del Risk assessment and management of exposure of health care workers in the context of COVID-19 de la Organización Mundial de la Salud. Se siguió del abordaje cualitativo, que consistió en observación de campo en cuatro unidades de APS. Resultados: del total, el 86,94% (n= 193) mencionó que las unidades evalúan los signos y síntomas de los usuarios antes de las consultas; el 63,96% (n=142) que había una rutina de limpieza diaria en la sala de espera; el 92,34% (n= 205) que existían métodos para la higiene de manos; el 77,48% (n= 172) que agendaba citas para mantener el distanciamiento físico; el 80,12% (n= 178) no realizó obras de reacondicionamiento y el 45,95% (n=102) proporcionó material educativo al usuario. Conclusiones: en la observación de campo se identificaron algunas evaluaciones de signos y síntomas de los usuarios, no se observaron acciones de limpieza en las unidades, se percibió que no había suficiente alcohol gel en dispensador, no había marcas en el suelo para mantener el distanciamiento, faltaba material educativo y no se verificó que se hubieran realizado obras de reacondicionamiento. En la integración de los datos hubo convergencia en la estructura física y el reacondicionamiento de las unidades.(AU)

Objective: to describe the Primary Care (PC) scenario regarding reconditioning, equipment and organization of services in order to face the pandemic and to measure the perception by professionals regarding these adaptations. Method: a research with mixed method in a city of the San Pablo state (Brazil). In the quantitative stage, a descriptive cross-sectional study was conducted in 222 PC professionals; the adapted Risk assessment and management of exposure of health care workers in the context of COVID-19 questionnaire by the World Health Organization was implemented. This was followed by the qualitative approach, which consisted in field observation in four PC units.Results: out of the total, 86.94% (n= 193) mentioned that there was an assessment of the signs and symptoms of the users before consultation; 63.96% (n=142) stated that a daily cleaning routine was followed in the waiting room; 92.34% (n= 205) claimed that there were methods available for hand hygiene; 77.48% (n= 172) said that appointments were scheduled in order to maintain physical distancing; 80.12% (n= 178) had not conducted any reconditioning work, and 45.95% (n=102) provided educational materials to users. Conclusions: during field observation, some assessments for signs and symptoms in users were detected; no cleaning actions were observed in the units, it was perceived that there was not enough alcohol gel in the dispenser, there were no marks on the floor to keep distancing, there was a lack of educational materials, and it was not verified that any reconditioning work had been conducted. During data integration, there was convergence regarding physical structure and unit reconditioning.(AU)

Impacto en la salud integral de profesionales del área de tecnología de la información que teletrabajan durante la COVID-19 / Impact in the integral health of the workers the area technology of the information who make home office during Covid -19

Resumen Introducción: con el aislamiento social impuesto a raíz de la pandemia COVID-19, la modalidad de teletrabajo desde casa ha sido una alternativa utilizada por algunas empresas. Objetivo:determinar el impacto del trabajo a distancia sobre la salud integral de personal del área de tecnología de la información. Metodología: se realizó un estudio transversal. Por medio de la plataforma Google Forms, se envió un cuestionario semiestructurado a 150 trabajadores de tecnología de la información de un municipio de mediano porte del estado de São Paulo, para obtener información sobre las variables edad, sexo, condiciones de trabajo, salud bucal y sistémica, hábitos de higiene bucal, dolor musculoesquelético, realización de ejercicios físicos y estado emocional. Resultados: de las 116 respuestas recibidas, el 87,07 % correspondió al sexo masculino, el 100 % refirió preocupación por su salud bucal y general, un 56,03 % relató cambios en sus hábitos alimentarios, un 44,83 % incrementó el consumo de alimentos y un 77,58 % reportó preocupación y ansiedad. La prevalencia de sintomatología musculoesquelética dolorosa se manifestó en el 100 % de los encuestados, sobre todo en la región cervical (53,44 %). De forma general, se corroboró baja frecuencia de actividad física y condiciones inadecuadas para el desempeño de tareas en casa. Conclusiones: el cambio de la rutina laboral presencial por la modalidad de teletrabajo impactó significativamente en la salud de profesionales de tecnología de la información. Ante la posibilidad de mantener dicha medida a fin de disminuir la exposición y el contagio del virus, se hace necesario adoptar estrategias para preservar su bienestar integral.

Abstract Introduction: With the social isolation imposed by the Covid 19 pandemic, teleworking in the home office modality has been an alternative used by some companies. Objective: To determine the impact of this remote work on the integral health of workers. Methodology: A cross-sectional study was carried out, through the "Google Forms" platform, a semi-structured questionnaire was elaborated that was sent to 150 information technology workers from a medium-sized municipality in the state of São Paulo, to obtain information on the variables: age, sex, working conditions, oral and systemic health, oral hygiene habits, musculoskeletal pain, physical exercises and emotional state. Results: Of the total of 116 responses received, 87.07% belonged to the male sex, 100% reported concern with their oral and general health, 56.03% reported changes in their eating habits, 44.83% increased food consumption and 77.58% reported feeling concerned and anxious. The prevalence of painful musculoskeletal symptomatology manifested in 100% of workers predominantly found in the cervical region (53.44%). In general, low frequency of physical activity and inadequate conditions for home work performance were corroborated. Conclusions: The change from the usual work routine to the home office modality (teleworking) significantly impacted the health of information technology workers. Given the possibility of maintaining this modality of remote work to reduce the exposure and spread of the virus, it is necessary to adopt strategies to preserve the integral health of these professionals.

Dentofacial Deformities and Implications on Quality of Life: A Presurgical Multifactorial Analysis in Patients Seeking Orthognathic Surgical Treatment.

PURPOSE: The purpose was to perform a quality-of-life survey in patients with skeletal malocclusion before undergoing orthognathic surgery, as well as delineate the sociodemographic profile and detect factors that may alter the quality of life. PATIENTS AND METHODS: This cross-sectional study was carried out in patients who sought care at the Hospital das Clínicas of the University of São Paulo Medical School (N = 106; average age, 27.2 years). Participants answered the Oral Health Impact Profile 14 (OHIP-14) questionnaire and Orthognathic Quality of Life Questionnaire (OQLQ). The χ2 or Fisher test was used to verify the association between impact and sociodemographic variables. RESULTS: On the Oral Health Impact Profile 14 (OHIP-14) questionnaire, the "psychological incapacity" dimension (64.15%) presented a higher prevalence of impact. The marital status of the interviewees had a statistically significant effect on the impact of quality of life (P = .0119). On the Orthognathic Quality of Life Questionnaire (OQLQ), the "facial esthetics" dimension represented 81.13% in the prevalence of impact on quality of life. The "gender" variable had a statistically significant effect on the quality of life of the respondents (P = .0005), with women having an 11.78 times greater chance of having this impact. CONCLUSIONS: In this study, psychological factors and esthetics exerted a strong influence on the quality of life of patients with dentofacial deformities, overlapping with functional aspects.

Evolución del sillón dental con la incorporación de elementos ergonómicos / Dentals Chair's evolution with the incorporation of ergonomics elements

Introducción: El desarrollo de la ciencia ha posibilitado la producción de equipamientos que benefician la salud de los seres humanos. A través del tiempo, la fabricación de los sillones dentales ha seguido protocolos a fin de garantizar la comodidad del paciente y del profesional. Objetivo: Describir la evolución del sillón dental y la aplicación de normas internacionales para su diseño y fabricación. Métodos: Se trata de un estudio descriptivo, de serie histórica. Los datos fueron obtenidos de la documentación histórica existente e imágenes fotográficas en la literatura científica. Se consultaron artículos en sitios web, BBO, Lilacs y Medline; todos relacionados con el tema de investigación. Resultados: Los sillones dentales mostraron una tendencia evolutiva significativa en los últimos años: en el inicio de la práctica odontológica, permitían el trabajo con el paciente sentado, luego aparecieron con diferentes posiciones en el espaldar y con el pasar del tiempo hubo un aumento de los dispositivos y control de los movimientos de cabezal, brazos, asiento y espaldar, lo cual posibilitó la realización de actividades con el paciente acostado. En el proceso de la evolución de los sillones, en relación con su diseño y construcción se siguen normas internacionales que garantizan la calidad y confort de estos, lo que ha sido satisfactorio en la disminución de afectaciones musculoesqueléticas de los profesionales dentistas. Conclusiones: A pesar de la existencia de las nuevas tecnologías establecidas, es preciso continuar incorporando elementos ergonómicos que produzcan el máximo de confort al profesional/paciente a fin de optimizar el trabajo odontológico(AU)

Introduction: The development of science has enabled the production of equipment that benefits the health of human beings. Over the course of time, the manufacturing of dental chairs has followed protocols in order to ensure the comfort of the patient and the professional. Objective: To describe the evolution of the dental chair and the application of international standards for its design and manufacture. Method: This is a descriptive study, of historical series. The data was obtained from the existing historical documentation and photographic images in the scientific literature, articles were consulted on websites, BBO, Lilacs and Medline, all related to the research topic. Results: Dental chairs showed a significant evolutionary tendency in the last years: at the beginning of the dental practice, they allowed the work with the patient sitting, then they appeared with different positions in the back and with the passage of time there was an increase of the devices and control of movements of head, arms, seat and back, making possible activities with the patient lying down. In the process of the evolution of the chairs, in relation to their design and construction, international standards are followed to guarantee the quality and comfort of these, which has been satisfactory in the reduction of musculoskeletal affectations of the dentist professionals. Conclusions: Despite of the existence of the new established technologies, it is necessary to continue incorporating ergonomic elements that produce maximum comfort to the professional and the patient in order to optimize the dental work(AU)

Concentrações de cortisol salivar de idosos institucionalizados e não institucionalizados / Concentraciones de cortisol salival de ancianos institucionalizados y no institucionalizados / Salivary cortisol concentrations in institutionalized and non-institutionalized elderly people

Introdução: devido às limitações inerentes do processo de envelhecimento, a institucionalização é uma realidade, podendo gerar impacto na saúde física e psicológica do individuo sênior. Objetivo: determinar as concentrações de cortisol salivar de idosos institucionalizados e não institucionalizados e verificar as condições de saúde bucal e dependência física. Métodos: estudo transversal, descritivo e analítico, com amostra composta por 80 indivíduos, sendo 45 institucionalizados e 35 não institucionalizados. Realizou-se exame clínico bucal para avaliação de uso e necessidade de prótese dentária nos arcos superior e inferior. Também foi realizada coleta salivar, para análise da concentração de cortisol, marcador biológico do nível de estresse. Resultados: a maioria dos idosos apresentou-se desdentado total, sendo 84,44 porcento no grupo institucionalizado e 71,43 porcento no grupo não institucionalizado. Os idosos institucionalizados apresentaram menor índice de uso de próteses, quando comparados ao grupo de idosos não institucionalizados (p= 0,0013). A análise das concentrações de cortisol salivar demonstrou diferenças significantes entre os grupos, com taxas mais elevadas no grupo institucionalizado (p= 0,0397). Maiores concentrações de cortisol salivar foram encontradas em indivíduos que possuíam necessidades protéticas, com diferença estatisticamente significante (p= 0,0454). Conclusão: os idosos institucionalizados apresentaram elevadas concentrações de cortisol salivar, maior necessidade de uso de próteses e apresentaram-se mais dependentes, quando comparados com o grupo não institucionalizado(AU)

Introducción: debido a las limitaciones inherentes del proceso de envejecimiento, la institucionalización es una realidad, lo que puede generar impacto en la salud física y psicológica del adulto mayor. Objetivo: determinar las concentraciones de cortisol salival de ancianos institucionalizados y no institucionalizados, y verificar variables como salud bucal y dependencia física. Métodos: estudio transversal, descriptivo y analítico, en el cual la muestra estuvo compuesta por 80 individuos, de estos 45 eran institucionalizados y 35 no institucionalizados. Se realizó examen clínico bucal para evaluar el uso y necesidad de prótesis en los arcos superior e inferior. También se realizó recolecta salivar, para análisis de la concentración de cortisol, marcador biológico del nivel de estrés. Resultados: la mayoría de los ancianos se presentaron desdentados totales, para el 84,44 por ciento en el grupo institucionalizado y 71,43 por ciento en el grupo no institucionalizado. Los ancianos institucionalizados presentaron menor índice de uso de prótesis, en comparación con el grupo de ancianos no institucionalizados (p= 0,0013). El análisis de las concentraciones de cortisol salival demostró diferencias significativas entre los grupos, con tasas más elevadas en el grupo institucionalizado (p= 0,0397). Mayores concentraciones de cortisol salivar fueron encontradas en individuos que poseían necesidades protésicas, con diferencia estadísticamente significante (p= 0,0454). Conclusiones: ancianos institucionalizados presentan elevadas concentraciones de cortisol salival, mayor necesidad de uso de prótesis y se presentan más dependientes, al ser comparados con el grupo no institucionalizado(AU)

Introduction: due to the limitations inherent to the process of aging, institutionalization is a reality which may have an impact on the physical and psychological health status of elderly people. Objectives: determine salivary cortisol concentrations in institutionalized and non-institutionalized elderly people, and verify variables such as oral health and physical dependence. Methods: a descriptive analytical cross-sectional study was conducted of a sample of 80 individuals, of whom 45 were institutionalized and 35 non-institutionalized. Oral clinical examination was performed to evaluate the use of and need for dental prostheses in the upper and lower arches. Saliva was collected to determine the concentration of cortisol, a biological marker of stress levels. Results: most of the sample were totally edentulous elderly people: 84.44 percent in the institutionalized group and 71.43 percent in the non-institutionalized group. A lower rate of prosthesis use was found in the institutionalized sample than in the non-institutionalized sample (p= 0.0013). Analysis of salivary cortisol concentrations revealed significant differences between the groups, with higher values in the institutionalized group (p= 0.0397). Higher salivary cortisol concentrations were found among individuals with prosthetic needs, the difference being statistically significant (p= 0.0454). Conclusions: institutionalized elderly people had higher salivary cortisol concentrations, greater prosthetic needs, and were more care dependent than the non-institutionalized group(AU)

Discriminación y prejuicio. La influencia del VIH/SIDA y la Hepatitis B en la actitud de los académicos en odontología / Discrimination and Prejudice. The Influence of HIV/AIDS and Hepatitis B in the Attitude of Dentistry Academics / Discriminação e preconceito. A influência de HIV/SIDA e Hepatite B na atitude dos acadêmicos em odontologia

Resumen Introducción: la Hepatitis B y el Síndrome de Inmunodeficiencia Adquirida (SIDA) son enfermedades virales de destaque en salud pública, debido a sus elevados índices epidemiológicos. La representación de ellas genera actitudes discriminatorias y prejuiciosas, principalmente en el acceso a servicios de salud. El objetivo es evaluar el conocimiento de las enfermedades y la existencia de actitudes discriminatorias de los académicos en odontología frente a la presencia del SIDA y Hepatitis B. Materiales y métodos: estudio exploratorio de corte transversal realizado en una facultad pública de odontología, con una muestra compuesta por 462 (88 %) académicos que aceptaron participar de la investigación. Para recolectar los datos, sé utilizado un cuestionario semiestructurado autoaplicable, creado para este estudio; para su análisis, se usó el test chi-cuadrado de proporciones, con nivel de significancia de 5 %. Resultados: se verificó que, aunque la mayoría de los académicos afirma tener conocimiento sobre el SIDA y la Hepatitis B, apenas el 58.9 % y el 55.8 %, respectivamente, acertaron sus agentes etiológicos. Sobre las actitudes de los académicos frente al tratamiento odontológico de pacientes infectados por el Virus de Inmunodeficiencia Humana (VIH) y de Hepatitis B (VHB) 85,3 % y 91,8 %, respectivamente, afirman atender; sin embargo, parte considerable de los alumnos piensa que existen diferencias en conductas clínicas a seguir. Conclusión: existen lagunas en el conocimiento de los graduados con relación al SIDA y Hepatitis B. Las actitudes de los alumnos, en la atención odontológica de pacientes infectados, fueron consideradas discriminatorias, con mayor expresividad en el recelo en ser atendido por un profesional infectado, en lugar de tratar pacientes enfermos.

Abstract Introduction: Hepatitis B and the Acquired Immunodeficiency Syndrome (AIDS) are viral diseases of great public health importance due to their high epidemiological indexes. The representation of these diseases generates discriminatory and prejudiced attitudes, mainly in the access to health services. The objective is to assess the current knowledge and the existence of discrimination by the attitudes of dentistry academics when facing HIV/AIDS and hepatitis. Materials and methods: This is an exploratory cross-sectional study conducted in a public college of dentistry. The sample consisted of 462 (88 %) academics who agreed to participate. In data collection, we used a semi-structured questionnaire, created for this study. In the data analysis, we used the chi-square test of proportions, the significance level was 5 %. Results: It was found that, although the majority of the students affirm that they knew or have had some information about aids and Hepatitis B, only 58.9 % and 55.8 %, respectively, actually had some knowledge on etiological agents. On the attitudes of students in dental treatment practice asked if they would accept treating patients infected with HIV and HBV, the acceptance of treatment performance reached 85.3 % and 91.8 %, respectively. However, a considerable part of the students believed that there are differences in clinical procedures to be followed. Conclusion: There are students' knowledge gaps in relation to AIDS and Hepatitis B. The attitudes of students, contrasted to the given dental care for patients infected, were considered discriminatory; in addition, there was a greater fear of being assisted by an infected professional, instead of having this infected professional treat sick dentistry patients.

Resumo Introdução: a Hepatite B e o Síndrome de Imunodeficiência Adquirida (SIDA) são doenças virais de destaque em saúde pública, devido a seus elevados índices epidemiológicos. A representação delas gera atitudes discriminatórias e preconceituosas, principalmente no acesso a serviços de saúde. O objetivo é avaliar o conhecimento das doenças e existência de atitudes discriminatórias dos acadêmicos em odontologia frente à representação do SIDA e Hepatite B. Materiais e métodos: estudo exploratório de corte transversal realizado em uma faculdade pública de odontologia, com amostra composta por 462 (88%) acadêmicos que aceitaram participar da pesquisa. Para recolher os dados foi utilizado um questionário semiestruturado autoaplicável, criado para este estudo. Para analisar os dados se utilizou o teste qui-quadrado de proporções, com nível de significância de 5 %. Resultados: verificou-se que, ainda que a maioria dos acadêmicos afirma ter conhecimento sobre o SIDA e a Hepatite B, apenas 58.9 % e 55.8% respectivamente, acertaram seus agentes etiológicos. Sobre as atitudes dos acadêmicos frente ao tratamento odontológico de pacientes infetados pelo Vírus de Imunodeficiência Humana (HIV) e de Hepatite B (VHB) 85.3% e 91.8 %, respectivamente, afirmam atender, no entanto, parte considerável dos alunos considera que existem diferenças em condutas clínicas a seguir. Conclusão: existem lacunas no conhecimento dos formados com relação ao SIDA e à Hepatite B. As atitudes dos alunos na atenção odontológica de pacientes infetados, foram consideradas discriminatórias com maior expressividade no receio em ser atendidos por um profissional infetado, em vez de tratar pacientes doentes.