Sentidos de (des)regulação do mercado de trabalho no setor da saúde em Portugal / Directions of health labor market (de)regulation in Portugal

Resumo Reconhece-se a escassez de investigação sobre o mercado de trabalho do setor da saúde. Com a ampliação dos fenómenos de precarização objetiva e subjetiva, decorrente da agenda neoliberal de mercadorização do valor do trabalho e das reformas gestionárias da saúde, a "atipicidade" dos vínculos laborais e a "insegurança" de vida dos profissionais de saúde têm introduzido lógicas de segmentação e polarização do mercado de trabalho. Este deixa de ser palco apenas de mercados protegidos, passando a incluir mercados desregulados e "híbridos". Neste artigo pretende-se explorar os sentidos, com implicações desiguais, da (des)regulação do mercado de trabalho no setor da saúde em Portugal. Parte-se de fontes secundárias e de investigação qualitativa suportada em 32 entrevistas semiestruturadas feitas com profissionais de saúde, que atestam o fenômeno da crescente individualização e subcontratação laboral. Propõe-se um modelo conceitual que capte os sentidos de (des)regulação, num continuum de regulação social e mobilidade profissional, traduzindo mercados protegidos (profissionais e internos) e mercados híbridos (terciarizados e secundários) a serem testados por confronto empírico e investigação futura.

Abstract The need for further research on the labor market in the health sector is acknowledged. With the expansion of the phenomena of objective and subjective precariousness, resulting from the neoliberal agenda of commodification of the value of work and the managerial reforms in health, the "atypicality" of labor ties and the "insecurity" of health professionals' lives have introduced segmentation and polarization logics into the labor market. The latter is no longer the stage for protected markets, but includes deregulated and "hybrid" markets. This article aims to explore the directions, with unequal implications, of the (de)regulation of the labor market in the health sector in Portugal. We begin from secondary and qualitative research supported by 32 semi-structured interviews with health professionals, which attest to the phenomenon of increasing individualization and labor subcontracting. A conceptual model is proposed that captures the meanings of (de)regulation, in a continuum of social regulation and professional mobility, translating protected markets (professional and internal) and hybrid markets (outsourced and secondary) to be tested by empirical confrontation and future research.

Fatores associados à capacidade para o trabalho de enfermeiros idosos / Factors associated with the capacity for the work of elderly nurses / Factores asociados a la capacidad para el trabajo de enfermeras mayores

Objetivo: Avaliar os fatores associados a capacidade para o trabalho de enfermeiros idosos. Métodos: Estudo seccional, realizado com 233 profissionais de enfermagem idosos atuantes em hospitais públicos na cidade do Recife, Pernambuco, Brasil. Os dados foram coletados por meio do Índice de Capacidade para o Trabalho e questionário estruturado, sendo analisados posteriormente por estatística descritiva e inferencial. Resultados: A capacidade para o trabalho foi considerada boa 119(51%) e esteve associada a raça negra/parda (p-valor = 0,030) e ao fato de não possuir um segundo emprego (p-valor = 0,010). Conclusão: A raça e a quantidade de empregos acumulados são fatores que interferem na capacidade para o trabalho de profissionais de enfermagem idosos, permitindo subsidiar estratégias visando promover a saúde e o bem-estar no trabalho. (AU)

Objective: To evaluate the factors associated with the work capacity of elderly nurses. Methods: Sectional study conducted with 233 elderly nursing professionals working in public hospitals in the city of Recife, Pernambuco, Brazil. Data were collected through the Work Ability Index and a structured questionnaire, which were subsequently analyzed using descriptive and inferential statistics. Results: The ability to work was considered good 119 (51%) and was associated with the black / brown race (p-value = 0.030) and the fact of not having a second job (p-value = 0.010). Conclusion: The race and the amount of accumulated jobs are factors that interfere in the work capacity of elderly nursing professionals, allowing to subsidize strategies to promote health and well-being at work. (AU)

Objetivo: Evaluar factores asociados a la capacidad laboral de enfermeras ancianas. Métodos: Estudio transversal realizado con 233 ancianos profesionales de enfermería que laboran en hospitales públicos de la ciudad de Recife, Pernambuco, Brasil. Los datos fueron recolectados mediante el Work Ability Index y un cuestionario estructurado, y posteriormente analizados mediante estadística descriptiva e inferencial. Resultados: la capacidad para el trabajo se consideró buena 119 (51%) y se asoció con la raza negra / morena (valor de p = 0,030) y no tener un segundo trabajo (valor de p = 0,010). Conclusión: La raza y la cantidad de puestos de trabajo acumulados son factores que interfieren en la capacidad laboral de los profesionales de enfermería de edad avanzada, permitiendo estrategias de subsidio para promover la salud y el bienestar en el trabajo. (AU)

Factors associated with absenteeism in elderly nursing workers.

OBJECTIVE: To analyze the factors associated with absenteeism in elderly nursing workers. METHODS: Cross-sectional study with 233 elderly nursing workers carried out in six hospitals in Recife, Pernambuco, Brazil. The data were analyzed using univariate analysis and multivariate regression. RESULTS: Of the 233 elderly nursing professionals interviewed, self-reported absenteeism was present in 34.3% (80) participants. 20.1% (47) of them reported having missed a few days and 14.2% (33) having done so in many days. After adjusted analysis, only work hours and satisfaction with health influenced absenteeism. CONCLUSION: Absenteeism is a complex phenomenon which, among elderly nursing professionals, had a low prevalence and was associated with a workload of more than 40 hours a week and dissatisfaction with health. Therefore, further research is needed in the field to provide quality of life and better working conditions for nursing professionals and regulate their workload.

Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports.

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

Factors associated with absenteeism in elderly nursing workers / Factores asociados al absentismo en trabajadores de enfermería de edad avanzada / Fatores associados ao absenteísmo em trabalhadores idosos de enfermagem

ABSTRACT Objective: To analyze the factors associated with absenteeism in elderly nursing workers. Methods: Cross-sectional study with 233 elderly nursing workers carried out in six hospitals in Recife, Pernambuco, Brazil. The data were analyzed using univariate analysis and multivariate regression. Results: Of the 233 elderly nursing professionals interviewed, self-reported absenteeism was present in 34.3% (80) participants. 20.1% (47) of them reported having missed a few days and 14.2% (33) having done so in many days. After adjusted analysis, only work hours and satisfaction with health influenced absenteeism. Conclusion: Absenteeism is a complex phenomenon which, among elderly nursing professionals, had a low prevalence and was associated with a workload of more than 40 hours a week and dissatisfaction with health. Therefore, further research is needed in the field to provide quality of life and better working conditions for nursing professionals and regulate their workload.

RESUMEN Objetivo: Analizar los factores asociados al absentismo en trabajadores de enfermería ancianos. Métodos: Estudio transversal con 233 trabajadores de enfermería de edad avanzada realizado en seis hospitales de Recife, Pernambuco, Brasil. Los datos se analizaron mediante análisis univariado y regresión multivariada. Resultados: De los 233 profesionales de enfermería ancianos entrevistados, el ausentismo autonotificado estuvo presente en el 34,3% (80) de los participantes. De estos, el 20,1% (47) informó haber perdido algunos días y el 14,2% (33) muchos días. En el análisis ajustado, solo las horas trabajadas y la satisfacción con la salud influyeron en el absentismo. Conclusión: El absentismo es un fenómeno complejo y entre los profesionales de enfermería ancianos tuvo baja prevalencia y se asoció con una carga de trabajo de más de 40 horas a la semana y la insatisfacción con la salud. Por lo tanto, más investigaciones sobre el tema son necesarias para traer calidad de vida y mejores condiciones laborales a los profesionales de enfermería y regular su carga de trabajo.

RESUMO Objetivo: Analisar os fatores associados ao absenteísmo em trabalhadores idosos de enfermagem. Métodos: Estudo transversal com 233 trabalhadores idosos de enfermagem realizado em seis hospitais do Recife, Pernambuco - BR. A análise de dados foi univariada e regressão multivariada. Resultados: Dos 233 profissionais de enfermagem idosos entrevistados, o absenteísmo autorreferido esteve presente em 34,3% (80) dos participantes. From them, 20.1% (47) reported having missed few days, while 14.2% (33) stated to have missed many days. Na análise ajustada, apenas as horas trabalhadas e a satisfação com a saúde influenciaram o absenteísmo. Conclusão: O absenteísmo é um fenômeno complexo e entre os profissionais de enfermagem idosos apresentou baixa prevalência e esteve associado a carga horária de trabalho acima de 40 horas semanais e a insatisfação com a saúde. Portanto, se faz necessário novas pesquisas na área para fornecer qualidade de vida e melhores condições de trabalho aos profissionais de enfermagem e regulamentação de sua carga horária.

Qualidade de vida segundo comorbidades mais prevalentes em idosos com o vírus da imunodeficiência adquirida / Quality of life according to the most prevalent comorbidities in the elderly with the acquired immunodeficiency virus / Calidad de vida según las comorbilidades más prevalentes en el anciano con el virus de la inmunodeficiencia adquirida

Objetivo: avaliar a qualidade de vida segundo as comorbidades mais prevalentes em idosos com HIV. Método: estudo transversal realizado com 241 idosos de ambos os sexos usuários dos serviços de referência para acompanhamento do paciente com HIV. Os dados foram obtidos por meio da entrevista face a face com o preenchimento de um questionário sociodemográfico e clínico além do HIV/AIDS Target-Quality of life. Resultados: as três comorbidades mais prevalentes foram hipertensão, diabetes e osteoporose e dentre todas as comorbidades encontradas, apenas a hipertensão e o diabetes não apresentaram diferença estatisticamente significante com nenhuma das dimensões do HIV/AIDS Target-Quality of life. Conclusão: osteoporose e osteoartrose são as comorbidades que tem impacto em mais dimensões da qualidade de vida

Objective: to assess quality of life according to the most prevalent comorbidities in elderly people with HIV. Method: cross-sectional study carried out with 241 elderly people of both sexes, users of reference services for monitoring HIV patients. The data were obtained through a face-to-face interview by completing a sociodemographic and clinical questionnaire in addition to the HIV / AIDS Target-Quality of life. Results: the three most prevalent comorbidities were hypertension, diabetes and osteoporosis and among all the comorbidities found, only hypertension and diabetes did not show a statistically significant difference with any of the dimensions of HIV / AIDS Target-Quality of life. Conclusion: osteoporosis and osteoarthritis are comorbidities that have an impact on more dimensions of quality of life

Objetivo: evaluar la calidad de vida según las comorbilidades más prevalentes en ancianos con VIH. Método: estudio transversal realizado con 241 ancianos de ambos sexos, usuarios de servicios de referencia para el seguimiento de pacientes con VIH. Los datos se obtuvieron a través de una entrevista presencial mediante la cumplimentación de un cuestionario sociodemográfico y clínico además de la HIV/AIDS Target-Quality of life. Resultados: las tres comorbilidades más prevalentes fueron hipertensión, diabetes y osteoporosis y entre todas las comorbilidades encontradas, solo la hipertensión y la diabetes no mostraron diferencia estadísticamente significativa con ninguna de las dimensiones de HIV/AIDS Target-Quality of life. Conclusión: la osteoporosis y la osteoartritis son comorbilidades que repercuten en más dimensiones de la calidad de vida

Association of clinical, social and environmental variables with dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water / Associação de variáveis clínicas, sociais e ambientais sobre a cárie dentária em adolescentes de um município brasileiro com água fluoretada

Abstract Background Although a trend towards dental caries reduction has been observed, further investigations on its pattern and development are still needed. Objective To investigate the influence of clinical, social and environmental variables on dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water in 2018. Method This study was conducted with a non-probabilistic sample of 277 adolescents aged 12 years of public schools in Nova Friburgo, state of Rio de Janeiro, Brazil. Clinical examinations were carried out by calibrated examiners to assess caries, periodontal disease, and fluorosis according to criteria of the World Health Organization (WHO). Semi-structured questionnaires were applied to record socio-environmental information. Results Individuals living in regions supplied with fluoridated water below the minimum required levels (OR=3.60, p=0.0006), with low income (OR=1.90, p=0.0444), presence of gingivitis (OR=3.36; p=0.0016), and whose reason for visiting the dentist was dental treatment (OR=2.41; p=0.0203) were more likely to have dental caries. A significant reduction (p<0.0001) in dental caries indexes was observed between 2012 and 2018. Conclusion Fluoridation of public water supply at unsuitable levels, as well as other social and clinical variables can influence the caries pattern in adolescents.

Resumo Introdução A tendência de redução da cárie dentária tem sido constatada, apesar de maiores investigações sobre seu padrão e desenvolvimento serem ainda necessárias. Objetivo investigar a influência de variáveis clínicas, sociais e ambientais sobre a cárie em adolescentes de um município brasileiro com água fluoretada, no ano de 2018. Método Empregou-se uma amostra não probabilística de 277 adolescentes de 12 anos, de escolas públicas de Nova Friburgo, Rio de Janeiro, Brasil. Exames clínicos foram realizados por examinadores calibrados, para avaliação de cárie, doença periodontal e fluorose, sob critérios da Organização Mundial da Saúde (OMS). Questionários semiestruturados foram aplicados para coletar informações socioambientais. Resultados Indivíduos residentes em regiões com flúor na água em subdoses (OR=3,60, p=0,0006), e aqueles com baixa renda (OR =1,90, p=0,0444), com presença de gengivite (OR = 3,36; p = 0,0016) e cuja razão para a visita ao dentista foi para tratamento dentário (OR=2,41; 0,0203), apresentaram mais chances de terem cárie. Uma redução significativa (p<0,0001) nos índices de cárie foi observada entre 2012 (primeiro levantamento epidemiológico) e 2018. Conclusão A fluoretação das águas de abastecimento público, quando em níveis não adequados, assim como outras variáveis sociais e clínicas, podem influenciar o padrão de cárie nos adolescentes.

Evidence of altitudinal gradient modifying genomic and chemical diversity in populations of Lychnophora pinaster Mart.

Lychnophora pinaster Mart. (Asteraceae) is endemic to the Brazilian Cerrado. It is distributed along the altitudinal gradient of the mountainous ranges of the state of Minas Gerais. This study aimed to evaluate the influence of altitude on the genetic diversity of L. pinaster populations and the effects of altitude and climatic factors on essential oil chemical composition. Essential oils from L. pinaster populations from the north (North 01, North 02, and North 03, 700-859 m) and the Metropolitan region of Belo Horizonte (MhBH 01 and MrBH 02, 1366-1498 m) were analyzed. SNP markers from L. pinaster in these regions and Campos das Vertentes (CV 01, CV 02, and CV 03, 1055-1292 m) were also analyzed. The main compounds in essential oils were 14-hydroxy-α-humulene (North 01 and North 03), cedr-8(15)-en-9-α-ol (North 02), 14-acetoxy-α-humulene (MrBH 01), and 4-oxo-15-nor-eudesman-11-ene (MrBH 02). Hierarchical cluster and heatmap analyses showed that the North and MrBH populations included five different groups, indicating the chemical composition of essential oils is distinct in each population. Furthermore, principal component analysis showed that higher altitudes (1366 m and 1498 m) in the MrBH influence the chemical composition of essential oils, and climatic factors determine the chemical composition in North region. The genetic diversity showed that most alleles are in Hardy-Weinberg equilibrium and imply high genetic variation and genetic polymorphisms between populations. Furthermore, the results of Mantel tests (R = 0.3861517; p = 0.04709529; R = 0.9423121; p = 0.02739726) also showed that higher altitude (>1360 m) shapes the genetic diversity at the MrBH. The genetic structure showed that higher altitudes (>1360 m) contribute to the structure of the MrBH populations, but not to North and CV populations. Therefore, the altitudinal ranges of Minas Gerais mountainous ranges determine the higher genetic and chemical diversity of L. pinaster populations.

Correlation between quality of life, depression, satisfaction and functionality of older people with HIV.

OBJECTIVE: To analyze the correlation between the quality of life, depression, life satisfaction, and functional capacity in elderly people living with the Human Immunodeficiency Virus (HIV). METHODS: A cross-sectional study developed in reference hospitals for treatment and follow-up of people with HIV. 241 elderly people participated by applying a questionnaire containing sociodemographic variables, the HIV/AIDS target quality of Life, the Barthel Index, the Life Satisfaction Scale, and the abbreviated version with 15 items of the Yesavage Geriatric Depression Scale. RESULTS: The analyses showed an inverse correlation between the dimensions of the HAT-Qol with depression, a positive correlation in the domain satisfaction with life, and statistically significant, but weak, with functionality. CONCLUSION: Depression impairs quality of life in all dimensions, while life satisfaction influences this aspect more positively than functional capacity. DESCRIPTORS: Quality of Life; Depression; Personal Satisfaction; Aged; HIV.

Influence of Mycosphaerella and Teratosphaeria leaf diseases on chemical composition of essential oils of Eucalyptus globulus and effect of these essential oils on ascospores germination.

In a first step, essential oils were extracted from Eucalyptus globulus leaves, healthy and with symptoms and signs of Mycosphaerella leaf disease (MLD) and Teratosphaeria leaf disease (TLD), in two leaf stages. Stage 1: sessile, oval leaves covered by a waxy layer of a bluish colour, with opposite phyllotaxis, inserted along stems of quadrangular section. Stage 2: narrow and sickle leaves with a greyish green surface, mainly on the abaxial surface, inserted in alternating pairs along rounded stems. The essential oils were extracted by hydrodistillation and were analyzed by gas chromatography coupled with mass spectrometry. Chemical composition data and percentages of essential oil constituents were submitted to cluster analysis and principal component analysis. In a second step, under in vitro conditions, was evaluated the germination of Teratosphaeria nubilosa (one of the causal agents of TLD) ascospores in contact with the four types of essential oils extracted. The evaluations were performed at 24, 48 and 72 h after the experiments were assembled. The present study made it possible to distinguish and identify the chemical composition of essential oils from the eucalypt leaves used, and allowed 1,8-cineole to be identified as the major component for the essential oils investigated. The contact between essential oils and T. nubilosa spores allowed to prove the inhibition of the ascospores germination, being more efficient for the essential oils extracted from materials with the disease, which presented high amounts of 1,8-cineole.

Effects of fluoride emission on the morphoanatomy of three plant species endemics to Brazil using passive biomonitoring.

Fluoride is the most phytotoxic atmospheric pollutant. The objective of this study was to evaluate the effects of fluoride emissions by an aluminum smelter on three plant species endemics to Brazil, located at Parque Estadual do Itacolomi (PEI). The monitored species were Byrsonima variabilis (Malpighiaceae), Myrceugenia alpigena (Myrtaceae), and Eremanthus erythropappus (Asteraceae), which were monitored during 9 months using passive biomonitoring at five different locations with different distances from the smelter. The monitored species did not show macroscopic phytotoxicity damage to fluoride; however, they did show microscopic damage. The species closer to the smelter presented more severe anatomic damages, such as rupture of cell walls, protoplast retraction, and trichome alterations. Damaged stomatal ledges, flaking epicuticular wax, and damages to trichomes were observed. M. alpigena showed a higher accumulation of fluoride than the other species at all monitored sites. The test for cell death with Evans Blue was positive for the three studied species. Through biomonitoring in the PEI, we concluded that the emissions from the aluminum smelter affect the native vegetation and that due to the greater accumulation of fluoride and the diversity of microscopic damage in M. alpigena, the use of this species in the monitoring of environments polluted by fluoride is enhanced.

Raman and Fluorescence Profiles Modifications of Muscular and Adipose Tissues Exposed to Low Energy X-ray Beams.

This work aims to investigate changes induced by low-energy radiation in adipose and muscular tissues employing autofluorescence and Raman spectroscopic techniques. X-ray beams expositions with 25 and 35 kV at 0.11, 1.1, and 2.1 Gy radiation dose levels were applied. Changes in Raman line intensities at specific bands assigned to collagen, proteins, and lipids were observed. Autofluorescent analysis exhibit variations in the collagen and nicotinamide adenine dinucleotide emission (NADH), resulting from the structural modifications, variations on the reduced/oxidized fluorophores equilibrium followed by radiation exposure. Results show that Raman and fluorescence spectroscopy are suitable techniques to evaluate radiation effects on biomolecules even at low radiation doses and energies.

Teleconsultation in the prevention and control of older persons' health with regard to the COVID-19 pandemic: study protoco / Teleconsulta para prevenção e controle da saúde do idoso frente à pandemia de COVID-19: protocolo do estudo

OBJECTIVE: To report the following study protocol: "Prevention program for older persons' health care focusing on the COVID-19 pandemic in the city of Recife ­ PE." METHODS: An action research study will be conducted with 151 older people of both sexes residing in the 8 health districts of Recife, Brazil. A teleconsultation service will be used to converse with participants. Activities will be organized into 2 moments: diagnosis and intervention. A guided conversation strategy will be used, dealing with issues related to coronavirus disease 2019 (COVID-19) prevention; social isolation; thoughts, emotions, and spirituality; family and community support; and personal development and ground rules for everyday life. The intervention with each older person will happen weekly for 12 weeks and will be characterized by listening to them and exchanging knowledge with the aim of bonding and optimizing adherence and compliance to COVID-19 prevention and control measures. Our data analysis will follow 3 approaches: cross-sectional (multivariate regression model), quasi-experimental (analysis of standardized residuals), and qualitative (interview and content analysis). EXPECTED RESULTS AND RELEVANCE: The construction of scientific knowledge is a key strategy when faced with the great challenge to global collective health presented by the COVID-19 pandemic. Data generated in this study may contribute to the improvement of knowledge, attitudes, and preventive practices, as well as to a good acceptance of the prevention program by older participants.'

OBJETIVO: Apresentar o protocolo "Programa de prevenção para a saúde do idoso com foco na pandemia de COVID-19 no município do Recife ­ PE". METODOLOGIA: Um estudo de pesquisa-ação será conduzido com 151 idosos de ambos os sexos que residem nos 8 distritos sanitários de Recife, Brasil. Um serviço de teleconsulta será usado para comunicação com os participantes. As atividades serão organizadas em 2 momentos: diagnóstico e intervenção. Uma estratégia de conversa guiada será adotada para com os idosos, tratando de temas relacionados à prevenção de COVID-19; isolamento social; pensamentos, emoções e espiritualidade; família e suporte comunitário; desenvolvimento pessoal; e regras básicas para o cotidiano. A intervenção com cada idoso ocorrerá uma vez por semana por 12 semanas, sendo caracterizada pela escuta e troca de conhecimentos com o objetivo de gerar um vínculo e otimizar a aderência e observância de medidas de prevenção e controle de COVID-19. A análise de dados seguirá 3 abordagens: transversal (modelo de regressão multivariada), quase-experimental (análise de resíduos padronizados), e qualitativa (entrevista e análise de conteúdo). RESULTADOS ESPERADOS E RELEVÂNCIA: A construção do conhecimento científico é uma estratégia chave frente ao grande desafio para a saúde coletiva global representado pela pandemia de COVID-19. Dados gerados por este estudo podem contribuir para a melhoria do conhecimento, atitudes, e medidas de prevenção, além de uma boa aceitação do programa de prevenção por parte dos participantes idosos.

Risco nutricional e fatores associados em idosos com HIV/aids em uso de terapia antirretroviral nas unidades de referência / Nutritional risk and associated factors in older people with HIV / AIDS and use of antiretroviral therapy in reference centers

Resumo Objetivo identificar o risco nutricional de pessoas idosas com HIV/aids em uso de terapia antirretroviral (TARV) e fatores associados. Método estudo de natureza transversal e analítico. Participaram 241 idosos cadastrados nos Serviços de Referência para tratamento de HIV/aids do Município de Recife/PE, Brasil. A variável dependente correspondeu ao risco nutricional, avaliado por meio da Mini Avaliação Nutricional e as independentes incluíram: dados sociodemográficos, estilo de vida e condições de saúde. ResuItados foram identificados 44% dos participantes com risco nutricional e verificada associação entre risco nutricional e sexo feminino, escolaridade entre 1-4 anos de estudo e sintomatologia depressiva. Conclusão Sugere-se a inclusão de medidas de rastreio para intervenção precoce do estado nutricional como a Mini Avaliação Nutricional na rotina do cuidado, com vistas a possibilitar maior integralidade na assistência e redução de riscos de morbimortalidade associada ao HIV.

Abstract Objective To identify the nutritional risk of older people with HIV / AIDS and the associated factors. Method It is a cross-sectional and analytical study. 241 older people from the Reference Services in Recife/PE, Brazil participated. The dependent variable was Nutritional risk, assessed by the Mini Nutritional Assessment and the independent ones, the sociodemographic, lifestyle and health conditions. Results 44% of participants with nutritional risk were identified. There was an association between nutritional risk and female gender, education between 1-4 years of study and symptoms of depression. Conclusion It is suggested to include screening measures for early intervention of nutritional status, such as Mini Nutritional Assessment in the care routine, with a view to enabling greater comprehensiveness in care in Gerontology and reducing the risk of morbidity and mortality associated with the disease, and promoting longevity of better quality for those living with HIV.

Cuidados paliativos e demência avançada: trajetória de idosos hospitalizados nas últimas 48h de vida / Palliative care and advanced dementia: trajectory of hospitalized elderly people in their last 48 hours of life

Analisar as últimas 48h de vida de idosos com demência avançada hospitalizados e o perfil de cuidados ao longo dos 5 anos analisados. Trata-se de um estudo transversal retrospectivo, através da análise de prontuários eletrônicos dos pacientes participantes do estudo, e que foram a óbito entre 01 janeiro de 2013 e 31 de dezembro de 2017. Foram analisados 328 prontuários no período definido e 97 preencheram os critérios de inclusão. Noventa e três pacientes (95,9%) tiveram registro de diretrizes antecipadas de vontade, 73,2% eram do sexo feminino, com idade média de 88,7 anos, 52,6% dos óbitos ocorreram em apartamento ou enfermaria, nas últimas 48h de vida, 64,9% estavam com dieta por sonda, 28,9% respirando com assistência ventilatória mecânica, 51% usando antibiótico, 86,6% com prescrição de analgesia fixa, contudo 19% tinham registro de dor não controlada. Ao longo dos 5 anos de observação, houve mudanças nos seguintes aspectos: redução de óbitos na unidade de terapia intensiva (60% x 36,4%), diminuição do uso de dieta por sondas (87% x 32%), do uso de assistência ventilatória mecânica (53% x 18%); do uso de cateter venoso central (47% x 27%); do uso de sonda vesical de demora (27% x 5%), e da presença de lesão por pressão (87% x 45%). Conclui-se que nos 5 anos de análise, uma tendência paliativista na assistência, caracterizada pela redução de procedimentos considerados invasivos, nas últimas 48h de vida, em pacientes com demência avançada.

This study aimed to analyze the last 48 hours of life of hospitalized elderly with advanced dementia and the profile of care over the 5 years analyzed. This is a retrospective cross-sectional study, through the analysis of electronic medical records of patients participating in the study, who died between January 1, 2013 and December 31, 2017. 328 medical records were analyzed in the defined period and 97 met the inclusion criteria. Ninety-three patients (95.9%) had records of advance directives of their wills, 73.2% were female, with a mean age of 88.7 years, 52.6% of deaths occurred in an apartment or infirmary, in the latter 48h of life, 64.9% were on an enteral diet, 28.9% were breathing by mechanical ventilation, 51% were using antibiotics, and 86.6% were prescribed fixed analgesia; however, 19% had a record of uncontrolled pain. Over the 5 years of observation, there were changes in the following aspects: reduction of deaths in the intensive care unit (60% vs. 36.4%), decrease in the use of tube feeding (87% vs. 32%), in the use of mechanical ventilation (53% vs. 18%); the use of central venous catheter (47% vs. 27%); the use of permanent urinary catheter (27% vs. 5%), and the presence of pressure injuries (87% vs. 45%). It is concluded that in the 5 years of analysis a palliative trend in care was characterized by the reduction of procedures considered invasive, in the last 48 hours of life, in patients with advanced dementia.

Correlation between quality of life, depression, satisfaction and functionality of older people with HIV / Correlación entre calidad de vida, depresión, satisfacción y funcionalidad de personas mayores con VIH / Correlação entre qualidade de vida, depressão, satisfação e funcionalidade das pessoas idosas com HIV

ABSTRACT Objective: To analyze the correlation between the quality of life, depression, life satisfaction, and functional capacity in elderly people living with the Human Immunodeficiency Virus (HIV). Methods: A cross-sectional study developed in reference hospitals for treatment and follow-up of people with HIV. 241 elderly people participated by applying a questionnaire containing sociodemographic variables, the HIV/AIDS target quality of Life, the Barthel Index, the Life Satisfaction Scale, and the abbreviated version with 15 items of the Yesavage Geriatric Depression Scale. Results: The analyses showed an inverse correlation between the dimensions of the HAT-Qol with depression, a positive correlation in the domain satisfaction with life, and statistically significant, but weak, with functionality. Conclusion: Depression impairs quality of life in all dimensions, while life satisfaction influences this aspect more positively than functional capacity. Descriptors: Quality of Life; Depression; Personal Satisfaction; Aged; HIV.

RESUMEN Objetivo: Analizar la correlación entre calidad de vida, depresión, satisfacción con la vida y capacidad funcional en personas mayores que conviven con el Virus de Inmunodeficiencia Humana (VIH). Métodos: estudio transversal, desarrollado en hospitales de referencia para el tratamiento y seguimiento de personas con VIH. Participaron 241 personas mayores mediante la aplicación de un cuestionario con variables sociodemográficas, del HIV/AIDS-Target Quality of Life, del Índice de Barthel, de la Escala de Satisfacción con la Vida y la versión abreviada con 15 ítems de la Escala Yesavage para Depresión Geriátrica. Resultados: los análisis mostraron correlación inversa entre las dimensiones del HIV/AIDS-Target Quality of Life y depresión, correlación positiva en el dominio de satisfacción con la vida y estadísticamente significativa, pero débil con funcionalidad. Conclusión: la depresión afecta la calidad de vida en todas las dimensiones, mientras que la satisfacción con la vida influye más positivamente en este aspecto que la capacidad funcional.

RESUMO Objetivo: Analisar a correlação entre qualidade de vida, depressão, satisfação com a vida e capacidade funcional nas pessoas idosas que vivem com o Vírus da Imunodeficiência Humana (HIV). Métodos: estudo de corte transversal, desenvolvido em hospitais de referência para tratamento e acompanhamento de pessoas com HIV. Participaram 241 idosos, mediante a aplicação de um questionário contendo variáveis sociodemográficas, o HIV/AIDS Target Quality of Life, do Índice de Barthel, da Escala de Satisfação com a Vida e da versão abreviada com 15 itens da Escala de Depressão Geriátrica de Yesavage. Resultados: as análises evidenciaram correlação inversa entre as dimensões do HAT-Qol com a depressão, correlação positiva no domínio satisfação com a vida e estatisticamente significante, porém fraca, com a funcionalidade. Conclusão: a depressão prejudica a qualidade de vida em todas as dimensões, enquanto a satisfação com a vida influencia mais positivamente este aspecto do que a capacidade funcional.

Factors that influence global quality of life of long-lived older adults (>80 years) / Fatores que influenciam a qualidade de vida global de idosos longevos

OBJECTIVE: To assess the global quality of life and its associated factors in long-lived older adults registered with family health centers. METHODS: This was a cross-sectional, quantitative study based on secondary data from a convenience sample of 100 older adults living in Recife, Brazil. Global quality of life was measured using the two general questions on the World Health Organization Quality of Life instrument. The independent study variables were: sociodemographic characteristics (age, race/skin color, marital status, sex, educational level, individual income, and religion); diagnosed morbidities noted on medical record; depressive symptomology (Geriatric Depression Scale, considering results with scores over 5 as symptomatic); and social support (Lubben Social Network Scale. Independent variables that exhibited statistically significant bivariate associations with the dependent variable at the 5% level were included in a multivariate model. RESULTS: The results of analyses revealed a mean age of 84.20 years, 77% of the sample were female, 46% had spent between 1 and 4 years in education, 63% were widowed, 76% had an income equivalent to one to two times the minimum wage, 77% had systemic arterial hypertension, 34% had diabetes mellitus, 27% had cardiovascular disease, 74% had social support, and 63% exhibited depressive symptomology. The frequency of satisfactory global quality of life in the sample studied was 35%. CONCLUSIONS: Concerning the global quality of life, assessed in terms of interviewees' satisfaction with their lives and health in conjunction, the majority of the study population reported not being satisfied. After completing all statistical analyses, factors associated with dissatisfaction were social support, depression, and osteoarthritis.

OBJETIVO: Avaliar a qualidade de vida global e os fatores associados em idosos longevos assistidos em unidades de saúde da família. MÉTODOS: Trata-se de um estudo transversal, quantitativo, com base em dados secundários, com uma amostra de conveniência de 100 idosos. Foi avaliada a qualidade de vida global por meio das duas questões gerais do instrumento World Health Organization Quality of Life. As variáveis independentes do estudo foram: características sociodemográficas (idade, raça/cor, situação conjugal, sexo, escolaridade, rendimento individual e religião), morbidade diagnosticada em prontuário, sintomatologia depressiva (escala Geriatric Depression Scale, considerando resultados cuja pontuação total foi maior que 5) e apoio social (escala de redes sociais de Lubben). As variáveis independentes que apresentaram associação bivariada estatisticamente significativa a um nível de 5% com a variável dependente foram incluídas no modelo multivariado. RESULTADOS: Os resultados demonstraram uma média de idade de 84,20 anos, sendo 77% do sexo feminino, 46% com escolaridade de um a quatro anos de estudo, 63% viúvo, 76% com renda de um a dois salários mínimos, 77% possuíam hipertensão arterial sistêmica, 34% com diabetes melito e 27% apresentavam doença cardiovascular, 74% tinham apoio social e 63% com presença de sintomatologia depressiva. A qualidade de vida global satisfatória apresentou uma frequência de 35% na amostra estudada. CONCLUSÕES: Em relação à qualidade de vida global, avaliada por meio da satisfação dos entrevistados com a vida e a saúde conjuntamente, a maioria da população estudada mostrou-se insatisfeita, tendo como fatores associados, após todas as análises estatísticas utilizadas, o apoio social, a depressão e a osteoartrite.

Problematization educational intervention to promote healthy habits in elderly people with diabetes: randomized clinical trial.

OBJECTIVE: to assess the effects of a problematization educational intervention to promote healthy habits in elderly people with diabetes. METHODS: a randomized clinical trial conducted with 202 individuals drawn for the intervention group and the control group. The intervention consisted of problematization educational activities on a monthly basis for over six months. The control group participated in conventional monitoring at the health unit. Data were collected through semi-structured interviews before and after the intervention, in addition to laboratory tests. RESULTS: after the intervention, when compared to the control group, there was an increase in knowledge about the disease (p<0.001), positive attitude towards self-care (p=0.011), physical activity (p=0.020), diet variety (p=0.002), and lower consumption of oils and fats (p<0.05). CONCLUSION: the intervention performed has a beneficial effect to promote healthy habits.