Accidente laboral y estresores de la organización del trabajo en el personal de salud: una mirada desde la seguridad y la salud en el trabajo: revisión narrativa / Workplace accident and work organization stressors in health personnel: a narrative review from safety and health at work / Acidentes de trabalho e estressores da organização do trabalho em profissionais de saúde: uma perspectiva de segurança e saúde no trabalho: revisão narrativa

Los accidentes laborales en el personal de salud se presentan como consecuencia de los estresores de la organización del trabajo. Estos estresores afectan la satisfacción laboral y la productividad. El objetivo de la presente revisión es reportar la evidencia científica sobre la relación entre el accidente laboral y los estresores de la organización del trabajo en el personal de salud, desde la perspectiva de la seguridad y salud en el trabajo. En la recolección de información se identificaron inicialmente 190 artículos, de los cuales se excluyeron siete por duplicación; se revisaron 183 títulos y resúmenes, descartando 139 de ellos. Luego, se revisaron 44 estudios completos, descartando 17. Por último, fueron incluidos en la revisión 27 estudios que cumplieron con los criterios de elegibilidad. En el sector salud los accidentes laborales se encuentran ligados a factores como la sobre­carga, largas jornadas de trabajo y el turno nocturno, que afectan de forma negativa la salud y el bienestar de los trabajadores. Los estresores de la organización del trabajo, específicamente la sobrecarga laboral, la falta o insuficiencia de recursos humanos y las jornadas extendidas de trabajo, son la principal causa de accidentes de origen laboral en el personal de salud, por ello, es necesario implementar estrategias de prevención y control tendientes al mejoramiento de las condiciones de salud y bienestar de los trabajadores.

Workplace accidents in health personnel occur as a consequence of work organization stressors. These stressors affect job satisfaction and productivity. The objective of this review is to report the scientific evidence on the relationship between workplace accidents and work organization stressors in health personnel, from the perspective of safety and health at work. In the collection of information, 190 articles were initially identified, of which seven were excluded due to duplication; 183 titles and abstracts were reviewed, discarding 139 of them. Then, 44 complete studies were reviewed, discarding 17. Finally, 27 studies that met the eligibility criteria were included in the review. In the health sector, workplace accidents are linked to factors such as overload, long work hours and night shifts, which negatively affect the health and well-being of health workers. The stressors of work organization, specifically work overload, the lack or insufficiency of human resources and extended working hours, are the main cause of work-related accidents in health personnel. Therefore, it is necessary to implement prevention and control management strategies aimed at improving the health and well-being of health workers.

Os acidentes de trabalho em profissionais de saúde ocorrem como consequência dos estressores da organização do trabalho. Esses estressores afetam a satisfação no trabal-ho e a produtividade. O objetivo desta revisão é relatar as evidências científicas sobre a relação entre acidentes de trabalho e estressores da organização do trabalho em profissionais de saúde, sob a perspectiva da saúde e segurança ocupacional. Na coleta de informações, inicialmente foram identificados 190 artigos, dos quais sete foram excluídos por duplicidade; Foram revisados 183 títulos e resumos, descartando-se 139 deles. Em seguida, 44 estudos completos foram revisados, descartando 17. Finalmente, 27 estudos que atenderam aos critérios de elegibilidade foram incluídos na revisão. No setor saúde, os acidentes de trabalho estão ligados a fatores como sobrecarga, longas jornadas de trabalho e plantões noturnos, que afetam negativamente a saúde e o bem-estar dos trabalhadores. Os estressores da organização do trabalho, especificamente a sobrecarga de trabalho, a falta ou insuficiência de recursos humanos e as jornadas de trabalho extensas, são a principal causa de acidentes de trabalho em profissionais de saúde, portanto, é necessário implementar estratégias de prevenção e controle que visem melhorar a saúde e o bem-estar dos trabalhadores.

Demandas e utilização de serviços de saúde entre imigrantes de uma região metropolitana do nordeste do Brasil / Demandas y uso de servicios de salud entre inmigrantes de uma región metropolitana del noreste de Brasil / Demands and use of health services among immigrants from a metropolitan region in northeastern Brazil

Resumo Objetivo analisar as demandas e a utilização dos serviços de saúde por imigrantes na Região Metropolitana de Aracaju, Sergipe. Método recrutaram-se, pelo método bola de neve, 186 imigrantes, alocados em clusters relacionados à renda per capita do país de origem e países da América Latina ou não. Utilizou-se questionário auto aplicado sobre as condições e práticas de saúde. Resultados imigrantes de países com renda baixa e média baixa (IMB) são mais jovens, com menor tempo de permanência no Brasil, possuem ensino fundamental/médio, exercem atividade laboral sem carteira de trabalho assinada e renda de até um salário mínimo (p<0,05). Imigrantes da América Latina (IAL) possuem aproximadamente duas vezes mais chances de ter alguma doença crônica não transmissível (DCNT), comparados aos imigrantes de outros países (IOP). A idade e o tempo de permanência no Brasil influenciam na autoavaliação da saúde, na busca por serviços de saúde e ter alguma DCNT (p<0,05). O Sistema Único de Saúde foi o mais buscado tanto na chegada ao Brasil quanto nos últimos 12 meses, principalmente pelos IMB e IAL (p<0,05). Conclusão e implicações para a prática observaram-se diferenças dentro dos subgrupos de imigrantes, principalmente em termos de padrões de utilização, ressaltando a importância da competência transcultural na assistência.

Resumen Objetivo fueron analizadas las demandas y el uso de los servicios de salud por los inmigrantes en la Región Metropolitana de Aracaju, Sergipe. Método fueron reclutados, mediante el método bola de nieve, 186 inmigrantes y se dividieron en agrupación es según la renta per cápita del país de origen y continente. Se utilizó un cuestionario auto aplicado sobre condiciones y prácticas de salud. Resultados los inmigrantes de países de renta baja y media baja (IMB) son más jóvenes, han pasado menos tiempo en Brasil, tien en educación primaria/secundaria, trabajan sin contrato formal y tienen una renta de hasta 1 mínimo salario (p<0,05). Los inmigrantes de Latinoamérica (LAI) tienen aproximadamente el doble de probabilidades de tener una enfermedad crónica no transmisible (ENT) em comparación con inmigrantes de otros países (IOP). La edad y el tiempo de permanencia en Brasil influyen en la autoevaluación de la salud, la búsqueda de servicios de salud y el tener algunas ENT (p<0,05). El Sistema Único de Salud (Sistema Único de Saúde) fue el más buscado tanto a su llegada a Brasil como en los últimos 12 meses, principalmente por el IMB y la IAL (p<0,05). Conclusión e implicaciones para la práctica se observaron diferencias dentro de los subgrupos de inmigrantes, principalmente en términos de sus patrones de uso, resaltando la importancia de la competencia intercultural em la asistencia.

Abstract Objective This study aimed to analyze the demands and use of health services by international migratory clusters in the metropolitan region of Aracaju, Sergipe. Method A total of 186 immigrants were recruited, and divided into clusters according to the country of origin and continent. An epidemiological questionnaire on health conditions and care-related. Results Low and low middle income country immigrants (LMI) are younger, with lower length of stay in Brazil, elementary education, working without a formal contract, with an income of up to 1 minimum wage (p<0.05). Latin America immigrants (LAI) are approximately twice as likely to have some Chronic noncommunicable disease (NCDs), compared to other country immigrants (OCI). Age and length of stay in Brazil influence self-rated health, search for health services and having some NCDs (p<0.05). The Unified Health System (Sistema Único de Saúde) was the most sought after both on arrival in Brazil and in the last 12 months, mainly by LMI and LAI (p<0.05). Conclusion and implications for practice Differences were observed within immigrant subgroups, mainly in terms of their use patterns and the importance for cross-cultural competence in health care.

Hospitalizations in Brazil according to National Health Survey estimates, 2013 and 2019 / Hospitalizações no Brasil pelas estimativas da Pesquisa Nacional de Saúde, 2013 e 2019

ABSTRACT OBJECTIVE To compare the profile and prevalence of hospitalizations in Brazil based on estimates from the National Health Survey (PNS), 2013 and 2019. METHODS A cross-sectional study that used data from the 2013 PNS and the 2019 PNS. The outcome was having been hospitalized for 24 hours or more in the last 12 months. We calculated the proportion of the population in different categories of age group, presence or absence of chronic diseases, and perception of health status. We estimated the total number of hospitalizations and the proportion corresponding to each category of age group, chronic disease, and perceived health status. We calculated the prevalence of hospitalization according to geographic, socioeconomic, and health conditions. We compared the estimates of two editions of the PNS using Student's t-test for independent samples. We considered significant differences when the p-value was less than 0.01. And finally, we compared hospitalization estimates with administrative data to assess data consistency. RESULTS We observed that the proportion of chronically ill people in the population increased from 15.04% to 31.48%. This group was responsible for 36.76% of the total number of hospitalizations in 2013 and 57.61% in 2019. The prevalence of hospitalizations increased significantly between the two surveys and the increases were higher in the Southeast region and among people who have private health insurance. A discrepancy was found between administrative data and survey estimates. Obstetric hospitalizations and health insurance hospitalizations were underestimated. CONCLUSION There was an increase in overall hospitalization rates in the period between the PNS 2013 and PNS 2019, especially among people with better access to health services. The hospitalization profile also changed—in the 2013 PNS, hospitalizations of people without chronic diseases predominated. This was reversed in PNS 2019.

RESUMO OBJETIVO Comparar o perfil e a prevalência das hospitalizações no Brasil com base nas estimativas da Pesquisa Nacional de Saúde (PNS), 2013 e 2019. MÉTODOS Estudo transversal seriado que utilizou os dados das PNS 2013 e PNS 2019. O desfecho foi ter ficado internado por 24 horas ou mais nos últimos 12 meses. Calculamos a proporção da população nas diversas categorias de faixa etária, de presença ou ausência de doenças crônicas e de percepção do estado de saúde. Estimamos o número total de hospitalizações e a proporção correspondente a cada categoria de faixa etária, de doença crônica e de percepção do estado de saúde. Calculamos a prevalência de internação segundo fatores geográficos, socioeconômicos e condições de saúde. Comparamos as estimativas das duas edições da PNS utilizando o teste t de Student para amostras independentes. Consideramos as diferenças significativas quando o valor de p foi menor que 0,01. E finalmente comparamos as estimativas de hospitalização com os dados administrativos para avaliar a consistência dos dados. RESULTADOS Observamos que a proporção de doentes crônicos na população passou de 15,04% para 31,48%. Este grupo foi responsável por 36,76% do total de internações em 2013 e de 57,61% em 2019. A prevalência de hospitalizações aumentou significativamente entre os dois inquéritos e os incrementos foram maiores na região Sudeste e entre pessoas que possuem plano de saúde privado. Foi encontrada uma discrepância entre os dados administrativos e as estimativas dos inquéritos. As internações obstétricas e as internações por plano de saúde foram subestimadas. CONCLUSÃO Houve um aumento nas taxas globais de hospitalização no período compreendido entre as PNS 2013 e 2019, especialmente entre as pessoas com melhor acesso aos serviços de saúde. O perfil de hospitalização também mudou - na PNS 2013 predominaram internações de pessoas sem doenças crônicas. Isto se inverteu na PNS 2019.

Status report on prison health in the WHO European Region 2022

This report provides an overview of the performance of prison health systems in the WHO European Region. It contains 2020 data obtained through a survey collected from 36 countries, where a total of 613 497 people were deprived of their liberty. In most of these countries, responsibility for delivering prison health care was shared between the Ministry of Health and the Ministry of Justice/the Interior. Preventive services, such as vaccines, were universally offered for COVID-19 in all Member States, even though deficiencies still persisted in access to vaccination for other diseases such as hepatitis B. The response implemented for COVID-19 was good, except when people were transitioning into the community. Continuity of care was an area needing investment, with only around half of Member States ensuring access to community health services. The most prevalent condition was mental health disorders, but the ratio of psychiatrists to people in prison did not ensure equity of care and access to treatment was suboptimal. Harm minimization focused mostly on access to drug use treatment and less on safe injecting or tattooing practices. Access to hepatitis C (HCV) treatment was not on track to achieve HCV elimination and needs urgent attention. The most common cause of death in prisons was suicide, followed by COVID-19 and drug overdose. Overcrowding was reported in 20% of Member States. Even though Member States are improving their capacity to provide disaggregated data, further investment is needed to increase capacity to provide morbidity and health behaviour data.

Relationship between anticholinergic load and self-perceived health in a population aged 44 years or older / Relação entre carga anticolinérgica e autopercepção de saúde em população com mais de 44 anos

OBJECTIVE: To investigate the relationship between anticholinergic load (ACL) and self-perceived general health in adults in a medium-sized municipality in southern Brazil. METHODS: This cross-sectional study was based on 2015 data from a medium-sized municipality in southern Brazil. All respondents aged 44 years or older who reported using drugs in the 2 weeks before the interview were included (n = 662). The Anticholinergic Drug Scale was used to measure the ACL. Self-perceived health was categorized as positive self-perception (PSP) or negative self-perception (NSP). Crude and adjusted Poisson regression analyses were conducted to investigate the association between ACL and self-perceived health. RESULTS: NSP was found in 50.91% of 662 respondents. Significant ACL, older age, lower economic status, lower education, polypharmacy, and depression correlated with a higher frequency of NSP. Individuals with significant ACL had a prevalence of NSP of 1.27 (95% confidence interval: 1.02 ­ 1.58), and each additional ACL level represented a 6.10% higher chance of worse self-perceived health, regardless of confounding factors. CONCLUSIONS: An association was found between significant ACL and NSP, with an effect dependent on ACL level

OBJETIVO: Investigar a relação entre carga anticolinérgica (CAC) e autopercepção de saúde em adultos de um município de médio porte do sul do Brasil. METODOLOGIA: Trata-se de um estudo transversal com dados de 2015, realizado em um município de médio porte do sul do Brasil. Todos os entrevistados com 44 anos ou mais que relataram uso de drogas nas duas semanas anteriores à entrevista foram incluídos (n = 662). A Anticholinergic Drug Scale (ADS) foi utilizada para medir a CAC. A autopercepção da saúde foi categorizada em autopercepção positiva (APP) ou autopercepção negativa (APN). Análises de regressão de Poisson bruta e ajustada foram realizadas para investigar a associação entre CAC e autopercepção de saúde. RESULTADOS: Entre os 662 participantes, a CAC foi encontrada em 50,91% dos respondentes. CAC significativa, idade avançada, situação econômica mais baixa, menor escolaridade, polifarmácia e depressão foram correlacionados com maior frequência de APN. Indivíduos com CAC significativo apresentaram prevalência de APN de 1,27 (intervalo de confiança de 95%: 1,02 ­ 1,58), e cada nível adicional de CAC representou uma chance 6,10% maior de pior autopercepção de saúde, independentemente de fatores de confusão. CONCLUSÕES: Encontrou-se associação entre ACL significativo e APN, com efeito dependente do valor do CAC

Relationship between self-reported health and neuroticism in older adults: a scoping review / Relação entre saúde autorreferida e neuroticismo em idosos: uma revisão de escopo

This scoping review aims to identify and map the existing literature regarding the relationship between neuroticism and self-reported health in community-dwelling older adults. We adopted the Joanna Briggs Institute Manual for Evidence Synthesis recommendations and followed the PRISMA-SCr when reporting it. The search was performed on ten different databases, including: Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, PsycArticles, PsycInfo, United States National Library of Medicine, Scopus, Web of Science, Ageline and Biblioteca Virtual em Saúde/Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde databases until February 2021. Data screening and extraction were performed by two independent reviewers. We included primary studies with older adults (≥60 years) [participants] that adopted validated instruments to assess neuroticism and self-reported health [concept] in the community [context], published in Portuguese, English, or Spanish. We identified 3453 articles and included 15 studies in this review. We extracted the main categories of included studies, characteristics of the participants, methodological issues, and biopsychosocial factors. Outcomes were reported in three sections: Focus of studies; Definitions and measures of neuroticism and self-reported health; Associations with biopsychosocial factors. We found an association between high neuroticism and poor self-reported health. Some biopsychosocial factors may influence this relationship, such as chronic diseases, depression, social support, and a sense of control, which must be considered in future studies to shed light on this topic

Esta revisão de escopo tem como objetivo identificar e mapear a literatura existente sobre a relação entre neuroticismo e saúde autorreferida em idosos vivendo na comunidade. Adotamos as recomendações do Joanna Briggs Institute Manual for Evidence Synthesis e seguimos o PRISMA-SCr ao reportá-lo. A busca foi realizada em dez bases de dados diferentes, incluindo: Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, PsycArticles, PsycInfo, United States National Library of Medicine, Scopus, Web of Science, Ageline e Biblioteca Virtual em Saúde/Centro Latino -Americano e do Caribe de Informação em Ciências da Saúde até fevereiro de 2021. A triagem e extração dos dados foram realizadas por dois revisores independentes. Incluímos estudos primários com idosos (≥60 anos) [participantes] que adotaram instrumentos validados para avaliar neuroticismo e saúde autorreferida [conceito] na comunidade [contexto], publicados em português, inglês ou espanhol. Identificamos 3.453 artigos e incluímos 15 estudos nesta revisão. Extraímos as principais categorias dos estudos incluídos, características dos participantes, questões metodológicas e fatores biopsicossociais. Os resultados foram relatados em três seções: Foco dos estudos; Definições e medidas de neuroticismo e autoavaliação de saúde; Associações com fatores biopsicossociais. Encontramos uma associação entre alto neuroticismo e má saúde autorrelatada. Alguns fatores biopsicossociais podem influenciar nessa relação, como doenças crônicas, depressão, suporte social e senso de controle, que devem ser considerados em estudos futuros para elucidar esse tema

COVID-19 y personas mayores en Chile: lecciones de dos años de pandemia / The impact of COVID-19 on the health status of older people in Chile

The article presents the main impact of COVID-19 pandemic on the health status of older people, systematizing the information about the direct impact of the pandemic in terms of number of cases, hospitalizations, deaths, the policies implemented for the prevention and management of COVID-19 in older people and the indirect impact of the two years of pandemic. Adopting a broad definition of health, the need to monitor and recover health care of older people is highlighted. The recovery of their functionality and mental health must be emphasized. The policies towards institutionalized older people must be revised. These areas should be the focus of health care policies for older people in Chile.

Bienestar subjetivo, estado de salud, funcionalidad y participación social en personas mayores de Chile / Subjective well-being, health status, functional capacity and social participation in Chilean older people

BACKGROUND: Chile is currently updating the Comprehensive Policy on Positive Aging, which establishes a positive association between Subjective Well-being, Self-perceived Health, Functional status, and Social Participation in older people. Aim: To study the relationship between Subjective Well-being, General Health, Functional status, and Social Participation in older people in Chile. MATERIAL AND METHODS: In a cross-sectional observational study, 2.031 people aged 60 years and over were included in the National Health Survey 2016-2017 (ENS). The study included analysis of correlations between the relevant variables, in addition to binomial logistic regression with Subjective Well-being as a response variable, as well as the application of structural equation techniques (SEM). Results: Subjective Well-being had a positive association with Self-perceived Health (Rho = 0.370), functional status (Rho = 0.360), and Social Participation (Rho = 0.290). However, in the logistic regression analysis only Self-perceived Health (OR = 0.293) and Functional status (OR = 0.932) had predictive capacity for Subjective Well-being. CONCLUSIONS: The relevance of Self-perceived Health and Functionality in the sensation of Well-being among older people, reinforces the need to improve health care within a framework of a comprehensive policy for this age group.

Determination of prevalence, characteristics, management and related factors for pain in the older adults: pain among nursing home residents

This study aimed to determine pain assessment approaches and pain management strategies in elderly people in a nursing home.The cross-sectional-descriptive study sample consisted of 147 older adults living in a nursing home in Turkey in 2019. They all agreed to participate in the study (n = 147); however, as our research was about older adultswith pain problems, the study was completed with a total of 108 older adultsexperiencing pain problems. The participants' average age was 73.60 ± 6.97 years. Geriatric pain scale scores were higher for women aged 75 years and over, those who had a chronic disease and those who received analgesics, and there was a statistically significant difference between the mean scores (p < 0.05). Nurses must pay attention to pain assessment and management in nursing homes because of the adverse effects of pain on older adults' health status, vital functions, and well-being.

Factors associated with dynapenia in older adults in the northeast of Brazil / Fatores associados à dinapenia em idosos do nordeste brasileiro

ABSTRACT This study identified factors associated with dynapenia in older adults residing in a small town in northeastern Brazil. It is a population-based study conducted with 208 senior citizens (58.7% women) from Aiquara, BA. Sociodemographic, behavioral and health information were obtained from face-to-face interviews, and nutritional status was assessed by body mass index. To measure their level of physical activity and sedentary behavior, the International Physical Activity Questionnaire was used. Dynapenia was diagnosed by sex, from the 25th percentile of handgrip strength, by means of a hydraulic dynamometer. For inferential analyses, Poisson regression was used, with a robust estimator, calculation of Prevalence Ratios (PRs) and their respective 95% Confidence Intervals (CIs). The prevalence of dynapenia was higher in older adults aged 70-79 (PR: 3.21; 95%CI: 1.55-6.64) and ≥80 years (PR: 4.91; 95%CI: 2.32-10.39), in those with low weight (PR: 2.20; 95%CI: 1.26-3.82), in those who are insufficiently active (PR: 1.99; 95%CI: 1.12-3.54), and among those with high level of sedentary behavior (PR: 1.88; 95%CI: 1.19-2.98). The factors identified as being associated with dynapenia were: age between 70 and 79 and ≥80 years, insufficient level of physical activity; high level of sedentary behavior, and low weight.

RESUMO Este estudo identificou os fatores associados à dinapenia em idosos residentes em um município de pequeno porte do Nordeste brasileiro. Trata-se de um estudo populacional, conduzido com 208 idosos (58,7% mulheres) de Aiquara-BA. As informações sociodemográficas, comportamentais e de condições de saúde foram obtidas em entrevistas face a face, e o estado nutricional foi avaliado pelo índice de massa corporal. Para mensuração do nível de atividade física e do comportamento sedentário, utilizou-se o International Physical Activity Questionnaire. O diagnóstico da dinapenia foi realizado por sexo, a partir do percentil 25 da força de preensão manual, averiguada com um dinamômetro hidráulico. Para análises inferenciais foi utilizada a regressão de Poisson, com estimador robusto, cálculo das Razões de Prevalência (RP) e de seus respectivos intervalos de confiança de 95% (IC). A prevalência de dinapenia foi maior nos idosos com idade entre 70-79 (RP: 3,21; IC95%: 1,55-6,64) e ≥80 anos (RP: 4,91; IC95%: 2,32-10,39), nos com baixo peso (RP: 2,20; IC95%: 1,26-3,82), nos insuficientemente ativos (RP: 1,99; IC95%: 1,12-3,54) e entre os com elevado comportamento sedentário (RP: 1,88; IC95%: 1,19-2,98). Identificou-se que os fatores associados à dinapenia foram: idade entre 70-79 e ≥80 anos, nível de atividade física insuficiente; elevado comportamento sedentário e baixo peso.

Association of social factors and health conditions with capacity and performance

ABSTRACT OBJECTIVE Determine and measure the association of social factors and health conditions with worse capacity and performance levels. METHODS Dependent variables consisted of performance and capacity; independent variables comprised age, gender, level of education, personal income, and health conditions. Means (95%CI) of performance and capacity were presented according to the independent variables. Generalized linear models, using a mutual adjustment for all variables considered statistically significant (p < 0.05), measured the associations between each exposure and outcomes. Study population included 12,265 individuals. RESULTS Older women with lower education and income levels and with some health condition showed the worst performance and capacity. CONCLUSION Results showed that the capacity and performance levels of the Chilean population changed according to social demographic characteristics and health conditions.

Hyoid displacement patterns in healthy swallowing

ABSTRACT Objective To describe the patterns of displacement of the hyoid bone in healthy individuals, considering their displacements during swallowing of different consistencies. Methods Two hundred one swallowing videofluoroscopy exams of 67 adult and elderly individuals without swallowing disorders were analyzed. Descriptive analysis was performed to identify and describe the patterns of displacement of the hyoid bone. Results Seven types of displacement of the hyoid bone were found: H1 (horizontal), H2 (short vertical and long horizontal), H3 (vertical and diagonal to upper), H4 (long vertical and short horizontal), H5 (vertical), H6 (diagonal), and H7 (brief). The standards were maintained in different consistencies. The most frequent pattern of displacement was type H2. The distribution of the types of displacement of the hyoid was different among men and women. Conclusion Seven patterns of displacement of the hyoid bone during swallowing of normal adults and older people have been described. The most frequent pattern of displacement was horizontal, with variations in distribution between men and women. The displacement pattern was maintained during the swallowing of the three different consistencies (thin, pasty and solid liquid).

Condições de saúde de mulheres e homens idosos com idade avançada: estudo longitudinal / Health status of older men and women: longitudinal study / Condiciones de salud de mujeres y hombres de edad avanzada: un estudio longitudinal

Objetivo: descrever as características sociodemográficas e de saúde de mulheres e homens com 75 anos ou mais de idade, no baseline e follow-up de quatro anos e verificar para mulheres e homens as mudanças nas condições de saúde. Métodos: estudo longitudinal com 109 idosos de 75 anos ou mais de idade de um município no Triângulo Mineiro. A coleta dos dados, realizada em dois momentos (2014-2018), ocorreu no domicílio com a aplicação de instrumentos validados no Brasil. Procederam-se às análises descritiva e teste t pareado (p<0,05). Os projetos foram aprovados pelo Comitê de Ética e Pesquisa com Seres Humanos. Resultados: verificaram-se, em ambos os sexos, aumento do número de morbidades e diminuição do escore total das atividades instrumentais da vida diária. Entre as mulheres observou-se, ainda, aumento do número de quedas e do escore de fragilidade. Conclusão: ao longo do seguimento houve piora nas condições de saúde dos idosos, sendo mais expressiva entre as mulheres.

Objective: to describe the sociodemographic and health characteristics of women and men aged 75 or over, at baseline and after four years of follow-up, and to ascertain changes in their health status. Methods: in this longitudinal study of 109 elderly people aged 75 or over from a city in the Triângulo Mineiro, data were collected at two points (2014 and 2018), at home, by applying instruments validated for use in Brazil. Descriptive analysis and paired t-tests were performed (p < 0.05). The projects were approved by the human research ethics committee. Results: in both genders, the number of morbidities increased and the total score for instrumental activities of daily living decreased. Among women, the number of falls and frailty score also increased. Conclusion: the older people's health status worsened over the course of follow-up, more so among the women.

Objetivo: describir las características sociodemográficas y de salud de mujeres y hombres de 75 años o más, en la base de referencia y el seguimiento durante cuatro años, y verificar los cambios en las condiciones de salud de mujeres y hombres. Métodos: estudio longitudinal con 109 personas mayores, de 75 años o más, de un municipio del Triângulo Mineiro. La recolección de datos, realizada en dos momentos (2014-2018), se realizó en sus domicilios aplicando instrumentos validados en Brasil. Se realizaron análisis descriptivos y prueba t pareada (p <0.05). Los proyectos fueron aprobados por el Comité de Ética en Investigación con Humanos. Resultados: en ambos os sexos, hubo un aumento en el número de morbilidades y una disminución en la puntuación total de las actividades instrumentales de la vida diaria. Entre las mujeres, se observó asimismo un aumento en el número de caídas y la puntuación de fragilidad. Conclusión: a lo largo del seguimiento, las condiciones de salud de las personas mayores empeoraron, más expresivamente entre las mujeres.

Participación laboral en espondiloartritis axial radiográfica y no radiográfica / Labor participation in radiographic and non-radiographic axial spondyloarthritis

Introducción: las limitaciones laborales son un punto importante a considerar en el tratamiento de la espondiloartritis axial (EspAax) dado que esta enfermedad afecta a las personas en la etapa más productiva de la vida. Objetivos: describir la situación laboral en pacientes con EspAax de Argentina, incluyendo la espondilitis anquilosante (EA) y la espondiloartritis axial no radiográfica (EspAax-nr), y evaluar los factores asociados a la pérdida de productividad laboral (PPL) en esta cohorte nacional y los factores asociados a estar empleado. Materiales y métodos: en este estudio transversal y multicéntrico se incluyeron pacientes con diagnóstico de EA y EspAax-nr según los criterios de clasificación de la Assessment of SpondyloArthritis international Society (ASAS 2009) y en edad laboral (≤65 años). Los objetivos principales fueron evaluar la situación laboral, el ausentismo y el presentismo, valorados por el cuestionario Work Productivity and Activity Impairment Spondyloarthritis (WPAI-SpA). Se utilizó el coeficiente de Spearman para evaluar la correlación entre las medidas de la enfermedad y la PPL. Se realizó un análisis bivariado y multivariado para evaluar los factores asociados a estar empleado. Resultados: se incluyeron 129 pacientes con EspAax, 95 (73,6 %) con EA y 34 (26,4%) con EspAax-nr. La mediana (p25-75) de edad fue de 45 (35-55) años. La duración mediana de la enfermedad fue de 62 (24-123) meses y el retraso en el diagnóstico fue de 24 (6-72) meses. Sesenta (46,5%) pacientes estaban empleados. La mediana (p25-75) de presentismo de los pacientes con EA fue del 29,6% (0-57) y del 30% (20-40) para los pacientes con EspAax-nr (p=0,02). Asimismo, la mediana (p25-75) de PPL fue del 30% en ambos grupos de pacientes. Se encontró una correlación positiva entre la PPL y las siguientes variables: ASDAS (Rho:0.60), BASDAI (Rho:0.50), BASFI (Rho:0.60), ASQoL (Rho:0.60) y ASAS health index (Rho:0.54). En el análisis bivariado, los factores asociados al desempleo fueron el diagnóstico de EA, la edad avanzada, la mayor duración de la enfermedad, las comorbilidades (hipertensión y diabetes), el menor número de años de educación, la peor calidad de vida y la menor capacidad funcional. En el análisis multivariado, una mejor función física (evaluada por BASFI) se asoció de forma independiente a estar empleado. Conclusiones: este estudio demostró que la PPL en esta cohorte nacional fue del 30% en la EspAax. Se asoció con la actividad de la enfermedad, el estado de salud, la calidad de vida y la capacidad funcional. Una mejor función física se relacionó en forma independiente con una mayor probabilidad de mantener a los pacientes con EspAax empleados.

Introduction: work disability is an important outcome in the treatment of spondyloarthritis (SpA) since this disease affects people in the most productive stage of life. Objectives: to investigate working status in patients with axial spondyloarthritis (axSpA) from Argentina, including ankylosing spondylitis (AS) and nonradiographic axial SpA (nr-axSpA), and to evaluate factors associated with work productivity loss (WPL) in this national cohort and factors associated with being employed. Materials and methods: patients with a diagnosis of AS and nr-axSpA according to Assessment of SpondyloArthritis international Society (ASAS 2009) classification criteria and in working age (≤65 years) were included in this multicentric cross-sectional study. Outcomes of interest were employment status, absenteeism and presenteeism, assessed by the Work Productivity and Activity Impairment Spondyloarthritis (WPAI-SpA) questionnaire. Spearman's coefficient was used to assess the correlation between disease measures and WPL. Bivariate and multivariate analysis were performed in order to evaluate factors associated with being employed. Results: 129 patients with axSpA were included, 95 (73.6%) with AS and 34 (26.4%) with nr-axSpA. Median (p25-75) age of 45 (35-55) years. Median (p25-75) disease duration was 62 (24-123) months and diagnosis delay was 24 (6-72) months. 60 (46.5%) of the patients were employed. Median (p25-75) presenteeism of AS patients was 29.6% (0-57) and 30% (20-40) for patients with EspAax-nr (p=0.02). Median (p25-75) WPL was 30% in both groups of patients. A positive correlation was found between WPL and the following variables: ASDAS (Rho:0.60), BASDAI (Rho:0.50), BASFI (Rho:0.60), ASQoL (Rho:0.60) and ASAS health index (Rho:0.54). In the bivariate analysis, the factors associated with unemployment were AS diagnosis, older age, longer disease duration, comorbidities (hypertension and diabetes), fewer years of education, worse quality of life and lower functional capacity. In the multivariate analysis, better physical function (assessed by BASFI) was independently associated with being employed. Conclusions: this study showed that WPL in this national cohort was 30% in axSpA. It was associated with disease activity, health status, quality of life and functional capacity. Better physical function was independently associated with a higher likelihood of keeping patients with axSpA employed.

Factores asociados a la salud autoevaluada en personas costarricenses: resultados para la cohorte de jubilación de CRELES / Factors associated with self-rated health in Costa Ricans: results for the CRELES retirement cohort

Resumen Introducción: La salud autoevaluada se ha considerado como una medida subjetiva del estado de salud general. El objetivo de este estudio consistió en identificar factores asociados a la salud autoevaluada en personas adultas costarricenses. Métodos: la muestra provino de un estudio de corte transversal que incluyó 992 hombres y 1570 mujeres participantes de una nueva corte de jubilación del proyecto Costa Rica: Estudio de Longevidad y Envejecimiento Saludable, referido como CRELES-RC. La salud autoevaluada se midió a través de una sola pregunta sobre la valoración del estado de salud, con cinco opciones de respuesta: excelente, muy buena, buena, regular y mala. Se calcularon odds ratios (OR) para cuantificar la contribución de las enfermedades crónicas y otros factores con una mala salud autoevaluada. Resultados: por un lado, los modelos de regresión logística determinaron que la salud autoevaluada se asocia con la zona de residencia, el nivel educativo, la percepción de la situación económica, la actividad física, el apoyo emocional y la presencia de enfermedad crónica. Por otro lado, las personas con alguna enfermedad crónica, excepto cáncer, evidenciaron una peor salud autoevaluada; la relación más fuerte se presentó con la artritis, la enfermedad pulmonar y la diabetes. Conclusiones: el estudio identificó que la zona de residencia, la actividad física, el nivel educativo, el apoyo emocional y la enfermedad crónica podrían afectar la salud de las personas.

Abstract Introduction: Self-rated health has been considered a subjective measure of general health status. We aim was identified factors associated with self-rated health in the Costa Ricans adult population. Methods: a population cross-sectional study with a total of 992 men and 1570 women representing a new retirement cohort participating in the project Costa Rica: Longevity and Healthy Aging Study and referred to as CRELES-RC. Self-rated health was measured through a single question on the assessment of health status that considers five options: excellent, very good, good, fair and poor. Odds ratios (OR) were calculated to quantify the contribution of chronic diseases and other factors to poor self-rated health. Results: The logistic regression models determined that self-rated health is associated with the area of residence, educational level, perception of the economic situation, physical activity, emotional support and the presence of chronic disease. People with a chronic disease, except cancer, indicate poorer self-rated health. The strongest relationship was with arthritis, lung disease, and diabetes. Conclusions: the study allowed to identify that the area of residence, education, physical activity, emotional support and chronic illness could affect people's health.

Risco de mortalidade por todas as causas e sua relação com estado de saúde em uma coorte de idosos residentes na comunidade: Estudo FIBRA / Risk of all-cause mortality and its association with health status in a cohort of community-dwelling older people: FIBRA study

Resumo O artigo tem por objetivos estimar o risco de óbito segundo características sociodemográficas, doenças crônicas, fragilidade, capacidade funcional e participação social em idosos e verificar, para as variáveis de estado de saúde e participação social, o tempo mediano de ocorrência do óbito. Estudo longitudinal retrospectivo com idosos (≥65 anos), realizado em 2008-09 e 2016-17 em Campinas-SP e Ermelino Matarazzo-SP. Realizaram-se entrevistas face a face em centros de convivência e nos domicílios. Estimou-se a incidência acumulada de óbito e associações com as variáveis preditoras foram analisadas pela regressão múltipla de Poisson. O método de Kaplan-Meier e o teste de Log-rank foram utilizados. Dos 741 idosos localizados no seguimento, 192 faleceram. Observou-se maior incidência de óbito nos mais idosos, nos que relataram doença do coração e nos dependentes para realização de atividades instrumentais da vida diária. Verificou-se menor incidência de óbito nas mulheres, no estrato com maior renda e nos que realizavam três ou mais atividades relacionadas à inserção social. Não se observaram diferenças nos tempos medianos de sobrevida. Os preditores de mortalidade podem contribuir para ampliar o conhecimento sobre as singularidades do processo de envelhecimento.

Abstract This article aims to estimate the risk of death according to sociodemographic characteristics, chronic diseases, frailty, functional capacity, and social participation in older people as well as determine the median time of death in relation to health status and social participation. A retrospective longitudinal study was conducted with older people (≥65 years) in 2008-09 and 2016-17 in the city of Campinas and the subdistrict of Ermelino Matarazzo in the city of São Paulo. Face-to-face interviews were conducted at community centers and the participants' homes. The cumulative incidence of death was estimated and associations with the predictor variables were analyzed using Poisson multiple regression. The Kaplan-Meier method and the log-rank test were also used. Among the 741 individuals located at follow-up, 192 had deceased. The incidence of death was higher among those who reported having heart disease and those who were dependent on others regarding the performance of instrumental activities of daily living. The incidence of death was lower among women, individuals in the highest income stratum, and those who performed three or more activities related to social inclusion. No differences in median survival times were found. Predictors of mortality can contribute to broadening knowledge on the singularities of the aging process.

Caracterización del estado de salud bucal de la población geriátrica / Characterization of oral health status in an older population

RESUMEN La vejez, si no es un divino tesoro, resulta un preciado don que en la actualidad disfrutan más de 600 millones de personas mayores de 60 años. El objetivo de esta investigación fue determinar el estado de salud bucal de la población geriátrica correspondiente al consultorio 21-21 del municipio Santa Clara. Se realizó un estudio observacional, descriptivo y de corte transversal en el consultorio 21-21 perteneciente al Policlínico Universitario «XX Aniversario» del municipio Santa Clara, entre enero 2017 - septiembre 2018. En la población de estudio predominó el sexo femenino y el grupo de edad de 70-74 años. La enfermedad sistémica encontrada con mayor frecuencia fue la hipertensión arterial y el principal problema bucal fue la dificultad masticatoria. El nivel de conocimiento de la población se clasificó como regular. Los ancianos presentaban gran variedad de enfermedades sistémicas y bucales, lo que se corresponde con el deterioro propio de la edad.

ABSTRACT Old age, if not a divine treasure, is a precious gift that is currently enjoyed by more than 600 million people over 60 years old. The objective of this research was to determine the oral health status in an older population belonging to the 21-21 doctor's office from Santa Clara municipality. A cross-sectional, descriptive and observational study was carried out in the 21-21 doctor's office belonging to "XX Aniversario" University Polyclinic from Santa Clara municipality, between January 2017 and September 2018. The study population was predominantly female and aged 70-74 years. Hypertension was the most common systemic disease found and masticatory difficulty was the main oral problem. The level of knowledge of the population was classified as fair. The elderly had a wide variety of systemic and oral diseases, which corresponds to age-related deterioration.

Anthropometric parameters, lower limb functionality and quality of life after high-intensity interval training in healthy young people versus older adults / Parámetros antropométricos, funcionalidad de miembros inferiores y calidad de vida posterior al entrenamiento interválico de alta intensidad en jóvenes versus personas mayores

SUMMARY: The aim of this study was to determine the effects of High-intensity interval training (HIIT) on the quality of life in healthy young people (YNG) and older adults (OLD)and its correlation with physical health status (anthropometric parameters and lower limb functionality) YNG (21 ? 2 years, BMI 26.37 ? 2.69 n = 12) and OLD (67 ? 5 years, BMI 27.16 ? 3.04 n = 12) groups underwent 12weeks of HIIT. Before and after the HIIT, anthropometric assessments, lower limb functionality tests, and SF-36 quality-of-life questionnaire were performed. There were no significant changes in the SF-36 dimensions (P>0.05). After HIIT, there were improvement percentage changes in Mental Component Summary (MCS) (YNG, +8.51 ? 25.80 % vs. OLD, +2.30 ? 9.05 %) and in Physical Component Summary (PCS) (YNG, +2.66 ? 20.54 % vs. OLD, +4.34 ? 22.71 %). Negative correlations were observed between body mass index (BMI) with PCS (R=-0.570, P=0.009) and with MCS (R=-0.649, P=0.002) in OLD as well as between MCS and waist circumference (R=-0.557, P?0.001) in both groups. Also, correlations were observed between PCS and the sit-to-stand test (R=-0.424, P=0.006) in both groups and gait speed (R=0.458, P=0.042) only in YNG. HIIT promotes positive percentage changes in quality of life, with YNG showing better results in PCS and OLD in MCS. Quality of life and physical health status were correlated in both groups.

RESUMEN: Determinar los efectos del entrenamiento interválico de alta intensidad (HIIT) sobre la calidad de vida en jóvenes sanos (YNG) y personas mayores (OLD) y su correlación con el estado de salud física (parámetros antropométricos y funcionalidad de miembros inferiores). Ambos grupos, YNG (21 ? 2 años, IMC 26,37 ? 2,69 n = 12) y OLD (67 ? 5 años, IMC 27,16 ? 3,04 n = 12) realizaron 12 semanas de HIIT. Antes y después del HIIT, se realizaron evaluaciones antropométricas, pruebas de funcionalidad de miembros inferiores y cuestionario de calidad de vida SF-36. No hubo cambios significativos en las dimensiones del SF-36 (P >0,05). Después del HIIT, hubo cambios porcentuales de mejora en el componente sumario mental (MCS) (YNG, +8.51 ? 25.80 % vs. OLD, +2.30 ? 9.05 %) y el componente sumario física (PCS) (YNG, +2,66 ? 20,54 % vs. OLD, +2,30 ? 9,05 %), correspondientes a la calidad de vida. Se observaron correlaciones negativas entre el índice de masa corporal (IMC) con PCS (R=-0,570; P=0,009) y con MCS (R=0,649; P=0,002) en OLD, así como entre MCS y circunferencia de cintura (R = - 0,557, P?0,001) en ambos grupos. Además, se observaron correlaciones entre PCS y la prueba de sentarse y levantarse (R = -0,424; P = 0,006) en ambos grupos y la velocidad de la marcha (R = 0,458; P = 0,042) solo en YNG. HIIT promueve cambios porcentuales positivos en la calidad de vida, con YNG mostrando mejores resultados en PCS y OLD en MCS. La calidad de vida y el estado de salud física se correlacionaron en ambos grupos.

Impact of chronic kidney disease on health-related quality of life in the pediatric population: meta-analysis

Abstract Objective: To meta-analyze health-related quality of life in pediatric patients with chronic kidney disease in comparison to healthy patients according to the dimensions of the PedsQL instrument. Sources of data: A systematic review was performed with meta-analysis for the mean difference in each of the health-related quality of life dimensions. The authors searched for ten scientific databases including PubMed, Scopus, SciELO, Science Direct, ProQuest, Google Scholar. Reproducibility by the Kappa index was evaluated, and Dersimonian and Laird's tests, RI coefficient, Begg statistic, Forest Plot, and sensitivity analysis were carried out. Summary of the findings: 17 investigations were included in the qualitative synthesis and 7 in the quantitative synthesis with a population of 1214 of both healthy and sick pediatric patients with 3−5 chronic kidney disease stages. The health-related quality of life in pediatric chronic kidney disease patients presented lower scores in all the evaluated dimensions: in the phys- ical dimension the difference is of 13.6 points, in the emotional dimension 7.8, in the social dimension 8.2, in the school dimension 20.8, with the total difference being 17.7 points. Conclusion: The findings of this study show that pediatric patients have lower health-related quality of life in all the evaluated dimensions, with the ''school'' dimension being the most affected and the ''emotional'' one the least. In this sense, we suggest monitoring the healthrelated quality of life of pediatric patients with chronic kidney disease so that interventions can be oriented to strengthen the affected dimensions, including adjustments to daily life and prevention of complications related to the disease.