BackgroundIn Brazil, a rapidly aging country suffering from large inequalities, the study of the quality of life (QOL) of aged people is important for the future health. The aim of this study was to examine the associations among QOL, gender, and physical and psychosocial health in older Brazilian community-dwelling adults to identify factors that are associated with better QOL.MethodsThe “Aging, Gender and Quality of Life (AGEQOL)” study, which included 2,052 respondents aged 60 or older, was conducted in Sete Lagoas, Brazil between January and July 2012. The respondents answered questions regarding their socioeconomic and demographic information, health and social situations, cognitive impairment, depressive symptoms and family satisfaction. The authors also applied the Brazilian version the World Health Organization Quality of Life QOL Assessment-Brief Instrument (WHOQOL-BREF) and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old). Ordinal logistic regression with the Proportional-Odds and Logit function was used to test the association between QOL and physical and psychosocial health according to age and socioeconomic status.ResultsOlder adults of both genders with five or more years of education, good self-rated health, an absence of depressive symptoms, and no family dysfunction reported better QOL. Retired men had a better QOL compared to non-retired men (OR = 2.2; 95% CI = 1.4–3.2), but this association was not observed in females. Men living in mixed arrangements (OR = 0.5; p = 0.033) and women who did not practice physical activity (OR = 0.7; p = 0.022) tended to have poorer QOL.ConclusionsWe conclude that there are gender differences related to better QOL in this sample. Women with good physical and psychosocial health are more likely to have a better QOL. For men, the best QOL was associated with high socioeconomic conditions and good physical and psychosocial health.

Resumo Objetivo Avaliar a funcionalidade familiar de idosos brasileiros; testar a influência de fatores determinantes. Métodos Estudo transversal com 2.052 idosos, a partir de dados coletados da linha base referente ao estudo “Aging, Gender and Quality of Life (AGEQOL)”, responderam questionários sobre funcionamento familiar; atividades básicas e instrumentais de vida diária (AVD e AIVD); estado cognitivo; e características sociodemográficas. Modelos multivariados de regressão ordinal e análise de correspondência múltipla identificaram fatores associados à boa funcionalidade familiar. Resultados A maior parte dos idosos gozava de boa funcionalidade familiar (76,3%), era casada e vivendo com cônjuge (55,5%), tinha mais de seis filhos e netos (85,4% e 76,7%, respectivamente) e independente para AIVD (71,5%). Análise de correspondência resultou em três grupos: alta, moderada e baixa funcionalidade familiar e perfil de idosos com distintas condições socioeconômicas. Conclusão Infere-se dos resultados implicações para a prática e política de atenção à família com membros idosos segundo seu funcionamento e distintas condições de vida e saúde das pessoas idosas.

Determinantes do envelhecimento ativo segundo a qualidade de vida e gêneroDeterminants of active aging according to quality of life and gender

Objective: to identify the healthy aging profile in octogenarians in Brazil. Method: this population-based epidemiological study was conducted using household interviews of 335 octogenarians in a Brazilian municipality. The decision-tree model was used to assess the healthy aging profile in relation to the socioeconomic characteristics evaluated at baseline. All of the tests used a p-value < 0.05. Results: the majority of the 335 participating older adults were women (62.1%), were aged between 80 and 84 years (50.4%), were widowed (53.4%), were illiterate (59.1%), had a monthly income of less than one minimum wage (59.1%), were retired (85.7%), lived with their spouse (63.8%), did not have a caregiver (60.3%), had two or more children (82.7%), and had two or more grandchildren (78.8%). The results indicate three age groups with a healthier aging profile: older adults aged 80 to 84 years (55.6%), older adults aged 85 years and older who are married (64.9%), and older adults aged 85 and older who do not have a partner or a caregiver (54.2%). Conclusion: the healthy aging profile of octogenarians can be explained by age group, marital status, and the presence of a caregiver.

The aim of this study was to identify factors influencing edentulous patients' preferences for treatment using conventional or implant dentures (ID). A consecutive sample of 112 patients was selected in a university facility. All patients responded to a questionnaire concerning preferences about treatment and factors influencing preferences for conventional complete dentures (CD), implant-retained overdentures (IRO) and fixed implant-supported prostheses (FISP). Subsequently, a set of 21 questions was presented, and patients were requested to rate the importance of various potential reasons influencing their choice of treatment. Preference for CD was more prevalent for maxilla (52·7%) and mandible (41·1%). Fixed implant-supported prostheses and IRO were preferred for the mandible (FISP=37·5%; IRO=21·4%) rather than maxilla (FISP=27·7%; IRO=19·6%). The most preferred treatment option among the subjects when evaluating both arches was the implant-supported fixed or removable prosthesis (FISP/IRO). A preference for combined upper and lower CD was also commonly reported (39·3%). Factor analysis identified six components that accounted for 72·2% of the total variance: (i) psychosocial benefits, (ii) functional performance, (iii) technical and financial concerns, (iv) post-insertion complaints, (v) removability and (vi) longevity. Technical and financial concerns (cost, complexity, surgery risks and duration of treatment) were more relevant for those who preferred ID (P<0·001). With the exception of post-insertion complaints, all mean scores of component factor loadings were positive for ID. Conventional complete dentures are associated with lower expected outcomes by patients, and cost-related issues are the major factors associated with the preferences for implant treatment of edentulous patients.

Background: The determinants of self-rated health (SRH) have been widely investigated to explain social differences and gender differences in health. This study aimed to investigate the gender differences in predictors of SRH among Brazilian and Chilean older adults. Methods: We used two samples of older people: 2052 Brazilian community-dwelling participants (1226 women and 862 men) and 1301 Chilean community-dwelling participants (855 women and 446 men). Sequential logistic regression analysis was used to examine the relationships between SRH and potential predictors in a hierarchical model. Results: Overall, 35.5% and 52.1% of individuals in Chile and Brazil, respectively, reported good SRH. There was a gradient association between good SRH and chronic diseases in both countries. Chilean men without chronic disease or with one had a higher chance of good SRH, compared to two or more diseases. For Brazilian men, no or one chronic disease was associated with good SRH. For women, the set of independent predictors for good SRH included no chronic diseases or one chronic disease, and no activities of daily living limitation. For men, the set also included instrumental activities limitation. For Brazilian adults of both genders, depression demonstrated the strongest independent association with good SRH.

BackgroundRecently, increasing importance has been placed on the social determinants of health and disease. The present study aimed to determine the prevalence of periodontal disease in Brazilian adults and identify possible relationships with social determinants.MethodsA cross-sectional study was performed using a sample of 743 adults (aged 35–49 years) living in an urban area of a large city in southeastern Brazil. The condition of the periodontium was assessed using the Community Periodontal Index (CPI) according to the diagnostic criteria established by the World Health Organization (WHO). The variables related to social determinants were collected using a structured questionnaire. A descriptive analysis of all study variables was performed. Multiple correspondence analysis was subsequently performed to identify relationships between periodontal disease and the social determinants of health.ResultsThe periodontal exams showed that 36.5% of adults had a healthy periodontium, 2.0% had gingival bleeding, 47.1% had calculus and 9.5% had periodontal pockets of 4–5 mm. Periodontal pockets of 6 mm or more were the worst periodontal condition found (affecting only 2.1% of the participants). The correspondence analysis enabled us to form three groups with different profiles. The first group was distinguished by the presence of bleeding (gingivitis) or a healthy periodontium. The members of this group were typically aged 35 to 39 years and had 9–12 years or more than 12 years of education. The second group consisted of subjects with calculus and periodontal pockets of 4–5 mm. The members of this group were typically white men aged 40–44 years with incomes greater than $ 300.00. The third group was distinguished by the presence of periodontal pockets of 6 mm or more. The members of this group were typically adult females, black and mixed individuals who had 8 years or less of schooling, individuals with incomes ≤ $ 300.00 and widowers.ConclusionThe results suggest that periodontal health is worse in the group for which the social indicators are worse. Therefore, the social determinants of health also affect the severity of periodontal disease in adults Brazilian society.

RESUMO:Estudo qualitativo, com inspiração fenomenológica. Teve por objetivo compreender o significado de ser colostomizado e participar de um programa de atendimento ao ostomizado. O estudo foi realizado com sete pessoas colostomizadas, por meio de entrevista contemplando a questão norteadora: "Qual o significado para você de ser portador de uma colostomia?". Emergiram as seguintes categorias: Mudanças no cotidiano da vida -adaptação a nova situação; Transformação do corpo -influência no contexto biopsicossocial; Influência do tempo e o apoio da religiosidade na aceitação em ser um ostomizado; Papel da família e do grupo operativo; Possibilidade de viver com algumas limitações, superando a discriminação. Concluímos que as pessoas com ostomias passam por alterações corporais que influenciam na autoestima e nas relações do convívio social. Percebe-se que o passar do tempo, associado com a religiosidade e apoio dos familiares e dos grupos operativos são fatores importantes para a aceitação e adaptação a nova condição. PALAVRAS-CHAVE: Colostomia; Assistência; Cuidados de enfermagem; Saúde da família. THE MEANING OF BEING COLOSTOMYZED AND BEING PART OF AN OSTOMY SERVICE PROGRAMABSTRACT: This is a qualitative study with phenomenological inspiration. Aimed to understand the meaning of being colostomyzed and participate in a program of care to ostomy patients. The study was conducted with seven colostomyzed people, by an interview contemplating the question: "What does it mean for you to have a colostomy?". The following categories emerged: changes in everyday life -adaptation to a new situation; Transformation of the body -influence in the biopsychosocial context; Influence of time and the religious support on acceptance in being stomatyzed; Role of the family and the operative group role; A chance to live with some limitations, overcoming discrimination. We conclude that people with ostomies go through bodily changes that influence self-esteem and relationships in social life. It is noticed that the course of time, and the association with religiosity and support of family members and operational groups are important for the acceptance and adaptation to new conditions. KEYWORDS: Colostomy; Assistance; Nursing; Health family. EL SIGNIFICADO DE SER COLOSTOMIZADO Y PARTICIPAR DE UN PROGRAMA DE ATENDIMIENTO AL OSTOMIZADORESUMEN: Estudio cualitativo, con inspiración fenomenológica. Tuvo por objetivo comprender el significado de ser colostomizado y participar de un programa de atendimiento al ostomizado. El estudio fue realizado con siete personas colostomizadas, por medio de entrevista contemplando la cuestión: "¿Qué significa, para ti, ser portador de una colostomía?". Emergieron las siguientes categorías: Cambios en cotidiano de la vida -adaptación a la nueva situación; Transformación del cuerpo -influencia en contexto biopsicosocial; Influencia del tiempo y el apoyo de la religiosidad en la aceptación en ser un ostomizado; Papel de la familia y del grupo operativo; Posibilidad de vivir con algunas limitaciones, superand...