Functional dependence in activities of daily living has implications for the oral health status of older people.
We aimed to assess the prevalence and characterize the profile of elder abuse in Brazil in this quantitative descriptive and exploratory study using a document analysis of cases of elder abuse against people aged 60 and over reported to Brazil's Notifiable Disease Information System ( Sistema de Informação de Agravos de Notificação-SINAN) from 2009 to 2013. Association between age groups (older adults and non-older adults) and (a) characteristics of the victims (gender, age, and race), (b) characteristics of the violence (type of violence, place of occurrence, and repeated violence) and, (c) characteristics of the perpetrator (gender, suspected alcohol consumption, and victim-perpetrator relationship) were assessed using the chi-square test and odds ratios (OR) with a 95% confidence interval. Statistical significance was set at p< .05. Elder abuse accounted for 5.7% of all cases of violence, with a higher prevalence among women (54.3%). Older men and older white people were more likely to suffer violence compared with their non-older peers (OR=1.75 and OR=1.47, respectively). Financial abuse (OR=5.95), violence resulting from legal intervention (OR=1.24), repeated violence (OR=1.22), and torture (OR=1.08) were at higher chances of occurring among older adults. In all, 30.3% of the cases of elder abuse were perpetrated by their children and 22% of the perpetrators were suspected to have consumed alcohol. Older adults were 30 times more likely to be abused by their children and eight times by caregivers and presented 2.37 more chances of evolving to death due to violence and 1.8 more chances to suffer violence in the household. The cases of elder abuse reported to SINAN highlight the greater fragility of this population group. In addition to reporting this public health problem, governmental and non-governmental actions are necessary to provide older adults with a healthy aging and ensure their rights, dignity, and autonomy.
OBJECTIVE To assess the perceptions of pregnant women about COVID-19 and the prevalence of common mental disorders during the implemented social distancing period. METHODS This was an observational, cross-sectional study using digital media, of pregnant women exposed to social distancing due to the COVID-19 pandemic, in Fortaleza, Ceará, Northeastern Brazil. Common mental disorders were estimated using the modified Self-Report Questionnaire-20 (SRQ-20) scale, and the feelings towards COVID-19 were assessed using the Fear of COVID-19 scale through telephone calls made in May 2020. COX multivariate regression models were used to verify the associations. RESULTS Of the 1,041 pregnant women, 45.7% (95%CI: 42.7–48.8) had common mental disorders (CMD). All items of the Fear of COVID-19 Scale showed a significant association with the prevalence of CMD (p < 0.001). A CMD risk gradient was observed, going from a prevalence ratio of 1.52 (95%CI: 1.13–2.04) in pregnant women with two positive items to 2.70 (95%CI: 2.08–3.51) for those with four positive items. Early gestational age and the lack of prenatal care were also associated with CMD. CONCLUSIONS The prevalence of common mental disorders in pregnant women was high during the period of social distancing and was aggravated by negative feelings towards COVID-19.
Objetivo: Analisar o estado atual da cobertura vacinal (CV) de crianças menores de três anos no município de Fortaleza, CE, e sua relação com a condição socioeconômica das famílias. Métodos: Pesquisa transversal de base populacional com amostragem aleatória. As informações foram obtidas por meio da aplicação de questionários e conferência de Cadernetas de Saúde quanto ao estado vacinal, bem como de dados ecológicos de desenvolvimento humano. A CV foi estimada em crianças na faixa etária de 19 a 36 meses. Resultados: Observou-se que 45,2% das crianças estudadas apresentavam-se com a CV recomendada pelo Ministério da Saúde (MS). Além disto, verificou-se fatores socioeconômicos determinantes de cobertura vacinal e que áreas descobertas de Agentes Comunitários de Saúde apresentaram pior cobertura. Conclusão: O presente estudo revela que é necessário fortalecer as ações que aumentem as cobertura vacinais no município.
Objective: To develop and validate an algorithm for safe hospital discharge after kidney transplantation (ASDKTx).Methods:This is a methodological study of algorithm development based on the following steps: 1) literature review; 2) historical cohort study, carried out in a reference transplant hospital in the city of Fortaleza - Ceará, including all isolated kidney transplant recipients, adults and children, that occurred between June 2017 and June 2019, who were discharged from the hospital for outpatient follow-up (n=265); 3) construction of the algorithm from the scientific evidence obtained in the literature review and information from the cohort study; 4) validation of the algorithm by expert judges, with the evaluation of the instruments in the domains: Objectives, Structure and Presentation and Relevance. Results: The sociodemographic profile of the patients in this study converges with the national literature. The overall mean length of hospital stay (HS) was 11 days, seven for living donor recipients and 11 for those who received a deceased donor transplant. The main early complications were: infection (25.6%), delayed graft function (31.6%), and surgical complications (8.3%), seven (2.7%) patients had rejection. All complications were associated with HS prolongation. The ASDKTx was validated by 19 expert judges in kidney transplantation, who considered the instrument adequate to support professionals in making decisions about patient discharge. All items of the evaluated dimensions presented an excellent Content Validity Index (CVI) equal to 1.00. Thus, the CVI of each domain was equal to 1.00, with a total CVI = 1.00. In the binomial analysis, the items presented p = 0.135, indicating no disagreement between the judges in the assigned score. The comments and suggestions supported the changes in the instrument that made it possible to define the final version of the algorithm. Conclusion: Given the common context of prolonged HS, an algorithm for safe discharge can be an essential strategy to improve understanding of the post-transplant care line and assess each patient for an early and safe discharge.
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