Objective: to describe updating of stratification of the Brazilian municipalities in order to evaluate health performance. Methods: this was a descriptive and methodological study with stratification of municipalities according to population size and conditions influencing health management, using data from the intercensal period (2015) and showing classification variations compared with the census period (2010); the original data on demographic characteristics, funding capacity and population purchasing power were adjusted for the year 2015 based on a baseline study conducted with census data. Results: some 15% of the municipalities were reclassified in the intercensal period, with the main factors of change being the conditions influencing health management. Conclusion: the need for intercensal updating of this form of classification was confirmed, given that the socioeconomic conditions of the municipalities vary in the five-year period; Primary Health performance evaluation should consider updated stratifications that include management conditions for the purpose of classification.
The aim of the study was to compare static postural balance of healthy individuals of three age groups in different conditions of support and vision. Seventy one individuals, divided into 3 groups, were analyzed: young group (YG: 22.2 ± 2.1 years), middle aged group (MAG: 50.7 ± 5.7 years) and older individuals group (EG: 66.8 ± 5.4 years). Their balance was tested on a force platform, under 3 support and 3 visual conditions. Measures included: total (TD), anterior-posterior (APD) and mediolateral displacement (MLD) of the center of pressure (CoP). ANOVA revealed significant differences for interactions between group X support conditions and group X visual conditions for the 3 variables (p<0.01), with greater displacements for the MAG and EG groups during single-leg stance with partial and occluded vision (p<0.05). Static postural balance decreased over time in healthy individuals, and conditions of support and visual negatively affected balance with the increment of age.
Introdução: A automassagem destaca-se na Política Nacional de Práticas Integrativas e Complementares (PNPIC) como proposta de meio terapêutico eficaz e de simples aprendizado que reforça o autocuidado e a autonomia do usuário na perspectiva de prevenção, promoção e recuperação da saúde. Objetivo: Descrever as percepções dos usuários praticantes de automassagem em um serviço referência da PNPIC em capital nordestina. Materiais e método: Estudo transversal e descritivo, com abordagem qualitativa, realizado com usuários de 18 anos ou mais, participante de prática guiadas semanais de automassagem no Serviço Integrado de Saúde do Recife. Os dados foram coletados a partir de formulários socioeconômicos e entrevistas semiestruturadas gravadas e transcritas, com posterior análise pela técnica do Discurso do Sujeito Coletivo. Resultados: Houve predomínio do sexo feminino, com 63,1±10,5 anos, perfil de patologias crônicas, renda familiar entre um e dois salários mínimos e vivência com a prática entre um e dois anos. Os discursos destacam a percepção de melhorias relacionadas às queixas principais, com relaxamento, maior autoestima e diminuição de dores, o que foi incentivador da prática individual e sua divulgação e realização entre amigos e familiares. Destacou-se negativamente a existência de barreiras de acesso devido ao horário, distância do local e filas de espera. Considerações finais: A automassagem evidenciou-se enquanto prática positiva sobre as percepções corpo e bem-estar dos sujeitos em um cenário que vai de encontro ao modelo biomédico vigente. Espera-se contribuir na tomada de decisões voltadas à ampliação do desenvolvimento das PICS nas redes de atenção à saúde.
Background: Respiratory muscle weakness is one of the primary factors associated with difficulty of ventilatory weaning in critically ill patients. In this sense, inspiratory muscle training (IMT) is a possible facilitator of successful weaning. One of the devices used for IMT is the POWERbreathe®, because it provides a linear pressure load, with the possibility of gradual increments. The effectiveness of early IMT in this population is not yet well known. The aim of this study is to assess the effects of early IMT with a mechanical loading device on the weaning time of patients on invasive mechanical ventilation (primary outcome), respiratory muscle strength, length of stay in the intensive care unit and in the success rate of weaning (secondary outcomes).Methods: This randomised controlled trial, a single blind evaluation, will be conducted in the intensive care unit of a university hospital on 42 adults, who will be randomly and blindly categorised into the control group, comprising patients who undergo routine physical therapy only, and the training group, comprising patients who undergo routine physical therapy associated with IMT twice a day, with load adjusted daily at 50% of maximum inspiratory pressure, three series of 10 repetitions with one minute rest in between. Both groups will be assessed when patients are eligible for the study and before the ventilatory support withdrawal. Effects of the training will be analysed from the collected data using intention-to-treat analysis. Between-group differences will be measured using generalised estimating equations for data analysis.Discussion: Results of this trial will likely provide valuable new information on the effects of IMT on weaning time, respiratory muscle strength, length of stay in the intensive care unit and the success rate of weaning in critically ill patients.Registration: ClinicalTrials.gov, NCT03758573. 29th November 2018.
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