The aim of this study was to investigate the association between depression and clinical illness among a group of elderly in the city of Salvador, Bahia, Brazil. The study population included 1,120 individuals over 60 years of age treated at a geriatric outpatient clinic. Crude and stratified prevalence ratios were calculated. Data were stratified by gender, age, and nutritional status. Ninety-five percent of the sample presented at least one chronic disease, the most frequent being hypertension (62.2%), osteoarthritis (40%), and urinary incontinence (35%). Depression was diagnosed in 23.4%, more commonly among women (PR = 1.28; 95%CI: 0.99-1.65) and those under 75 years (PR = 1.24; 95%CI: 1.00-1.53). There was an association between number of chronic diseases (> 3) and depression (PR = 1.31; 95%CI: 1.04-1.66). Parkinson's disease was associated with depression, more evident among females (PR = 1.59; 95%CI: 1.05-2.41) and in the 70-79-year age group (PR = 2.02; 95%CI: 1.28-3.20). The study demonstrates an association between depression and chronic comorbidity. Since many elderly present multiple chronic diseases, health professionals should be alert to the possibility of depressive symptoms in these patients.

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O estudo em questão considera o suicídio um problema de saúde pública, um acontecimento complexo desencadeado pela influência de fatores estressores sobre o indivíduo. O objetivo deste artigo é avaliar o componente social nas mortes por suicídio, pela análise de indicadores socioeconômicos. Trata-se de um estudo do tipo ecológico exploratório que busca a associação entre dez indicadores socioeconômicos e a taxa de suicídio em todas as capitais do país. Os dados utilizados foram obtidos no DATASUS e no Atlas de Desenvolvimento Humano no Brasil do IBGE, referentes ao ano 2000. Os resultados apontam que a taxa de mortalidade por suicídio variou de 0,77 / 100 mil habitantes em Salvador (BA) a 14,04 / 100 mil habitantes em Boa Vista (AC). O sexo masculino apresenta risco relativo 3,7 vezes maior de cometer suicídio do que o feminino. A faixa etária de 15 a 29 anos apresentou menor risco relativo de cometer suicídio, enquanto o maior risco relativo foi encontrado na população com idade igual ou superior a 60 anos. Ambos os indicadores de desigualdade social (Índice de Gini e Índice L de Theil) apresentaram correlação negativa com a taxa de mortalidade por suicídio, com significância estatística (rs = -0,479, p = 0,011 e rs = -0,403, p = 0,037, respectivamente). Concluiu-se que há associação entre os indicadores de desigualdade social e as taxas de suicídio. Nenhum outro indicador socioeconômico apresentou correlação, o que leva a acreditar que a origem e o amadurecimento do pensamento suicida parecem sofrer influência preponderante de fatores biopsicológicos.

<p>As substâncias psicoativas (SPA) representam uma questão de ordem internacional em decorrência dos efeitos negativos do seu consumo. Este estudo descreve as internações hospitalares por transtornos mentais e comportamentais devido ao uso de SPA na região Nordeste do Brasil em 2018.<strong> Método:</strong> Estudo observacional, retrospectivo, com dados agregados, tipo ecológico. <strong>Resultados: </strong>As internações totalizaram 11.250 casos, sendo que outras SPA tiveram taxas superiores na maioria das unidades federativas (UF). As maiores taxas são de pacientes de 30 a 39 anos, sexo masculino e considerados pardos.<strong> </strong>O valor médio das internações foi de R$1.274,83 e a média de permanência é de 25,6 dias. A taxa de mortalidade total foi de 0,77, tendo o álcool como principal responsável na maioria das UF. <strong>Conclusão: </strong>Os dados evidenciam a relevância da atualização de estudos epidemiológicos voltados para o abuso de SPA. A educação em saúde é fundamental para o enfrentamento do drogadição.</p>

This paper presents a novel policy framework to support government responses to COVID-19 in long-term care facilities (LTCFs) in low and middle-income countries. It focuses on issues that are of specific relevance to Brazilian policy-settings, including examples of its local implementation. The CIAT Framework combines and summarizes broad elements for an emergency strategy to address the potential effects of COVID-19. The 4 steps of the Framework entail policies to coordinate, identify, assess, and target support. Those policies can be applied immediately to mitigate the impact of the COVID-19 pandemic in LTCFs. It is, however, essential to situate these responses within a more comprehensive and permanent strategy. Intersectoral collaboration must evolve into a fully institutionalized system.

OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) morbidity and mortality in long-term care facilities (LTCFs) in the state of Bahia, Brazil. METHODS: This is an ecological study involving identified and active LTCFs in Bahia, monitored by the Intersectoral Monitoring Commission of LTCFs. Data analysis included COVID-19 incidence among older residents and workers and COVID-19 hospitalization, fatality, and mortality rates among older residents. In addition to a global analysis of data from Bahia, a stratified analysis compared (i) the East macroregion with the rest of Bahia, and (ii) private LTCFs with philanthropic ones. RESULTS: Our sample consisted of 175 LTCFs, more than half located in the East macroregion (n = 99). Most facilities declared themselves as philanthropic (n = 94) or private (n = 59). From April/2020 to June/2021, COVID-19 incidence was 30.71% among residents and 19.86% among LTCF workers. Considering older residents, mortality was 3.57% and fatality was 11.63%. Incidence was lower in the East macroregion, for older residents (relative risk [RR] = 0.77; 95% confidence interval [CI] 0.68–0.87) and LTCF workers (RR = 0.70; 95%CI 0.59–0.83). The hospitalization rate due to COVID-19 was 19.97%, being higher in private LTCFs (RR = 1.61; 95%CI 1.30–2.00). CONCLUSIONS: This study reveals that COVID-19 morbidity and mortality in LTCFs in Bahia were consistent with the wide ranges described in the literature, although case fatality was lower than expected. This demonstrates the importance of strategies to coordinate, identify, assess, and target support for LTCFs, highlighting the need for stronger public policies.

RESUMO Objetivo Descrever as estratégias de enfrentamento à COVID-19 em Instituições de Longa Permanência para Idosos no estado da Bahia. Metodologia Trata-se de uma pesquisa retrospectiva, por meio de uma análise documental do acervo produzido pela Comissão Intersetorial de Monitoramento de Instituições de Longa Permanência para Idosos no Estado da Bahia, no período de abril/2020 a junho/2021. O tratamento dos dados baseou-se na análise de conteúdo de Bardin. Resultados Emergiram duas categorias temáticas: Articulação em rede Intersetorial e telemonitoramento de instituições de longa permanência para idosos. Conclusão Concluiu-se que o conjunto de ações de articulação em rede intersetorial e telemonitoramento realizadas pela Comissão Intersetorial de Monitoramento de Longa Permanência foram estratégias fundamentais para mitigar o impacto da COVID-19 nas instituições. Destaca-se a necessidade de implementação de políticas públicas efetivas de apoio às instituições de longa permanência para idosos, repensando criticamente sobre a tipologia destes equipamentos.

Introduction: According to the National Curricular Guidelines, the graduate of the Medical Course should have a generalist, humanistic, critical and reflexive education, with a sense of social responsibility and commitment to citizenship, as a promoter of the integral health of the human being. Several diseases are stigmatized in our contemporary society, which results in deterioration of social identity, aggravation of functional limitations and reduction of rehabilitation possibilities. Objective: To report the experience of the Social Stigma of Diseases approach in the Medicine course. Methodology: After sensitization with a documentary on the social stigma of leprosy, followed by a brief dialogue about the theme, the students of three classes of the fourth semester of the Medicine Course (50 students / class) were invited to elaborate audiovisual media combating stigma of any stigmatized diseases, for dissemination in social networks. Results: The students were very sensitive to the theme, sharing their impressions and some testimonials about the stigma experienced by themselves and their families with stigmatizing diseases. All 30 teams of 5 students adhered to the proposal, of an optional nature, being produced 30 media (flyers or videos) that, through social networks, can help society to deconstruct the social stigma of diseases. Conclusion: The methodology used was effective in raising the awareness of medical students about the subject and culminated in the production of audiovisual media, which can be used in social networks, as a strategy to reduce the social stigma of diseases and the promotion of recognition of citizenship and dignity human disease of the carriers of such diseases.