Variáveis relacionadas ao processo de adesão a um programa de prevenção de quedas em idosos cadastrados na Estratégia de Saúde da Família

Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult

Quedas em idosos assistidos na estratégia saúde da família: frequência e fatores associados

The growth of the elderly population is a global phenomenon and, in Brazil, this transformation is happening in a very rapid rhythm. With the current population aging, this emerging age group will need more health care and attention. One of the characteristics of the population aging is the progressive accumulation of disabilities, which makes it more vulnerable to falls. This study was developed with the purpose of knowing the episode falls in the scope of an elderly population treated at a Family Health Unit. It is a research with cross-sectional nature, and its sample was composed by 121 elderly. The research was approved by the Ethics Committee of HUOL, with Opinion nº 816.022. We applied a questionnaire to the participants, and the results were statistically analyzed by using Chi-square test and Fisher’s exact test to verify the association between variables. In order to perform a multivariate analysis, we used the method of the Binomial Logistic Regression. For both tests, we accepted significance p<0,05 and CI of 95%. The results prove that the majority belongs to the female gender (76,9%); the age group of elderly reaches 88,4% and 11,6% is over-aged; regarding the marital status, 35,3% are married and 29,4% widowed; 92,1% with family income between one and two minimum wages; and 91,8% live with their partners and/or children. Regarding the frequency of falls, we found that 61,2% of the surveyed elderly suffered one or more falls in 2014. As associated factors, it became clear that 73,8% were due to extrinsic factors, 6,4% to intrinsic factors and 21,4% to both factors. As a consequence of the fall, we found that 89,2% have fear of falling again, 37,3% showed anxiety and 13,3% had their ambulation affected. Concerning the exposure to the risk factors, the most prevalent places were: street/avenue (31,0%), pavement (19,0%), living room (14,3%) and courtyard/backyard (10,7%). The study has proven a statistically significant association among female gender (p=0,001), rubble/objects in the backyard (p=0,015) and furniture that may cause accidents (p=0,005). It was evident among the elderly people surveyed, 72.7% receive little information about falls, being a risk factor for falls. We conclude that there is a high frequency of falls in the surveyed elderly, thereby constituting a worrisome data because this event in the elderly population is a serious matter, which raises the need to ensure them a safe environment in their homes and, above all, outside them. The information provided by the Family Health Strategy team are important to avoid these occurrences, which reinforces the need for developing health education activities together with the population as a way to prevent and reduce the occurrence of falls, thereby improving the quality of life of elderly.

Definições para o resultado de enfermagem comportamento de prevenção de quedas: uma revisão integrativa

Devido à necessidade de mensurar o risco de quedas em concordância à linguagem padronizada de enfermagem, foi selecionado o resultado de enfermagem Comportamento para Prevenção de Quedas da Nursing Outcomes Classification (NOC), com objetivo de identificar evidências sobre seus elementos, mensuração, comparação com indicadores existentes e construir definições constitutivas. Foi efetuada revisão integrativa entre abril e novembro de 2009, mediante identificação da questão, estabelecimento de critérios de inclusão/exclusão, extração das informações, avaliação, interpretação e síntese. Destacaram-se pesquisas transversais e perspectivas de especialistas. Os indicadores Uso de recursos de correção da visão e Uso de sapatos amarrados e do tamanho adequado foram considerados insuficientes para avaliar fatores de risco como déficits sensoriais e roupas/calçados inadequados. Percebe-se que algumas definições precisam ser melhor desenvolvidas e que esse resultado de enfermagem merece refinamento sobretudo referente aos indicadores. Foram identificados 22 indicadores e definições foram propostas baseadas nas evidências da literatura

Acidentes por quedas em um grupo específico de idosos

Este estudo objetivou conhecer a incidência do evento queda e identificar a presença de seus principais fatores de risco. Estudo exploratório, realizado de março a novembro/2009, com aplicação de um formulário sobre quedas em um grupo de idosos. Os dados foram analisados por cálculo de frequências, média e desvio-padrão. Participaram 62 idosos, 41,9% relataram queda nos últimos seis meses, a maioria mulheres. Identificou-se ocorrência de agravos concomitantes: visão regular, audição boa, polifarmácia, IMC normal, forte força de preensão palmar e condições dos pés adequadas. Na maioria dos que caiu, o desequilíbrio foi apontado como principal motivo. A queda ocorreu mais no período da manhã, em local de piso áspero e seco, sem degraus, rampas ou tapetes, iluminação adequada e o tipo de calçado mais utilizado foi chinelo de borracha. Percebe-se a alta ocorrência das quedas na população idosa, fato que fundamenta a necessidade de avaliação das condições de risco envolvidas

Diagnóstico de enfermagem risco de quedas em pacientes com angina instável

O risco de quedas pode ser reconhecido como fenômeno ou diagnóstico de enfermagem. Pesquisas relacionam diretamente isquemias miocárdicas, como a angina instável e o risco de cair. Objetivou-se analisar o diagnóstico de enfermagem Risco de quedas na ocorrência de angina instável por um estudo transversal realizado em 57 indivíduos internados em um hospitalescola, mediante exame físico e formulário. Para o tratamento estatístico foram utilizados teste qui-quadrado, teste exato de Fisher, Mann-Whitney, teste-t e Coefi ciente Phi (p<0,05). O Risco de quedas foi o diagnóstico de enfermagem mais prevalente (87,71%), sobretudo em homens, mais velhos, com menos anos de estudo e renda inferior. Presença da angina instável, hipertensão arterial, medicação anti-hipertensiva, doença vascular, difi culdades visuais e insônia apresentaram associação com o diagnóstico de enfermagem Risco de quedas. Conclui-se que é imprescindível o desenvolvimento de parâmetros claros e objetivos à mensuração mais acurada do risco de quedas no âmbito hospitalar

Imagens do medo na mídia: uma análise das representações da violência em Natal-RN

Social violence is one of the phenomena of human life that produce effects on the social imaginary as it is in it that are designed conflicting values concerning what is most vital to humans, such as respect for the strength and the fear of death, pleasure trespass for injury and pain, the rejection of injustice and anger that is born of revolt. The variability of feelings and reasons that constitute violence has required academic knowledge increasingly sensitive reflections that encompass the complexity of its manifestations. The feeling of fear and insecurity which constitute the collective social imagination has caused large changes in the behavior of both individuals and the society as a whole. This study aims to reflect on media representations the social violence in Natal-RN. Through a thematic survey and documentary analysis of three newspapers of Rio Grande do Norte - Tribuna do Norte, Novo Jornal and Jornal Metropolitano - was possible to list events and trace different discursive strategies that lead to receptors ideological interests of class, constitute social and spatial segregations and maximize violations of rights and of the human dignity, with important implications in the construction of social representations concerning the reality of violence

Medo e violência na cidade: imagens, discursos e sociabilidade nas praças de João Pessoa - PB

The present work analyses and discusses the sociability in the culture of contemporary cities focusing on the theme of fear and violence in the daily life of squares in the city of João Pessoa-PB. We analyse the relations between places in town and make correlations of history and setting of neighborhoods with the process of urban growth, including recent interventions of public authorities in their public spaces. We observed in this dynamics social attitudes and actions that range from a desired peaceful coexistence to social exclusion. Thus, we discuss, based upon the imaginary vision, that the squares exist as a locus of equality, citizenship and political, and, also, as a space for everyone, despite the existence of symbolic forces working towards segregation and privatization, ruled in fear and violence. We aimed to investigate the different symbolic logics from the issue of fear and violence that allows the exclusion and the inclusion of groups and individuals in the quotidian use of public spaces of contemporary cities. We believe that the social action is demarcated by violence ant its corollary, the social fear, and operates based on the logic of a relational game always confrontational but experienced in different forms according to the social segment or group under study. We used a qualitative and quantitative methodology relating data and statistical analysis with categories created for the understanding of subjective factors. Our analyses combined ethnographic elements, periodics research and images of the city and its spaces, with the contribution of a survey that allowed comparisions of five squares of neighborhood based on the daily life under investigation. Our proposal was to deepen the investigations related to the public space of contemporary cities, expanding the look on João Pessoa and its cultural dynamics with an analysis of discourses, images, the collective imaginary and the social appropriation of the spaces based on fear and violence. The research accomplished in different areas and the analysis of images and speeches published in newspapers reports, books, advertising etc. allowed the approach of differentiated patterns of sociability in the same urban process. The neighborhoods in study are indeed spatially and economically distanced and the process of creation and construction of squares occurred in very different ways in the respective location. We defend the thesis that neighborhood community squares provide reinvigorated spaces and public spheres in the urban process and in the dynamics of sociability in the cities. These squares are also social spaces par excellence for the perception of the logic of individualism and segregation so marked by fear and violence in contemporary cities

O medo da morte e os temores infundados: uma investigação acerca da natureza da alma em Lucrécio.

Lucrèce, penseur latin du siècle I, avant J.C., écrire que le peur de la mort imputé par la religion et la superstition, nourrit le souhait à la richesse, l'ambition du pouvoir et les actes insensés, dont les conséquences se reflètent dans les maladies de l'âme. La terreur qui s'installe chez l'homme, à l'être confronté au décès, est aussi un obstacle à la liberté et à la vie équilibrée. Les craintes sans fondement seulement seraient surmonter, avec la compréhension de la nature et du mouvement de l'âme, en percevant leur génération, corporéité et finitude. Pour cela, la compréhension des atomes et du vide, les éléments primordiaux de la nature se basent tout la connaissance de l'âme. L'objectif de ce travail est enquêter la nature de l'âme dans Lucrèce, en présentant une réflexion sur les craintes sans fondement et la peur de la mort, comme une manière de percevoir le mouvement de la vie elle-même, et de que manière sa philosophie affronte à la crainte de la mort.

Comparação e mobilidade, equilíbrio corporal e desempenho muscular segundo a auto-eficácia para quedas em idosas

The aging process modifies various systems in the body, leading to changes in mobility, balance and muscle strength. This can cause a drop in the elderly, or not changing the perceived self-efficacy in preventing falls. Objective: To compare the mobility, body balance and muscle performance according to self-efficacy for falls in community-dwelling elderly. Methods: A cross-sectional comparative study with 63 older (65-80 years) community. Were evaluated for identification data and sociodemographic, cognitive screening using the Mini Mental State Examination (MMSE), effective for the fall of Falls Efficacy Scale International Brazil (FES-I-BRAZIL), Mobility through the Timed Up and Go Test , the balance Berg Balance Scale (BBS) and the Modified Clinical Test tests of Sensory Interaction on Balance (mCTSIB), tandem walk (TW) and Sit to Stand (STS) of the Balance Master® System. Finally, muscle performance by using isokinetic dynamometry. Statistical analysis was performed Student t test for comparison between groups, with p value ≤ 0.05. Results: Comparing the elderly with low-efficacy for falls with high-efficacy for falls, we found significant differences only for the variable Timed Up and Go Test (p = 0.04). With regard to data on balance tests were significant differences in the speed of oscillation firm surface eyes open modified Clinical Test of Sensory Interaction on Test of Balance (p = 0.01). Variables to isokinetic dynamometry were no significant differences in movement knee extension, as regards the variables peak torque (p = 0.04) and power (p = 0.03). Conclusion: The results suggest that, compared to older community with low-and high-efficacy for falls, we observed differences in variables related to mobility, balance and muscle function

Mundo de medo: inquisição e cristãos-novos nos espaços coloniais capitanias de Pernambuco, Itamaracá e Paraíba (1593-1595)

Founded in 1536, the Court of the Holy Office of the Portuguese Inquisition was established as an ecclesiastical institution, but at the same time subordinate to the real powers. Among the main victims of persecution effected by the Holy Office, were the New Christians - Jews forcibly converted in 1497 or their descendants - that due to their socio-religious were repeatedly accused of heresy. This paper conducted a survey that sought to understand the historical performance of the Inquisition in Brazil in the sixteenth century on the New Christians, especially those accused of secretly retaining the religious customs of the Mosaic law, given the investigative and punitive procedures employed by the Inquisition as part of a set of actions that produce social insecurities and producers / broadcasters of fear in the populations under scrutiny. In this sense, the approach was based on the analysis of documents produced on the first visit of inspection performed in Brazil inquisitorial sixteenth century, concerning the captaincy of Pernambuco and Paraiba Itamaracá (1593-1595), not excluding, however, the sources of the first stage of visitation that occurred between 1591-1593 in the province of Bahia de Todos os Santos, even though its use is ancillary and punctual. The objective of this research was to understand the consequences of inquisitorial procedures generated on the imaginary, and the Inquisition, using the expressions and signs of fears relating to individuals contained in the New Christian complaints to the Holy Office as documentary evidence of the fear caused by the Holy Tribunal. The adoption of specific behaviors by the New Christians in the home - these spaces are appropriate and adapted to the detriment of the religious practices of Judaism features - characterizes the spatial perspective of the study, thus indicating a further objective of the study: to understand how the New Christians experienced domestic spaces in a historical context marked by behavioral surveillance generally considered morally condemned and suspected of heresy. The research was conducted to analyze the complaints and quantitative survey of some indices of documentation for the understanding of overall charges and how individuals New Christians were concerned with the domestic space, using them to maintain criptojudaica religiosity, transformed places housing often esnogas, makeshift synagogue for meetings and celebrations of Judaizing New Christians. The formulations of Michel de Certeau on appropriations and meanings of space - presented by the author in the metaphor of "practice areas" - were integrated into the workforce in order to understand the ways in which the New Christians appropriated the colonial houses, designed these spaces a very specific language in the Crypto, in which women are prominent figures. The works of Jean Delumeau and Bartholomé Benassar integrate the discussion of the Inquisition and the sensibilities of fear in the work performed. The analysis allowed the documentation to understand the meaning and the extent related to the general fear that the Inquisition represented. Some complaints are indicative of fears that can be perceived implicitly based on behaviors and attitudes adopted by the New Christians, others, however, are direct expressions of fear caused by allusion or initiative of the actions of the Inquisition in colonial Brazil in the sixteenth century

Medo de dentista em cena: uma análise de produções cinematográficas

The fear related to dental procedures can be acquired through disturbing experiences and/or negative cultural influences related in experiences of previous generations. Such influences may be present in diverse forms of cultural expression: in the cinema, plastic arts, music, literature, and diverse vehicles of printed and visual media. This research aimed investigates the images of fear related to the dental service and dentist in motion pictures. The study has qualitative approach, which used the documentary analysis of movies. The data collection was accomplished through research in the Internet by means of the Google tool (http://www.google.com.br), using the describing words filme and dentista . A total of 44 films were found. Of these, after selective criterion for films with scenes showing interaction between dentist and patient in the execution of clinical procedure, only 24 films were enclosed. Then, these were registered in data base created for this research. After second selective criterion of inclusion (scenes with suggestion of dental anxiety), 15 films remained. As regards cinematographic gender, the films with scenes showing "dental anxiety" varied between comedy (8), horror (3), drama (2), thriller (1) and childish (1). Of these films, scenes with images of situations that suggest fear of the dentist and his job were selected and described. The images were categorized by the identification of negative characteristics that incite "dental anxiety". Then, the classification of the categories was proceeded detaching the most recurrent characteristics in the scenes: situation of fear in the waiting-room; pain; instrument coarse/rudimentary; coarseness of the dentist; torture; and low qualification technique. The waiting-room was observed as a place of great tension, due to the noises coming from the dental attendance. The pain related to the Dentistry was the predominant subject in the majority of films (14), associated to others negative characteristics. The rudimentary aspects of procedures and instruments, and the coarse attitudes of the professional could be observed too. The dentist was characterized as confused, sadist, violent, insensitive, incompetent person and disturbed. Such results suggest that, despite the technological advances of the profession, the image of the dentist and his job is still transmitted in a negative way aspect and reinforces the dental anxiety

Participação do circuito dopaminérgico nas alterações do comportamento de medo inato de camundongos infectados pelo Toxoplasma gondii

The protozoan parasite Toxoplasma gondii transforms the innate aversion of rats for cat urine into a fatal attraction, that increases the likelihood of the parasite completing its life cycle in the cat s intestine. The neural circuits implicated in innate fear, anxiety, and learned fear all overlap considerably, raising the possibility, that T. gondii may disrupt all of these nonspecifically. In this study, we evaluated immunoreactivity for tyrosine hydroxylase (TH) in areas associated with innate fear of infected male swiss mice. The latent Toxoplasma infection converted the aversion of mice to feline odors into attraction. This loss of fear is remarkably specific, as demonstrated by Vyas et al (2007), because infection did not diminish learned fear, anxiety-like behavior, olfaction, or nonaversive learning. However, the neurochemical mechanism related to alterations in innate fear due to T. gondii infection remains poorly studied. 20 mice were inoculated with bradyzoites (25 cysts) from a Toxoplasma gondii (Me-49 strain). The brains were removed after 60 days, sectioned and processed for TH immunohistochemistry. The correlation between the amount of cysts per area and the densitometric analysis of neurotransmitter reactivity was low in the areas implicated in innate fear of infected animals, when comparated with noninfected controls

Definições para o resultado de enfermagem comportamento de prevenção de quedas: uma revisão integrativa

Devido à necessidade de mensurar o risco de quedas em concordância à linguagem padronizada de enfermagem, foi selecionado o resultado de enfermagem Comportamento para Prevenção de Quedas da Nursing Outcomes Classification (NOC), com objetivo de identificar evidências sobre seus elementos, mensuração, comparação com indicadores existentes e construir definições constitutivas. Foi efetuada revisão integrativa entre abril e novembro de 2009, mediante identificação da questão, estabelecimento de critérios de inclusão/exclusão, extração das informações, avaliação, interpretação e síntese. Destacaram-se pesquisas transversais e perspectivas de especialistas. Os indicadores Uso de recursos de correção da visão e Uso de sapatos amarrados e do tamanho adequado foram considerados insuficientes para avaliar fatores de risco como déficits sensoriais e roupas/calçados inadequados. Percebe-se que algumas definições precisam ser melhor desenvolvidas e que esse resultado de enfermagem merece refinamento sobretudo referente aos indicadores. Foram identificados 22 indicadores e definições foram propostas baseadas nas evidências da literatura

Acidentes por quedas em um grupo específico de idosos

Este estudo objetivou conhecer a incidência do evento queda e identificar a presença de seus principais fatores de risco. Estudo exploratório, realizado de março a novembro/2009, com aplicação de um formulário sobre quedas em um grupo de idosos. Os dados foram analisados por cálculo de frequências, média e desvio-padrão. Participaram 62 idosos, 41,9% relataram queda nos últimos seis meses, a maioria mulheres. Identificou-se ocorrência de agravos concomitantes: visão regular, audição boa, polifarmácia, IMC normal, forte força de preensão palmar e condições dos pés adequadas. Na maioria dos que caiu, o desequilíbrio foi apontado como principal motivo. A queda ocorreu mais no período da manhã, em local de piso áspero e seco, sem degraus, rampas ou tapetes, iluminação adequada e o tipo de calçado mais utilizado foi chinelo de borracha. Percebe-se a alta ocorrência das quedas na população idosa, fato que fundamenta a necessidade de avaliação das condições de risco envolvidas

Diagnóstico de enfermagem risco de quedas em pacientes com angina instável

O risco de quedas pode ser reconhecido como fenômeno ou diagnóstico de enfermagem. Pesquisas relacionam diretamente isquemias miocárdicas, como a angina instável e o risco de cair. Objetivou-se analisar o diagnóstico de enfermagem Risco de quedas na ocorrência de angina instável por um estudo transversal realizado em 57 indivíduos internados em um hospitalescola, mediante exame físico e formulário. Para o tratamento estatístico foram utilizados teste qui-quadrado, teste exato de Fisher, Mann-Whitney, teste-t e Coefi ciente Phi (p<0,05). O Risco de quedas foi o diagnóstico de enfermagem mais prevalente (87,71%), sobretudo em homens, mais velhos, com menos anos de estudo e renda inferior. Presença da angina instável, hipertensão arterial, medicação anti-hipertensiva, doença vascular, difi culdades visuais e insônia apresentaram associação com o diagnóstico de enfermagem Risco de quedas. Conclui-se que é imprescindível o desenvolvimento de parâmetros claros e objetivos à mensuração mais acurada do risco de quedas no âmbito hospitalar