Use of health services by residents at a seniors-only living facility

The objective of the study was to compare the use of medical and dental services by seniors residing at a seniors-only living facility and in the general community. It was a quantitative study, among 50 residents of the living facility and 173 in the general community. The data were collected between November 2011 and February 2012 through a questionnaire, and subjected to statistical analysis. Performance of clinical exams and satisfaction with health services was greater among seniors living in the general community; however, physical therapy treatment was more common among those living in the facility. The use of medical and dental services showed a statistically significant difference. The seniors in both groups need oral health monitoring and those living in the facility also require coverage by the Family Health Strategy. The presence of professionals with the right profile to adequately serve residents and the network of available services are determining factors for the success of this new housing policy.

Living with pain: the experience of children and adolescents in palliative care

A qualitative study was conducted with semi-structured interviews with the aim of understanding the experience of children and adolescents under palliative care when managing pain daily and how they describe the intensity, quality and location of pain. We used Piaget’s theory of cognitive development as a theoretical framework and oral history as a methodological framework. We found four themes: describing pain; seeking a life closer to normality, despite pain and disease; using a variety of alternatives for pain control; and living with damaged physical appearance. Although pain is a limiting factor in the lives of children and adolescents, we found that they faced their daily pain and still had a life beyond pain and illness. In addition, we highlight the relevance of nurses’ understanding that effective management of pain in children is essential for a normal life and less suffering.

Late diagnosis and vulnerabilities of the elderly living with HIV/AIDS

OBJECTIVE To identify vulnerabilities of elderly people with HIV/AIDS and the trajectory that they follow until reaching the diagnosis of the disease. METHOD Qualitative research conducted in specialized clinics in the state of São Paulo, from January to June 2011. Semi-structured interviews were conducted with 11 elderly people who were found to be infected with the virus at the age of 60 years or older. The interviews were analyzed using content analysis. RESULTS In this process four categories emerged, then analyzed with reference to the theoretical framework of vulnerability. CONCLUSION Late diagnosis of HIV infection or AIDS among the elderly happens in the secondary or tertiary service. Issues related to sexual life of the elderly are only questioned by health professionals after the diagnosis, also the time that condom use becomes absolute. It is believed that the investigation of the vulnerability of the elderly to HIV/AIDS allows for carrying out appropriate interventions for this population.

Prevalence of infection in kidney transplantation from living versus deceased donor: systematic review and meta-analysis

OBJECTIVE To verify if the type of donor is a risk factor for infection in kidney transplant recipients. METHODS Systematic Review of Literature with Meta-analysis with searches conducted in the databases MEDLINE, LILACS, Embase, Cochrane, Web of Science, SciELO and CINAHL. RESULTS We selected 198 studies and included four observational studies describing infections among patients distinguishing the type of donor. Through meta-analysis, it was shown that in patients undergoing deceased donor transplant, the outcome infection was 2.65 higher, than those who received an organ from a living donor. CONCLUSION The study showed that deceased kidney donor recipients are at an increased risk for developing infections and so the need for establishing and enforcing protocols from proper management of ischemic time to the prevention and control of infection in this population emerges.

Primary Health Care from the perception of women living in a rural area

AbstractOBJECTIVEUnderstanding the perception of women living in a rural area about the actions and services of Primary Health Care (PHC) in a municipality of southern Brazil, which is the only one regarded as predominantly rural.METHODA descriptive study of qualitative approach, carried out with women who lived in the countryside and required health services in the 15 days prior to collection.RESULTSThe results registered low fidelity to PHC attributes, focusing its functional axis on sickness, transforming the unit into small points of emergency care and a bureaucratic place where patients are referred to other types of services. The quality of service offered is compromised to offering quick, fragmented and unequal treatment in the rural context.CONCLUSIONThe findings of this study highlight the need for greater efforts in order to adequate the new care model in the development of appropriate actions as designated by PHC in the rural context studied.

Perceived stress in elderly stroke survivors after hospital discharge to home

AbstractOBJECTIVETo evaluate the relationship between perceived stress and comorbidities, neurological deficit, functional independence and depressive symptoms of stroke survivors after hospital discharge.METHODCross-sectional study with 90 elderly stroke survivors. The National Institutes of Health Stroke Scale instrument, the Functional Independence Measure instrument, the Geriatric Depression Scale and the Perceived Stress Scale were used. Bivariate Pearson correlation, independent t test and multiple regression analysis were used to evaluate the relationship between perceived stress and other variables.RESULTSThe final regression model showed that higher perceived stress was related to less functional independence (p= 0.022) and more depressive symptoms (p <0.001).CONCLUSIONAt hospital discharge, interventions should be planned for the treatment of depressive symptoms and to create adaptation strategies to the reduction of functional independence, in order to reduce the stress of the survivors.

Validity of the Katz Index to assess activities of daily living by informants in neuropathological studies

Abstract OBJECTIVE To analyze the evidences of construct validity of the Katz Index for the retrospective assessment of activities of daily living (ADL) by informants, to assist neuropathological studies in the elderly. METHOD A cross-sectional study analyzed the functional ability of ADL measure by the Katz Index, of 650 cases randomly selected from the Brazilian Brain Bank of the Ageing Brain Study Group (BBBABSG) database. Sample was divided in two subsamples for the analysis (N=325, each) and then stratified according to cognitive decline assessed by the Clinical Dementia Rating Scale (CDR). Factor analyses with calculations of internal consistency and invariance were performed. RESULTS Factor analysis evidenced a unidimensional instrument with optimal internal consistency, in all subgroups. Goodness of fit indices were obtained after two treatments of covariance, indicating adequacy of the scale for assessing ADL by informants. The scale is invariant to cognitive decline meaning that it can be used for subjects with or without cognitive impairment. CONCLUSION Katz Index is valid for the retrospective assessment of basic ADL by informants, with optimal reliability.

Breeding sites of Neotropical Drosophilidae (Diptera): IV. living and fallen flowers of Sessea brasiliensis and Cestrum spp. (Solanaceae)

The flowering phenologies of Sessea brasiliensis and three species of Cestrum (C. amictum, C. schlechtendalii and C. sendtnerianum), all belonging to the Solanaceae, were monitored in a fragment of the montane Atlantic rain forest within São Paulo city from July 1993 through June 1995. A total of 11,021 flies belonging to five species of the flavopilosa group of Drosophila (D. cestri, D. cordeiroi, D. hollisae, D. incompta and D. mariaehelenae), plus 1,244 flies belonging to four species of Zygothrica (Z. dispar, Z. vittimaculosa, Z. vittinubila and Z. aff. vittipunctata) emerged from 33,955 sampled flowers. Cestrum amictum, C. sendtnerianum and Sessea brasiliensis are recorded for the first time as host plants for the species of the Neotropical flavopilosa group ofDrosophila. Additionally, at least ten less abundant taxa belonging also to the Drosophilidae, plus 1,073 microhymenopteran parasitoids (Braconidae, Eucoilidae, and Pteromalidae), emerged from the sampled flowers of S. brasiliensis e Cestrum spp. The present study raised from nine to eleven the number of species of Cestrum previously recorded as breeding sites for these flies. A comprehensive list of species of Solanaceae known to host six species of Drosophila and four species of Zygothrica in southeastern and southern Brazil is included.

More than one inseminated female in colonies of the independent-founding wasp Mischocyttarus cassununga von Ihering (Hymenoptera, Vespidae)

In the primitively eusocial wasps, especially Polistini and Mischocyttarini tribes, the physiological condition of each individual is strongly associated with its dominance status in the colonial hierarchy. As a rule, in independent-founding wasps, female wasps are all morphologically alike, and their role is apparently quite flexible even as adults. However, some studies have shown that differences in body size can exist between reproductive and non-reproductive females. Thus, the present study aimed at detecting differences between reproductive (inseminated) and non-reproductive (uninseminated) individuals based on morphological and physiological parameters. We tape-recorded the daily behavioural repertory of six colonies of Mischocyttarus cassununga for determining the hierarchical dominance in the field, and then collected these colonies (in different cycle stages) for measuring 13 set characters, and assessing the physiological condition of each individual by inspecting their fat bodies and ovaries. Our results revealed that inseminated and uninseminated females are not significantly different in relation to body size, in spite of first group shows higher average than second in almost all measured parts. The physiological evaluation of each individual demonstrated more than one inseminated female per colony during all stages of the colony cycle, suggesting a strategic condition of this species against difficulties (predation and parasitism of the colony) in nature.