Dimensions of self-rated health in older adults

OBJECTIVE To analyze the association between negative self-rated health and indicators of health, wellbeing and sociodemographic variables in older adults. METHODS Cross-sectional study that used data from a population-based health survey with a probability cluster sample that was carried out in Campinas, SP, Southeastern Brazil,, in 2008 and 2009. The participants were older adults (≥ 60 years) and the dependent variable was self-rated health, categorized as: excellent, very good, good, bad and very bad. The adjusted prevalence ratios were estimated by means of Poisson multiple regression. RESULTS The highest prevalences of bad/very bad self-rated health were observed in the individuals who never attended school, in those with lower level of schooling, with monthly per capita family income lower than one minimum salary. Individuals who scored five or more in the physical health indicator also had bad self-rated health, as well as those who scored five or more in the Self-Reporting Questionnaire 20 and those who did not refer feeling happiness all the time. CONCLUSIONS The independent effects of material life conditions, physical and mental health and subjective wellbeing, observed in self-rated health, suggest that older adults can benefit by health policies supported by a global and integrative view of old age.

Influence of altitude, latitude and season of collection (Bergmann's Rule) on the dimensions of Lutzomyia intermedia (Lutz & Neiva, 1912) (diptera, psychodidae, phlebotominae)

The influence of altitude and latitude on some structure sizes of Lutzomyia intermedia was noted; several structures of insects collected in higher localities were greater, according to Bergmann's rule. This influence was more remarkable in two localities of the State of Espírito Santo, probably due to greater differences in altitude. Comparing insects from different latitudes, more differences were noted in comparisons of insects from low altitude localities than in those of material from higher altitudes. The small number of differences between insects collected in July and in December does not indicate a defined influence of season and temperature on the size of adults. The possible epidemiological implications of these variations are discussed.

Content validation of the dimensions constituting non-adherence to treatment of arterial hypertension

The objective of the study was to validate the content of the dimensions that constituted nonadherence to treatment of arterial systemic hypertension. It was a methodological study of content validation. Initially an integrative review was conducted that demonstrated four dimensions of nonadherence: person, disease/treatment, health service, and environment. Definitions of these dimensions were evaluated by 17 professionals, who were specialists in the area, including: nurses, pharmacists and physicians. The Content Validity Index was calculated for each dimension (IVCi) and the set of the dimensions (IVCt), and the binomial test was conducted. The results permitted the validation of the dimensions with an IVCt of 0.88, demonstrating reasonable systematic comprehension of the phenomena of nonadherence.

International drivers of Brazilian agricultural cooperation in Africa in the post-2008 economic crisis

This text focuses on the major drivers of Brazilian agricultural cooperation in Africa as conceived and pursued from 2004 to 2014, with emphasis on the impacts of political and economic international changes that took place in that period, and particularly the impacts of the 2008 economic crisis, in framing Brazil's foreign policy and development assistance initiatives. It addresses current international forces and developments at the systemic level, but also analyses recent economic domestic developments, in particular those directly related to Brazilian agriculture and those related to the policy framework of its evolving internationalization. Special attention is paid to the dual dimensions of Brazilian agricultural policy and to its projection in agricultural cooperation as pursed in Africa.

Comprometimento organizacional em organizações autentizóticas: um estudo luso-brasileiro

Este artigo tem o objetivo de mostrar como as percepções dos indivíduos acerca de seis características organizacionais autentizóticas - espírito de camaradagem, credibilidade do superior, comunicação aberta com o superior, oportunidades de aprendizagem e desenvolvimento pessoal, eqüidade e conciliação trabalho-família - explicam três dimensões do comprometimento organizacional. Na primeira fase, replicou-se estudo anterior, realizado em Portugal, com o objetivo de operacionalizar o construto das organizações autentizóticas. Na segunda fase, realizaram-se estudos confirmatórios, em Portugal e no Brasil. A evidência empírica salienta as boas propriedades psicométricas do construto e mostra como as variáveis autentizóticas explicam o comprometimento, sobretudo o componente afetivo. As dimensões autentizóticas mais relevantes são o espírito de camaradagem, a credibilidade do superior e as oportunidades de aprendizagem e desenvolvimento pessoal.

Impact of socioeconomic status on Brazilian elderly health

OBJECTIVE: To investigate the impact of socioeconomic status on elderly health. METHODS: The study was based on cross-sectional data from Survey on Health, Well-Being, and Aging in Latin America and the Caribbean. The sample comprised 2,143 non-institutionalized elderly aged 60 years and older living in the urban area of São Paulo, southeastern Brazil. Linear regression models estimated the effect of socioeconomic status indicators (years of schooling completed, occupation and purchasing power) on each one of the following health indicators: depression, self-rated health, morbidity and memory capacity. A 5% significance level was set. RESULTS: There was a significant effect of years of education and purchasing power on self-rated health and memory capacity when controlled for the variables number of diseases during childhood, bed rest for at least a month due to health problems during childhood, self-rated health during childhood, living arrangements, sex, age, marital status, category of health insurance, intake of medicines. Only purchasing power had an effect on depression. Despite the bivariate association between socioeconomic status indicators and number of diseases (morbidity), this effect was no longer seen after including the controls in the model. CONCLUSIONS: The study results confirm the association between socioeconomic status indicators and health among Brazilian elderly, but only for some dimensions of socioeconomic status and certain health outcomes.

Locus of control and contraceptive knowledge, attitude and practice among university students

OBJECTIVE: To assess the relationship between locus of control and knowledge, attitude and practice regarding pill and condom use among university students. METHODS: The inquiry was developed in Campinas, a city in Southeastern Brazil, in 2006. A total of 295 adolescent newcomers to a public university answered a structured questionnaire and Levenson's multidimensional locus of control scale. The scores of the dimensions of locus of control were calculated and Spearman's correlation coefficient was used to assess their correlation with knowledge and practice concerning pill and condom use. In order to assess the relationship between the dimensions of locus of control and sociodemographic variables and variables related to the individuals' sex life, Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: Male adolescents had higher scores of powerful others externality when compared to female adolescents (p=0.01). Students living alone had lower internality (p=0.01). When locus of control was compared to condom use in the first intercourse, considering only the 102 students who informed the age of the beginning of sexual activity, greater internality was found among male adolescents who did not use condoms (p<0.05). When the locus of control scores were correlated with contraceptive knowledge and practice, it was found that the higher the powerful others externality locus, the lower the adequate use of contraceptive methods (r = -0.22, p=0.03). CONCLUSIONS: The powerful others externality locus influences the practice of contraceptive use in this group of adolescents.

Model for the evaluation of drug-dispensing services in primary health care

OBJECTIVE To develop a model for evaluating the efficacy of drug-dispensing service in primary health care. METHODS An efficacy criterion was adopted to determine the level of achievement of the service objectives. The evaluation model was developed on the basis of a literature search and discussions with experts. The applicability test of the model was conducted in 15 primary health care units in the city of Florianópolis, state of Santa Catarina, in 2010, and data were recorded in structured and pretested questionnaires. RESULTS The model developed was evaluated using five dimensions of analysis for analysis. The model was suitable for evaluating service efficacy and helped to identify the critical points of each service dimension. CONCLUSIONS Adaptations to the data collection technique may be required to adjust for the reality and needs of each situation. The evaluation of the drug-dispensing service should promote adequate access to medications supplied through the public health system.

Diabetes burden in Brazil: fraction attributable to overweight, obesity, and excess weight

OBJECTIVE To estimate the burden of type 2 diabetes mellitus and its percentage attributable to overweight and obesity in Brazil.METHODS The burden of diabetes mellitus was described in terms of disability-adjusted life years, which is the sum of two components: years of life lost and years lived with disability. To calculate the fraction of diabetes mellitus attributable to overweight, obesity, and excess weight, we used the prevalence of these risk factors according to sex and age groups (> 20 years) obtained from the 2008 Pesquisa Dimensões Sociais das Desigualdades (Social Dimensions of Inequality Survey) and the relative risks derived from the international literature.RESULTS Diabetes mellitus accounted for 5.4% of Brazilian disability-adjusted life years in 2008, with the largest fraction attributed to the morbidity component (years lived with disability). Women exhibited higher values for disability-adjusted life years. In Brazil, 49.2%, 58.3%, and 70.6% of diabetes mellitus in women was attributable to overweight, obesity, and excess weight, respectively. Among men, these percentages were 40.5%, 45.4%, and 60.3%, respectively. Differences were observed with respect to Brazilian regions and age groups.CONCLUSIONS A large fraction of diabetes mellitus was attributable to preventable individual risk factors and, in about six years, the contribution of these factors significant increased, particularly among men. Policies aimed at promoting healthy lifestyle habits, such as a balanced diet and physical activity, can have a significant impact on reducing the burden of diabetes mellitus in Brazil.

Perceptions of the usefulness of external support to immunization coverage in Guinea-Bissau: a Delphi analysis of the GAVI-Alliance cash-based support

INTRODUCTION: Although many countries have improved vaccination coverage in recent years, some, including Guinea-Bissau, failed to meet expected targets. This paper tries to understand the main barriers to better vaccination coverage in the context of the GAVI-Alliance (The Global Alliance for Vaccines and Immunisation) cash-based support provided to Guinea-Bissau. METHODS: The analysis is based on a document analysis and a three round Delphi study with a final consensus meeting. RESULTS: Consensus attributed about 25% of the failure to perform better to implementation problems; and about 10% to governance and also 10% to scarce resources. The qualitative analysis validates the importance of implementation issues and upgraded the relevance of the human resources crisis as an important drawback. The recommendations were balanced in their upstream-downstream focus but were blind to health information issues and logistical difficulties. CONCLUSIONS: It is commendable that such a fragile state, with all sorts of barriers, manages to sustain a slow steady growth of its vaccination coverage. Not reaching the targets set reflects the inappropriateness of those targets rather than a lack of commitment of the health workforce. In the unstable context of countries such as Guinea-Bissau, the predictability of the funds from global health initiatives like the GAVI-Alliance seem to make all the difference in achieving small consistent health gains even in the presence of other major bottlenecks.

External quality assessment in the voluntary counseling and testing centers in the Brazilian Amazon using dried tube specimens: results of an effectiveness evaluation

INTRODUCTION : In 2011, the Brazilian Ministry of Health rolled out a program for the external quality assessment of rapid human immunodeficiency virus (HIV) tests using the dried tube specimen (DTS) method (EQA-RT/DTS-HIV). Our objective was to evaluate the implementation of this program at 71 voluntary counseling and testing centers (VCTCs) in the Brazilian Legal Amazonian area one year after its introduction. METHODS : Quantitative and qualitative study that analyzed secondary data and interviews with healthcare workers (HCWs) (n=39) and VCTC coordinators (n=32) were performed. The assessment used 18 key indicators to evaluate the three dimensions of the program's logical framework: structure, process, and result. Each indicator was scored from 1-4, and the aggregate results corresponding to the dimensions were expressed as proportions. The results were compared to the perceptions of the HCWs and coordinators regarding the EQA-RT/DTS-HIV program. RESULTS: The aggregate scores for the three dimensions of structure, process, and result were 91.7%, 78.6%, and 95%, respectively. The lowest score in each dimension corresponded to a different indicator: access to Quali-TR online system 39% (structure), registration in Quali-TR online system 38.7% (process), and VCTC completed the full process in the program's first round 63.4% (result). Approximately 36% of the HCWs and 52% of the coordinators reported enhanced trust in the program for its rapid HIV testing performance. CONCLUSIONS: All three program dimensions exhibited satisfactory results (>75%). Nevertheless, the study findings highlight the need to improve certain program components. Additionally, long-term follow-ups is needed to provide a more thorough picture of the process for external quality assessment.

Geological characteristics of the nesting areas of the giant Amazon river turtle (Podocnemis expansa) in the Crixás-Açu river in Goiás State, Brazil

A large population of the giant Amazon river turtle (Podocnemis expansa) nests along the beaches of the Crixás-Açu River in the central western region of Brazil. In spite of the existence of several point bars in the area, only a selected group of beaches is used for nesting by P. expansa. Geological aspects, such as river width and depth, beach height above 200 cm with sandy sediments, were indispensable for the choice of these nesting sites. The relatively reduced dimensions of the point bars and the great number of turtles, which nest in the same local, contributed to the existence of a high nest concentration. The rapid rise of the Crixás-Açu River caused the flooding of the beaches and the drowning of hatchlings and embryos. It is estimated that nearly all the nests were lost. The height of the nesting place and the time of flooding related to the incubation period are decisive in embryo survivorship. The Retiro, Júnior, Assombrado and Limoeiro beaches, which are situated at heights of 183 to 310 cm, were inundated on 8 November 2000. The Barreira Branca beach, with a height of up to 380 cm was completely inundated on 13 December 2000. All of these beaches were flooded before the hatchlings emerged.

Sexual distinction between 5th instar nymphs of six species of Triatominae (Hemiptera, Reduviidae)

The aim of this paper is to present the analysis of sexual morphological differences observed in 5th instar nymphs of the following species: Panstrongylus megistus; Rhodnius neglectus; Triatoma brasiliensis; T. infestans; T. matogrosensis and T. tibiamaculata. Male and female nymphs were examined and photographed with a Scanning Electron Microscope. The 9th segment dimensions of dorsal and ventral faces were determined through a Profile Projector. Results and statistical analysis showed significant differences: the 9th sternite is significantly broader in male than female nymphs, while in five species; tergites in female nymphs are broad and in male are narrow.

Effects of Polydispyrenia simulii (Microspora; Duboscqiidae) on Development of the Gonads of Simulium pertinax (Diptera; Simuliidae)

The effects of the infection caused by the microsporidium Polydispyrenia simulii in gonads of the simuliid Simulium pertinax were evaluated. This blackfly species is the main target of control programmes in southeastern Brazil. Infected and noninfected blackflies were reared from larval stage to adults using a laboratory rearing system. There was no significant difference between the oogenic development and dimensions of ovarian follicles of healthy females compared to those reared from infected larvae. Otherwise, there was a significant difference between the fecundity of healthy females and those reared from infected larvae. In males, there was an evident reduction of motility of spermatozoids of males reared from infected larvae. The results obtained suggest that the microsporidium P. simulii have an important effect on the natural population dynamics of S. pertinax.