The impact of perinatal and socioeconomic factors on mental health problems of children from a poor Brazilian city: a longitudinal study

Low birth weight and preterm birth, and social disadvantage may negatively affect mental health of children, but findings have been inconsistent. To assess the influence of perinatal and social factors on mental health problems in children aged 7-9 years. A random sample of 805 births in So Luis, Brazil was studied in 1997/1998 and again in 2005/2006. Perinatal, socioeconomic and demographic variables were assessed within 24 h after delivery. The Strengths and Difficulties Questionnaire (SDQ) was used to assess mental health problems in the children. Simple and multiple Poisson regressions were used for statistical analysis. The overall prevalence of mental health problems in the total sample was 47.7%. The prevalences of emotional and conduct problems were 58.2 and 48.8%, respectively. Only paternal age (< 20 years) was associated with mental health problems as measured by the full SDQ scale (prevalence ratio PR = 1.27). Children born to single mothers (PR = 1.31) and those with birth weight from 1,500 to 2,499 g (PR = 1.18) and from 2,500 to 2,999 g (PR = 1.17) had a higher risk of emotional problems, but those from low income families had a lower risk (PR = 0.80). Children with a father of less than 20 years had a higher risk of having problems with their peers (PR = 1.75). A maternal education of 9 years or over was inversely associated with peer (PR = 0.70) and conduct problems (PR = 0.73). Girls had a lower risk of conduct (PR = 0.77) and hyperactivity problems (PR = 0.68). A maternal education of 4 years or less increased the risk of hyperactivity (PR = 1.48). Socioeconomic and demographic conditions were better predictors of mental health problems in children than birth weight or preterm birth. However, since most effect sizes were small most mental health problems were, unexplained by the variables in the study.

Aluminum Concentrations in Water of Elderly People`s Houses and Retirement Homes and Its Relation with Elderly Health

The purpose of this study was to determine the concentrations of aluminum (Al) and other metals in water samples from elderly people`s houses and retirement homes. Forty-six duplicate water samples from kitchen taps were collected in Ribeiro Preto/SP, Brazil. Metal levels were measured by atomic absorption spectrophotometer. Aluminum concentration exceeded the maximum allowed values in 26% of samples according to the Decree 518/2004 of the Brazilian Health Ministry. It was noted that 11% of elderly living at monitored houses, as well as 19% living at retirement homes presented Alzheimer disease diagnostic. These results suggest taking into account Al risks among vulnerable elderly population groups.

Conduct after Epley`s maneuver in elderly with posterior canal BPPV in the posterior canal

Benign Paroxysmal Positional Vertigo is the most common peripheral vestibular disorder, especially in the elderly and presents as the predominant etiology in this population of the degeneration of the utricular macula. Aim: To compare the effectiveness of the approaches after Epley maneuver. Study Design: longitudinal cohort. Materials and Methods: The study included 53 volunteers with Benign Paroxysmal Positional Vertigo of the posterior semicircular canal, divided into Group 1, who underwent Epley maneuver associated with the use of neck collar and post-maneuver instructions, Group 2 underwent the Epley maneuver without the use cervical collar and/or post-maneuver restrictions, and Group 3 underwent the Epley maneuver associated with the use of a mini vibrator, without the use of neck collar and/or post-maneuver restrictions. Results: In the three groups, the number of Epley maneuvers ranged from one to three. We employed the Brazilian Dizziness Handicap Inventory - pre- and post-treatment and observed a statistically significant difference on most scores pre- and post-treatment for both groups. Conclusion: Regardless of the post Epley maneuver treatment selected for the treatment of Benign Paroxysmal Positional Vertigo, it was effective when comparing the Brazilian Dizziness Handicap Inventory pre- and post-treatment.

Evaluation of the performance of normal elderly in a limb praxis protocol: Influence of age, gender, and education

Limb praxis can be influenced by age, gender, and education. The present Study investigated the influence of these variables on gesture production by healthy elderly Subjects. We evaluated 96 individuals divided into two age groups (60-74 and 75-88 years). Each group contained 48 men and 48 women and was subdivided into four groups according to education: illiterates and 1-3, 4-7, and 8 or more years of education. Individuals were requested to carry Out tasks oil verbal command and imitation. There were no differences between the performance of men and women, while older individuals performed worse than their younger counterparts. Regarding educational level, three major groups emerged: illiterates, individuals with 1-7 years of education, and those with 8 or more years of education. In conclusion, age and education significantly influenced the performance of individuals in limb praxis tests. (JINS, 2009, 157 618-622.)

Assessment of two central auditory tests in elderly patients without hearing complaints

Speech understanding disorders in the elderly may be due to peripheral or central auditory dysfunctions. Asymmetry of results in dichotic testing increases with age, and may reflect on a lack of inter-hemisphere transmission and cognitive decline. Aim: To investigate auditory processing of aged people with no hearing complaints. Study design: clinical prospective. Materials and Methods: Twenty-two voluntary individuals, aged between 55 and 75 years, were evaluated. They reported no hearing complaints and had maximal auditory thresholds of 40 dB HL until 4 KHz, 80% of minimal speech recognition scores and peripheral symmetry between the ears. We used two kinds of tests: speech in noise and dichotic alternated dissyllables (SSW). Results were compared between males and females, right and left ears and between age groups. Results: There were no significant differences between genders, in both tests. Their Left ears showed worse results, in the competitive condition of SSW. Individuals aged 65 or older had poorer performances than those aged 55 to 64. Conclusion: Central auditory tests showed worse performance with aging. The employment of a dichotic test in the auditory evaluation setting in the elderly may help in the early identification of degenerative processes, which are common among these patients.

Poor ovarian response in patients younger than 35 years: Is it also a qualitative decline in ovarian function?

Objective. To investigate whether poor response to controlled ovarian stimulation (COS) is due to a qualitative decline in ovarian function. Methods. This retrospective cohort study included 436 patients younger than 35-years old, undergoing COS for intracytoplasmic sperm injection (ICSI). Patients with four or fewer MII oocytes after COS (poor-responder group, PR, n = 52) were age-matched with normoresponder patients (NR, n = 364). Results. Although similar duration of stimulation (10.5 +/- 0.4 and 9.3 +/- 0.8 days; p = 0.1358), increased doses of gonadotrophins (2510 +/- 865 and 2253 +/- 572 IU; p = 0.0061) were used in the PR. The results show a increased chance of cycle ending of PR (PR: 26.9% and NR: 3.1%; p < 0.0001). Although the lower total number of oocytes retrieved (2.4 +/- 1.4 and 16.2 +/- 9.3; p < 0.0001), equal rate of fertilization (70.2% and 72.0%, p = 0.1190) and high quality embryos were obtained (50.0% and 45.2%; p = 0.4895), resulting in similar implantation (14.5% and 19.7%; p = 0.2246) and abortion (10.0% and 15.4%; p = 1.00) rates, respectively. A trend towards increased pregnancy rate per embryo transfer in NR group was noted (PR: 26.3% and NR: 42.2%; p = 0.0818). Conclusions. Low ovarian response could be associated mainly with a quantitative rather than a qualitative decline in ovarian function. Therefore, even if the ovarian response to stimulation is low, patients aged <= 35 years should process to oocyte retrieval.

Education's role in economic development and in assisting the poor

Much faith has been put in the increased supply of education as a means to promote national economic development and as a way to assist the poor and the disadvantaged. However, the benefits that nations can obtain by increasing the level of education of their workforce depends on the availability of other forms of capital to complement the use of its educated workforce in production. Generally, less developed nations are lacking in complementary capital compared to more developed ones and it is appropriate for less developed countries to spend relatively less on education. The contribution of education to economic growth depends on a nation’s stage of economic development. It is only when a nation becomes relatively developed that education becomes a major contributor to economic growth. It is possible for less developed nations to retard their economic growth by favouring investment in educational capital rather than other forms of capital. Easy access to education is often portrayed as a powerful force for assisting the poor and the disadvantaged. Several reasons are given here as to why it may not be so effective in assisting the poor and in promoting greater income equality even though the aim is a worthy one. Also, an economic argument is presented in favour of special education for the physically and mentally handicapped. This paper is not intended to belittle the contribution of education to economic development nor to devalue the ideal of making basic education available to all. Instead, it is intended as an antidote to inflated claims about the ability of greater investment in education to promote economic growth and about the ability of more widespread access to education to reduce poverty and decrease income inequality.

A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses

Objectives: To verify the consequences of implant-supported fixed oral rehabilitation on the quality of life (QL) of elderly individuals. Material and methods: Fifteen patients were studied, being 10 females and five males; all were aged > 60 years, were completely edentulous, wore removable dentures on both arches, and were treated with implant-supported fixed dentures. Three QL questionnaires were applied, two related to the oral conditions (Oral Impact on Daily Performance - OIDP - and Oral Health Impact Profile, short version - OHIP-14) and one dealing with global aspects (World Health Organization Quality of Life - WHOQOL-BREF), before 3, 6, and 18 months after surgical placement of implants. Results: Scores in the OIDP and OHIP-14 questionnaires were better after dental treatment. The WHOQOL-BREF was less sensitive, confirming the higher reliability of specific questionnaires (focal) compared with general questions in such situations. Conclusion: Treatment with implant-supported fixed prostheses improved QL in the elderly; these effects are better detected by specific instruments focused on the subject.

Effects of Mandibular Fixed Implant-Supported Prostheses on Masticatory and Swallowing Functions in Completely Edentulous Elderly Individuals

To evaluate the effect of oral rehabilitation with immediately loaded fixed implant-supported mandibular prostheses on chewing and swallowing in elderly individuals. Materials and Methods: Fifteen completely edentulous patients aged more than 60 years (10 women and five men), wearing removable dentures in both arches, had a mandibular denture replaced by an implant-supported prosthesis. All individuals were evaluated before surgery and again 3, 6, and 18 months later with regard to mastication and swallowing conditions. Examinations entailed an interview, evaluation of tactile sensitivity of the face, and observation of food intake, masticatory type, formations of bolus, and pain during mastication. The swallowing evaluation comprised observation of clinical signs related to the oral and pharyngeal stages of swallowing, as well as the presence of oral residue. The findings of different evaluations before and 3, 6, and 18 months after the surgical-prosthetic procedure were statistically compared by analysis of variance for repeated measurements at a significance level of 5%. Results: The questionnaire revealed a reduction in complaints of masticatory and swallowing disturbances, a decreased need for liquid ingestion, and reduced choking and coughing. Clinical evaluations showed improved oral function and bolus propulsion for both solid and paste-consistency foods; pain during mastication was also resolved. Conclusion: Treatment with mandibular implant-supported dentures had positive effects on the clinical aspects of mastication and swallowing in elderly individuals. INT J ORAL MAXILLOFAC IMPLANTS 2009; 24:110-117

A comparison of the dental health of Brazilian and Canadian independently living elderly

Objective: To compare the dental status of Brazilian and Canadian elderly populations with respect to socioeconomic and quality of life factors. Materials and methods: A total of 496 adults aged 60-75 years, having four or more teeth, and physically and cognitively suitable for a clinical oral examination were included. Subjects answered questions concerning their lifestyle and completed the Geriatric Oral Health Assessment Index (GOHAI) questionnaire. Results: In all populations, the majority were females, aged between 60 and 65 years and married. Although the Canadian New Immigrant population had lower mean income, they had more remaining teeth (23.04 +/- 6.1), more functional teeth (sound and restored teeth) (14.92 +/- 5.7), more sound teeth (15.40 +/- 7.6), but more carious teeth (2.97 +/- 3.0). The Brazilian population had higher numbers of restored teeth (12.26 +/- 6.8) and fewer remaining teeth (17.80 +/- 7.6). In all populations, females, married and younger (60-65 years old) adults were more likely to retain 20 or more teeth. The mean GOHAI scores were similar for Canadians (40.55 +/- 5.7) and Canadian New Immigrants (39.28 +/- 6.5), but were higher than that among Brazilians (31.97 +/- 8.9). Conclusions: The numbers of remaining teeth were related to greater education and higher income status for Brazilian and Canadian populations. However, Canadian New Immigrants with lower income and education retained more teeth than the other populations.

Conceptualizing quality of life for elderly people with stroke

Purpose : Despite increased interest in quality of life (QOL) as an outcome measure and as a means of identifying client needs in health care, its conceptualisation and the identification of its constituents have been poorly researched for elderly people with stroke in Hong Kong. Method: This article analysed the literature to identify components relevant to the QOL of Chinese elderly people with stroke living in the community in Hong Kong. Results : While common components of QOL for elderly people with and without stroke and regardless of cultural background were identified, a number were specific to an elderly Chinese stroke population. Conclusion : Recommendations for future research have been made with reference to further exploring and validating these components for the target population. A clear understanding of these aspects is essential for the development of sensitive QOL measures to guide and evaluate service delivery to this population.